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Rimmer B, Finch T, Balla M, Dutton L, Williams S, Lewis J, Gallagher P, Burns R, Araújo‐Soares V, Menger F, Sharp L. Understanding supported self-management for people living with a lower-grade glioma: Implementation considerations through the lens of normalisation process theory. Health Expect 2024; 27:e14073. [PMID: 38733245 PMCID: PMC11087884 DOI: 10.1111/hex.14073] [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: 12/22/2023] [Revised: 02/16/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Supported self-management can improve clinical and psychosocial outcomes in people with cancer; the considerations required to implement self-management support (SMS) for people living with a lower-grade glioma (LGG)-who often have complex support needs-are not known. We aimed to identify and understand these implementation considerations through the lens of normalisation process theory (NPT), from the perspectives of healthcare professionals (HCP) and people with LGG. METHODS We conducted semistructured interviews with HCPs who support adults with brain tumours (n = 25; 12 different healthcare professions), and people with LGG who had completed primary treatment (n = 28; male n = 16, mean age 54.6 years, mean time since diagnosis 8.7 years), from across the United Kingdom. Interviews were transcribed and inductive open coding conducted, before deductively mapping to constructs of NPT. We first mapped HCP data, then integrated data from people with LGG to explore alignment in experiences and perspectives. RESULTS We generated supporting evidence for all four NPT constructs and related subconstructs, namely: 'Coherence', 'Cognitive participation', 'Collective action' and 'Reflexive monitoring'. Data from HCPs and people with LGG clearly demonstrated that effective SMS constitutes a collective activity. Key implementation considerations included: ensuring awareness of, and access to, support; building strong HCP-support recipient relationships; and careful inclusion of close family and friends. We identified pertinent challenges, such as identifying support needs (influenced by the extent to which those with LGG engage in help-seeking), resistance to support (e.g., technology literacy), training for HCPs and HCP cooperation. CONCLUSIONS This study demonstrates the collective nature of, and provides insight into the individual roles within, supported self-management. We outline considerations to operationalise, sustain and appraise the implementation of SMS for people with LGG. PATIENT OR PUBLIC CONTRIBUTION People with brain tumours, and informal caregivers, were involved in the development of information materials and topic guides to ensure accessibility and pertinence. They also had opportunities to comment on interview findings.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
| | - Tracy Finch
- Department of Nursing, Midwifery and HealthNorthumbria UniversityNewcastle upon TyneUK
| | - Michelle Balla
- Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
| | - Sophie Williams
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Joanne Lewis
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | | | - Richéal Burns
- Faculty of ScienceAtlantic Technological UniversitySligoIreland
- Health and Biomedical Strategic Research CentreAtlantic Technological UniversitySligoIreland
| | - Vera Araújo‐Soares
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
- Department for Prevention of Cardiovascular and Metabolic Disease, Centre for Preventive Medicine and Digital Health, Medical Faculty MannheimHeidelberg UniversityHeidelbergGermany
| | - Fiona Menger
- School of Education, Communication and Language SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for CancerNewcastle UniversityNewcastle upon TyneUK
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Rimmer B, Balla M, Dutton L, Williams S, Lewis J, Gallagher P, Finch T, Burns R, Araújo-Soares V, Menger F, Sharp L. "It changes everything": Understanding how people experience the impact of living with a lower-grade glioma. Neurooncol Pract 2024; 11:255-265. [PMID: 38737616 PMCID: PMC11085834 DOI: 10.1093/nop/npae006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Quantitative studies show people living with a lower-grade glioma (LGG) often report low health-related quality of life. However, it is unclear how this impact is experienced; resulting supportive care needs are also poorly understood. We explored how people experience the impact of living long-term with an LGG, to help identify potential supportive care needs. Methods We conducted semi-structured interviews with a diverse group of people with LGG (n = 28) across the United Kingdom, who had completed primary treatment (male n = 16, female n = 12, mean age 54.6 years, mean time since diagnosis 8.7 years). Interviews were transcribed and inductive thematic analysis was conducted. Results Four themes relating to the impact experiences of people with LGG were generated: "Emotional response to the diagnosis," "Living with the 'What ifs'," "Changing relationships," and "Faltering independence." These reflect participants' experiences with symptoms (eg, fatigue, seizures) and impairments (eg, motor dysfunction, cognitive deficits), and how these, in turn, drive impacts on daily living (including on work, relationships, social activities, and transport). Participants spoke about their experiences with profound emotion throughout. Conclusions People with LGG can experience wide-ranging everyday impacts and may have extensive supportive care needs. This study highlights how this impact is experienced and what it means to people with LGG. Best practice suggestions for conducting comprehensive needs assessments tailored to those with LGG, and the development of personalized plans to meet those needs, would be a critical step to ensure that people with LGG are best supported in living with their condition.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Sophie Williams
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Joanne Lewis
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
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Rimmer B, Balla M, Dutton L, Williams S, Araújo-Soares V, Gallagher P, Finch T, Lewis J, Burns R, Menger F, Sharp L. Barriers and facilitators to self-management in people living with a lower-grade glioma. J Cancer Surviv 2024:10.1007/s11764-024-01572-9. [PMID: 38512564 DOI: 10.1007/s11764-024-01572-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Self-management can have clinical and quality-of-life benefits. However, people with lower-grade gliomas (LGG) may face chronic tumour- and/or treatment-related symptoms and impairments (e.g. cognitive deficits, seizures), which could influence their ability to self-manage. Our study aimed to identify and understand the barriers and facilitators to self-management in people with LGG. METHODS We conducted semi-structured interviews with 28 people with LGG across the United Kingdom, who had completed primary treatment. Sixteen participants were male, mean age was 50.4 years, and mean time since diagnosis was 8.7 years. Interviews were audio-recorded and transcribed. Following inductive open coding, we deductively mapped codes to Schulman-Green et al.'s framework of factors influencing self-management, developed in chronic illness. RESULTS Data suggested extensive support for all five framework categories ('Personal/lifestyle characteristics', 'Health status', 'Resources', 'Environmental characteristics', 'Healthcare system'), encompassing all 18 factors influencing self-management. How people with LGG experience many of these factors appears somewhat distinct from other cancers; participants described multiple, often co-occurring, challenges, primarily with knowledge and acceptance of their incurable condition, the impact of seizures and cognitive deficits, transport difficulties, and access to (in)formal support. Several factors were on a continuum, for example, sufficient knowledge was a facilitator, whereas lack thereof, was a barrier to self-management. CONCLUSIONS People with LGG described distinctive experiences with wide-ranging factors influencing their ability to self-manage. IMPLICATIONS FOR CANCER SURVIVORS These findings will improve awareness of the potential challenges faced by people with LGG around self-management and inform development of self-management interventions for this population.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England.
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | | | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle Upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England
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Moore C, Gallagher P, Dunne S. Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers. Front Psychol 2024; 15:1283227. [PMID: 38434952 PMCID: PMC10904647 DOI: 10.3389/fpsyg.2024.1283227] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.
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Affiliation(s)
- Chloe Moore
- School of Psychology, Dublin City University, Dublin, Ireland
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Rimmer B, Balla M, Dutton L, Lewis J, Burns R, Gallagher P, Williams S, Araújo-Soares V, Finch T, Sharp L. 'A Constant Black Cloud': The Emotional Impact of Informal Caregiving for Someone With a Lower-Grade Glioma. Qual Health Res 2024; 34:227-238. [PMID: 37967320 PMCID: PMC10768339 DOI: 10.1177/10497323231204740] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Those closest to people with lower-grade gliomas (LGGs) often assume the role of informal caregiver (IC). The additional responsibilities mean ICs of people with cancer can experience adverse impacts on their own lives. We explored the emotional impact of informal caregiving for people with LGGs. This was a descriptive qualitative study within the multi-method Ways Ahead project. We conducted semi-structured interviews with individuals from the United Kingdom, who currently, or in the past 5 years, informally cared for someone with an LGG. Interviews encompassed experiences of emotional impact as a consequence of caregiving for someone with an LGG. Inductive thematic analysis was undertaken. We interviewed 19 ICs (mean age 54.6 years; 14 females, 5 males). Participants reported substantial emotional impact. Four themes and associated subthemes were generated: Emotional responses to the illness (e.g. feeling helpless), Emotional responses to the unknown (e.g. anxiety about future uncertainty), Emotional consequences of care recipient changes (e.g. challenges of changed relationship dynamics), and Emotional weight of the responsibility (e.g. feeling burnout). Emotional impact in one area often exacerbated impact in another (e.g. future uncertainty impacted feelings of helplessness). Participants detailed the factors that helped them manage the emotional impact (e.g. being resilient). ICs of people with LGGs can experience wide-ranging emotional responses to and impacts of the illness, uncertain prognosis, care recipient changes, and the toll of caregiving. Adjustment and resilience are key protective factors, though further consideration of ways to identify and fulfil the emotional support needs of ICs of people with LGGs is required.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
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McNicholl A, Desmond D, Gallagher P. Feeling valued: the interplay of assistive technology and identity. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 38116935 DOI: 10.1080/17483107.2023.2294987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The aim of this study was to explore the impact of AT in identity for students with disabilities in higher education and if/how this changes over time. METHODS Using a longitudinal qualitative research design, semi-structured interviews were conducted with students with disabilities (n = 13) in higher education in Ireland on two occasions during an academic year. A trajectory approach to longitudinal analysis was employed. This involved the use of matrices and identification of a through line for the study, which connects participant change over time. RESULTS The through line identified was feeling valued, which was central in the negotiation of identity over time across three themes: feelings of autonomy and competence; claiming disability; and feeling like you belong as a student. AT impacted experiences across the three themes which subsequently promoted or undermined students' sense of value. Reciprocally, feeling valued influenced use and perceptions of AT. Factors specific to a higher education context were also identified which influenced meanings attached to AT over time. CONCLUSION Creating an environment where students feel valued is key in promoting use of and positive perceptions of AT. This should form an integral part of AT and disability policy in higher education.
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Affiliation(s)
- Aoife McNicholl
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Deirdre Desmond
- Department of Psychology and Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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Rimmer B, Brown MC, Sotire T, Beyer F, Bolnykh I, Balla M, Richmond C, Dutton L, Williams S, Araújo-Soares V, Finch T, Gallagher P, Lewis J, Burns R, Sharp L. Characteristics and Components of Self-Management Interventions for Improving Quality of Life in Cancer Survivors: A Systematic Review. Cancers (Basel) 2023; 16:14. [PMID: 38201442 PMCID: PMC10777971 DOI: 10.3390/cancers16010014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024] Open
Abstract
Self-management can improve clinical and psychosocial outcomes in cancer survivors. Which intervention characteristics and components are beneficial is unclear, hindering implementation into practice. We systematically searched six databases from inception to 17 November 2021 for studies evaluating self-management interventions for adult cancer survivors post-treatment. Independent reviewers screened for eligibility. Data extraction included population and study characteristics, intervention characteristics (TIDieR) and components (PRISMS), (associations with) quality of life (QoL), self-efficacy, and economic outcomes. Study quality was appraised, and narrative synthesis was conducted. We identified 53 papers reporting 32 interventions. Studies had varying quality. They were most often randomised controlled trials (n = 20), targeted at survivors of breast (n = 10), prostate (n = 7), or mixed cancers (n = 11). Intervention characteristics (e.g., provider, location) varied considerably. On average, five (range 1-10) self-management components were delivered, mostly "Information about condition and its management" (n = 26). Twenty-two studies reported significant QoL improvements (6 also reported significant self-efficacy improvements); these were associated most consistently with combined individual and group delivery. Economic evaluations were limited and inconclusive. Self-management interventions showed promise for improving QoL, but study quality was variable, with substantial heterogeneity in intervention characteristics and components. By identifying what to adapt from existing interventions, these findings can inform development and implementation of self-management interventions in cancer.
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Affiliation(s)
- Ben Rimmer
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Morven C. Brown
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Tumi Sotire
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Iakov Bolnykh
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Catherine Richmond
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Lizzie Dutton
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Sophie Williams
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - Vera Araújo-Soares
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Pamela Gallagher
- School of Psychology, Dublin City University, D09 N920 Dublin, Ireland
| | - Joanne Lewis
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, F91 YW50 Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, F91 YW50 Sligo, Ireland
| | - Linda Sharp
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
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Woods S, Dunne S, Gallagher P. Examining the Utility of Stress-, Motivation-, and Commitment-Based Perspectives of Athlete Burnout. J Sport Exerc Psychol 2023; 45:257-268. [PMID: 37597841 DOI: 10.1123/jsep.2022-0127] [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] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 08/21/2023]
Abstract
Burnout, characterized by exhaustion, reduced accomplishment, and devaluation, can have substantial negative implications for athletes. Notably, researchers continue to examine burnout from multiple perspectives, commonly focusing on stress-, motivation-, or commitment-related factors, with limited efforts to consider these perspectives together. In contrast, this study aimed to assess the utility of these multiple perspectives and the key predictors of burnout in the same athlete sample. Data on burnout, stress, motivation, motivational climate, and sport commitment were gathered from 370 Gaelic games athletes. Separate structural equation models incorporating stress, motivation, and commitment factors as predictors of burnout dimensions were assessed. All models showed adequate fit. However, differences in effect size suggest that stress is more strongly associated with exhaustion, while commitment and motivation showed a stronger relationship with reduced accomplishment and devaluation. Evidence of significant predictors across perspectives also supports an integrated approach and may inform integration efforts and targeted intervention strategies.
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Affiliation(s)
- Siobhán Woods
- School of Psychology, Dublin City University, Dublin,Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Dublin,Ireland
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Byrne E, Gaffey J, Hayden L, Daly A, Gallagher P, Dunne S. Body image and cancer-related lymphoedema: A systematic review. Psychooncology 2023; 32:1528-1538. [PMID: 37681525 DOI: 10.1002/pon.6215] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Cancer-related lymphoedema is a common side effect of cancer, affecting 24%-49% of people with cancer. Body image contributes to the well-being of individuals with this condition. This systematic review aimed to explore, for the first time, the state of the science concerning body image in cancer-related lymphoedema, including how body image is measured and variables associated with body image concerns. METHODS Six databases were systematically searched for peer-reviewed articles describing empirical quantitative studies where body image was measured with a reliable and valid measurement tool in adults with cancer-related lymphoedema. RESULTS Nine studies with 977 participants were included. The studies involved individuals who had experienced breast, head and neck, melanoma, and urogenital cancers and developed lymphoedema. There was considerable heterogeneity in body image measures used, precluding meta-analysis. The following variables were associated with increased body image concern: higher body integrity beliefs, experience of physical changes (e.g. pain) and differences in sensation and function, including changes in appearance related thoughts, feelings and emotions. Several studies described behavioural and psychological interventions which positively impacted body image outcomes in individuals with lymphoedema relating to specific cancers. CONCLUSION Regular screening for body image concerns could encourage more positive body image awareness in individuals with cancer-related lymphoedema and lessen some of its associated negative consequences. Future longitudinal and individual differences research in this area is important to inform intervention development. There is also need for a more standardised approach to the study and measurement of body image in people with cancer-related lymphoedema.
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Affiliation(s)
- Emma Byrne
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Jane Gaffey
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Lucy Hayden
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Adam Daly
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | - Simon Dunne
- School of Psychology, Dublin City University, Dublin, Ireland
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Walker H, Rimmer B, Dutton L, Finch T, Gallagher P, Lewis J, Burns R, Araújo-Soares V, Williams S, Sharp L. Experiences of work for people living with a grade 2/3 oligodendroglioma: a qualitative analysis within the Ways Ahead study. BMJ Open 2023; 13:e074151. [PMID: 37770270 PMCID: PMC10546132 DOI: 10.1136/bmjopen-2023-074151] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES This study aimed to explore the work experiences of people living with an oligodendroglioma. DESIGN This was a descriptive qualitative study. One-time semi-structured interviews exploring supportive care needs were conducted; work was discussed at various points throughout each interview. An inductive thematic analysis was undertaken. SETTING Participants were recruited across the UK through four National Health Service hospitals and the Brain Tumour Charity research involvement networks. PARTICIPANTS 19 people with grade 2 or 3 oligodendroglioma (mean age 52 years; male n=11). At diagnosis, 16 participants were working, 2 studying and 1 retired. At the interview (mean time since diagnosis 9.6 years; range 1-18 years), seven participants were working, eight retired (four on medical grounds) and four unable to work due to illness. RESULTS Seven themes were constructed: (1) physical and cognitive limitations; (2) work ability and productivity; (3) work accommodations; (4) changing roles; (5) attitudes of clients and coworkers; (6) feelings and ambitions; and (7) financial implications. Fatigue, seizures and cognitive deficits influenced work ability. A stressful work environment could exacerbate symptoms. Changes in job roles and work environment were often required. Employer and coworker support were integral to positive experiences. Work changes could result in financial stress and strain. CONCLUSIONS This study has highlighted, for the first time, influences on work experiences in this understudied population. These findings have implications for clinicians and employers, when considering the importance of work in rehabilitation for people with oligodendrogliomas, and the individually assessed adjustments required to accommodate them, should employment be desired.
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Affiliation(s)
- Hayley Walker
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery, and Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Rimmer B, Balla M, Dutton L, Lewis J, Brown MC, Burns R, Gallagher P, Williams S, Araújo-Soares V, Finch T, Menger F, Sharp L. Identifying and understanding how people living with a lower-grade glioma engage in self-management. J Cancer Surviv 2023:10.1007/s11764-023-01425-x. [PMID: 37450254 DOI: 10.1007/s11764-023-01425-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Lower-grade gliomas (LGG) are mostly diagnosed in working-aged adults and rarely cured. LGG patients may face chronic impairments (e.g. fatigue, cognitive deficits). Self-management can improve clinical and psychosocial outcomes, yet how LGG patients self-manage the consequences of their tumour and its treatment is not fully understood. This study, therefore, aimed to identify and understand how LGG patients engage in the self-management of their condition. METHODS A diverse group of 28 LGG patients (age range 22-69 years; male n = 16, female n = 12; mean time since diagnosis = 8.7 years) who had completed primary treatment, were recruited from across the United Kingdom. Semi-structured interviews were conducted. Informed by a self-management strategy framework developed in cancer, directed content analysis identified and categorised self-management types and strategies used by patients. RESULTS Overall, 20 self-management strategy types, comprising 123 self-management strategies were reported; each participant detailed extensive engagement in self-management. The most used strategy types were 'using support' (n = 28), 'creating a healthy environment' (n = 28), 'meaning making' (n = 27), and 'self-monitoring' (n = 27). The most used strategies were 'accepting the tumour and its consequences' (n = 26), 'receiving support from friends (n = 24) and family' (n = 24), and 'reinterpreting negative consequences' (n = 24). CONCLUSIONS This study provides a comprehensive understanding of the strategies used by LGG patients to self-manage their health and wellbeing, with a diverse, and substantial number of self-management strategies reported. IMPLICATIONS FOR CANCER SURVIVORS The findings will inform the development of a supported self-management intervention for LGG patients, which will be novel for this patient group.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England.
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Morven C Brown
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle Upon Tyne, England
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
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12
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Benson A, Rawdon C, Tuohy E, Murphy N, McDonnell C, Swallow V, Gallagher P, Lambert V. Relationship between parent-adolescent communication and parent involvement in adolescent Type 1 diabetes management, parent/family wellbeing and glycaemic control. Chronic Illn 2023:17423953231184423. [PMID: 37386763 DOI: 10.1177/17423953231184423] [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] [Indexed: 07/01/2023]
Abstract
OBJECTIVES This study investigated the relationship between parent-reported degree of openness and extent of problems in parent-adolescent communication and parent involvement in adolescent Type 1 diabetes management, parent and family wellbeing and adolescent glycaemic control. METHODS A cross-sectional quantitative survey was conducted. Parents completed measures of parent-adolescent communication, parent monitoring of diabetes care, diabetes family responsibility, parent knowledge of diabetes care, parent activation, parent diabetes distress, and diabetes family conflict. RESULTS In total, 146 parents/guardians (121 mothers, mean age 46.56 years, SD 5.18) of adolescents aged 11-17 years (mean age 13.9 years, SD 1.81) with Type 1 diabetes completed the survey. Open parent-adolescent communication was significantly correlated to adolescents' voluntarily disclosing diabetes-specific information to their parents more frequently, increased parental knowledge of their adolescent's diabetes care completion, parents feeling more capable and willing to take action in relation to their adolescent's diabetes health, lower levels of diabetes-related parental distress, less diabetes-specific family conflict, and optimal glycaemic control. DISCUSSION Parent-adolescent communication has an important role to play in Type 1 diabetes healthcare management and psychosocial wellbeing during adolescence. Optimising open parent-adolescent communication represents a potentially useful target for interventional research and should be considered by healthcare professionals during healthcare encounters.
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Affiliation(s)
- Ailbhe Benson
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - Caroline Rawdon
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - Ella Tuohy
- School of Psychology, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - Nuala Murphy
- Diabetes and Endocrine Unit, Children's Health Ireland, Dublin, Ireland
| | - Ciara McDonnell
- Diabetes and Endocrine Unit, Children's Health Ireland, Dublin, Ireland
- Trinity Research in Childhood Centre, School of Medicine, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Veronica Swallow
- College of Health, WellBeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Pamela Gallagher
- School of Psychology, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - Veronica Lambert
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, Ireland
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13
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Clarke N, Hayes L, McQueen A, Gallagher P, Kearney PM, McNamara D, O'Morain CA, von Wagner C, Mooney T, Sharp L. The role of defensive information processing in population-based colorectal cancer screening uptake. Cancer 2023; 129:1253-1260. [PMID: 36740959 DOI: 10.1002/cncr.34603] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Internationally, colorectal cancer screening participation remains low despite the availability of home-based testing and numerous interventions to increase uptake. To be effective, interventions should be based on an understanding of what influences individuals' decisions about screening participation. This study investigates the association of defensive information processing (DIP) with fecal immunochemical test (FIT)-based colorectal cancer screening uptake. METHODS Regression modeling of data from a cross-sectional survey within a population-based FIT screening program was conducted. The survey included the seven subdomains of the McQueen DIP measure. The primary outcome variable was the uptake status (screening user or nonuser). Multivariable logistic regression was used to estimate the odds ratio (OR) for screening nonuse by DIP (sub)domain score, with adjustments made for sociodemographic and behavioral factors associated with uptake. RESULTS Higher scores (equating to greater defensiveness) on all DIP domains were significantly associated with lower uptake in the model adjusted for sociodemographic factors. In the model with additional adjustments for behavioral factors, the suppression subdomains of "deny immediacy to be tested" (OR, 0.53; 95% confidence interval [CI], 0.43-0.65; p < .001) and "self-exemption" (OR, 0.80; 95% CI, 0.68-0.96; p < .001) independently predicted nonuse of FIT-based screening. CONCLUSIONS This is the first study outside the United States that has identified DIP as a barrier to colorectal cancer screening uptake, and it is the first focused specifically on FIT-based screening. The findings suggest that two suppression barriers, namely denying the immediacy to be tested and self-exempting oneself from screening, may be promising targets for future interventions to improve uptake.
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Affiliation(s)
- Nicholas Clarke
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Louise Hayes
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Amy McQueen
- Health Communication Research Laboratory, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
- Division of General Medical Sciences, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | | | - Deirdre McNamara
- Department of Clinical Medicine, Adelaide and Meath Hospital, Dublin, Ireland
| | - Colm A O'Morain
- Faculty of Health Science, Trinity College Dublin, Dublin, Ireland
| | - Christian von Wagner
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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14
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Tuohy E, Gallagher P, Rawdon C, Murphy N, Swallow V, Lambert V. Adolescent perspectives on negotiating self-management responsibilities for type 1 diabetes with their parents. Patient Educ Couns 2023; 109:107629. [PMID: 36641999 DOI: 10.1016/j.pec.2023.107629] [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] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/24/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The overall purpose of this study was to explore adolescent perspectives on communicating about self-management of type 1 diabetes (T1D) and negotiating responsibilities for self-management with parents. METHODS Semi-structured interviews were conducted with 28 adolescents aged 11-17 years living with T1D. Interviews were audio-recorded, transcribed verbatim and thematically analysed. RESULTS Two themes and five subthemes were identified. The first theme, 'changing levels of involvement in self-management' describes the division of responsibility for self-management within the family and adolescents collaborating and sharing responsibilities with parents for self-management. The second theme, 'talking about self-management with parents' describes changes in patterns of parent-adolescent communication about T1D over time, adolescents' seeking parental feedback and advice and the factors that contribute to the promotion of self-management communication between adolescents and parents. CONCLUSION This study identified that how adolescents perceive communication with their parents contributes to negotiation of responsibilities for self-management during adolescence. The findings provide a nuanced understanding of adolescent perspectives on communication with parents about T1D self-management and how parent-adolescent communication can be framed in ways that promote positive adolescent engagement with T1D self-management. PRACTICE IMPLICATIONS Targeting parent-adolescent communication strategies may result in more optimal sharing of responsibilities and improved self-management.
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Affiliation(s)
- Ella Tuohy
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | - Caroline Rawdon
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Nuala Murphy
- Diabetes and Endocrine Unit, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Veronica Swallow
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
| | - Veronica Lambert
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland.
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15
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Deegan A, Brennan C, Gallagher P, Lambert V, Dunne S. Social Support and Childhood Cancer Survivors: A Systematic Review (2006-2022). Psychooncology 2023. [PMID: 36944590 DOI: 10.1002/pon.6128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/15/2022] [Revised: 02/23/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Research has indicated that social support may play a protective role in the face of stress and help children and adolescents cope with the demands and challenges they face on a daily basis during their cancer journey. However, social support tends to reduce over time as survivors overcome their illness despite its ongoing importance even years after treatment has finished. The current review aimed to systematically examine existing evidence on social support in child and adolescent cancer survivors. METHODS Five databases (PsychINFO, CINAHL, EMBASE, PubMed and Web of Science) were searched systematically to identify quantitative studies which explored social support from the perspective of child and adolescent cancer survivors aged 18 years or younger. RESULTS A total of ten studies met the eligibility criteria for inclusion. Findings from the review indicate that family and friends, particularly parents, are important sources of social support for survivors. Social support was positively related to posttraumatic growth, school re-entry and physical activity, and negatively related to psychological stress, depression, anxiety and stress. Furthermore, findings relating to gender, age and group differences were mixed. A number of methodological concerns were identified in the reviewed studies including small sample sizes, as well as a lack of consistency in the measurement of social support. CONCLUSIONS Future studies of social support for child and adolescent cancer survivors need to address these shortcomings to help inform care and support interventions promoting social support in survivors. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Avril Deegan
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Ciara Brennan
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | - Veronica Lambert
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Dublin, Ireland
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16
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Rimmer B, Bolnykh I, Dutton L, Lewis J, Burns R, Gallagher P, Williams S, Araújo-Soares V, Menger F, Sharp L. Health-related quality of life in adults with low-grade gliomas: a systematic review. Qual Life Res 2023; 32:625-651. [PMID: 35931881 PMCID: PMC9992080 DOI: 10.1007/s11136-022-03207-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Low-grade glioma (LGG) patients may face health-related quality-of-life (HRQoL) impairments, due to the tumour, treatment and associated side-effects and prospects of progression. We systematically identified quantitative studies assessing HRQoL in adult LGG patients, for: aspects of HRQoL impacted; comparisons with non-cancer controls (NCC) and other groups; temporal trends; and factors associated with HRQoL. METHODS MEDLINE, CINAHL, Embase, PubMed, and PsycINFO were systematically searched from inception to 14th September 2021. Following independent screening of titles and abstracts and full-texts, population and study characteristics, and HRQoL findings were abstracted from eligible papers, and quality appraised. Narrative synthesis was conducted. RESULTS Twenty-nine papers reporting 22 studies (cross-sectional, n = 13; longitudinal, n = 9) were identified. Papers were largely good quality, though many excluded patients with cognitive and communication impairments. Comparators included high-grade gliomas (HGG) (n = 7); NCCs (n = 6) and other patient groups (n = 3). Nineteen factors, primarily treatment (n = 8), were examined for association with HRQoL. There was substantial heterogeneity in HRQoL instruments used, factors and aspects of HRQoL assessed and measurement timepoints. HRQoL, primarily cognitive functioning and fatigue, in adult LGG patients is poor, and worse than in NCCs, though better than in HGG patients. Over time, HRQoL remained low, but stable. Epilepsy/seizure burden was most consistently associated with worse HRQoL. CONCLUSION LGG patients experience wide-ranging HRQoL impairments. HRQoL in those with cognitive and communication impairments requires further investigation. These findings may help clinicians recognise current supportive care needs and inform types and timings of support needed, as well as inform future interventions.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle upon Tyne, NE1 7RU, Newcastle, England.
| | - Iakov Bolnykh
- Faculty of Medical Sciences, Newcastle University, Newcastle, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle upon Tyne, NE1 7RU, Newcastle, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, England
| | - Richéal Burns
- Department of Health and Nutritional Sciences, Sligo, IT, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle upon Tyne, NE1 7RU, Newcastle, England.,Faculty of Behavioural, Management and Social Sciences, Department of Health Technology and Services Research, University of Twente, Twente, The Netherlands
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle upon Tyne, NE1 7RU, Newcastle, England
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17
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Maguire S, Wilson F, Gallagher P, O'Shea FD. Worse scores but similar patterns of disease activity: interpreting outcomes in women with axial spondyloarthropathy. Scand J Rheumatol 2023; 52:142-149. [PMID: 35048786 DOI: 10.1080/03009742.2021.2007609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of sex on disease activity in axial spondylitis (axSpA). METHOD Data were extracted from the Ankylosing Spondylitis Registry of Ireland (ASRI). In this cross-sectional study, patients were analysed on the basis of sex, with a series of comparison analyses performed. RESULTS Overall, 886 participants were enrolled in the ASRI [232 (26.2%) women, 644 (72.6%) men]. Females recorded significantly worse Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (4.57 vs 3.83, p < 0.01) and Ankylosing Spondylitis Quality of Life questionnaire (ASQoL) (7.51 vs 6.12, p < 0.01) scores than males. There was a stronger correlation in the Bath Ankylosing Spondylitis Functional and Metrology Indices (BASFI and BASMI) in females (rs = 0.619, p < 0.01) than in males (rs = 0.572, p < 0.01). Analysis of factors in BASDAI revealed that the higher total scores in females compared to males were due not to any single component, but to worse scores in all six components of the BASDAI combined. Ranking of components by severity between sexes revealed identical ranking in four of the six components of the BASDAI. CONCLUSIONS Women with axSpA reported significantly worse disease activity, quality of life, and functional ability than men. However, the BASDAI capturedsimilar patterns of disease activity. Limitation of spinal mobility in women with axSpA corresponded to greater impairment in functional ability. Further evaluation of disease monitoring tools is required to ensure that disease activity is accurately captured in men and women with axSpA.
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Affiliation(s)
- S Maguire
- Department of Rheumatology, St James' Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - F Wilson
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland
| | - P Gallagher
- Department of Rheumatology, St Vincent's Hospital, Dublin, Ireland
| | - F D O'Shea
- Department of Rheumatology, St James' Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
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18
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Wu Y, Levis B, Daray FM, Ioannidis JPA, Patten SB, Cuijpers P, Ziegelstein RC, Gilbody S, Fischer FH, Fan S, Sun Y, He C, Krishnan A, Neupane D, Bhandari PM, Negeri Z, Riehm KE, Rice DB, Azar M, Yan XW, Imran M, Chiovitti MJ, Boruff JT, McMillan D, Kloda LA, Markham S, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Al-Adawi S, Beck KR, Beraldi A, Bernstein CN, Boye B, Büel-Drabe N, Bunevicius A, Can C, Carter G, Chen CK, Cheung G, Clover K, Conroy RM, Costa-Requena G, Cukor D, Dabscheck E, De Souza J, Downing M, Feinstein A, Ferentinos PP, Flint AJ, Gallagher P, Gandy M, Grassi L, Härter M, Hernando A, Jackson ML, Jenewein J, Jetté N, Julião M, Kjærgaard M, Köhler S, König HH, Krishna LKR, Lee Y, Löbner M, Loosman WL, Love AW, Löwe B, Malt UF, Marrie RA, Massardo L, Matsuoka Y, Mehnert A, Michopoulos I, Misery L, Nelson CJ, Ng CG, O'Donnell ML, O'Rourke SJ, Öztürk A, Pabst A, Pasco JA, Peceliuniene J, Pintor L, Ponsford JL, Pulido F, Quinn TJ, Reme SE, Reuter K, Riedel-Heller SG, Rooney AG, Sánchez-González R, Saracino RM, Schellekens MPJ, Scherer M, Benedetti A, Thombs BD, Et Al. Comparison of the accuracy of the 7-item HADS Depression subscale and 14-item total HADS for screening for major depression: A systematic review and individual participant data meta-analysis. Psychol Assess 2023; 35:95-114. [PMID: 36689386 DOI: 10.1037/pas0001181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit
| | | | - Simon Gilbody
- Department of Health Sciences, Hull York Medical School, University of York
| | - Felix H Fischer
- Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin
| | - Suiqiong Fan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | | | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | | | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University
| | - Dean McMillan
- Department of Health Sciences, Hull York Medical School, University of York
| | | | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Zahinoor Ismail
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary
| | | | | | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Kevin R Beck
- Department of Psychiatry, Singapore General Hospital, Singapore
| | - Anna Beraldi
- kbo Lech-Mangfall-Klinik für Psychatrie, Psychotherapie und Psychsomatik, Garmisch-Partenkirchen
| | | | - Birgitte Boye
- Department of Behavioural Medicine, University of Oslo
| | | | | | - Ceyhun Can
- Adana City Training and Research Hospital
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle
| | - Chih-Ken Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Gary Cheung
- Department of Psychological Medicine, University of Auckland
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle
| | - Ronán M Conroy
- Division of Population Health Sciences, Royal College of Surgeons in Ireland
| | - Gema Costa-Requena
- Department of Psychiatry, Clinical Psychology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigacióo Biomédica en Red de Salud Mental
| | | | | | | | | | | | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens
| | | | | | - Milena Gandy
- The School of Psychological Sciences, Macquarie University
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg, University of Hamburg
| | | | | | - Josef Jenewein
- Department of Medical Psychology and Psychotherapy, Medical University of Graz
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf
| | | | - Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig
| | | | | | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf
| | - Ulrik F Malt
- Department of Research and Education Division of Surgery and Clinical Neuroscience, University of Oslo
| | - Ruth Ann Marrie
- Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
| | - Loreto Massardo
- Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia, Universidad San Sebastián
| | - Yutaka Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens
| | | | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya
| | | | | | | | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig
| | - Julie A Pasco
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University
| | - Jurate Peceliuniene
- Faculty of Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius University
| | - Luis Pintor
- Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer
| | | | | | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow
| | - Silje E Reme
- Department of Psychology, Faculty of Social Sciences, University of Oslo
| | - Katrin Reuter
- Private Practice for Psychotherapy and Psycho-oncology, Freiburg, Baden-Württemberg
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig
| | | | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar
| | - Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | | | - Martin Scherer
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital
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McNicholl A, Desmond D, Gallagher P. Assistive technologies, educational engagement and psychosocial outcomes among students with disabilities in higher education. Disabil Rehabil Assist Technol 2023; 18:50-58. [PMID: 33320728 DOI: 10.1080/17483107.2020.1854874] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Increasing numbers of students with disabilities are accessing higher education each year, yet little is known about their assistive technology (AT) needs and its influence on relevant outcomes. The aim of this study was to examine met/unmet AT needs on educational engagement, academic self-efficacy and well-being and the impact of AT use in the areas of competence, adaptability and self-esteem for students with disabilities in higher education in Ireland. METHODS One hundred and eleven students with disabilities completed a cross-sectional online survey comprising the College Learning Effectiveness Inventory, the Student Course Engagement Questionnaire, the Self-Efficacy for Learning Form Abridged, the Psychosocial Impact of Assistive Devices Scale, and the Warwick-Edinburgh Mental Well-Being Scale. RESULTS AT use was found to have a positive psychosocial impact in the areas of competence, adaptability and self-esteem. Those whose AT needs were fully met scored significantly higher on academic self-efficacy, well-being, and on 4 of the 10 educational engagement subscales compared to those who had unmet AT needs. Met/unmet AT needs were not predictive of educational engagement. CONCLUSION These findings highlight the importance of AT from both educational engagement and psychosocial perspectives for students with a wide variety of disability diagnoses. The wide-reaching benefits of AT must be considered by governmental departments when making funding allocations to disability services within higher education institutions. Implications for rehabilitationStudents with disabilities can face many additional challenges within the higher education environment.Findings from this research show that access to appropriate assistive technology can support students' educational engagement, increase well-being and academic self-efficacy and have a positive impact in the areas of competence, adaptability and self-esteem.Disability and Assistive Technology Officers in higher education should be cognizant of both the educational and psychological benefits of assistive technology across diverse students with various disability diagnoses.Policy makers should consider the wide-reaching benefits of assistive technology when making funding allocations to higher education institutions.
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Affiliation(s)
- Aoife McNicholl
- School of Psychology, Dublin City University, Glasnevin, Ireland
| | - Deirdre Desmond
- Department of Psychology and Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Pamela Gallagher
- School of Psychology, Dublin City University, Glasnevin, Ireland
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Rawdon C, Kilcullen SM, Murphy N, Swallow V, Gallagher P, Lambert V. Parents' perspectives of factors affecting parent-adolescent communication about type 1 diabetes and negotiation of self-management responsibilities. J Child Health Care 2022:13674935221146009. [PMID: 36529483 DOI: 10.1177/13674935221146009] [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] [Indexed: 12/23/2022]
Abstract
Adolescence is an important time in which young people take on type 1 diabetes (T1D) self-management responsibility. Parents are key facilitators of this process. Little is known about parents' experiences of communicating with their children about T1D during adolescence. Semi-structured interviews were conducted with 32 parents (24 mothers and 8 fathers) of adolescents (11-17 years) living with T1D to explore how parents communicate about T1D and self-management with their adolescent children. Parents were recruited through two national child and adolescent diabetes and endocrine clinics and online advertisement through a national diabetes advocacy organisation. Interviews were transcribed verbatim and thematically analysed. Six themes were identified: parent factors, quality of the parent-adolescent relationship, communication strategies, adolescent factors, communication triggers and family/system factors. Understanding factors that impact communication about self-management between parents and adolescents will enable healthcare professionals to provide support and targeted interventions as parent and adolescent roles change over time.
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Affiliation(s)
| | | | - Nuala Murphy
- 11457Children's Health Ireland at Temple Street, Dublin, Ireland
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21
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Scriney A, Russell A, Loughney L, Gallagher P, Boran L. The impact of prehabilitation interventions on affective and functional outcomes for young to midlife adult cancer patients: A systematic review. Psychooncology 2022; 31:2050-2062. [PMID: 36073575 PMCID: PMC10092088 DOI: 10.1002/pon.6029] [Citation(s) in RCA: 4] [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: 03/28/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Cancer remains one of the most enduring health crises of the modern world. Prehabilitation is a relatively new intervention aimed at preparing individuals for the stresses associated with treatment from diagnosis. Prehabilitation can include exercise, psychological and nutrition-based interventions. The present systematic review aimed to assess the efficacy of prehabilitation on affective and functional outcomes for young to midlife adult cancer patients (18-55 years). Outcomes of interest included prehabilitation programme composition, duration, mode of delivery and measures used to determine impact on affective and functional outcomes. METHODS The following databases were searched with controlled and free text vocabulary; Psychological Information database (PsychINFO), Culmunated Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE) and Public MEDLINE (PubMed). Abstract and full-text screening was conducted with a secondary reviewer and final texts were subject to risk of bias analysis. RESULTS Thirteen texts were included at full-text. These included data of 797 prehabilitation participants (mean age 53 years) and a large representation of female participants (71% average). Evidence was found for the efficacy of psychological prehabilitation for anxiety reduction. Prehabilitation did not significantly affect health related quality of life. Findings moderately supported the therapeutic validity of exercise prehabilitation for functional outcomes, both in terms of clinical and experimental improvement with respect to the quality of evidence. Variation between all prehabilitation types was observed. There was insufficient evidence to support the efficacy of psychological prehabilitation on stress, distress or depression. CONCLUSION Implications for future research are highlighted and then discussed with respect to this young to midlife age group.
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Randles M, Gallagher P, O'Mahony D. 241 STOPPCASCADE: DEVELOPMENT OF A NOVEL EXPLICIT SCREENING TOOL FOR POTENTIALLY CLINICALLY RELEVANT PRESCRIBING CASCADES IN OLDER ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Prescribing cascades represent an important, often underrecognized, element of problematic polypharmacy. Cascades occur when an Adverse Drug Event (ADE) is misinterpreted as a new medical condition, with the subsequent prescription of another, potentially inappropriate drug. Our objective was to develop and validate an explicit list of potentially clinically relevant prescribing cascades in older adults to facilitate the detection of more common and clinically important prescribing cascades and assist clinicians in medication review.
Methods
A structured literature search of PubMed, Cinahl and Google Scholar was undertaken. Search terms included Prescribing Cascades OR Cascades OR Cascade AND Older Adults OR Adults Over 65 OR Older People OR Gero* OR Geri*. We included adults aged ≥65 including studies in all settings i.e. community, hospital and residential care. We included all study designs including reviews, experimental and observational studies, case series and case reports. We also included published abstracts from scientific meetings in the literature search. Studies that didn’t include prescribing cascades in the abstract, studies with no access to full text article or English version of article and studies exclusively describing patients aged ≤65 were excluded. A physiological systems-based short-list was compiled with Anatomical Therapeutic Chemical codes identifying the initial prescribed drug (Drug A). Three assessment panellists (academic geriatricians) were asked to evaluate each individual published cascade and the accompanying evidence using a 5-point Likert scale to evaluate each cascade for inclusion/exclusion in the list. Potential cascades scored Likert 4 or 5 by 2 or 3 of the panellists were included in the final list.
Results
131 potential cascades were reviewed by the panel, 71 individual cascades were accepted, involving 41 drugs/drug classes.
Conclusion
The STOPPCascade list comprises 71 potentially important prescribing cascades in older adults. This novel explicit list is designed to identify potential prescribing cascades and to facilitate appropriate deprescribing.
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Affiliation(s)
- M Randles
- Cork University Hospital Department Of Geriatric Medicine, , Cork, Ireland
- University College Cork , Cork, Ireland
| | - P Gallagher
- Bon Secours Hospital Department Of Geriatric Medicine, , Cork, Ireland
- University College Cork , Cork, Ireland
| | - D O'Mahony
- Cork University Hospital Department Of Geriatric Medicine, , Cork, Ireland
- University College Cork , Cork, Ireland
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Randles M, Gannon E, Gallagher P, O'Mahony D. 242 FALLS-RISK INCREASING DRUGS AND FRAILTY IN OLDER ADULTS EXPERIENCING FALLS: A PROSPECTIVE OBSERVATIONAL STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Frailty characteristics such as compromised response to stressors and accumulation of deficits in physiological systems may leave frailer older adults at higher risk of falls, a leading cause of injury and injury-related mortality. One of the more prominent extrinsic risk factors for falls in older adults is the use of Falls-Risk Increasing Drugs (FRIDS). This study aims to examine the relationship between measured frailty and FRIDS in older people who have experienced a fall in the previous 12 months.
Methods
A prospective observational study was undertaken. Inclusion criteria were age ≥ 65 years and a history of falling in the preceding 12 months. Exclusion criteria were age <65 years of age, inability to provide informed consent or participation declined. Medical chart and drugs Kardex review was carried out, followed by a short interview with the patient using a standardised data collection proforma. Frailty was measured using the Clinical Frailty Scale (CFS) and the point-prevalence of FRIDS was established using the STOPPFall screening tool.
Results
Results are presented for the first 100 participants: The mean (±standard deviation [SD]) age of study participants was 82.1 (±6.2), 63% were female. The prevalence of frailty measured using the CFS was 60% (CFS ≥5). The median number of falls in the previous 12 months was 3 (IQR 3). 82% of people who had fallen in the previous 12 months had ≥1 STOPPFall FRID. The difference between number of FRIDs in Frail vs Non-Frail people was not statistically significant.
Conclusion
Prescription of FRIDS was detected in over 4 out 5 older fallers. Structured medication review using the STOPPFall screening tool for older adults at risk of falls is one useful and easy way of detecting FRIDS with a view to deprescription. Measured frailty does not appear to increase the prevalence of FRIDS in older fallers.
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Affiliation(s)
- M Randles
- Cork University Hospital Department of Geriatric Medicine, , Cork, Ireland
- University College Cork , Cork, Ireland
| | - E Gannon
- Cork University Hospital Department of Geriatric Medicine, , Cork, Ireland
| | - P Gallagher
- University College Cork , Cork, Ireland
- Bon Secours Hospital Department of Geriatric Medicine, , Cork, Ireland
| | - D O'Mahony
- Cork University Hospital Department of Geriatric Medicine, , Cork, Ireland
- University College Cork , Cork, Ireland
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Murphy C, Timon C, Heffernan E, Hopper L, Gallagher P, Hussey P. 67 TECHNOLOGY TO SUPPORT INDEPENDENT LIVING AT HOME: ONLINE SURVEY OF USER NEEDS AND REQUIREMENTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Technology can play a key role in supporting older adults to live independently at home. A User Needs and Requirements study including co-design workshops and an online survey was conducted to inform the development of a technological solution aimed at supporting older adults to remain living independently at home. The online survey component is reported here.
Methods
Eligibility criteria included that respondents were older adults living at home or caregiving stakeholders providing care to older adults at home e.g. family caregivers or health/social care professionals. Recruitment took place throughout Ireland through civil society organisations and age friendly networks in local councils. Quantitative and qualitative data were gathered from June to July 2020. Descriptive statistics were applied to quantitative data and inductive thematic analysis was performed on free text responses.
Results
In total, 380 respondents completed the survey (n= 235 older adults, n=77 family caregivers, n=47 healthcare professionals and n=21 home support workers). Older adults identified key issues where technology might support them to live independently, these included, home security (33% n=77), falls (30% n=69), reduced mobility (23% n=55) and loneliness (23% n=54). Thematic analysis highlighted key areas where technology could assist stakeholders in providing care for older adults living independently, these included, remote monitoring of family members (family caregivers), communication with clients (healthcare professionals) and falls (home support workers). Older adults reported that data privacy and the cost of technology were key concerns. All groups reported a high level of willingness to use technology such as ambient sensors, wearable devices and voice activated assistants to support independent living.
Conclusion
Results of this survey provide insights into user needs and requirements in combination with results from co-design workshops to inform the design, development and trial of a technology system to support independent living at home.
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Affiliation(s)
- C Murphy
- Dublin City University School of Nursing, Psychotherapy and Community Health, , Dublin, Ireland
- Dublin City University Centre for eIntegrated Care, , Dublin, Ireland
| | - C Timon
- Dublin City University Centre for eIntegrated Care, , Dublin, Ireland
| | - E Heffernan
- Dublin City University Centre for eIntegrated Care, , Dublin, Ireland
| | - L Hopper
- Dublin City University School of Psychology, , Dublin, Ireland
- Dublin City University Centre for eIntegrated Care, , Dublin, Ireland
| | - P Gallagher
- Dublin City University School of Psychology, , Dublin, Ireland
- Dublin City University Centre for eIntegrated Care, , Dublin, Ireland
| | - P Hussey
- Dublin City University School of Nursing, Psychotherapy and Community Health, , Dublin, Ireland
- Dublin City University Centre for eIntegrated Care, , Dublin, Ireland
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Tsabary C, Hopper L, Kilcullen S, Gallagher P. 181 UNDERSTANDING OLDER ADULTS’ PERCEPTIONS AND EXPERIENCES OF NOVELTY: A PILOT STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Our institution is currently developing a technology solution to support adults to live well at home for longer. As the system develops, there is an emerging emphasis on strict structure/routine in older adults’ activities of daily living. In contrast, engagement in novel experiences is widely endorsed as a buffer against cognitive decline. Despite this, there is scant research into the perceptions and experiences of novelty in older adults. Understanding older adults’ views on novelty is necessary to inform the advancement of the current project.
Methods
A multiple-methods, exploratory approach was used. A 90-minute focus group was held with 4 older adults to explore their conceptualisations of novelty, discussing what constitutes a novel experience and gauging the value placed on routine and novelty in daily life. Questionnaires measuring Mental Well-Being (MWB), personality, Novelty-Need Satisfaction (NNS), and preference for routine were subsequently completed by each participant.
Results
Four main themes emerged from the qualitative data. They comprised the contrast between planned and unplanned novel experiences, the influence of context on the enjoyment of novelty, the value of the vicarious experience of novelty and the challenge associated with change at a social/global level. The quantitative data revealed that 91.9% of the variation in MWB is attributed to its relationship with NNS.
Conclusion
The focus group served as a strong foundation; especially into the contextual influence of both internal (psychological/attitude-related) and external (environmental/social) factors upon the enjoyment of novelty; as well as indicating that further research is merited into the contrasting views on planned and unplanned novel experiences. The quantitative data corroborate the importance of maintaining novelty in older age. Understanding how to preserve novelty while supporting routines will allow assistive technology projects such as this, to adopt a holistic approach and encourage consideration for this aspect of life, often neglected in the lives of older adults.
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Affiliation(s)
- C Tsabary
- Dublin City University , Dublin, Ireland
| | - L Hopper
- Dublin City University , Dublin, Ireland
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Hayden L, Byrne E, Deegan A, Dunne S, Gallagher P. A qualitative meta-synthesis examining spirituality as experienced by individuals living with terminal cancer. Health Psychol Open 2022; 9:20551029221121526. [PMID: 36105766 PMCID: PMC9465615 DOI: 10.1177/20551029221121526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This review aimed to examine and synthesise literature on spirituality as experienced by individuals living with terminal cancer. Six databases were systematically searched for studies with qualitative findings relevant to spirituality and terminal cancer. Thirty-seven studies were included and thematic synthesis was used to identify themes. Analytical themes included: making sense of dying; living with dying; feeling connected; and being reflective. This review highlights how the experience of spirituality can positively impact the lives of terminal cancer patients. Further, these findings suggest that spirituality can be a transformative experience that allows individuals to experience peace at end of life.
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Affiliation(s)
- Lucy Hayden
- School of Psychology, Dublin City University, Ireland
| | - Emma Byrne
- School of Psychology, Dublin City University, Ireland
| | - Avril Deegan
- School of Psychology, Dublin City University, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Ireland
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Carty J, Marsh K, Gallagher P, O’shea FB, Fitzgerald G. POS0999 HIGHER CARDIOVASCULAR MORBIDITY SEEN IN MEN WITH LONGER DELAY TO THE DIAGNOSIS OF AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundDiagnostic delay in axial spondyloarthritis (axSpA) is a well-defined feature of the disease, despite increased awareness. Morbidity and mortality are higher in axSpA than the general population1. Much of this excess burden is due to increased comorbidity. However, the association between delayed diagnosis and increased comorbidity in this population is unknown.Objectives(1)Examine the relationship between delayed diagnosis and comorbidity in a large cohort of well characterised individuals with axSpA(2)Assess the impact of sex on the relationship between diagnostic delay and comorbidity.MethodsThe Ankylosing Spondylitis Registry of Ireland (ASRI), a descriptive epidemiological study of the Irish axSpA population, provided the cohort for this study. A standardised clinical assessment was performed on each patient. Delay to diagnosis was calculated as age at diagnosis minus age at symptom onset. Comorbidities were considered as any condition present in addition to axial SpA, excluding extra-musculoskeletal manifestations (EMM). SPSS was used for statistical analysis, with appropriate tests used for normally and non-normally distributed data.ResultsOf the 913 included patients, 659 (72%) were male and mean age was 46 years (SD 13). Detailed baseline clinical and demographic characteristics are outlined in Table 1. Median delay to diagnosis was 5 (2, 12) years. Comorbidity was present in 37% (n=341) of the cohort, with hypertension the most prevalent (see Figure 1).Table 1.Baseline demographic and clinical characteristicsVariableAge, mean (SD)45.8 (12.6)Female, n (%)254 (27.8)Caucasian, n (%)819 (96.5)Ever Smoker, n (%)*527 (57.7)HLA-B27 positive, n (%)631 (89.9)Disease duration, median (25th,75th)17.1 (9.5, 27.8)Delay to diagnosis, median (25th, 75th)5.0 (2.0, 12.0)AAU, n (%)308 (34.4)PsO, n (%)150 (16.7)IBD, n (%)96 (10.7)Biologic use, n (%)628 (68.5)BASMI, mean (SD)3.6 (2.1)BASFI, mean (SD)3.4 (2.9)BASDAI, mean (SD)3.9 (2.4)HAQ, median (25th, 75th)0.38 (0.0, 0.9)The median delay to diagnosis was significantly longer in those with ≥1 comorbidity compared to those with none (7 v 5 years, p<0.01). Hypertension (6 v 5 years, p=0.1) and cerebrovascular disease (10 v 5 years, p=0.03) were associated with a significantly longer delay to diagnosis, with a similar trend seen in those with hyperlipidaemia (7 v 5 years, p=0.09) and ischaemic heart disease (10 v 5 years, p=0.07). The delay to diagnosis was also longer in those that currently (7 v 5 years, p=0.03) or ever smoked (6 v 5 years, p<0.01). The delay to diagnosis was significantly longer in those with depression (9 v 5, p<0.05). The presence of EMM did not contribute to a delay to diagnosis, and there was no association with any categories of medication.There was no significant difference in the median delay to diagnosis between females (5 v 6 years) for males. However, there were differences in the relationship between delay to diagnosis and the pattern of comorbidities between sexes. There was a significantly (p<0.05) longer delay to diagnosis in men with cerebrovascular disease (12 v 6 years), ischaemic heart disease (10 v 6 years) and diabetes (10 v 6 years), which wasn’t evident in females. Depression was associated with a longer delay to diagnosis in males (10 v 6 years, p<0.05), but not females (6 v 5 years, p=0.5).ConclusionDelay to diagnosis of axSpA was associated with a higher prevalence of comorbidities. This was particularly evident in men, with higher cardiovascular morbidity in those with a longer delay to diagnosis. Further research is needed to determine if shortening the delay to diagnosis would reduce the burden of cardiovascular morbidity.References[1]Chaudhary et al. All-Cause and Cause-Specific Mortality in Psoriatic Arthritis and Ankylosing Spondylitis: A Systematic Review and Meta-Analysis. Arthritis Care Res. 2021 Nov 17 (online).Disclosure of InterestsNone declared
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Marsh K, Carty J, Gallagher P, Maguire S, O’shea FB, Fitzgerald G. POS1001 CURRENT SMOKING IS ASSOCIATED WITH LOWER RISK OF UVEITIS AND PERIPHERAL ARTHRITIS IN MALES WITH AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe associations between smoking and extra-axial manifestations of axial spondyloarthritis (axSpA) are inadequately described. Previous observational studies have demonstrated smoking as protective against some but not other manifestations. However, the impact of sex on these associations is unknown.ObjectivesUsing a large descriptive epidemiological dataset, we performed a sex-stratified analysis of the association between smoking status and extra-axial manifestations in axSpA.MethodsThis study was carried out within the framework of ASRI (Ankylosing Spondylitis Registry of Ireland), a descriptive epidemiological study of the axSpA population of Ireland. A standardised clinical assessment was performed on each patient, collecting demographic and clinical data. Smoking status was characterised as current, previous or never. The number of cigarettes per day, plus number of years smoking was also collected. Data on the following extra-axial manifestations was collected: arthritis, enthesitis, dactylitis, acute anterior uveitis (AAU), psoriasis (PsO), inflammatory bowel disease (IBD). Standardised measures of disease severity were also collected. Separate logistic regression models were used to define the association between extra-axial manifestations and smoking, controlling for potential confounders. SPSS was used for statistical analysis.ResultsSmoking data was available for 913 out of the 917 axSpA individuals with data in ASRI (mean age 46 (SD 13) years, disease duration 19 (SD 12) years, 72% male, 97% Caucasian). Twenty eight percent (n=259) were current smokers, 29% (n=268) were past smokers and 42% (n=386) were never smokers. Of the current smokers, the mean number of cigarettes per day was 12 (SD 7) and number of years smoking was 22 (SD 12). Thirty one percent had peripheral arthritis, 7% had dactylitis, 18% had enthesitis, 34% had AAU, 17% had psoriasis and 11% had IBD.Current smokers had a significantly lower prevalence of arthritis and uveitis than past or non-smokers (see Table 1). A sex-stratified analysis was performed. There was no association between smoking status and any extra-axial manifestation in females. However, current smoking was associated with lower prevalence of arthritis in males compared to past or non-smokers (22% v 36% v 42%, p=0.002). A similar pattern was seen for uveitis, where male current smokers had a lower prevalence than non-smokers (24% v 38%, p=0.01). In contrast, psoriasis was more prevalent in men who were current smokers compared to non-smokers (18% v 12%, p=0.01), with no difference seen in females. There was no association with number of cigarettes smoked or number of years smoking.Table 1.Association between smoking status and extra-axial manifestations in axSpA.AxSpA cohortCurrent smokerPast smokerNon-smokerArthritis30.9%22.4%a35.5%b33.3%bDactylitis6.7%5.5%a6.7% a7.4% aEnthesitis18.1%17.4% a16.2% a19.9% aUveitis34.3%27.4%a35.0%b38.6%bPsoriasis16.7%18.5% a19.3% a13.8% aInflammatory bowel disease10.7%9.9% a13.2% a9.5% aDifferent subscript letters denote significant (p<0.05) differences between groups. Significant values highlighted in bold.There was no association between smoking status and disease severity by subjective or objective measures, either for the cohort as a whole or by sex.When compared to non- or ex-smokers and controlled for potential confounders including sex, age, biologic use, the association remained only between current smokers and lower risk of uveitis (OR 0.68, 95% CI 0.49 to 0.96) and arthritis (OR 0.62, 95% CI 0.43 to 0.88), in separate logistic regression models. The association between current smoking and increased prevalence of psoriasis in males did not remain significant once controlled for confounders (OR 1.10, 96% CI 0.73 to 1.65).ConclusionWe demonstrated that current smoking is independently associated with a lower risk of uveitis and arthritis in males with axSpA, but not females. More research is needed to further investigate this paradoxical finding.Disclosure of InterestsNone declared
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Hanlon M, Canavan M, Neto N, Song Q, Gallagher P, Mullan R, Hurson C, Moran B, Monaghan M, Nagpal S, Veale D, Fearon U. OP0013 LOSS OF SYNOVIAL TISSUE MACROPHAGE HOMEOSTASIS PRECEDES RHEUMATOID ARTHRITIS CLINICAL ONSET. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSynovial tissue macrophages significantly contribute to Rheumatoid Arthritis, yet the precise nature/function of macrophage subsets within the inflamed joint remains unexplored.ObjectivesTo fully explore the spectrum of distinct macrophage activation states residing within the synovium of RA, at risk and healthy individuals.MethodsSingle-cell synovial tissue suspensions from RA (n=44), IAR (n=5), HC (n=11), PsA (n=11) and OA (n=4) were obtained, and synovial macrophage subsets examined by advanced multiparameter flow cytometric analysis, bulk RNA-sequencing, metabolic and functional assays.ResultsMultidimensional analysis identifies enrichment of CD206+CD163+ synovial-tissue macrophages co-expressing CD40 in the RA joint compared to healthy synovial-tissue, with frequency of CD206+CD163+CD40+ macrophages associated with increased disease activity and treatment response. In contrast, CX3CR1-expressing macrophages which form a protective barrier in healthy synovium are significantly depleted in RA. Importantly this signature of enriched CD40 expression coupled with depleted CX3CR1 expression is an early phenomenon, occurring prior to clinical manifestation of disease in individuals ‘at-risk’ of RA (IAR). RNAseq and metabolic profiling of sorted RA synovial-macrophages identified that this population is transcriptionally distinct, displaying unique inflammatory, phagocytic and tissue-resident gene signatures, paralleled by a bioenergetically stable profile as indicated by NAD(P)H emission. Functionally CD206+CD163+ RA macrophages are potent producers of pro-inflammatory mediators (reversed by CD40-signalling inhibition) and induce an invasive phenotype in healthy synovial-fibroblasts. These findings identify a distinct pathogenic population of synovial-tissue macrophage involved in shaping the immune response in RA. Crucially, this signature is present pre-disease representing a unique opportunity for early diagnosis and therapeutic intervention.ConclusionWe have identified a novel population of tissue-resident macrophages in the RA synovium which are transcriptionally/metabolically distinct and capable of contributing to disease pathology. Uncovering the molecular patterns and cues that transform this immunoregulatory macrophage population into a dysfunctional inflammatory activation state may provide opportunities to reinstate joint homeostasis in RA patients.Disclosure of InterestsMegan Hanlon: None declared, Mary Canavan: None declared, Nuno Neto: None declared, Qingxuan Song Employee of: Employee of Janssen Pharmaceuticals, Phil Gallagher: None declared, Ronan Mullan: None declared, Conor Hurson: None declared, Barry Moran: None declared, Michael Monaghan: None declared, Sunil Nagpal Employee of: Employee of Janssen Pharmaceuticals, Douglas Veale Consultant of: Janssen, Eli Lilly, Pfizer, Ursula Fearon Consultant of: Janssen, Eli Lilly, Pfizer
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Timon CM, Heffernan E, Kilcullen SM, Lee H, Hopper L, Quinn J, McDonald D, Gallagher P, Smeaton AF, Moran K, Hussey P, Murphy C. Development of an Internet of Things Technology Platform (the NEX System) to Support Older Adults to Live Independently: Protocol for a Development and Usability Study. JMIR Res Protoc 2022; 11:e35277. [PMID: 35511224 PMCID: PMC9121220 DOI: 10.2196/35277] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/27/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background In a rapidly aging population, new and efficient ways of providing health and social support to older adults are required that not only preserve independence but also maintain quality of life and safety. Objective The NEX project aims to develop an integrated Internet of Things system coupled with artificial intelligence to offer unobtrusive health and wellness monitoring to support older adults living independently in their home environment. The primary objective of this study is to develop and evaluate the technical performance and user acceptability of the NEX system. The secondary objective is to apply machine learning algorithms to the data collected via the NEX system to identify and eventually predict changes in the routines of older adults in their own home environment. Methods The NEX project commenced in December 2019 and is expected to be completed by August 2022. Mixed methods research (web-based surveys and focus groups) was conducted with 426 participants, including older adults (aged ≥60 years), family caregivers, health care professionals, and home care workers, to inform the development of the NEX system (phase 1). The primary outcome will be evaluated in 2 successive trials (the Friendly trial [phase 2] and the Action Research Cycle trial [phase 3]). The secondary objective will be explored in the Action Research Cycle trial (phase 3). For the Friendly trial, 7 older adult participants aged ≥60 years and living alone in their own homes for a 10-week period were enrolled. A total of 30 older adult participants aged ≥60 years and living alone in their own homes will be recruited for a 10-week data collection period (phase 3). Results Phase 1 of the project (n=426) was completed in December 2020, and phase 2 (n=7 participants for a 10-week pilot study) was completed in September 2021. The expected completion date for the third project phase (30 participants for the 10-week usability study) is June 2022. Conclusions The NEX project has considered the specific everyday needs of older adults and other stakeholders, which have contributed to the design of the integrated system. The innovation of the NEX system lies in the use of Internet of Things technologies and artificial intelligence to identify and predict changes in the routines of older adults. The findings of this project will contribute to the eHealth research agenda, focusing on the improvement of health care provision and patient support in home and community environments. International Registered Report Identifier (IRRID) DERR1-10.2196/35277
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Affiliation(s)
- Claire M Timon
- Centre for eIntegrated Care, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Emma Heffernan
- Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | | | - Hyowon Lee
- School of Computing, Dublin City University, Dublin, Ireland
| | - Louise Hopper
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | | | | | - Alan F Smeaton
- Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Kieran Moran
- Insight Centre for Data Analytics, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Pamela Hussey
- Centre for eIntegrated Care, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Catriona Murphy
- Centre for eIntegrated Care, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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Woods S, Dunne S, Gallagher P, Harney S. Is a pandemic as good as a rest? Comparing athlete burnout and stress before and after the suspension of organised team sport due to Covid-19 restrictions, and investigating the impact of athletes' responses to this period. Psychol Sport Exerc 2022; 60:102168. [PMID: 35210943 PMCID: PMC8855617 DOI: 10.1016/j.psychsport.2022.102168] [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] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/31/2021] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic resulted in social-distancing measures and the suspension of organised sport globally, and has been shown to have negatively impacted mental health. However, athletes may have experienced reprieve from sport demands, which have previously been linked with maladaptive responses such as burnout and stress. The aims of this study were (1) compare levels of burnout and stress reported by Gaelic games athletes pre- and post-COVID-19 suspension period, (2) explore how athletes utilised and perceived this period and the return to sport, and (3) examine the implications of this for burnout. Participants completed an online questionnaire, which included the athlete burnout questionnaire, perceived stress scale, sport emotion questionnaire, demographic questions, weekly training hours, and other hours for sport (e.g. travel) before Covid-19 (BC-19) and after the Covid-19-induced suspension (AC-19_S). Questions relating to how athletes utilised (e.g. training focus) and perceived (positive/negative impact) the period were included AC-19 S. Data was compared across time-points and we explored predictors of burnout AC-19_S. Ninety-two athletes completed the questionnaire at both time-points. No significant differences in burnout or stress were identified, suggesting the suspension period did not significantly impact these variables. Burnout BC-19, stress AC-19_S, unpleasant emotions about returning to sport and using the period to rest/recover positively predicted burnout AC-19_S. Reduction in other hours across time-points and pleasant emotions about returning predicted lower burnout. Results suggest an athletes' response to a suspension period and subsequent return to sport can impact feelings of burnout, and may have implications for future unanticipated change events.
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Affiliation(s)
- Siobhán Woods
- School of Psychology, Dublin City University, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Ireland
| | | | - Sibéal Harney
- School of Psychology, Dublin City University, Ireland
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Cassidy A, Gallagher P. Acute Encephalopathy in a Child with Threadworm Infection Treated with Mebendazole. Ir Med J 2022; 115:589. [PMID: 35695939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- A Cassidy
- Paediatric Department, Midlands Regional Hospital Portlaoise
| | - P Gallagher
- Paediatric Department, Midlands Regional Hospital Portlaoise
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Burgess JL, Bradley AJ, Anderson KN, Gallagher P, McAllister-Williams RH. The relationship between physical activity, BMI, circadian rhythm, and sleep with cognition in bipolar disorder. Psychol Med 2022; 52:467-475. [PMID: 32597742 DOI: 10.1017/s003329172000210x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cognitive deficits affect a significant proportion of patients with bipolar disorder (BD). Problems with sustained attention have been found independent of mood state and the causes are unclear. We aimed to investigate whether physical parameters such as activity levels, sleep, and body mass index (BMI) may be contributing factors. METHODS Forty-six patients with BD and 42 controls completed a battery of neuropsychological tests and wore a triaxial accelerometer for 21 days which collected information on physical activity, sleep, and circadian rhythm. Ex-Gaussian analyses were used to characterise reaction time distributions. We used hierarchical regression analyses to examine whether physical activity, BMI, circadian rhythm, and sleep predicted variance in the performance of cognitive tasks. RESULTS Neither physical activity, BMI, nor circadian rhythm predicted significant variance on any of the cognitive tasks. However, the presence of a sleep abnormality significantly predicted a higher intra-individual variability of the reaction time distributions on the Attention Network Task. CONCLUSIONS This study suggests that there is an association between sleep abnormalities and cognition in BD, with little or no relationship with physical activity, BMI, and circadian rhythm.
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Affiliation(s)
- Jennifer L Burgess
- Academic Psychiatry Department, Campus of Ageing and Vitality, Westgate Road, Newcastle-upon-Tyne, NE4 6BE, UK
| | - Andrew J Bradley
- Academic Psychiatry Department, Campus of Ageing and Vitality, Westgate Road, Newcastle-upon-Tyne, NE4 6BE, UK
| | - Kirstie N Anderson
- Academic Psychiatry Department, Campus of Ageing and Vitality, Westgate Road, Newcastle-upon-Tyne, NE4 6BE, UK
| | - P Gallagher
- Academic Psychiatry Department, Campus of Ageing and Vitality, Westgate Road, Newcastle-upon-Tyne, NE4 6BE, UK
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Cochrane A, Gallagher P, Dunne S. "You just need to learn": A qualitative study on the information needs of family caregivers of people with lung cancer. Eur J Oncol Nurs 2021; 56:102082. [PMID: 34871938 DOI: 10.1016/j.ejon.2021.102082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Lung cancer caregivers often face considerable duties and responsibilities yet frequently feel unprepared for this role. The current study is the first to purposefully explore the information needs of family caregivers throughout the lung cancer trajectory. METHODS Semi structured interviews were conducted with nine lung cancer caregivers (7 female) including those bereaved within five years. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS Four main themes emerged: 1) "He knew that I'd ask questions, you see": Information-gathering during appointments; 2) "You can't really ask that with mum there": Discordant information needs between caregiver and the person with lung cancer; 3) "Trying to get the answers": Seeking information beyond the hospital; 4) "It took a while to kind of get into": Learning to adjust to changing roles and circumstances. CONCLUSIONS Lung cancer caregivers need reliable information to feel competent in their new roles and responsibilities. In the current study, there were a number of areas in which information was lacking, including those related to treatment, side effects, care services and symptom management. The provision of appropriate and timely information to lung cancer caregivers can ensure they feel supported in their roles and responsibilities. This will in turn benefit lung cancer survivors by ensuring that they understand information in consultations with oncology nurses and other health professionals and receive appropriate support from their caregivers that enhances their quality of life along the cancer trajectory.
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Affiliation(s)
- Andreanne Cochrane
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Pamela Gallagher
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland.
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Randles M, Gallagher P, O'Mahony D. 243 MEASURED FRAILTY AND POTENTIALLY INAPPROPRIATE PRESCRIBING IN ACUTELY HOSPITALISED OLDER ADULTS: A PROSPECTIVE OBSERVATIONAL STUDY. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Frailty characteristics such as compromised response to stressors and accumulation of deficits in physiological systems may leave frailer older adults at higher risk of adverse outcomes from PIP, compared with their non-frail counterparts of the same age. This study aims to examine the relationship between measured frailty and potentially inappropriate prescribing in older adults presenting acutely to hospital.
Methods
A prospective observational study was conducted. Participants were acutely hospitalised older adults. Inclusion Criteria: Age ≥ 65 years old, acute admission <72 hours, expected length of stay >24 hrs. Exclusion Criteria: <65 years of age, actively dying, direct admission to ICU, inability to provide informed consent and next of kin declined consent, patients in isolation for infection control purposes. Medical chart review was carried out, followed by a short interview using a standardised data collection proforma. Frailty was measured using the Clinical Frailty Scale and the Frail-VIG frailty index. Potentially Inappropriate Prescribing was identified using the STOPP/START criteria. Results are presented for the first 200 participants.
Results
The mean (±standard deviation [SD]) age of study participants was 79.25[±7.14], 56.5% were female. The prevalence of frailty measured using the CFS and Frail-VIG were 61.5% and 50.5% respectively. Applying the CFS, the mean number of STOPP criteria in non-frail patients was 1.03 and 1.87 for frail patients (p = 0.001 CI 95%) and 1.14 and 2.10 (p = 0.001 CI 95%) using the Frail-Vig Index.
Conclusion
Frailty is associated with functional decline, falls, hospitalisation and death. Frail patients had a higher mean number of STOPP criteria. As medication side effects are themselves included as part of the frailty syndrome, in-hospital medication review and patient centred medication optimisation should be guided by patient’s frailty status to reduce adverse outcomes.
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Affiliation(s)
- M Randles
- University College Cork , Cork, Ireland
- Cork University Hospital , Cork, Ireland
| | - P Gallagher
- University College Cork , Cork, Ireland
- Bon Secours Hospital , Cork, Ireland
| | - D O'Mahony
- University College Cork , Cork, Ireland
- Cork University Hospital , Cork, Ireland
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Maguire S, Wilson F, Gallagher P, O'Shea F. The toll of unemployment in axial spondyloarthropathy: high prevalence and negative impact on outcomes captured in a national registry. Scand J Rheumatol 2021; 51:300-303. [PMID: 34788188 DOI: 10.1080/03009742.2021.1992861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Axial spondyloarthropathy (axSpA) is an inflammatory arthritis of the axial skeleton. Persistent disease activity can result in significant disability and affect the ability to maintain employment. This study aimed to determine the prevalence of unemployment in axSpA and the impact on patient outcomes. METHOD Data from the Ankylosing Spondylitis Registry of Ireland (ASRI) were cleaned, and information on employment, demographics, and disease characteristics was extracted. Patients were analysed on the basis of employment and categorized as employed or unemployed. RESULTS Of the 759 participants included in the analysis, 23.5% (178) were unemployed, higher than national averages of 6.2-13.1% during the study period. Unemployed participants reported significantly worse Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 5.1 vs 3.6), Metrology Index (BASMI; 4.8 vs 3.4), Functional Index (BASFI; 5.2 vs 3.0), Health Assessment Questionnaire (HAQ; 0.82 vs 0.40), and Ankylosing Spondylitis Quality of Life (ASQoL; 9.4 vs 5.4) scores compared to employed (all p < 0.01). Male gender (odds ratio, 95% confidence interval: 2.65, 1.46-4.83), worse BASMI (1.16, 1.02-1.33), and worse HAQ scores (2.18, 1.13-4.19) were significantly associated with unemployment. CONCLUSION The prevalence of unemployment in axSpA patients is higher than in the general population, and is associated with worse quality of life, poorer levels of function, and higher levels of disease activity. Predictors of unemployment in axSpA were male gender, worse spinal mobility, and poorer level of function. Recognition of patients at risk of unemployment will improve opportunities for intervention and maintain participation in the workforce.
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Affiliation(s)
- S Maguire
- Department of Rheumatology, St James' Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - F Wilson
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland
| | - P Gallagher
- Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland
| | - F O'Shea
- Department of Rheumatology, St James' Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
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Curtin D, O'mahony D, Gallagher P. Drug consumption and futile medication prescribing in the last year of life: an observational study. Age Ageing 2021; 50:e19. [PMID: 29800084 DOI: 10.1093/ageing/afy084] [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] [Received: 05/16/2018] [Indexed: 11/13/2022] Open
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Cochrane A, Woods S, Dunne S, Gallagher P. Unmet supportive care needs associated with quality of life for people with lung cancer: A systematic review of the evidence 2007-2020. Eur J Cancer Care (Engl) 2021; 31:e13525. [PMID: 34729855 DOI: 10.1111/ecc.13525] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/02/2020] [Revised: 07/01/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this review was to systematically examine the evidence on the relationship between quality of life (QoL) and unmet supportive care needs in patients with lung cancer. METHODS Six databases were searched for studies published since 2007. Studies were included if they measured QoL using a standardised tool and examined its association with unmet supportive care needs in lung cancer patients. RESULTS Six studies involving 562 patients were included. Nearly two thirds of the patients had been diagnosed with advanced cancer (Stage III or IV), and the majority had been diagnosed for less than 2 years. There was a negative association between QoL and unmet needs using two different measures (Supportive Care Needs Survey[SCNS] and Cancer Survivors Unmet Needs Survey [CaSUN]). In two studies, the relationship was limited to physical and/or psychological domains. CONCLUSIONS Unmet supportive care needs are associated with poorer QoL for people with lung cancer: The findings suggest that unmet physical and psychological needs may have the most impact on QoL and reflect the high symptom burden and psychological distress associated with lung cancer. Further work is needed to examine these relationships to identify the services and interventions that address the range of care needs across the disease trajectory.
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Affiliation(s)
- Andy Cochrane
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Siobhan Woods
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Dublin, Ireland
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Affiliation(s)
- Conor P Mahon
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Richard Lombard-Vance
- Department of Psychology and Assisting Living & Learning Institute, Maynooth University, Ireland
| | - Gemma Kiernan
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Dublin, Ireland
| | - John E. Pachankis
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
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Browning Carmo K, McCarron M, Kendrick T, Gallagher P, Roxburgh J, Berry A. Re Pathways and factors that influence time to definitive trauma care for injured children in New South Wales, Australia by Curtis et al. published in 2021. Injury 2021; 52:2483-2485. [PMID: 33766432 DOI: 10.1016/j.injury.2021.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 02/02/2023]
Affiliation(s)
- K Browning Carmo
- New South Wales Newborn & paediatric Emergency Transport Service, Australia; University of Sydney, Australia.
| | - M McCarron
- New South Wales Newborn & paediatric Emergency Transport Service, Australia; University of Sydney, Australia
| | - T Kendrick
- New South Wales Newborn & paediatric Emergency Transport Service, Australia
| | - P Gallagher
- New South Wales Newborn & paediatric Emergency Transport Service, Australia
| | - J Roxburgh
- New South Wales Newborn & paediatric Emergency Transport Service, Australia
| | - A Berry
- New South Wales Newborn & paediatric Emergency Transport Service, Australia
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Canavan M, Marzaioli V, Bhargava V, Nagpal S, Gallagher P, Hurson C, Mullan R, Veale D, Fearon U. AB0018 ACCUMULATION OF FUNCTIONALLY MATURE CD1C+ DENDRITIC CELLS CONTRIBUTES TO SYNOVIAL INFLAMMATION IN INFLAMMATORY ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Myeloid Dendritic Cells (DC) are potent antigen presenting cells that can be subdivided into CD141 and CD1c+ DC. We have previously reported an unacknowledged role for CD141+DC in the IA synovium. However, the identification and function of CD1c+ DC in the IA synovium has yet to be fully elucidated.Objectives:To investigate if CD1c+DC reside in the IA synovium and ascertain if they represent a unique population, distinct from peripheral CD1c+DC and if they contribute to synovial inflammation.Methods:Synovial tissue (ST) biopsies and synovial fluid mononuclear cells (SFMC) were obtained via arthroscopy and healthy control (HC) ST was obtained during ACL surgery. Synovial tissue single cells suspensions were generated following enzymatic and mechanical digestion. Single cell analysis of synovial tissue cell suspensions, along with PBMC and SFMC was performed by multicolour flow cytometry. CD1c+DC were sorted from IA synovial fluid and peripheral blood and bulk RNA sequencing was performed. CD1c+DC functionality and maturation was assessed using OVA DQ phagocytosis assays, multiplex ELISA and DC: T cell cocultures.Results:Within the circulation the frequency of CD1c+DC are significantly decreased in IA peripheral blood compared to HC (p<0.01) in addition to expressing significantly higher levels of the maturation markers CD80 (p<0.01) and CD40 (p=0.08). IA peripheral blood DC also express significantly higher levels of CXCR3 (p<0.01) and CCR7 (p<0.05) compared to HC - suggestive of DC migration from the periphery to the synovium. Following RNA-seq analysis, IPA and differentially expressed gene (DEG) analysis revealed an enrichment in genes involved in DC maturation, TLR signalling and chemokine signalling in IA peripheral blood compared to HC. In support of the hypothesis that DC migrate and accumulate in the IA synovium, CD1c+ DC were identified in IA ST and were significantly enriched compared to IA peripheral blood (p<0.01). IA ST CD1c+DC express significantly higher levels of the activation marker CD80 compared to IA peripheral blood (p<0.05) or HC ST (p<0.05). Upon examination of IA synovial fluid, we report similar findings to ST, whereby CD1c+DC are enriched in synovial fluid compared to PB (p<0.001). Moreover, RNA sequencing and PCA analysis of synovial versus blood CD1c+DC revealed distinct transcriptional variation between both sites. Functionally, synovial CD1c+DC express higher levels of the maturation markers CD80, CD83, CD40, PD-L1 and BTLA (all p<0.05) and have distinct coexpression of these maturation markers which is unique to the synovium. Synovial CD1c+DC are less phagocytic compared to peripheral blood DC, have decreased production of MMP1 and MMP9 and importantly are still capable of additional activation in-vitro. Finally, synovial CD1c+DC induce the proinflammatory cytokines TNFα, GMCSF, IL-17a and IFNγ from CD4+ T-cells in allogeneic DC: T cells cocultures.Conclusion:Mature circulatory CD1c+DC migrate and accumulate in the IA synovium. Synovial DC are present in the IA synovium in a mature state, have distinct tissue specific characteristics and can induce proinflammatory CD4+T cell responses.Acknowledgements:We would like to thank all the patients who contributed to this studyDisclosure of Interests:Mary Canavan: None declared, Viviana Marzaioli: None declared, Vipul Bhargava Employee of: Janssen Research and Development, Sunil Nagpal Employee of: Janssen Research and Development, Phil Gallagher: None declared, Conor Hurson: None declared, Ronan Mullan: None declared, Douglas Veale Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, MSD, UCB, Consultant of: Abbvie, Janssen, Novartis, Pfizer, MSD, UCB, Grant/research support from: Pfizer, Janssen, AbbVie, UCB, Ursula Fearon Speakers bureau: Abbvie, Grant/research support from: Pfizer, Janssen, Abbvie, UCB
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Hanlon M, Canavan M, Song Q, Neto N, Gallagher P, Mullan R, Hurson C, Monaghan M, Nagpal S, Veale D, Fearon U. OP0028 CD206+CD163+ PATHOGENIC MACROPHAGES ENRICHED IN RHEUMATOID ARTHRITIS SYNOVIAL TISSUE WITH DISTINCT TRANSCRIPTIONAL SIGNATURES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Synovial tissue macrophages are an exquisitely plastic pool of innate cells that play a key role in RA disease progression. However, the precise nature, diversity, and function of macrophage subsets within the inflamed joint remains unexplored.Objectives:Therefore, the aims of this study are to phenotypically, transcriptionally and functionally characterise synovial tissue macrophages residing within the inflamed joint.Methods:Rheumatoid Arthritis, Psoriatic Arthritis, Osteoarthritis and healthy control synovial-tissue biopsies and synovial-fluid mononuclear cells were analysed using the following panel (CD40,-CD45,-CD64,-CD68,-CD163,-CD206,-CD253,-CCR4,-CCR7,-CXCR1,-CXCR3). CD206+CD163+ and CD206-CD163- macrophages were sorted from RA synovial-tissue by FACSAria sorter; RNAseq and FLIM analysis, autologous T-cell co-culture and heathy fibroblast experiments performed. Cytokine expression was measured by MSD immunoassay.Results:RA synovial tissue and fluid macrophages display markers typical of both M1 (CD40+CD253+) and M2 (CD206+CD163+) macrophages with a spectrum of macrophage activation states identified. Within this spectrum, significant enrichment of dominant CD206+CD163+ macrophage-subtype is present in synovial tissue versus fluid (p<0.05). CD206+CD163+ synovial tissue macrophages express significantly more CD40 than synovial fluid (p<0.0003), positively correlate with disease activity (r=0.6, p<0.01), with baseline levels predicting response to therapy (p<0.05). Moreover, CD206+CD163+CD40+ macrophages are enriched in RA synovial tissue compared to PsA and OA pathotypes (p<0.05). While the CD206+CD163+ subset is present in healthy synovial tissue, expression of CD40 is completely absent in healthy synovium (p<0.05) with dramatically decreased expression of CX3CR1 on RA macrophages. RNA-seq analysis indicates that CD206+CD163+ population is transcriptionally distinct from synovial tissue CD206-CD163-, synovial fluid CD206+CD163+, and RA monocyte-derived M1/M2 macrophages, with unique tissue-resident gene signatures. Moreover, differing metabolic demands between CD206+CD163+ and CD206-CD163- subsets was demonstrated by RNAseq and FLIM analysis. CD206+CD163+ macrophages enhance autologous T-cell responses, spontaneously secrete high levels of pro-inflammatory cytokines and activate healthy fibroblasts towards pro-inflammatory mechanisms thus further contributing to the local inflammatory response. Finally, inhibition of CD40 activity abrogates the expression of pro-inflammatory mediators (TNFa, IL-1B, IL-6, IFNy) and induces IL-10 expression in sorted CD206+CD163+ synovial tissue-macrophages suggesting a key role for CD40 in driving this pathogenic phenotype.Conclusion:This data identifies for the first-time enrichment of a previously undescribed dysfunctional dominant and transcriptionally distinct macrophage subtype in RA synovial tissue. Taken together, this data provides a greater understanding of the critical role tissue-resident macrophages play in perpetuating inflammation in RA. Further investigation of the molecular patterns and cues that shape specific synovial macrophage subsets may provide opportunities to reinstate RA joint homeostasis.Disclosure of Interests:Megan Hanlon: None declared, Mary Canavan: None declared, Qingxuan Song Employee of: Janssen Research & Development, Nuno Neto: None declared, Phil Gallagher: None declared, Ronan Mullan: None declared, Conor Hurson: None declared, Michael Monaghan: None declared, Sunil Nagpal Employee of: Janssen Research & Development, Douglas Veale Speakers bureau: Abbvie, Janssen, Novartis, MSD, Pfizer, UCB, Consultant of: Abbvie, Janssen, Novartis, MSD, Pfizer, UCB, Grant/research support from: Janssen, Abbvie, Pfizer, UCB, Ursula Fearon Speakers bureau: Abbvie, Grant/research support from: Janssen, Abbvie, Pfizer, UCB
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Maguire S, Gallagher P, O’shea FB. OP0051 LOOKING BEYOND BASDAI TOTAL SCORES: ANALYSIS OF THE BASDAI ON THE BASIS OF SEX. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Females with axial spondyloarthropathy (axSpA) average scores on patient reported outcomes (PROs) than males. However, this does not necessarily correlate to worse clinical findings. The Ankylosing Spondylitis Registry of Ireland (ARSI) is a national registry on patients with axSpA in Ireland and a source of epidemiological data.Objectives:The purpose of this study was to compare the scores of each sex across the individual components of the BASDAI to understand why females report worse scores than males.Methods:Analysis of the ASRI was preformed using IBM SPSS version 26. Patients were analyzed on the basis of gender. Comparison of baseline characteristics and mean BASMI, BASFI, HAQ and ASQoL were tested for significance using an independent two tailed t-test and a Mann Whitney U test. Mean total BASDAI score and mean score for each component of the BASDAI were compared and tested for significance with the same statistical tests. A chi-squared test for independence was used to determine significance in variation of HLA-B27 status and radiographic findings.Results:A total of 857 patients were included in the analysis. Patient population was 24.9% (213) female and 75.1% (644) male with a mean age of 45.9 years and mean disease duration of 19.4 years (means: BASDAI 4.02, BASMI 4, BASFI 3.67, HAQ 0.53, ASQoL 6.48). Females had worse BASDAI(4.6 vs 3.83, p<0.01), HAQ(0.6 vs 0.51, p=0.03) and ASQoL scores (7.62 vs 6.12, p<0.01) than males. BASFI scores were worse in females which did not reach significance (3.89 vs 3.63, p=0.26). However, females had significantly better BASMI scores than males (3.51 vs 4.16, p<0.01). Within the BASDAI, females scored significantly worse than males across all components (Fatigue: 5.56 vs 4.51, p<0.01; Spinal pain: 5.51 vs 4.63, p<0.01; Other pain: 3.82 vs 3.19, p=0.01; Discomfort: 4.05 vs 3.29, p<0.01; EMS: 4.55 vs 3.94, p=0.01), however duration of EMS did not reach significance (3.54 vs 3.12, p=0.07)(graph 1). Within the BASDAI, females recorded highest mean scores for fatigue (5.56), while males recorded highest mean scores for spinal pain(4.63). Lowest mean scores for both genders was for EMS duration (3.54 vs 3.12). Ranking of the BASDAI components by mean scores show similarity in the ranking of discomfort, EMS, other pain and EMS duration(Table 1).Table 1.Ranking in order of severity by mean scoreFemalesMales1 -most severeFatigueSpinal pain2Spinal PainFatigue3EMSEMS4DiscomfortDiscomfort5Other painOther pain6 -least severeEMS durationEMS durationGraph 1.Breakdown of BASDAI scores in Females compared to MalesConclusion:AxSpA females have consistently worse PROs but have better spinal mobility than males. Despite females recording worse BASDAI scores than males, the pattern of active disease is similar in 4 of the 6 components of the BASDAI. However, fatigue is the most problematic symptom in females with active axSpA while spinal pain is the most problematic symptom for males. This variation by gender should be kept in consideration when evaluating a patient with suspected active axSpA.References:Disclosure of Interests:Sinead Maguire Grant/research support from: Recipient of the Gilead Inflammation Fellowship, Phil Gallagher: None declared, Finbar Barry O’Shea: None declared
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Turk M, Gorman A, Murray K, Alammari Y, Young F, Turk J, Zahavi E, Gallagher P, Freeman L, Fearon U, Veale D. POS0462 ALCOHOL AND INFLAMMATORY ARTHRITIS DISEASE ACTIVITY: PERSPECTIVES FROM A 979-PATIENT COHORT WITH SYSTEMATIC REVIEW AND META-ANALYSIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The effect of alcohol on disease activity in inflammatory arthritis remains poorly understood. Studies of alcohol and the incidence or risk of inflammatory arthritis are conflicting [1,2]. Alcohol does downregulate pro-inflammatory cytokines and may therefore reduce immune-mediated disease activity.Objectives:This study investigates the relationship between alcohol consumption and disease activity in our inflammatory arthritis patient cohort and performs a systematic review with meta-analysis.Methods:Cohort Study Design and data analysisPatients attending a rheumatology clinic between 2010-2020 were prospectively followed. Information on demographics, alcohol use, smoking habits, and disease outcome measures were collected. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann Whitney-U tests, and one-way ANOVA with Tukey’s HSD.Meta-analysisEMBASE, Pubmed, the Cochrane library, and Web of Science were searched. Studies reporting on alcohol consumption and disease activity in a cohort of RA patients were included for further investigation. Forest plots were generated from 95% confidence intervals of extracted data using mean differences. Linear regression was used to determine correlations between alcohol and antibody status, gender, and smoking status.Results:Cohort StudyOf the 979 analysed patients, 62% had RA, 26.7% had PsA, and 11.2% had AS. Mean DAS28-CRP in RA and PsA at one year was 2.96 ± 1.39, and 64.2% of patients were in remission (DAS28-CRP ≤ 2.6 or BASDAI ≤ 4). Both male gender and risky drinking (>15 units of weekly alcohol) were both significantly associated with remission. Compared to women, men had an odds ratio of 1.78 [1.04, 2.52] (p=0.034) for any alcohol consumption and 6.9 [4.7, 9.1] (p=0.001) for drinking at least 15 weekly drinks. when adjusted for gender, there was no significant association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still influenced disease activity.Meta-analysisThe search identified 4126 citations of which 14 were included. The pooled mean difference in DAS28 (95% CI) was 0.34 (0.24,0.44) (p<10-5) between non-drinkers and drinkers, 0.33 (0.05,0.62) (p=0.02) between non-drinkers and heavy drinkers, and 0 (-0.3,0.3) (p=0.98). between low- and high-risk drinkers. There was a significant difference in the mean difference of HAQ assessments between those who drink alcohol compared to those who do not (0.3 (0.18,0.41), p<10-5). There was no significant correlation between drinking and gender, smoking status, or antibody positivity.Conclusion:While it appears that alcohol is linked to remission in inflammatory arthritis, this association is lost when adjusted for gender. Men with inflammatory arthritis drink significantly more than women and men generally have less severe disease activity. However, the meta-analysis suggests alcohol consumption is associated with lower disease activity and self-reported health assessment in rheumatoid arthritis.References:[1]Bae S-C, Lee YH. Alcohol intake and risk of rheumatoid arthritis: a Mendelian randomization study. Z Rheumatol 2019;78:791–6. doi:10.1007/s00393-018-0537-z[2]Scott IC, Tan R, Stahl D, et al. The protective effect of alcohol on developing rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 2013;52:856–67. doi:10.1093/rheumatology/kes376Figure 1.Mean differences in DAS28 between drinking groups. A between non-drinkers and drinkers. B between non-drinkers and high-risk drinkers. C between low-risk and high-risk drinkers.Disclosure of Interests:None declared
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Murray K, Turk M, Alammari Y, Young F, Gallagher P, Saber TP, Fearon U, Veale D. POS0625 ASSOCIATIONS OF REMISSION AND PERSISTENCE OF BIOLOGICS AT 1 AND 12 YEARS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Biologic therapies have greatly improved outcomes in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Yet, our ability to predict long-term remission and persistence or continuation of therapy remains limited.Objectives:To compare RA and PsA outcomes at 1 and 12 years after commencing biologic DMARDs and to identify predictors of remission and persistence of therapy.Methods:RA and PsA patients were prospectively recruited from a biologic clinic. Outcomes on commencing therapy, at 1 year and 12 years were reviewed. Demographics, medications, morning stiffness, patient global health score, tender and swollen joint counts, antibody status, CRP and HAQ were collected. Outcomes at 1 and 12 years are reported and predictors of EULAR-defined remission (DAS28-CRP < 2.6) and biologic persistence are examined with univariate and multivariate analysis.Results:A total of 403 patients (274 RA and 129 PsA) were analysed. PsA patients were more likely to be male, in full-time employment and have completed higher education. PsA had higher remission rates than RA at both 1 year (60.3% versus 34.5%, p < 0.001) and 12 years (91.3% versus 60.6%, p < 0.001). This difference persisted when patients were matched for baseline disease activity (p < 0.001). Biologic continuation rates were high for RA and PsA at 1 year (49.6% versus 58.9%) and 12 years (38.2% versus 52.3%). In PsA, patients starting on etanercept had lower CRP at 12 years (p = 0.041). Multivariate analysis showed 1-year continuation [OR 4.28 (1.28–14.38)] and 1-year low-disease activity [OR 3.90 (95% CI 1.05–14.53)] was predictive of a 12-year persistence. Persistence with initial biologic at 12 years [OR 4.98 (95% CI 1.83–13.56)] and male gender [OR 4.48 (95% CI 1.25–16.01)] predicted 12 year remission.Conclusion:This is the first real world data to show better response to biologic therapy in PsA compared to RA at 12 years. Long-term persistence with initial biologic agent was high and predicted by biologic persistence and low-disease activity at 1 year. Interestingly, PsA patients had higher levels of employment, educational attainment, and long-term remission rates compared to RA patients.Disclosure of Interests:Kieran Murray Grant/research support from: Bresnihan Molloy and Newman Fellowships, Matthew Turk: None declared, Yousef Alammari: None declared, Francis Young: None declared, Phil Gallagher: None declared, Tajvur Parveen Saber: None declared, Ursula Fearon: None declared, Douglas Veale: None declared
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Maguire S, Gallagher P, Wilson F, O’shea FB. POS0949 HIGH PREVALENCE OF ABDOMINAL OBESITY IN FEMALES WITH AXIAL SPONDYLOARTHROPATHY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Worldwide prevalence of obesity has been steadily increasing, despite significant public health campaigns to raise health awareness. In axial spondyloarthropathy (axSpA) obesity has been shown to be associated with higher levels of disease activity and decreased response to treatment. The waist to hip ratio (WtHpR) is a tool to screen for abdominal obesity. Abdominal deposition of adipose tissue is associated with increased risk of cardiovascular disease, type II diabetes and premature death. Abdominal obesity is more commonly found in males, while females are more prone to gluteal-femoral fat deposition. The Ankylosing Spondylitis Registry of Ireland (ASRI) is a source of epidemiological data of axSpA patients in Ireland.Objectives:To capture the prevalence of abdominal obesity in a large cohort of axSpA patients and assess for variation in prevalence between sexes.Methods:Participants were analysed on the basis of sex and presence of obesity by BMI and WtHpR. Obesity was defined by body mass index (BMI) with a result of >30 categorised as obese as per CDC definitions. Abdominal obesity was assessed by WtHpR and defined as per WHO guidelines. Categorical variables were recorded as frequencies, with a chi2 test for independence used to test for statistical significance. Numerical variables were recorded as means within each group and an independent t-test or Mann Whitney U test was used to test for statistical significance between groups. A p-value of <0.05 was deemed significant. IBM SPSS version 26 was used for statistical analysis of the patient population captured within the ASRI.Results:At the time of analysis, physical measurements were available on 692 patients in the ASRI made up of 96.2% (666) Caucasians with 22.3% (154) females and 77.7% (538) males. The average age was 45.9 years with a mean disease duration of 18.8 years (mean scores: BASDAI 4.09, BASFI 3.71, BASMI 3.99, HAQ 0.54, ASQoL 6.72). 80.9% (560) of patients had radiographic sacroiliitis while 49.1% (340) had sacroiliitis on MRI.Overall 29.5% (215) patients were obese based on BMI results, while 37.5% (274) were centrally obese as per the WtHpR. Analysis on the basis of sex revealed no significant variation in mean BMI (28.1 vs 27.7, p=0.45) or prevalence of obesity as assessed by BMI (29.9% vs 28.6%, p=0.49) between males and females(table 1). As expected analysis of WtHpR revealed higher mean ratios in males compared to females (0.96 vs 0.89, p<0.01), however there was a significantly higher prevalence of abdominal obesity in females (29.9% vs 68.2%, p<0.01).Table 1.Assessment of Obesity by SexMalesFemalesp valuen77.7% (538)22.3% (154)Weight (kg)84.9872.76<0.01BMI28.0827.690.45Underweight0.9% (5)0.06% (1)0.49Normal Weight29.2% (157)36.4% (56)Overweight39.2% (211)34.4% (53)Obese29.9% (161)28.6% (44)Waist Circumference (cm)97.4390.03<0.01Hip Circumference (cm)102.11101.270.56Waist to Hip Ratio0.9560.8901<0.01Normal Weight23.8% (128)17.5% (27)<0.01Overweight46.3% (249)14.3% (22)Obese29.9% (161)68.2% (105)Conclusion:There is a high prevalence of abdominal obesity as assessed by WtHpR in axSpA, this is especially high in females with axSpA. Use of WtHpR should be considered when screening for obesity in this population.Disclosure of Interests:Sinead Maguire Grant/research support from: Recipient of the Gilead Inflammation fellowship grant, Phil Gallagher: None declared, Fiona Wilson: None declared, Finbar Barry O’Shea: None declared
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Quinn S, Maguire S, O’shea FB, O’neill L, Molloy E, Fearon U, Gallagher P, Veale D. POS0964 CHARACTERISTICS AND BURDEN OF DISEASE IN PATIENTS WITH RADIOGRAPHIC VERSUS NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS IN THE ANKYLOSING SPONDYLITIS REGISTRY OF IRELAND COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Axial spondyloarthritis (axSpA) is an umbrella term for types of inflammatory arthritis that primarily affect the spine and the sacroiliac joints. It is comprised of patients with both radiographic (r-axSpA) and non-radiographic features (nr-axSpA). R-axSpA was historically known as Ankylosing Spondylitis. Previous studies have shown the burden of disease to be largely similar in patients with radiographic versus non-radiographic axial spondyloarthritis in cohorts both in the US and Europe [1]. The Ankylosing Spondylitis Registry of Ireland (ASRI) was formed with the objective to measure the burden of axial spondyloarthritis in the population and identify early predictors of a poor outcome. All patients in the registry are 18 years or older and meet Assessment of Spondyloarthritis International Society (ASAS) criteria for a diagnosis of SpA.Objectives:To compare the characteristics and burden of disease in patients with radiographic versus non-radiographic axial spondyloarthritis in the ASRI cohort.Methods:Patients with radiographic axial spondyloarthritis (r-axSpA) were defined as those with x-ray evidence of sacroiliitis. Patients with non-radiographic axial spondyloarthritis (nr-axSpA) were defined as having MRI evidence of sacroiliitis but no x-ray evidence of sacroiliitis. A standardised clinical assessment was performed on each patient and structured interviews provided patient-reported data. For each patient the following scores were captured: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Health Assessment Questionnaire (HAQ) assesses the self-reported functional status for performing activities of daily living, and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. Categorical variables were summarized as percentages with frequency counts, and continuous variables with a mean and standard deviation. Statistical comparisons between subgroups were evaluated using 2 sample t-tests for continuous variables and chi-square tests for categorical variables.Results:764 patients were available for analysis. Analysis of radiographic status showed 88.1% (n=673) of patients with r-axSpA and 11.9% (n=91) with nr-axSpA. Patients with nr-axSpA were younger (41.3 vs. 46.6 years, p<0.01), had shorter disease duration (14.8 vs. 20.2 years, p<0.01), lower proportion of males (66.6% vs. 78.4%, p=0.02) with lower rates of HLA-B27 positivity (73.6% vs. 90.5%, p<0.01). The nr-axSpA group had lower BASDAI (3.37 vs. 4.05, p=0.01), BASFI (2.46 vs. 3.88, p<0.01), BASMI (2.33 vs. 4.34, p<0.01), ASQoL (5.2 vs. 6.67, p=0.02), and HAQ scores (0.38 vs. 0.57, p<0.01). There were no significant differences in the prevalence of extra-articular manifestations.Conclusion:This study provides evidence that the burden of disease is less in patients with non-radiographic axial spondyloarthritis than radiographic axial spondyloarthritis, as demonstrated by better BASDAI, BASFI, BASMI, HAQ and ASQoL scores.References:[1]López-Medina C, et al. Characteristics and burden of disease in patients with radiographic and non-radiographic axial Spondyloarthritis: a comparison by systematic literature review and meta-analysis. RMD Open, 2019. 5(2) p1108.Table 1.r-axSpAnr-axSpAp valuen67391Age (years)46.6 (+/-12.4)41.3 (+/-12.4)<0.01Disease duration (years)20.2 (+/-12.4)14.8 (+/-11.7)<0.01Delay to diagnosis (years)8.41 (+/-8.6)6.34 (+/-7.2)0.03Males78.8% (528)65.9% (60)0.02Females21.5% (145)34.1% (31)0.02HLA-B27+90.50%(440 of 486 available results)73.60%(53 of 72 available results)<0.01BASDAI4.05 (+/-2.39)3.37 (+/-2.31)0.01BASFI3.88 (+/-3.00)2.46 (+/-2.39)<0.01BASMI4.34 (+/-2.08)2.33 (+/-1.42)<0.01ASQoL6.67 (+/-5.55)5.2 (+/-5.53)0.02HAQ0.57 (+/-0.54)0.38 (+/-0.44)<0.01Psoriasis17.8% (120)15.4% (14)0.31IBD11% (74)8.8% (8)0.58Uveitis33.9% (228)34.1% (31)0.54Disclosure of Interests:Sean Quinn: None declared, Sinead Maguire: None declared, Finbar Barry O’Shea: None declared, Lorraine O’Neill: None declared, Eamonn Molloy: None declared, Ursula Fearon Speakers bureau: Abbvie, Grant/research support from: Janssen, Abbvie, Pfizer, UCB, Phil Gallagher: None declared, Douglas Veale Speakers bureau: AbbVie, BMS, Celgene, Pfizer, MSD, Roche, Consultant of: AbbVie, Actelion, BMS, Novartis, Pfizer, MSD, Roche, Regeneron/Sanofi, Grant/research support from: AbbVie, Pfizer, MSD, Novartis, Roche, Janssen.
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Cochrane A, Reid O, Woods S, Gallagher P, Dunne S. Variables associated with distress amongst informal caregivers of people with lung cancer: A systematic review of the literature. Psychooncology 2021; 30:1246-1261. [PMID: 33945184 DOI: 10.1002/pon.5694] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 02/12/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Informal caregivers of people with lung cancer often experience a substantial care burden and associated negative consequences due to the often-contracted course of the disease. The objective of this review was to systematically examine the evidence on the factors associated with lung cancer caregiver distress. METHODS Five databases (MEDLINE, CINAHL, EMBASE, PsychINFO and Web of Science) were searched for studies investigating factors associated with distress amongst caregivers of people with lung cancer. Empirical studies published up to July 2020 were included if they measured distress using a valid and reliable measure and examined its association with at least one other factor, with a sample of 50 or more caregivers. RESULTS Thirty publications describing 27 studies (16 cross-sectional; 6 prospective; 8 intervention) involving 3744 caregivers (primarily spouse or adult child) were included. A narrative synthesis of the findings is presented due to heterogeneity in study design, variables measured and analyses conducted. Patient variables associated with greater distress included: stage of cancer and quality of spousal relationship. Caregiver variables associated with higher distress included: social support, coping strategies and self-efficacy. CONCLUSIONS Several variables were associated with distress amongst lung cancer caregivers. Understanding these variables could inform the development of interventions that will enable caregivers to care effectively while maintaining their own well-being. Screening for distress among caregivers may identify those caregivers who would benefit from early intervention.
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Affiliation(s)
- Andy Cochrane
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Olivia Reid
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Siobhan Woods
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | | | - Simon Dunne
- School of Psychology, Dublin City University, Dublin 9, Ireland
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Mahon CP, Pachankis JE, Kiernan G, Gallagher P. Correction to: Risk and Protective Factors for Social Anxiety Among Sexual Minority Individuals. Arch Sex Behav 2021; 50:1033. [PMID: 33683505 DOI: 10.1007/s10508-021-01956-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Conor P Mahon
- School of Psychology, Dublin City University, 620 Collins Ave Ext, Glasnevin, Dublin 9, D09 X984, Ireland.
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Gemma Kiernan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Pamela Gallagher
- School of Psychology, Dublin City University, 620 Collins Ave Ext, Glasnevin, Dublin 9, D09 X984, Ireland
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Clarke N, Kearney PM, Gallagher P, McNamara D, O'Morain CA, Sharp L. Negative emotions and cancer fatalism are independently associated with uptake of Faecal Immunochemical Test-based colorectal cancer screening: Results from a population-based study. Prev Med 2021; 145:106430. [PMID: 33482227 DOI: 10.1016/j.ypmed.2021.106430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 12/24/2022]
Abstract
Although systematic colorectal cancer screening is efficacious, many programmes suffer from low uptake. Few behavioural or attitudinal factors have been identified as being associated with participation in colorectal cancer screening. We explored knowledge, beliefs about cancer, subjective health literacy, emotional attitudes to screening, and social influences among individuals invited to a population-based screening programme. Regression modelling of a cross-sectional survey of 2299 individuals (users and non-users) of a population-based Faecal Immunochemical Test (FIT) screening programme in Dublin was conducted. Questions were derived from previous theoretically-informed qualitative work and assessed using previously used and validated measures. The primary outcome variable was uptake status (User/Participation or Non-User/Non-participation); multivariable logistic regression was used to estimate the odds ratios (OR) for screening participation. Stronger fatalistic beliefs independently predicted lower uptake (OR = 0.94; 95% CI 0.90-0.98; P = 0.003). Those aged <65 who disagreed that "cancer can often be cured" also had lower uptake (OR = 0.43; 95% CI 0.22-0.82: P = 0.017). Agreement that the test was disgusting and tempting fate predicted lower uptake (OR = 0.16: 95% CI 0.10-0.27: p < 0.001), while the influence of a partner on decision to be screened was associated with higher uptake (OR = 1.32; 95% CI 1.15-1.50: P < 0.001). Negative cancer-related and screening-related beliefs and emotions are associated with non-participation in FIT (-based screening). Research is warranted to explore if these negative beliefs and emotions are modifiable and, if so, whether this would improve screening uptake. The association between the influence of a partner and screening participation present a challenge around improving uptake among those not in co-habiting relationships.
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Affiliation(s)
| | | | | | - Deirdre McNamara
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Adelaide and Meath Hospital, Dublin, Ireland.
| | - Colm A O'Morain
- Faculty of Health Science, Trinity College Dublin, Dublin, Ireland.
| | - Linda Sharp
- Newcastle University Centre for Cancer, Population Health Sciences Institute, Newcastle University, England, UK.
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