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Davis KL, Ackermann N, Klesges LM, Leahy N, Walsh-Bailey C, Humble S, Drake B, Sanders Thompson VL. Understanding disruptions in cancer care to reduce increased cancer burden. eLife 2023; 12:e85024. [PMID: 37643471 PMCID: PMC10449381 DOI: 10.7554/elife.85024] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
Background This study seeks to understand how and for whom COVID-19 disrupted cancer care to understand the potential for cancer health disparities across the cancer prevention and control continuum. Methods In this cross-sectional study, participants age 30+residing in an 82-county region in Missouri and Illinois completed an online survey from June-August 2020. Descriptive statistics were calculated for all variables separately and by care disruption status. Logistic regression modeling was conducted to determine the correlates of care disruption. Results Participants (N=680) reported 21% to 57% of cancer screening or treatment appointments were canceled/postponed from March 2020 through the end of 2020. Approximately 34% of residents stated they would need to know if their doctor's office is taking the appropriate COVID-related safety precautions to return to care. Higher education (OR = 1.26, 95% CI:1.11-1.43), identifying as female (OR = 1.60, 95% CI:1.12-2.30), experiencing more discrimination in healthcare settings (OR = 1.40, 95% CI:1.13-1.72), and having scheduled a telehealth appointment (OR = 1.51, 95% CI:1.07-2.15) were associated with higher odds of care disruption. Factors associated with care disruption were not consistent across races. Higher odds of care disruption for White residents were associated with higher education, female identity, older age, and having scheduled a telehealth appointment, while higher odds of care disruption for Black residents were associated only with higher education. Conclusions This study provides an understanding of the factors associated with cancer care disruption and what patients need to return to care. Results may inform outreach and engagement strategies to reduce delayed cancer screenings and encourage returning to cancer care. Funding This study was supported by the National Cancer Institute's Administrative Supplements for P30 Cancer Center Support Grants (P30CA091842-18S2 and P30CA091842-19S4). Kia L. Davis, Lisa Klesges, Sarah Humble, and Bettina Drake were supported by the National Cancer Institute's P50CA244431 and Kia L. Davis was also supported by the Breast Cancer Research Foundation. Callie Walsh-Bailey was supported by NIMHD T37 MD014218. The content does not necessarily represent the official view of these funding agencies and is solely the responsibility of the authors.
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Affiliation(s)
- Kia L Davis
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Nicole Ackermann
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Lisa M Klesges
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Nora Leahy
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | | | - Sarah Humble
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Bettina Drake
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
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Moeller C, Rubinstein G, Lotan D, Oren D, Clerkin K, Raikhelkar J, Colombo P, Leahy N, Fried J, Takeda K, Naka Y, Topkara V, Yuzefpolskaya M, Sayer G, Uriel N. Validation of the Heartmate 3 Survival Risk Score in a Large Left Ventricular Assist Device Center. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Lewis-Thames MW, Leahy N, Kruse-Diehr AJ, Ackermann N, Maki J, Davis KL, Drake BF. Adapting a Research and Community Capacity-Building Program to Address Rural Cancer Burden and Facilitate Partnership Development Between Rural Community Stakeholders and an Urban Comprehensive Cancer Center. J Cancer Educ 2023:10.1007/s13187-022-02256-7. [PMID: 36595213 PMCID: PMC10315419 DOI: 10.1007/s13187-022-02256-7] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
While rural-urban cancer disparities persist, the research building capacity between rural communities and high-quality cancer centers remains limited. Thus, we describe how a National Cancer Institute-designated cancer center partnered with rural community stakeholders to adapt a cancer prevention-focused research and community capacity-building workshop. The workshop's goal was to strengthen community-academic partnerships and facilitate the development of sustainable well-resourced rural cancer-focused research. Researchers from the Siteman Cancer Center partnered with community leaders from rural counties in southern Illinois. We adapted the workshop from an existing evidence-based program. We analyzed changes in knowledge and research capacity and relevance to their community work. From February to May 2019, community partners guided all elements of the workshop development. Workshop participants were mostly White race (93%), had a college degree or beyond (75%), reported living in a rural community (93%), and represented an academic, faith-based, or healthcare institution (78%). Participants' mean knowledge scores of the presented content increased significantly after each session, from 9.3 to 9.9 for session 1 (p = 0.05) and 6.8 to 9.7 (p < 0.001) for session two. Through the workshop, participant scores also increased in research capacity skills, confidence, and their understanding of conducting research in the community. The workshop, co-curated and led by rural community leaders and researchers from Siteman Cancer Center, successfully increased knowledge of and interest in building cancer research capacity. Lessons from our work can inform the implementation of similar programs that address rural cancer health through research and community capacity building between rural community partners and urban cancer centers.
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Affiliation(s)
- Marquita W Lewis-Thames
- Department of Medical Social Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
- Center for Community Health, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, Chicago, IL, 60611, USA.
| | - Nora Leahy
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Social Services, Vivent Health, St. Louis, MO, 63110, USA
| | - Aaron J Kruse-Diehr
- Dept. of Family and Community Medicine, University of Kentucky College of Medicine, 2195 Harrodsburg Rd, Suite 125, Lexington, KY, 40504, USA
| | - Nicole Ackermann
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Julia Maki
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Kia L Davis
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Bettina F Drake
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, USA
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Loudon KMW, Tarr G, Lean IJ, McLerie L, Leahy N, Pethick DW, Gardner GE, McGilchrist P. Short term magnesium supplementation to reduce dark cutting in pasture finished beef cattle. Meat Sci 2021; 180:108560. [PMID: 34029856 DOI: 10.1016/j.meatsci.2021.108560] [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: 01/25/2021] [Revised: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
This study assessed the capacity of magnesium supplementation to reduce muscle glycogen loss, ultimate pH and increase plasma magnesium in pasture fed slaughter cattle. Beef cattle (n = 1075) from 14 farms were supplemented with or without magnesium pellets for 7-14 days prior to slaughter. Magnesium was allocated at 9.83 g of elemental magnesium per head per day, while the control diet was balanced to be isoenergetic and isonitrogenous, but contained no added magnesium. Groups of cattle (n = 44) were slaughtered at the same processing plant over two consecutive seasons, from August - September 2016 to May - July 2017. Magnesium supplementation increased muscle glycogen (P < 0.01) in cattle supplied from 2 of 14 farms, and increased plasma magnesium in 4 of 14 farms (P < 0.01). Magnesium supplementation had no effect on overall incidence of ultimate pH between the magnesium and control supplementation groups. The benefits of short term magnesium supplementation prior to slaughter was inconsistent for protecting muscle glycogen.
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Affiliation(s)
- K M W Loudon
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia.
| | - G Tarr
- School of Mathematics and Statistics, The University of Sydney, Sydney, NSW 2006, Australia
| | - I J Lean
- Scibus, Camden, NSW 2570, Australia
| | - L McLerie
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - N Leahy
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - D W Pethick
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - G E Gardner
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - P McGilchrist
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia; School of Environmental and Rural Science, University of New England, Armidale, NSW 2350, Australia
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Thompson VLS, Leahy N, Ackermann N, Bowen DJ, Goodman MS. Community partners' responses to items assessing stakeholder engagement: Cognitive response testing in measure development. PLoS One 2020; 15:e0241839. [PMID: 33227007 PMCID: PMC7682898 DOI: 10.1371/journal.pone.0241839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 10/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background Despite recognition of the importance of stakeholder input into research, there is a lack of validated measures to assess how well constituencies are engaged and their input integrated into research design. Measurement theory suggests that a community engagement measure should use clear and simple language and capture important components of underlying constructs, resulting in a valid measure that is accessible to a broad audience. Objective The primary objective of this study was to evaluate how community members understood and responded to a measure of community engagement developed to be reliable, valid, easily administered, and broadly usable. Method Cognitive response interviews were completed, during which participants described their reactions to items and how they processed them. Participants were asked to interpret item meaning, paraphrase items, and identify difficult or problematic terms and phrases, as well as provide any concerns with response options while responding to 16 of 32 survey items. Results The results of the cognitive response interviews of participants (N = 16) suggest concerns about plain language and literacy, clarity of question focus, and the lack of context clues to facilitate processing in response to items querying research experience. Minimal concerns were related to response options. Participants suggested changes in words and terms, as well as item structure. Conclusion Qualitative research can improve the validity and accessibility of measures that assess stakeholder experience of community-engaged research. The findings suggest wording and sentence structure changes that improve ability to assess implementation of community engagement and its impact on research outcomes.
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Affiliation(s)
| | - Nora Leahy
- Washington University in St. Louis, School of Medicine, St. Louis, MI, United States of America
| | - Nicole Ackermann
- Washington University in St. Louis, School of Medicine, St. Louis, MI, United States of America
| | - Deborah J. Bowen
- University of Washington, Department of Bioethics and Humanities, Seattle, WA, United States of America
| | - Melody S. Goodman
- New York University, School of Global Public Health, New York, NY, United States of America
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Madbouly A, Gragert L, Freeman J, Leahy N, Gourraud PA, Hollenbach JA, Kamoun M, Fernandez-Vina M, Maiers M. Validation of statistical imputation of allele-level multilocus phased genotypes from ambiguous HLA assignments. ACTA ACUST UNITED AC 2014; 84:285-92. [DOI: 10.1111/tan.12390] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 03/28/2014] [Accepted: 05/12/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A. Madbouly
- Bioinformatics Research; National Marrow Donor Program; Minneapolis MN USA
| | - L. Gragert
- Bioinformatics Research; National Marrow Donor Program; Minneapolis MN USA
| | - J. Freeman
- Bioinformatics Research; National Marrow Donor Program; Minneapolis MN USA
| | - N. Leahy
- Bioinformatics Research; National Marrow Donor Program; Minneapolis MN USA
| | - P.-A. Gourraud
- Department of Neurology; University of California San Francisco; San Francisco CA USA
| | | | - M. Kamoun
- Pathology and Laboratory Medicine; Hospital of the University of Pennsylvania; Philadelphia PA USA
| | - M. Fernandez-Vina
- Department of Pathology, School of Medicine; Stanford University; Stanford CA USA
| | - M. Maiers
- Bioinformatics Research; National Marrow Donor Program; Minneapolis MN USA
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Askar M, Daghstani J, Thomas D, Leahy N, Dunn P, Claas F, Doran S, Saji H, Kanangat S, Karoichane M, Tambur A, Monos D, El-Khalifa M, Turner V, Kamoun M, Mustafa M, Ramon D, Gandhi M, Vernaza A, Gorodezky C, Wagenknecht D, Gautreaux M, Hajeer A, Kashi Z, Fernandez-Vina M. 16(th) IHIW: global distribution of extended HLA haplotypes. Int J Immunogenet 2013; 40:31-8. [PMID: 23302097 DOI: 10.1111/iji.12029] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 11/09/2012] [Accepted: 11/12/2012] [Indexed: 01/02/2023]
Abstract
This report describes the project to identify the global distribution of extended HLA haplotypes, a component of 16th International HLA and Immunogenetics Workshop (IHIW), and summarizes the initial analyses of data collected. The project aims to investigate extended HLA haplotypes, compare their distribution among different populations, assess their frequency in hematopoietic stem cell unrelated donor registries and initiate an international family studies database and DNA repository to be made publicly available. HLA haplotypes compiled in immunogenetics laboratories during the evaluation of transplant candidates and related potential donors were analysed. Haplotypes were determined using the pedigree analysis tool publicly available from the National Marrow Donor Program (NMDP) website. Nineteen laboratories from 10 countries (11 laboratories from North America, five from Asia, two from Latin America and one from Australia) contributed data on a total of 1719 families comprised of 7474 individuals. We identified 10393 HLA haplotypes, of which 1682 haplotypes included high-resolution typing at HLA-A, B, C, DRB1 and DQB1 loci. We also present haplotypes containing MICA and other HLA loci and haplotypes containing rare alleles seen in these families. The project will be extended through the 17th IHIW, and investigators interested in joining the project may communicate with the first author.
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Affiliation(s)
- M Askar
- Allogen Laboratories, Cleveland Clinic, Cleveland, OH 44195, USA.
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Tu B, Leahy N, Yang R, Cha N, Kariyawasam K, Hou L, Xiao Y, Masaberg C, Pulse-Earle D, Maiers M, Ng J, Kurtzberg J, Hurley CK. Extensive haplotype diversity in African American mothers and their cord blood units. ACTA ACUST UNITED AC 2012; 81:28-34. [PMID: 23163897 DOI: 10.1111/tan.12035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 10/18/2012] [Accepted: 10/25/2012] [Indexed: 11/29/2022]
Abstract
HLA-A, -B, -C, -DRB1, -DQB1 assignments were obtained for 374 pairs of African American mothers and their umbilical cord blood units (CBU) by DNA sequencing. An algorithm developed by the National Marrow Donor Program was used to assign 1122 haplotypes by segregation. Seventy percent of the haplotypes carried assignments at all five loci. In the remainder, alleles at various loci, most often DQB1 in 48% of the haplotypes with a missing assignment, could not be assigned due to sharing of both alleles by mother and CBU. There were 652 haplotypes carrying a unique combination of alleles at the five loci; the majority (74%) were singletons. Novel B∼C and DRB1~DQB1 associations were observed. The results show the genetic diversity in this population and provide validation for a publically available tool for pedigree analysis. Our observations underscore the need for procurement of increased numbers of units in the national cord blood inventory in order to identify matching donors for all patients requiring hematopoietic stem cell transplantation.
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Affiliation(s)
- B Tu
- Department of Pediatrics, CW Bill Young Marrow Donor Recruitment and Research Program, Georgetown University, Washington, DC 20057, USA
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Zietman A, Sacco D, Skowronski U, Montgomery E, Gomery P, Leahy N, Kaufman D, Heney N, Althausen A, Krane R, Shipley W, Talcott J. Organ conservation as an alternative to radical cystectomy for invasive bladder cancer: urodynamic and quality of life evaluation of patients treated by trimodality therapy. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03163-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Batchelor T, Leahy N, Kaufman D. High-dose methotrexate for isolated central nervous system relapse in patients with testicular non-Hodgkin's lymphoma. Clin Lymphoma 2001; 2:116-9; discussion 120-2. [PMID: 11707852 DOI: 10.3816/clm.2001.n.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Four consecutive patients with testicular non-Hodgkin's lymphoma who initially achieved a complete response to treatment with standard combination therapy later developed isolated central nervous system (CNS) relapses. At the time of CNS relapse, staging evaluations were negative for lymphoma outside the nervous system in all 4 patients. These patients were treated with high-dose intravenous methotrexate alone, and a complete remission was achieved in all 4 patients.
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Affiliation(s)
- T Batchelor
- Brain Tumor Center, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.
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Leahy N, Hawker R. Re-inventing the wheel. Ment Health Care 1998; 1:275. [PMID: 9791437] [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: 02/09/2023]
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Leahy N. An orientation program for the new neurological nurse. J Neurosci Nurs 1983; 15:313-6. [PMID: 6556227 DOI: 10.1097/01376517-198310000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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