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Henry M, Harvey R, Chen LM, Meaney M, Nguyen TTT, Kao HT, Rosberger Z, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Richardson K, Greenwood CMT, Melnychuk D, Gold P, Chartier G, Black M, Mascarella M, MacDonald C, Sadeghi N, Sultanem K, Shenouda G, Cury F, O'Donnell KJ. Genetic predisposition to depression and inflammation impacts symptom burden and survival in patients with head and neck cancer: A longitudinal study. J Affect Disord 2023; 331:149-157. [PMID: 36948466 DOI: 10.1016/j.jad.2023.03.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The primary purpose of this study was to investigate the contribution of genetic predispositions to depression and inflammation, as measured through polygenic risk scores, on symptom burden (physical and psychological) in patients with head and neck cancer in the immediate post-treatment period (i.e., at three months post-diagnosis), as well as on 3-, 6-, 12-, 24- and 36-month survival. METHODS Prospective longitudinal study of 223 adults (72 % participation) newly diagnosed with a first occurrence of primary head and neck cancer, paired with genetic data (Illumina PsychArray), validated psychometric measures, Structured Clinical Interviews for DSM Disorders (SCID-I), and medical chart reviews. RESULTS Symptom burden at 3 months was predicted by (R2 adj. = 0.38, p < 0.001): a baseline SCID-I Anxiety Disorder (b = 1.69, B = 0.23, 95%CI = 0.43-2.94; p = 0.009), baseline levels of HADS anxiety (b = 0.20, B = 0.29, 95%CI = 0.07-0.34; p = 0.003), the polygenic risk score (PRS) for depression (b = 0.66, B = 0.18, 95%CI = 0.003-1.32; p = 0.049), and cumulated dose of radiotherapy (b = 0.002, B = 0.46, 95%CI = 0.001-0.003; p < 0.001). When controlling for factors known to be associated with cancer survival, patients with a higher PRS associated with depression and inflammation, respectively, presented higher risk of death within 36 months (b = 1.75, Exp(B) = 5.75, 95%CI = 1.55-21.27, p = 0.009 and b = 0.14, Exp(B) = 1.15, 95%CI = 1.01-1.30, p = 0.03). CONCLUSIONS Our results outline three potential pathways of symptom burden in patients with head and neck cancer: a genetic predisposition towards depression; an initial anxiety disorder upon being diagnosed with cancer or high levels of anxiety upon diagnosis; and a dose-related response to radiotherapy. One may want to investigate early interventions in these areas to alleviate symptom burden in patients faced with a life-threatening disease, as well as consider targeting genetic predisposition towards depression and inflammation implicated in survival. The high prevalence of distress in patients with head and neck cancer is an opportunity to study genetic predispositions, which could potentially be broadly generalized to other cancers and diseases.
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Affiliation(s)
- Melissa Henry
- McGill University, Canada; Jewish General Hospital, Canada; Lady-Davis Institute for Medical Research, Canada.
| | | | | | | | | | - Han-Tin Kao
- McGill University, Canada; Douglas Hospital, Canada
| | - Zeev Rosberger
- McGill University, Canada; Jewish General Hospital, Canada; Lady-Davis Institute for Medical Research, Canada
| | - Saul Frenkiel
- McGill University, Canada; Jewish General Hospital, Canada; Douglas Hospital, Canada
| | - Michael Hier
- McGill University, Canada; Jewish General Hospital, Canada; Lady-Davis Institute for Medical Research, Canada
| | - Anthony Zeitouni
- McGill University, Canada; McGill University Health Centre, Canada
| | - Karen Kost
- McGill University, Canada; McGill University Health Centre, Canada
| | - Alex Mlynarek
- McGill University, Canada; Jewish General Hospital, Canada; McGill University Health Centre, Canada
| | - Keith Richardson
- McGill University, Canada; McGill University Health Centre, Canada
| | - Celia M T Greenwood
- McGill University, Canada; Lady-Davis Institute for Medical Research, Canada
| | | | - Phil Gold
- McGill University, Canada; Jewish General Hospital, Canada
| | | | - Martin Black
- McGill University, Canada; Jewish General Hospital, Canada
| | - Marco Mascarella
- McGill University, Canada; McGill University Health Centre, Canada
| | | | - Nader Sadeghi
- McGill University, Canada; McGill University Health Centre, Canada
| | - Khalil Sultanem
- McGill University, Canada; McGill University Health Centre, Canada
| | - Georges Shenouda
- McGill University, Canada; McGill University Health Centre, Canada
| | - Fabio Cury
- McGill University, Canada; McGill University Health Centre, Canada
| | - Kieran John O'Donnell
- McGill University, Canada; Douglas Hospital, Canada; Yale Child Study Center, Yale School of Medicine, Yale University, United States of America; Department of Obstetrics Gynecology & Reproductive Sciences, Yale School of Medicine, Yale University, United States of America
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Ahmed S, LePage K, Benc R, Erez G, Litvin A, Werbitt A, Chartier G, Berlin C, Loiselle CG. Lessons Learned from the Implementation of a Person-Centred Digital Health Platform in Cancer Care. Curr Oncol 2022; 29:7171-7180. [PMID: 36290841 PMCID: PMC9600520 DOI: 10.3390/curroncol29100564] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 01/13/2023] Open
Abstract
The SARS-CoV-2 (COVID-19) pandemic has accelerated the development and use of digital health platforms to support individuals with health-related challenges. This is even more frequent in the field of cancer care as the global burden of the disease continues to increase every year. However, optimal implementation of these platforms into the clinical setting requires careful planning and collaboration. An implementation project was launched between the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest-de-I'Île-de-Montreal and BELONG-Beating Cancer Together-a person-centred cancer navigation and support digital health platform. The goal of the project was to implement content and features specific to the CIUSSS, to be made available exclusively for individuals with cancer (and their caregivers) treated at the institution. Guided by Structural Model of Interprofessional Collaboration, we report on implementation processes involving diverse stakeholders including clinicians, hospital administrators, researchers and local community/patient representatives. Lessons learned include earlier identification of shared goals and clear expectations, more consistent reliance on virtual means to communicate among all involved, and patient/caregiver involvement in each step to ensure informed and shared decision making.
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Affiliation(s)
- Saima Ahmed
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences McGill University, Montreal, QC H4A 3J1, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Karine LePage
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Renata Benc
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Guy Erez
- Belong.life Inc., New York, NY 10001, USA
| | | | | | - Gabrielle Chartier
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Carly Berlin
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Carmen G. Loiselle
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences McGill University, Montreal, QC H4A 3J1, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3T2, Canada
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 2M7, Canada
- Correspondence:
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Cherba M, Brummans BHJM, Hier MP, Giguère L, Chartier G, Jacobs H, Forest VI, Mlynarek A, Sultanem K, Henry M. Framing Concerns about Body Image during Pre- and Post-Surgical Consultations for Head and Neck Cancer: A Qualitative Study of Patient–Physician Interactions. Curr Oncol 2022; 29:3341-3363. [PMID: 35621662 PMCID: PMC9139818 DOI: 10.3390/curroncol29050272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 12/04/2022] Open
Abstract
Patients with head and neck cancer report high unmet psychosocial needs as they undergo lifesaving treatments that can significantly alter their appearance and cause functional impairments. This qualitative analysis of recordings of 88 pre- and post-surgical consultations involving 20 patients respond to the need for empirical studies of patient–provider conversations about body image concerns. It indicates that the emphasis on concerns about survival, cure, and physical recovery during clinical consultations may leave concerns about the impacts of surgery on appearance and function unexplored and even silenced. The interviews with patients and medical team members that complement the analysis of the recordings suggest that an emphasis on survival, cure, and physical recovery can respond to the need for reassurance in the context of serious illness. However, it can also be problematic as it contributes to the silencing of patients’ concerns and to a potential lack of preparedness for the consequences of surgery. The results of this study can contribute to raising surgeons’ awareness of the interactional dynamics during clinical consultations. Moreover, the results highlight the unique role that surgeons can play in validating patients’ psychosocial concerns to support patients’ rehabilitation in both physical and psychosocial domains.
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Affiliation(s)
- Maria Cherba
- Department of Communication, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence:
| | | | - Michael P. Hier
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Lauriane Giguère
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Gabrielle Chartier
- Department of Nursing, Oncology Division, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Hannah Jacobs
- Department of Audiology and Speech-Language Pathology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Véronique-Isabelle Forest
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Alex Mlynarek
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Khalil Sultanem
- Division of Radiation Oncology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada;
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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Henry M, Albert JG, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Mascarella M, Morand GB, Chartier G, Sadeghi N, Lo C, Rosberger Z. Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study. Front Psychol 2022; 13:816587. [PMID: 35401366 PMCID: PMC8988682 DOI: 10.3389/fpsyg.2022.816587] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Head and neck cancer (HNC) treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: (1) the prevalence, level, and course of body image concerns; (2) correlates of upon cancer diagnosis (pre-treatment) body image concerns; (3) predictors of immediate post-treatment body image concerns; and (4) association between body image concerns and levels of anxiety, depression, suicidal ideation, support (i.e., satisfaction with support from physician, social/family wellbeing, and unmet support needs), and alcohol and drug misuse. Methods Two hundred and twenty-three (participation rate = 72%), newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model. Results Sixty-eight percent of patients with HNC (n = 148 of 218) presented some level of body image concerns. Body image concerns at baseline (i.e., upon cancer diagnosis, pre-treatment) and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment (i.e., at 3 month follow-up), 89% (n = 132 of 148) presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism. Conclusion This longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions.
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Affiliation(s)
- Melissa Henry
- Department of Oncology, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Oncology, Jewish General Hospital, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Justine G. Albert
- Department of Oncology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Saul Frenkiel
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Michael Hier
- Department of Oncology, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Karen Kost
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Alex Mlynarek
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Martin Black
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Christina MacDonald
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
- Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
| | - Keith Richardson
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Marco Mascarella
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Gregoire B. Morand
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
- Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
| | - Nader Sadeghi
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Christopher Lo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Zeev Rosberger
- Department of Oncology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
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Henry M, Arnovitz E, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Mascarella M, Morand GB, Chartier G, Sadeghi N, Rosberger Z. Psychosocial outcomes of human papillomavirus (HPV)- and non-HPV-related head and neck cancers: A longitudinal study. Psychooncology 2022; 31:185-197. [PMID: 35122670 DOI: 10.1002/pon.5803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) has prompted a need to further investigate how this new biomarker changes the head and neck cancer (HNC) psychosocial landscape. This study aimed to: (a) characterize the sociodemographic, psychological, and social profiles of patients with HPV-positive versus -negative squamous cell carcinoma of the head and neck; and (b) identify how HPV status contributes to anxiety and depression (primary outcome), quality of life (QoL), and sexuality needs. METHODS We conducted a prospective longitudinal study of 146 patients newly diagnosed with oral, oropharyngeal, nasopharyngeal, and hypopharyngeal cancer. Seventy-nine patients were HPV-positive and 67 HPV-negative. Patients completed self-administered psychometric measures upon HNC and 3-month follow-up, and Structured Clinical Interviews for DSM Diagnoses. RESULTS Patients with HPV-negative tumors generally presented with higher anxiety and depression and lower QoL immediately post-HNC diagnosis (<2 weeks) compared to HPV-positive cancers. A Major Depressive Disorder (MDD) immediately post-HNC diagnosis negatively affected patients' anxiety and depression and QoL levels upon diagnosis only when the cancer was HPV-positive. Immediately posttreatment, HPV status was not associated with outcomes. A previous history of suicidal ideation, and upon cancer diagnosis cigarette smoking, anxiety and depression, and feeling close to one's partner were instead explanatory. CONCLUSION While patients with HPV-positive HNC generally present with initially lower psychological distress, their vulnerability immediately posttreatment indicates an equal need for support. Head and neck clinics may need to better address MDD, anxiety and depression, a prior history of suicidal ideation, health behavior change, and quality of relationships.
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Affiliation(s)
- Melissa Henry
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Emily Arnovitz
- McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Saul Frenkiel
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael Hier
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Alex Mlynarek
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin Black
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Keith Richardson
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | | | - Nader Sadeghi
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Zeev Rosberger
- McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
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Turkdogan S, Roy CF, Chartier G, Payne R, Mlynarek A, Forest VI, Hier M. Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2022; 148:173-179. [PMID: 34967863 PMCID: PMC8719273 DOI: 10.1001/jamaoto.2021.3765] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Patient education and engagement is a pivotal component of surgical recovery. Ensuring proper patient education involves a thorough understanding of one's diagnosis and recovery plan, while reducing language and learning barriers to help patients make informed decisions and improve their hospital experience. Objective To assess whether using an animated surgical guide will help patients who are undergoing head and neck surgery feel more satisfied with their surgery and recovery process. Design, Setting, and Participants A randomized clinical trial was conducted between January and August 2020 at a single tertiary care academic center in Montreal, Canada. A consecutive sample of individuals who were undergoing any of the following surgical procedures was recruited: head and neck cancer resection with or without reconstruction, parotidectomy, thyroidectomy, parathyroidectomy, laryngectomy, or transoral robotic resection. The treating team was masked to group allocation, while study participants in the nonintervention group were unaware of the multimedia platform to avoid introducing bias in their survey responses. Interventions Patients were randomly allocated to either the treatment arm, in which they obtained access to a multimedia patient education platform, or the control arm, in which they received traditional patient education methods via clinical visits. Main Outcomes and Measures Primary analysis compared patient satisfaction scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire INFO 25, a validated questionnaire on the perceived quality of information received by patients with cancer (possible scores ranging from 20 to 80). Results A total of 100 patients (50 in each arm; 63 women [63%]; 6 African American [6%, 12 Hispanic/Latino [12%], 11 Middle Eastern [11%], and 78 White [78%] individuals) completed the preintervention and postintervention questionnaires. In those who received access to the patient education platform, there was an 11.3-point (Cohen d = 1.02; control group score, 61.1 of 80; treatment group score, 72.4 of 80) difference of greater postoperative satisfaction scores at 1 month. While both groups felt that they received an adequate amount of information concerning their disease process, patients in the treatment arm had significantly better satisfaction with information concerning their medical tests, treatments, and other services. Conclusions and Relevance This randomized clinical trial of patients undergoing head and neck cancer treatment demonstrates that multimedia patient education platforms may enhance current traditional methods, providing complementary information on patients' treatment plans and recovery process, mental health, family life, and supplementary services. Further research is currently underway to confirm whether this platform will lead to decreased hospital stay, shorter complication rates, and long-term effects. Trial Registration ClinicalTrials.gov Identifier: NCT04048538.
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Affiliation(s)
- Sena Turkdogan
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada
| | - Catherine F. Roy
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada,Department of Nursing, Jewish General Hospital, Montreal, Québec, Canada
| | - Richard Payne
- Department of Otolaryngology Head & Neck Surgery, McGill University Health Centre, Montreal, Québec, Canada,Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
| | | | - Michael Hier
- Department of Otolaryngology Head & Neck Surgery, Jewish General Hospital, Montreal, Québec, Canada
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Henry M, Sargi E, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Chartier G, Sadeghi N, Rosberger Z. Longitudinal study indicating antecedent psychosocial vulnerability as predictor of anxiety disorders post-treatment in people with head and neck cancer. Psychooncology 2021; 30:1910-1919. [PMID: 34190381 DOI: 10.1002/pon.5760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to: (1) determine the contribution of pre-cancer psychosocial vulnerability as an independent predictor of anxiety disorder (AD) onset immediately post-treatment in patients diagnosed with a first occurrence of head and neck cancer (HNC), controlling for sociodemographics and medical variables; and (2) estimate prevalence of AD and identify trajectories from the moment of diagnosis to the immediate post-treatment (i.e., over a period of 3 months) in this population. METHODS Two-hundred twenty-four consecutive patients (participation rate = 72%) newly diagnosed with a primary HNC were assessed with a structured clinical interview for a mental disorder, validated psychometric measures, and medical chart reviews. RESULTS Twenty-five percent of patients presented a lifetime AD, 19.4% within 2 weeks of HNC diagnosis, and 16.6% immediately post-treatment; representing 26.7% of patients with AD at any timepoint from the moment of diagnosis to immediately post-treatment. Patients were more likely to present an AD immediately post-treatment when they: were diagnosed with advanced-stage cancer (OR = 3.40, p = 0.006), presented a upon cancer diagnosis AD (OR = 2.45, p = 0.008) and/or experienced childhood abuse (OR = 1.96, p = 0.03). CONCLUSIONS Several AD trajectories may arise when patients are diagnosed with primary HNC. Health professionals should address AD and screen for risk factors (i.e., advanced stage cancer, AD upon cancer diagnosis, history of childhood abuse) as early as possible to assure optimal mental health care in this vulnerable population.
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Affiliation(s)
- Melissa Henry
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada
| | - Elyonora Sargi
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Saul Frenkiel
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Martin Black
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Christina MacDonald
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Keith Richardson
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nader Sadeghi
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada
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8
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Henry M, Fuehrmann F, Hier M, Zeitouni A, Kost K, Richardson K, Mlynarek A, Black M, MacDonald C, Chartier G, Zhang X, Rosberger Z, Frenkiel S. Contextual and historical factors for increased levels of anxiety and depression in patients with head and neck cancer: A prospective longitudinal study. Head Neck 2019; 41:2538-2548. [PMID: 30887617 DOI: 10.1002/hed.25725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/01/2019] [Accepted: 02/18/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This study aimed at examining predictors of clinical anxiety and depressive symptoms in patients with head and neck cancer (HNC) at 3, 6, and 12 months post-diagnosis, with a particular interest in contextual and historical factors. METHODS Prospective longitudinal study of 219 consecutive patients newly diagnosed with a first occurrence of primary HNC, including psychometric measures, Structured Clinical Interview for DSM-IV Diagnoses (SCID), and medical chart reviews. RESULTS Point prevalence of clinical anxiety symptoms (Hospital Anxiety and Depression Scale-Anxiety subscale) was 32.0%, 21.9%, 12.1%, and 12.6% at baseline, 3, 6, and 12 months; and clinical depressive symptoms on the Depression Subscale was 19.4%, 21.9%, 13.5%, and 9.2%, respectively. Predictors of anxiety and depressive symptoms included upon diagnosis SCID major depressive or anxiety disorder, stressful life events in previous year, neuroticism, and levels of anxiety and depressive symptoms upon cancer diagnosis. CONCLUSIONS This study emphasizes the predictive contribution of broader personal contextual and historical factors that increase psychological vulnerability in HNC and merit consideration.
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Affiliation(s)
- Melissa Henry
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Fabienne Fuehrmann
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Keith Richardson
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin Black
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Gabrielle Chartier
- Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Xun Zhang
- McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Saul Frenkiel
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
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Henry M, Alias A, Frenkiel S, Richardson K, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Chartier G, Rosberger Z. Contribution of psychiatric diagnoses to extent of opioid prescription in the first year post-head and neck cancer diagnosis: A longitudinal study. Psychooncology 2018; 28:107-115. [PMID: 30308695 DOI: 10.1002/pon.4917] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/31/2018] [Accepted: 10/06/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE The purpose of this study was to determine, within the first-year post-head and neck cancer (HNC) diagnosis, the contribution of past and upon HNC psychiatric diagnoses (ie, substance use disorder, major depressive disorder, and anxiety disorder) to the extent (ie, cumulated dose) of opioid prescription. METHODS Prospective longitudinal study of 223 consecutive adults (on 313 approached; 72% participation) newly diagnosed (<2 weeks) with a first occurrence of primary HNC, including Structured Clinical Interviews for DSM-IV disorders, validated psychometric measures, and medical chart reviews. Opioid doses were translated into standardized morphine milligram equivalents (MME) using CDC guidelines. A model of variables was tested using multiple linear regression. RESULTS Fifty-five percent (123/223) of patients received opioids at some point during the first 12 months post-HNC diagnosis, 37.7% (84/223) upon HNC diagnosis (pre-treatment), 40.8% (91/223) during treatments, and 31.4% (70/223) post-treatment. The multiple linear regression indicated that an AD (P = 0.04) upon HNC diagnosis in early stage contributes to cumulated MME dose in the first year post-HNC diagnosis. CONCLUSION This study underlines how anxiety has important repercussions on the management of pain and illustrates the importance of screening for AD upon HNC diagnosis to allow for early prophylactic treatment and support.
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Affiliation(s)
- Melissa Henry
- McGill University, Montreal, Canada.,Jewish General Hospital, Montreal, Canada
| | | | - Saul Frenkiel
- McGill University, Montreal, Canada.,Jewish General Hospital, Montreal, Canada.,McGill University Health Centre, Montreal, Canada
| | - Keith Richardson
- McGill University, Montreal, Canada.,McGill University Health Centre, Montreal, Canada
| | - Michael Hier
- McGill University, Montreal, Canada.,Jewish General Hospital, Montreal, Canada
| | - Anthony Zeitouni
- McGill University, Montreal, Canada.,McGill University Health Centre, Montreal, Canada
| | - Karen Kost
- McGill University, Montreal, Canada.,McGill University Health Centre, Montreal, Canada
| | - Alex Mlynarek
- McGill University, Montreal, Canada.,Jewish General Hospital, Montreal, Canada.,McGill University Health Centre, Montreal, Canada
| | - Martin Black
- McGill University, Montreal, Canada.,Jewish General Hospital, Montreal, Canada
| | | | | | - Zeev Rosberger
- McGill University, Montreal, Canada.,Jewish General Hospital, Montreal, Canada
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10
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Cohen A, Ianovski LE, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Richardson K, Black M, MacDonald C, Chartier G, Rosberger Z, Henry M. Barriers to psychosocial oncology service utilization in patients newly diagnosed with head and neck cancer. Psychooncology 2018; 27:2786-2793. [DOI: 10.1002/pon.4889] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Alexandra Cohen
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | | | - Saul Frenkiel
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Michael Hier
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | - Anthony Zeitouni
- McGill University; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Karen Kost
- McGill University; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Alex Mlynarek
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Keith Richardson
- McGill University; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Martin Black
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | | | | | - Zeev Rosberger
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | - Melissa Henry
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
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11
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Henry M, Chang Y, Frenkiel S, Chartier G, Payne R, MacDonald C, Loiselle C, Black MJ, Mlynarek AM, Ehrler A, Rosberger Z, Tamilia M, Hier MP. Feelings of Disenfranchisement and Support Needs Among Patients With Thyroid Cancer. Oncol Nurs Forum 2018; 45:639-652. [PMID: 30118450 DOI: 10.1188/18.onf.639-652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/17/2022]
Abstract
PURPOSE To offer a better understanding of the experiences, preferences, and needs of patients with thyroid cancer. PARTICIPANTS & SETTING 17 patients with thyroid cancer receiving treatment at a university-affiliated hospital in Montreal, Québec, Canada. METHODOLOGIC APPROACH Interviews were conducted with patients, and descriptive phenomenology was used to explore patients' lived experience. FINDINGS Coping with uncertainty was a major theme that emerged from interviews, with some of the main concerns being difficult treatment decisions, long surgery wait times, and fears about surgical complications, potential metastases, and death. Study participants reported that without a nurse and an interprofessional team, they would be lost in a system they believed minimized their illness and offered few resources to support them in a time of crisis. IMPLICATIONS FOR NURSING Nurses must understand how the needs of individuals with thyroid cancer are often overlooked because of the good prognosis associated with the disease and should work to meet these information and support needs.
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12
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Henry M, Rosberger Z, Bertrand L, Klassen C, Hier M, Zeitouni A, Kost K, Mlynarek A, Richardson K, Black M, MacDonald C, Zhang X, Chartier G, Frenkiel S. Prevalence and Risk Factors of Suicidal Ideation among Patients with Head and Neck Cancer: Longitudinal Study. Otolaryngol Head Neck Surg 2018; 159:843-852. [PMID: 29865939 DOI: 10.1177/0194599818776873] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 11/16/2022]
Abstract
OBJECTIVES (1) Determine 1-year period prevalence of suicidal ideation, suicide attempt, and completed suicide among patients newly diagnosed with a first occurrence of head and neck cancer (HNC). (2) Characterize stability and trajectory of suicidal ideation over the year following cancer diagnosis. (3) Identify patients at risk of suicidal ideation. STUDY DESIGN Prospective longitudinal study with 1-year follow-up. SETTING Three university-affiliated outpatient departments of otolaryngology-head and neck surgery. SUBJECTS AND METHODS The study comprised a representative sample of 223 consecutive patients who were newly diagnosed (<2 weeks) with a first occurrence of primary HNC, were ≥18 years old and able to consent, and had a Karnofsky Performance Scale score ≥60. Patients completed the Beck Scale for Suicidal Ideation and Structured Clinical Interview for DSM-IV-TR Axis I Disorders. RESULTS Sixteen percent (15.7%) of patients with HNC were suicidal <1 year from diagnosis, with point prevalences of 8.1% <2 weeks, 14.8% at 3 months, 9.4% at 6 months, and 10.4% at 12 months; 0.4% committed suicide within 3 months, and 0.9% attempted suicide. An a priori comprehensive conceptual model revealed 2 predictors of 1-year period prevalence of suicidal ideation in HNC: psychiatric history ( P = .017, β = 2.1, 95% CI = 0.4-3.8) and coping with the diagnosis by using substances (alcohol/drugs; P = .008, β = 0.61, 95% CI = 0.16-1.06). All other predictors, including medical predictors, were nonsignificant. A clinical suicide risk assessment revealed low risk among 71.4% and medium to high risk among 28.6%. CONCLUSION Suicide prevention strategies are clearly needed as part of routine clinical care in head and neck oncology, as well as their integration into clinical practice guidelines for HNC.
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Affiliation(s)
- Melissa Henry
- 1 McGill University, Montreal, Quebec, Canada.,2 Jewish General Hospital, Montreal, Quebec, Canada
| | - Zeev Rosberger
- 1 McGill University, Montreal, Quebec, Canada.,2 Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Michael Hier
- 1 McGill University, Montreal, Quebec, Canada.,2 Jewish General Hospital, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- 1 McGill University, Montreal, Quebec, Canada.,3 McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- 1 McGill University, Montreal, Quebec, Canada.,3 McGill University Health Centre, Montreal, Quebec, Canada
| | - Alex Mlynarek
- 1 McGill University, Montreal, Quebec, Canada.,2 Jewish General Hospital, Montreal, Quebec, Canada.,3 McGill University Health Centre, Montreal, Quebec, Canada
| | - Keith Richardson
- 1 McGill University, Montreal, Quebec, Canada.,3 McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin Black
- 1 McGill University, Montreal, Quebec, Canada.,2 Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Xun Zhang
- 1 McGill University, Montreal, Quebec, Canada.,3 McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Saul Frenkiel
- 1 McGill University, Montreal, Quebec, Canada.,2 Jewish General Hospital, Montreal, Quebec, Canada.,3 McGill University Health Centre, Montreal, Quebec, Canada
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13
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Cawthorpe D, Kerba M, Narendran A, Ghuttora H, Chartier G, Sartorius N. Temporal order of cancers and mental disorders in an adult population. BJPsych Open 2018; 4:95-105. [PMID: 29971152 PMCID: PMC6020283 DOI: 10.1192/bjo.2018.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 01/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Population-based examination of comorbidity is an emerging field of study. AIMS The purpose of the present population level study is to expand our understanding of how cancer and mental illness are temporally associated. METHOD A sample of 83 648 056 physician billing records for 664 838 (56% female) unique individuals over the age of 18 was stratified on ages 19-49 years and 50+ years, with temporal order of mental disorder and cancer forming the basis of comparison. RESULTS Mental disorders preceded cancers for both genders within each age strata. The full range of cancers and mental disorders preceding or following each pivot ICD class are described in terms of frequency of diagnosis and duration in days, with specific examples illustrated. CONCLUSIONS The temporal comorbidity between specific cancers and mental disorders may be useful in screening or clinical planning and may represent indicators of disease mechanism that warrant further screening or investigation. DECLARATION OF INTEREST None.
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Affiliation(s)
- David Cawthorpe
- Faculty of Medicine, Departments of Psychiatry & Community Health Sciences, Institute for Child and Maternal Health, University of Calgary, Alberta, Canada
| | - Marc Kerba
- Department of Oncology, University of Calgary, Alberta, Canada
| | - Aru Narendran
- Pediatric Oncology Experimental Therapeutics Investigators Consortium (POETIC) Laboratory, Department of Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Harleen Ghuttora
- Master of Biomedical Technology, University of Calgary, and Program Coordinator - Health, Genome Alberta, Canada
| | - Gabrielle Chartier
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Norman Sartorius
- Visiting Professor at the Institute of Psychiatry, London, UK, Adjunct Professor at the University of St Louis, New York, USA, and President Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Henry M, Rosberger Z, Ianovski LE, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Zhang X, Fuhrmann F, Chartier G, Frenkiel S. A screening algorithm for early detection of major depressive disorder in head and neck cancer patients post-treatment: Longitudinal study. Psychooncology 2018. [DOI: 10.1002/pon.4705] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Melissa Henry
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Department of Psychology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada. Department of Oncology and Segal Cancer Center; Jewish General Hospital; Montreal Quebec Canada. Louise-Granofsky Psychosocial Oncology Program (LG-POP); Jewish General Hospital; Montreal Quebec Canada
| | - Zeev Rosberger
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Department of Psychology; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
- Department of Oncology and Segal Cancer Center; Jewish General Hospital; Montreal Quebec Canada
- Louise-Granofsky Psychosocial Oncology Program (LG-POP); Jewish General Hospital; Montreal Quebec Canada
| | - Lola E. Ianovski
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
| | - Michael Hier
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada
- Department of Oncology and Segal Cancer Center; Jewish General Hospital; Montreal Quebec Canada
| | - Anthony Zeitouni
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; McGill University Health Centre; Montreal Quebec Canada
| | - Karen Kost
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; McGill University Health Centre; Montreal Quebec Canada
| | - Alex Mlynarek
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada
- Department of Oncology and Segal Cancer Center; Jewish General Hospital; Montreal Quebec Canada. Department of Otolaryngology-Head and Neck Surgery; McGill University Health Centre; Montreal Quebec Canada
| | - Martin Black
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada
- Department of Oncology and Segal Cancer Center; Jewish General Hospital; Montreal Quebec Canada
| | - Christina MacDonald
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada
- Department of Nursing; Jewish General Hospital; Montreal Quebec Canada
| | - Keith Richardson
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; McGill University Health Centre; Montreal Quebec Canada
| | - Xun Zhang
- Centre for Outcomes Research and Evaluation; Research Institute of the McGill University Health Centre; Montreal Quebec Canada
| | - Fabienne Fuhrmann
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
| | - Gabrielle Chartier
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada
- Department of Nursing; Jewish General Hospital; Montreal Quebec Canada
| | - Saul Frenkiel
- Faculty of Medicine, Department of Oncology; McGill University; Montreal Quebec Canada
- Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery; McGill University; Montreal Quebec Canada
- Lady-Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
- Department of Otolaryngology-Head and Neck Surgery; Jewish General Hospital; Montreal Quebec Canada
- Department of Oncology and Segal Cancer Center; Jewish General Hospital; Montreal Quebec Canada. Department of Otolaryngology-Head and Neck Surgery; McGill University Health Centre; Montreal Quebec Canada
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15
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MacDonald C, Benc R, Buono AT, Champagne L, Chartier G, Cooke A, Drummond N, Gartshore K, Ehrler A, Gottlieb L. Strength based nursing: caring for the whole person. IJWPC 2018. [DOI: 10.26443/ijwpc.v5i1.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Strengths-Based Nursing (SBN) is an integrated value-driven approach based on a philosophy of care to guide actions. It consists of eight values which guide nursing practice to promote care of the whole person and family. SBN promotes empowerment, collaborative partnership, innate health and healing, authentic relationships while focusing on enhancing and developing strengths to cope with challenges and minimize, contain or circumvent that which is not working.Our poster will illustrate the basics of SBN and how it can be utilized in the promotion of whole person care.Conclusion: SBN has enlarged our perspective, broadened our skilled-know how, and opened us to new ways of caring for persons and families dealing with cancer. It has also given us insights into our nursing practices and illustrates the importance these eight values have in supporting development of whole person care.
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16
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Henry M, Frenkiel S, Chartier G, MacDonald C, Payne RJ, Black MJ, Mlynarek AM, Zeitouni A, Kost K, Loiselle C, Ehrler A, Rosberger Z, Tamilia M, Chang YX, de la Mora C, Arbaud C, Hier MP. Thyroid cancer patients receiving an interdisciplinary team-based care approach (ITCA-ThyCa) appear to display better outcomes: Program evaluation results indicating a need for further integrated care and support. Psychooncology 2018; 27:937-945. [PMID: 29178318 DOI: 10.1002/pon.4590] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/18/2017] [Accepted: 11/14/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Thyroid cancer (ThyCa) is generally associated with a favorable prognosis and excellent surgical outcomes. Consequently, its treatment is medically focused and current guidelines recommend interdisciplinary care including access to a nurse for complex cases alone. To date, no studies have evaluated the need for and impact of an Interdisciplinary Team-based Care Approach (ITCA-ThyCa) for general thyroid cancer patients, including a dedicated nurse as part of a larger interdisciplinary team, as well as patient-reported outcomes, as is recommended worldwide in cancer care. Our aim was to evaluate such a program. METHODS The ITCA-ThyCa was evaluated within a quasi-experimental design using the Centers for Disease Control Framework for Program Evaluation, including process and outcome measures. Patients eligible were adults with a biopsy indicating confirmed or highly suspicious ThyCa (TNM-Classification + Bethesda score of V/VI). The intervention group (IG) received ITCA-ThyCa and the comparison group (CG), usual care alone. RESULTS In our sample comprised of 200 participants (122 IG; 78 CG), ITCA-ThyCa patients appeared to show significantly better outcomes than CG patients, namely, higher levels of overall well-being (P = .001) and fewer physical (P = .003) and practical (P = .003) issues and concerns. More satisfied with their overall care (P = .028), including care coordination (P = .049), they reported their health care provider as more approachable (P = .007), respectful (P = .005), and trustworthy (P = .077; trend) and were more likely to recommend their hospital (P = .02). Ninety-eight percent of IG patients recommended ITCA-ThyCa. CONCLUSION Data from our program illustrates that hospital resources should not be allocated based on medical trajectory alone and challenges the idea that ThyCa is "straightforward." ThyCa patients seem to experience symptom distress at a level comparable to-or exceeding-that of general oncological patients despite their promising medical outcomes, indicating that better integrated care and support are in order.
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Affiliation(s)
- Melissa Henry
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Oncology and Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Saul Frenkiel
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Christina MacDonald
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Richard J Payne
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin J Black
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alex M Mlynarek
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carmen Loiselle
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,McGill Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Antoinette Ehrler
- Department of Oncology and Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Oncology and Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Michael Tamilia
- Department of Medicine, Division of Endocrinology and Metabolism, McGill University, Montreal, Quebec, Canada.,Department of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yu Xin Chang
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cecilia de la Mora
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Camille Arbaud
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Michael P Hier
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
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Yong H, Chartier G, Quandt J. Modulating inflammation and neuroprotection in multiple sclerosis. J Neurosci Res 2017; 96:927-950. [PMID: 28580582 DOI: 10.1002/jnr.24090] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/17/2017] [Accepted: 05/04/2017] [Indexed: 12/13/2022]
Abstract
Multiple sclerosis (MS) is a neurological disorder of the central nervous system with a presentation and disease course that is largely unpredictable. MS can cause loss of balance, impaired vision or speech, weakness and paralysis, fatigue, depression, and cognitive impairment. Immunomodulation is a major target given the appearance of focal demyelinating lesions in myelin-rich white matter, yet progression and an increasing appreciation for gray matter involvement, even during the earliest phases of the disease, highlights the need to afford neuroprotection and limit neurodegenerative processes that correlate with disability. This review summarizes key aspects of MS pathophysiology and histopathology with a focus on neuroimmune interactions in MS, which may facilitate neurodegeneration through both direct and indirect mechanisms. There is a focus on processes thought to influence disease progression and the role of oxidative stress and mitochondrial dysfunction in MS. The goals and efficacy of current disease-modifying therapies and those in the pipeline are discussed, highlighting recent advances in our understanding of pathways mediating disease progression to identify and translate both immunomodulatory and neuroprotective therapeutics from the bench to the clinic.
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Affiliation(s)
- Heather Yong
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gabrielle Chartier
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacqueline Quandt
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
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18
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Chartier G, Garel P, Herba C, Booij L. Cognitive Vulnerability to Depression in Adolescents with Depression, their Healthy Siblings and a Control Group: A Cross-sectional Study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1934] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionAt least half of first depressive episode appear before adulthood. A negative cognitive bias is present among individuals who suffer from major depression. This bias is also reported among individuals at high risk of major depression (e.g. child of depressed mother). When present, cognitive vulnerability may predispose to major depression. No study to date aimed to evaluate the cognitive vulnerability of siblings of depressed individuals.Objectives and aimsTo review the principles behind cognitive vulnerability. To assess cognitive vulnerability in depressed adolescents, in healthy siblings and in a control group.MethodsEighty adolescents (27 adolescents treated for depression, 24 healthy siblings and 29 controls), aged between 12 and 20 years old, were recruited and assessed using validated measures of bio-psycho-social vulnerabilities. All diagnoses were confirmed using a K-SADS interview. Cortisol level samples were obtained through morning saliva. Cognitive vulnerability was assessed using self-report questionnaires (CES-D, LEIDS-R, EPQ) as well as computer-based tasks (Ekman's tasks of facial recognition and the movie for assessment of social cognition [MASC]). We translated the MASC from German to French. The parents of the adolescents also filled the LEIDSR and the CESD.ResultsThe LEIDS-R presented a significant increase in certain subscales (hopelessness, aggression and rumination) compared to the healthy siblings and the controls. Interestingly, there was also a correlation between the LEIDS R results of the parents and of the depressed adolescent (r = 0.43, P = 0.04).ConclusionsThe LEIDSR appears to be the most sensitive task to detect cognitive vulnerability. A relation between the parent response and the depressed adolescent response could be found.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Chartier G. Why can't I find the people I need? J Dent Technol 2000; 17:27-8. [PMID: 11396414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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20
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Mounier E, Yip GL, Noutsios PC, Chartier G, Benech P, Rimet R. Improved loss characteristics of buried waveguides. Opt Lett 1993; 18:1624-1626. [PMID: 19823466 DOI: 10.1364/ol.18.001624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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21
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Chartier G, Woo K, Pic E, Reinisch R, Voirin G. Diffraction d'une onde électromagnétique de surface par l'extrémité du support de propagation. ACTA ACUST UNITED AC 1984. [DOI: 10.1051/jphys:01984004503042900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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22
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Reinisch R, Chartier G, Neviere M, Hutley M, Clauss G, Galaup J, Eloy J. Experiment of diffraction in nonlinear optics : second harmonic generation by a nonlinear grating. ACTA ACUST UNITED AC 1983. [DOI: 10.1051/jphyslet:0198300440240100700] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Chartier G, Collier P, Guez A, Jaussaud P, Won Y. Graded-index surface or buried waveguides by ion exchange in glass. Appl Opt 1980; 19:1092-1095. [PMID: 20220991 DOI: 10.1364/ao.19.001092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Graded-index surface or buried waveguides have been realized by thermal or electrically induced ionic exchange in glass. Deep waveguides can be obtained up to 200 microm when Li(+) ions are used. Using Ag(+) ions, buried waveguides can be obtained with a maximum index at 80 microm into the substrate. Typical losses for these devices are 0.5 dB/cm. Maximum index variations can be tuned from 0 to 0.11.
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