Fear of progression in patients with low-risk malignant melanoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21615-e21615
Author(s):  
Katharina C. Kaehler ◽  
Tobias Wagner ◽  
Christine Blome ◽  
Andrea Forschner ◽  
Claus Garbe ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Cancer Progression ◽  
Psychosocial Support ◽  
Depression Scale ◽  
Low Risk ◽  
Short Version ◽  
Fear Of Progression ◽  
Risk Melanoma ◽  
Melanoma Patients ◽  
The Impact

e21615 Fear of progression in patients with low-risk malignant melanoma Fear of cancer progression (FoP) is one of the problems most commonly reported by cancer patients and is among the most prevalent cancer-related worries in cancer survivors. FCR is highly variable in different cancer entities. Background: This study aimed to elicit the prevalence and significance of FCR in melanoma patients with low risk tumors and further to assess psychosocial and demographic factors predicting severity of FoP as well as to determine the impact of FoP on quality of life (QoL). Methods: In total, 133 patients with low-risk melanoma (pT1a) completed the short version of the Fear of Progression Questionnaire (FoP-Q-SF), the Hospital Anxiety and Depression Scale (HADS), and the EQ-5D questionnaire, as well as self-constructed questions on the socio-demographic background. Results: MeanFoP-Q-SF sum score was 30.1 points (± 8.4 points SD) and the median 29 points. Two thirds of patients deviated not more than 1 SD from the mean. Risk factors for elevated FoP were female gender (p < 0.01), young age (p = 0.04) and working (p = 0.02) patients and patients with severe comorbidities (p = 0.03). Cancer in closely related persons predicted higher FoP (p < 0.01). HADS anxiety scale (r = 0.49, p < 0.01) and depression scale (r = 0.26, p < 0.01) correlated with FoP. A negative correlation with the EQ-5D index was found (r = -0.34, p < 0.01). Conclusions: As in many other malignancies,FoP is prevalent in low-risk melanoma patients and is associated with reduced QoL. Severe comorbidities, cancer in related persons, gender and income could be identified as predictors of FoP. Considerable high levels of FoP even in patients with low-risk malignancies underline the need of psychosocial support and intervention for special subgroups of melanoma patients to enable the patient to manage FoP more successfully.

scholarly journals Willingness to pay for a cure of low-risk melanoma patients in Germany

PLoS ONE ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. e0197780 ◽  
Author(s):  
Matthias Augustin ◽  
Christine Blome ◽  
Andrea Forschner ◽  
Ralf Gutzmer ◽  
Axel Hauschild ◽  
...  
Keyword(s):  
Willingness To Pay ◽  
Low Risk ◽  
Risk Melanoma ◽  
Melanoma Patients

scholarly journals ADAPTAÇÃO ACADÊMICA E SAÚDE MENTAL DE ESTUDANTES DE MEDICINA NA COVID19: ESTUDO EXPLORATÓRIO NO BRASIL

2021 ◽  
Vol 18 (1) ◽  
pp. 159-170
Author(s):  
Gabriela Tacaci Michelis ◽  
Julia Galvão ◽  
Samara Almeida de Freitas ◽  
Camélia Santina Murgo ◽  
Celeste Corral Tacaci Neves Baptista
Keyword(s):  
Depression Scale ◽  
Academic Experiences ◽  
Short Version ◽  
Professional Performance ◽  
Behavioral Variables ◽  
The Face ◽  
Academic Adaptation ◽  
Advanced Stages ◽  
The University ◽  
The Impact

Research shows that university students are more vulnerable to the occurrence of mental disorders than the general population. In this sense, the medical course is considered a great source of stress. This study aimed to characterize the variables of academic adaptation (personal, interpersonal, career, study and institutional) of students facing the pandemic period of COVID-19, as well as to present descriptive statistics regarding emotional, physical and behavioral variables associated with mental health (stress, depression and anxiety). 513 medical students participated in the research, with ages varying between 18 and 29 years (M = 22.41; SD = 2.49), coming from public (18.7%; n = 96) and private universities (81, 3%; n = 417). Three questionnaires were used for data collection: the Academic Experiences Questionnaire - short version (QVA-r); the Depression Scale, Anxiety and Stress DASS-21 and a sociodemographic questionnaire. It was observed that most of the sample reported losses in concentration levels (79.5%) and academic performance (59.8%) during the pandemic, and this contingent also did not feel supported by the university to deal with the issues of this period. Regarding professional performance, most students (53.6%) do not feel prepared to guide conduct, as well as the perception that pandemic interferes in the relationship with patients in primary care (93.8%). Regarding the levels of depression, anxiety and stress, the first and second year students had higher averages when compared to students in more advanced stages. This article contributed to identify the impact of remote education on the training of future doctors and, thus, encourage research and study of this new adaptation in the face of the current pandemic of COVID-19.

scholarly journals Systemic inflammation and emotional responses during the COVID-19 pandemic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Odessa S. Hamilton ◽  
Dorina Cadar ◽  
Andrew Steptoe
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Systemic Inflammation ◽  
Smoking Status ◽  
Large Population ◽  
Depression Scale ◽  
High Sensitivity ◽  
Epidemiological Studies ◽  
Short Version ◽  
The Impact

AbstractThe impact of the COVID-19 pandemic on population mental health is of global concern. Inflammatory processes are thought to contribute to mental ill-health, but their role in experiences of psychological distress during the pandemic has not been investigated. We tested the hypothesis that elevated inflammatory biomarkers (high-sensitivity plasma C-reactive protein [CRP] and plasma fibrinogen) measured pre-pandemic would be positively predictive of increased depressive symptoms experienced during the pandemic. Data were analysed from the English Longitudinal Study of Ageing (ELSA), with 3574 individuals aged >50 for CRP and 3314 for fibrinogen measured in waves 8 (2016/17) or 9 (2018/19). Depressive symptoms were measured with a short version of the Centre for Epidemiological Studies Depression Scale (CES-D) pre-pandemic (2016–2019) and during the pandemic (June/July 2020). Participants with higher baseline CRP concentrations had 40% higher odds of developing depressive symptoms during the pandemic (ORadjusted = 1.40, 95% CI 1.12–1.73, p = 0.003) after full adjustment. Fibrinogen concentrations were also associated with depressive symptoms during the pandemic (ORadjusted = 1.23, 95% CI 1.04–1.46, p = 0.019), but this association was no longer significant after controlling for lifestyle factors (smoking status, alcohol consumption and physical activity). In this large population study, systemic inflammation measured 1–3 years pre-pandemic was associated with greater depressed mood during the early months of the pandemic. This finding is consistent with the hypothesis that higher levels of inflammation increase the vulnerability of older people to impaired mental health in the presence of the widespread stress of the COVID-19 pandemic.

scholarly journals Discovery and Validation of a Metastasis-Related Prognostic and Diagnostic Biomarker for Melanoma Based on Single Cell and Gene Expression Datasets

2020 ◽  
Vol 10 ◽  
Author(s):  
Qi Wan ◽  
Chengxiu Liu ◽  
Chang Liu ◽  
Weiqin Liu ◽  
Xiaoran Wang ◽  
...  
Keyword(s):  
Gene Expression ◽  
High Risk ◽  
Malignant Melanoma ◽  
Single Cell ◽  
Low Risk ◽  
Gene Set Enrichment Analysis ◽  
Mesenchymal Transition ◽  
Immune Infiltration ◽  
Single Cell Sequencing ◽  
Melanoma Patients

BackgroundSingle cell sequencing can provide comprehensive information about gene expression in individual tumor cells, which can allow exploration of heterogeneity of malignant melanoma cells and identification of new anticancer therapeutic targets.MethodsSingle cell sequencing of 31 melanoma patients in GSE115978 was downloaded from the Gene Expression Omniniub (GEO) database. First, the limma package in R software was used to identify the differentially expressed metastasis related genes (MRGs). Next, we developed a prognostic MRGs biomarker in the cancer genome atlas (TCGA) by combining univariate cox analysis and the least absolute shrinkage and selection operator (LASSO) method and was further validated in another two independent datasets. The efficiency of MRGs biomarker in diagnosis of melanoma was also evaluated in multiple datasets. The pattern of somatic tumor mutation, immune infiltration, and underlying pathways were further explored. Furthermore, nomograms were constructed and decision curve analyses were also performed to evaluate the clinical usefulness of the nomograms.ResultsIn total, 41 MRGs were screened out from 1958 malignant melanoma cell samples in GSE115978. Next, a 5-MRGs prognostic marker was constructed and validated, which show more effective performance for the diagnosis and prognosis of melanoma patients. The nomogram showed good accuracies in predicting 3 and 5 years survival, and the decision curve of nomogram model manifested a higher net benefit than tumor stage and clark level. In addition, melanoma patients can be divided into high and low risk subgroups, which owned differential mutation, immune infiltration, and clinical features. The low risk subgroup suffered from a higher tumor mutation burden (TMB), and higher levels of T cells infiltrating have a significantly longer survival time than the high risk subgroup. Gene Set Enrichment Analysis (GSEA) revealed that the extracellular matrix (ECM) receptor interaction and epithelial mesenchymal transition (EMT) were the most significant upregulated pathways in the high risk group.ConclusionsWe identified a robust MRGs marker based on single cell sequencing and validated in multiple independent cohort studies. Our finding provides a new clinical application for prognostic and diagnostic prediction and finds some potential targets against metastasis of melanoma.

scholarly journals Alcohol use and depression from middle age to the oldest old: gender is more important than age

2012 ◽  
Vol 24 (8) ◽  
pp. 1275-1283 ◽  
Author(s):  
Robert J. Tait ◽  
Davina J. French ◽  
Richard Burns ◽  
Kaarin J. Anstey
Keyword(s):  
Mental Health ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Oldest Old ◽  
Depression Scale ◽  
Risk Groups ◽  
Low Risk ◽  
Short Term ◽  
The Impact

ABSTRACTBackground: Alcohol use disorders are associated with other mental health disorders in young adults, but there are few data on alcohol use and mental health outcomes in older adults, particularly the oldest old. This study examines the relationship between alcohol consumption and depressive symptoms.Methods: Data were collected from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project, which has pooled nine Australian longitudinal studies. Alcohol consumption was classified using standard drinks (10 g alcohol)/day as: abstinent, low risk (<0–≤2 standard drinks), long-term risk (>2–≤4) and short-term risk (>4). Probable depression was classified from harmonized scores on various standard instruments (e.g. Centre for Epidemiological Studies Depression scale).Results: Overall, 39,104 (86%) participants contributed data. Alcohol classification at baseline showed 7,526 abstinent, 28,112 low risk, 2,271 long-term risk, and 1,195 short-term risk participants. Age ranged from 45 to 103 year (median 60). Using generalized estimating equations (GEE), there were significant gender by alcohol and gender by age interactions, so the analysis was split by gender. Among males, the abstinent and short-term risk groups had increased likelihood of depression: in females the abstinent, long- and short-term risk groups had increased odds of depression. Increased odds of depression was also associated with former and current smoking, younger age-group, not being partnered, leaving school before age 15 and increasing levels of health-impaired walking, dressing, or bathing.Conclusion: The impact of alcohol use differs by gender, nevertheless those using higher levels of alcohol or who smoke should be screened for depression and may benefit from interventions.

scholarly journals Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) Cohort Study: influences of complex environmental exposures on maternal and child health in Suriname

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034702
Author(s):  
Wilco Zijlmans ◽  
Jeffrey Wickliffe ◽  
Ashna Hindori-Mohangoo ◽  
Sigrid MacDonald-Ottevanger ◽  
Paul Ouboter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Occupational Health ◽  
Pregnant Women ◽  
Fish Consumption ◽  
Depression Scale ◽  
Environmental Exposures ◽  
International Standards ◽  
Long Term Effects ◽  
The Impact ◽  
Environmental And Occupational Health

PurposeThe Caribbean Consortium for Research in Environmental and Occupational Health prospective environmental epidemiologic cohort study addresses the impact of chemical and non-chemical environmental exposures on mother/child dyads in Suriname. The study determines associations between levels of environmental elements and toxicants in pregnant women, and birth outcomes and neurodevelopment in their children.ParticipantsPregnant women (N=1143) were enrolled from December 2016 to July 2019 from three regions of Suriname: Paramaribo (N=738), Nickerie (N=204) and the tropical rainforest interior (N=201). Infants (N=992) were enrolled at birth. Follow-up will take place until children are 48 months old.Findings to dateBiospecimens and questionnaire data on physiological and psychosocial health in pregnant women have been analysed. 39.1% had hair mercury (Hg) levels exceeding values considered safe by international standards. Median hair Hg concentrations in women from Paramaribo (N=522) were 0.64 µg/g hair (IQRs 0.36–1.09; range 0.00–7.12), from Nickerie (N=176) 0.73 µg/g (IQR 0.45–1.05; range 0.00–5.79) and the interior (N=178) 3.48 µg/g (IQR 1.92–7.39; range 0.38–18.20). 96.1% of women ate fish, respective consumption of the three most consumed carnivorous species, Hoplias aimara, Serrasalmus rhombeus and Cichla ocellaris, known to have high Hg levels, was 44.4%, 19.3% and 26.3%, respectively, and was greater among the interior subcohort. 89% frequently consumed the vegetable tannia, samples of which showed presence of worldwide banned pesticides. 24.9% of pregnant women had Edinburgh Depression Scale scores indicative of probable depression.Future plansFish consumption advisories are in development, especially relevant to interior women for whom fish consumption is likely to be the primary source of Hg exposure. Effects of potentially beneficial neuroprotective factors in fish that may counter neurotoxic effects of Hg are being examined. A pesticide literacy assessment in pregnant women is in progress. Neurodevelopmental assessments and telomere length measurements of the children to evaluate long-term effects of prenatal exposures to toxicant mixtures are ongoing.

scholarly journals Evaluation of the online-based self-help programme “Selfapy” in patients with unipolar depression: study protocol for a randomized, blinded parallel group dismantling study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rico Krämer ◽  
Stephan Köhler
Keyword(s):  
Depressive Symptoms ◽  
Depression Scale ◽  
Drop Out ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Online Interventions ◽  
Phone Calls ◽  
Self Help ◽  
Low Threshold ◽  
The Impact

Abstract Background Patients with mild to moderate depressive symptoms can have limited access to regular treatment; to ensure appropriate care, low-threshold treatment is needed. Effective online interventions could increase the supply of low-threshold treatment. Further research is needed to evaluate the effectiveness of online interventions. This study aims to evaluate the online-based self-help programme “Selfapy” on a sample of depressive subjects and compares the impact of the programme’s unaccompanied version with its therapeutic accompanied version. Methods A sample of 400 subjects that have a mild to severe depressive episode (Becks Depression Inventory - II and Hamilton Depression Scale) will be used. Subjects are randomly assigned to immediate access to an unaccompanied course (no support from psychologist via weekly phone calls), immediate access to an accompanied course (support from a psychologist via weekly phone calls) or a waiting list control group (access to the intervention after 24 weeks). The intervention will last for a period of 12 weeks. Depressive symptoms as a primary parameter, as well as various secondary parameters, such as life satisfaction, therapeutic relationships, social activation, self-esteem, attitudes towards Internet interventions and drop-out rates, are recorded at four different points in time: at baseline (T1), 6 weeks after the start of the intervention (T2), 12 weeks after the start of the intervention (T3) and 3 months after completion of the treatment follow-up (T4). Conclusion This randomized and controlled, blinded study will make use of a “dismantled” approach to adequately compare the accompanied and unaccompanied versions of the intervention. Positive and meaningful results are expected that could influence the acceptance and implementation of online interventions. Trial registration German Clinical Trials Register DRKS00017191. Registered on 14 June 2019

scholarly journals The Impact of Work Hours on Depressive Symptoms among Koreans Aged 45 and Over

2021 ◽  
Vol 18 (3) ◽  
pp. 853
Author(s):  
Juyeong Kim ◽  
Eun-Cheol Park
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Social Services ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Work Hours ◽  
Middle Aged ◽  
Health Studies ◽  
Males And Females ◽  
The Impact

Background: Given the documented importance of employment for middle-aged and older adults’ mental health, studies of the association between their number of work hours and depressive symptoms are needed. Objectives: To examine the association between the number of work hours and depressive symptoms in Korean aged 45 and over. Methods: We used data from the first wave to fourth wave of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 9845 individuals. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression scale. We performed a longitudinal analysis to estimate the prevalence of depressive symptoms by work hours. Results: Both unemployed males and females aged 45–65 years were associated with higher depressive symptoms (β = 0.59, p < 0.001; β = 0.32, p < 0.001). Females working ≥ 69 h were associated with higher depressive symptoms compared to those working 41–68 h (β = 0.25, p = 0.013). Among those both middle-aged and older adults, both males and females unemployed were associated with higher depressive symptoms. Those middle-aged female working ≥69 h were associated with higher depressive symptoms. Conclusions: An increase in depressive symptoms was associated with unemployed males and females working ≥69 h compared to those working 41–68 h. Although this association was found among middle-aged individuals, a decrease in depressive symptoms in both sexes was associated with working 1–40 h. Depressive symptoms should decrease by implementing employment policies and social services to encourage employers to support middle-aged and older adults in the workforce considering their sex and age differences.

scholarly journals Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gerhard Müller ◽  
Manuela Bombana ◽  
Monika Heinzel-Gutenbrenner ◽  
Nikolaus Kleindienst ◽  
Martin Bohus ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Distress ◽  
Linear Models ◽  
Longitudinal Research ◽  
Depression Scale ◽  
Routine Data ◽  
Medical Costs ◽  
First Year ◽  
Second Year ◽  
The Impact

Abstract Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

scholarly journals Exploring the impact of pharmacist comprehensive annual care plans on perceived quality of chronic illness care by patients in Alberta, Canada

2021 ◽  
pp. 171516352110203
Author(s):  
Candace Necyk ◽  
Jeffrey A. Johnson ◽  
Ross T. Tsuyuki ◽  
Dean T. Eurich
Keyword(s):  
Quality Of Care ◽  
Chronic Illness ◽  
Care Plan ◽  
Short Version ◽  
Chronic Illness Care ◽  
Online Questionnaire ◽  
Care Plans ◽  
Funding Program ◽  
The Impact

Background: In 2012, the Government of Alberta introduced a funding program to remunerate pharmacists to develop a comprehensive annual care plan (CACP) for patients with complex needs. The objective of this study is to explore patients’ perceptions of the care they received through the pharmacist CACP program in Alberta. Methods: We invited 3442 patients who received a pharmacist-billed CACP within the previous 3 months and 6888 matched controls across Alberta to complete an online questionnaire. The questionnaire consisted of the short version Patient Assessment of Chronic Illness Care (PACIC-11), with 3 additional pharmacy-specific assessment questions added. Additional questions related to health status and demographics were also included. Results: Overall, most patients indicated a low level of chronic illness care by pharmacists, with few differences noted between CACP patients and non-CACP controls. Of note, controls reported higher quality of care for 5 domains within the adapted PACIC-like tool compared with CACP patients ( p < 0.05 for all). Interestingly, only 79 (44%) of CACP patients reported that they had received a CACP, whereas only 192 (66%) of control patients reported that they did not receive a care plan. In a sensitivity analysis including only these respondents, individuals who received a CACP perceived a significantly higher quality of chronic illness care across all PACIC domains. Conclusion: Overall, chronic illness care incentivized by the pharmacist CACP program in Alberta is perceived to be moderate to low. When limited to respondents who explicitly recognized receiving the service or not, the perceptions of quality of care were more positive. This suggests that better implementation of CACP by pharmacists may be associated with improved quality of care and that some redesign is needed to engage patients more. Can Pharm J (Ott) 2021;154:xx-xx.

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