6 results
58 Emotional Functioning in Long COVID Neuropsychological Evaluations: Comparison to Post-Concussion Syndrome Using the Personality Assessment Inventory
- Laura Fry, Eric Waldron, Erin Holker, Jim Porter, Courtney Eskridge, Sarah Taylor, Michael Basso, Tanya Melnik, Savana Naini, Douglas Whiteside
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 54-55
-
- Article
-
- You have access Access
- Export citation
-
Objective:
COVID-19 has significantly impacted society for over 2.5 years, and Long COVID is concerning for its long-term impact on the healthcare system. Further, cognitive and emotional functioning in Long COVID has limited research, but 2 recent studies (Whiteside et al., 2022a, Whiteside et al., 2022b) examined cognitive and emotional functioning in Long COVID patients approximately 6 months post-diagnosis. The studies found limited cognitive deficits, but significant depression and anxiety, which in turn were the best predictors of low average cognitive scores. Further, the mean Personality Assessment Inventory (PAI) profile included highest mean elevations on somatic preoccupation (SOM) and depression (DEP) subscales. To further explore personality functioning in Long COVID, this study compared PAI profiles of Long COVID patients with a potentially similar group with post-concussion syndrome (PCS) which has been shown to have a strong psychological component.
Participants and Methods:Participants included 44 consecutive outpatients (Mean age = 47.89, SD = 13.05, 84% Female, 75% Caucasian) referred from a Long COVID clinic with cognitive complaints related to COVID, while the comparison group of PCS patients included 50 consecutive referrals (Mean age = 38.82, SD = 16.24, 52% Female, 90% Caucasian) related to cognitive complaints attributed to PCS. A series of t-tests between the 2 groups was conducted on the PAI validity, clinical, interpersonal, and treatment consideration scales. PAI clinical subscales were also compared. To control for multiple comparisons, p < .01 was utilized and effect sizes were compared.
Results:The results demonstrated that both Long COVID (SOM M = 68.66, SD = 12.56; DEP M = 63.39, SD = 12.70) and PCS groups (SOM M = 65.28, SD = 12.06; DEP M = 70.32, SD = 16.15) displayed the highest mean elevations on PAI SOM and DEP scales but no statistically significant differences in mean scale elevations between Long COVID and PCS groups on SOM (t [92] = 1.33, p = .80) and DEP (t [92] = -2.11, p = .097). However, results demonstrated statistically significant differences on the paranoia subscale (PAR; t [92] = -3.27, p = .009), antisocial features subscale (ANT; t [92] = -2.22, p = .01), stress subscale (STR; t [90] = -3.51, p = .006) and suicidal ideation subscale (SUI; t [92] = -2.73, p = .000) of the PAI. Specifically, the mean scores for the PCS group were higher across the paranoia (M = 57.30), antisocial features (M= 52.24), stress (M = 58.44), and suicidal ideation subscales (M = 57.82) of the PAI than the Long COVID group. While these patterns of reporting differed between groups, mean scores for both groups were in the normal range.
Conclusions:Results support the similarities in emotional/personality functioning across Long COVID and PCS patients and the importance of evaluating psychological functioning in these samples as a standard part of neuropsychological evaluations. Further, the results suggest that psychological treatment strategies utilized with PCS patients may be helpful for Long COVID patients, but more research is needed.
Knowledge, goals, and misperceptions about palliative care in adults with chronic disease or cancer
- Katherine Ramos, Brystana G. Kaufman, Joseph G. Winger, Abby Boggins, Courtney H. Van Houtven, Laura S. Porter, S. Nicole Hastings
-
- Journal:
- Palliative & Supportive Care , First View
- Published online by Cambridge University Press:
- 10 August 2023, pp. 1-7
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Objectives
Limited evidence investigates how knowledge, misconceptions, and beliefs about palliative care vary across patients with cancerous versus non-cancerous chronic disease. We examined the knowledge of and misconceptions about palliative care among these groups.
MethodsWe used weighted data from the National Cancer Institute Health Information National Trends Survey 5 (Cycle 2) for nationally representative estimates and logistic regression to adjust for respondent characteristics. We identified respondents who reported having (1) cancer ([n = 585]; breast, lung, and colorectal), (2) chronic conditions ([n = 543]; heart failure, lung disease, or chronic obstructive pulmonary disorder), or (3) neither cancer nor other chronic conditions (n = 2,376).
ResultsCompared to cancer respondents, chronic condition respondents were more likely to report being Black or Hispanic, report a disability, and have lower socioeconomic status. In the sample, 65.6% of cancer respondents and 72.8% chronic conditions respondents reported they had never heard of palliative care. Chronic condition respondents were significantly (p < 0.05) less likely to report high palliative care knowledge than cancer respondents (9.1% vs. 16.6%, respectively). In adjusted analyses, cancer respondents had greater odds of high palliative care knowledge (odd ratio [OR] = 1.70; 95% confidence interval [CI] = 1.01, 2.86) compared to respondents with neither cancer nor chronic disease; chronic condition respondents did not have increased odds (OR = 0.96; CI = 0.59, 1.54).
Significance of resultsDisparities in palliative care knowledge exist among people with non-cancerous chronic disease compared to cancer. Supportive educational efforts to boost knowledge about palliative care remains urgent and is critical for promoting equity, particularly for underserved people with chronic illnesses.
A community-partnered approach for diversity in COVID-19 vaccine clinical trials
- Yelba Castellon-Lopez, Raphael Landovitz, Ejiro Ntekume, Courtney Porter, Rachelle Bross, Robin Hilder, Aziza Lucas-Wright, Eric S. Daar, Pedro Chavez, Christopher Blades, Savanna Carson, D’Ann Morris, Stefanie Vassar, Alejandra Casillas, Arleen Brown
-
- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 06 October 2022, e23
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Introduction:
Communities of color have faced disproportionate morbidity and mortality from COVID-19, coupled with historical underrepresentation in US clinical trials, creating challenges for equitable participation in developing and testing a safe and effective COVID-19 vaccine.
Methods:To increase diversity, including racial and ethnic representation, in local Los Angeles County NIH-sponsored Phase 3 SARS-CoV-2 vaccine clinical trials, we used deliberative community engagement approaches to form a Community Consultant Panel (CCP) that partnered with trial research teams. Thirteen members were recruited, including expertise from essential workers, community-based and faith-based organizations, or leaders from racial and ethnic minority communities.
Results:Working closely with local investigators for the vaccine studies, the CCP provided critical insight on best practices for community trust building, clinical trial participation, and reliable information dissemination regarding COVID-19 vaccines. Modifying recruitment, outreach, and trial protocols led to majority–minority participants (55%–78%) in each of the three vaccine clinical trials. CCP’s input led to cultural tailoring of recruitment materials, changes in recruitment messaging, and supportive services to improve trial accessibility and acceptability (transportation, protocols for cultural competency, and support linkages to care in case of an adverse event). Barriers to clinical trial participation unable to be resolved included childcare, requests for after-hours appointment availability, and mobile locations for trial visits.
Conclusion:Using deliberative community engagement can provide critical and timely insight into the community-centered barriers to COVID-19 vaccine trial participation, including addressing social determinants of health, trust, clinical trial literacy, structural barriers, and identifying trusted messenger and reliable sources of information.
The current practice and care of paediatric patients post cardiac catheterisation
- Loren Brown, Karen Hinsley, Michelle Hurtig, Courtney L Porter, Jean A Connor
-
- Journal:
- Cardiology in the Young / Volume 29 / Issue 2 / February 2019
- Published online by Cambridge University Press:
- 26 November 2018, pp. 146-151
-
- Article
- Export citation
-
Background
Literature is lacking to guide standardised care and assessment practices for paediatric patients post cardiac catheterisation. In response to this gap, we sought to describe the current state of practice in cardiology programmes performing paediatric cardiac catheterisations procedures in the United States of America.
Materials and methodsA web-based survey was distributed to the Congenital Cardiovascular Interventional Study Consortium Listserv, with representation from 113 identified institutions. A 36-question survey, including fixed-choice and open-ended questions, was developed and piloted for reliability and validity before distribution. Data were summarised descriptively with count and frequency or median and range.
ResultsOf the 113 identified institutions, 52% (n=59) responded to the survey. Manual pressure is used to achieve haemostasis by 94.9% of the respondents. Pressure dressings are used by a majority of the facilities and the length of time for bed rest is variable, with the majority using 6 hours for arterial access and 4 hours for venous access. Predominantly, respondents use the time of haemostasis as the start time of bed rest while a third of respondents reported using the time the sheath was removed.
ConclusionIn this study, variation in a number of post catheterisation care and assessment practices for paediatric patients was noted across cardiology programmes. Information from this assessment identifies key opportunities to collaborate in developing standardised practices for the care and assessment of the paediatric patients post catheterisation.
2485: ETV6 represses Pax5 in early B-cell development
- Greg Kirkpatrick, Courtney Jones, Susan Fosmire, Christopher Porter, Jorge DiPaola
-
- Journal:
- Journal of Clinical and Translational Science / Volume 1 / Issue S1 / September 2017
- Published online by Cambridge University Press:
- 10 May 2018, pp. 65-66
-
- Article
-
- You have access Access
- Open access
- Export citation
-
OBJECTIVES/SPECIFIC AIMS: The goal of this project is to determine the role of ETV6 in early B-cell development and define how germline ETV6 mutations result in predisposition to leukemia. METHODS/STUDY POPULATION: Gene expression commons were queried for expression levels of Etv6 and Pax5 at different stages of hematopoiesis. Mouse bone marrow was isolated and fractioned into cells committed to the B cell lineage via B220+ and CD43+ staining by flow cytometry and then separated into the following fractions: Fraction A (CD24low, CD19−), Fraction B (CD19+, CD24+, BP1−), and Fraction C (CD19+ CD24+ BP1+). Wild-type or germline mutant P214L ETV6 were cloned in an MiG vector and expressed in Ba/F3 cells. ChIP-PCR was performed by cross-linking proteins to DNA with 1% formaldehyde for 10 minute at room temperature, followed by cell lysis with RIPA buffer. Lysates were sonicated to shear DNA to a length of 200–1000 base pairs, then Protein A agarose beads were used to clean and immunoprecipitate chromatin. RESULTS/ANTICIPATED RESULTS: We observed that Etv6 is highly expressed in hematopoietic stem and lymphoid progenitor cells through the pre-pro-B stage (FrA), but its expression is significantly reduced in fraction B and thereafter (p<0.0001). Etv6 expression decreases as B cells develop and is negatively correlated with Pax5 expression (r2=0.9993; p=0.0167). We next confirmed the expression patterns of ETV6 and PAX5 during B cell development in human samples. We found that ETV6 expression was higher in the early B cell fraction (CD10+, CD34+, CD19−, and CD20−) compared to the pre-B cell fraction (CD10+, CD34−, CD19+, CD20−). Conversely, we observed that PAX5 expression was higher in the preB cell fraction compared with the early B cell fraction. In Ba/F3 cells expressing ETV6 constructs, ETV6, but not ETV6 P214L overexpression significantly decreased Pax5 expression (p≤0.05). ETV6 is associated with the proximal GGAA site 72 base pairs upstream of the Pax5 TSS, but not GGAA sites further from the TSS. In addition, the transcriptional repressors SIN3A and HDAC3 were detected on the same regions of the Pax5 locus. We detected association of ETV6, SIN3A, and HDAC3 with the proximal GGAA site upon expression of WT ETV6, but not ETV6 P214L. DISCUSSION/SIGNIFICANCE OF IMPACT: Our results provide a mechanism of interaction for ETV6 and PAX5, 2 genes often disrupted in B-cell leukemia. These findings are significant because PAX5 misregulation results in a B cell development halt, lineage infidelity, and leukemogenesis. In continuing our studies, we have generated a transgenic mouse endogenously expressing the ETV6 P214L mutation by CRISPR/Cas9 editing, and these mice appear to have a thrombocytopenic phenotype similar to that observed in patients carrying the ETV6 P214L mutation. These animals will be the focus of our continued investigation of the mechanism by which ETV6 germline mutation results in a predisposition to leukemia. Our ultimate goal is a comprehensive understanding of how this process may be targeted more efficiently in patients with both heritable and sporadic forms of leukemia involving ETV6.
Monitoring the health of the work environment with a daily assessment tool: the REAL – Relative Environment Assessment Lens – indicator
- Karen E. Hinsley, Audrey C. Marshall, Michelle H. Hurtig, Jason M. Thornton, Cheryl A. O’Connell, Courtney L. Porter, Jean A. Connor, Patricia A. Hickey
-
- Journal:
- Cardiology in the Young / Volume 26 / Issue 6 / August 2016
- Published online by Cambridge University Press:
- 01 October 2015, pp. 1082-1089
-
- Article
- Export citation
-
Background
Evidence shows that the health of the work environment impacts staff satisfaction, interdisciplinary communication, and patient outcomes. Utilising the American Association of Critical-Care Nurses’ Healthy Work Environment standards, we developed a daily assessment tool.
MethodsThe Relative Environment Assessment Lens (REAL) Indicator was developed using a consensus-based method to evaluate the health of the work environment and to identify opportunities for improvement from the front-line staff. A visual scale using images that resemble emoticons was linked with a written description of feelings about their work environment that day, with the highest number corresponding to the most positive experience. Face validity was established by seeking staff feedback and goals were set.
ResultsOver 10 months, results from the REAL Indicator in the cardiac catheterisation laboratory indicated an overall good work environment. The goal of 80% of the respondents reporting their work environment to be “Great”, “Good”, or “Satisfactory” was met each month. During the same time frame, this goal was met four times in the cardiovascular operating room. On average, 72.7% of cardiovascular operating room respondents reported their work environment to be “Satisfactory” or better.
ConclusionThe REAL Indicator has become a valuable tool in assessing the specific issues of the clinical area and identifying opportunities for improvement. Given the feasibility of and positive response to this tool in the cardiac catheterisation laboratory, it has been adopted in other patient-care areas where staff and leaders believe that they need to understand the health of the environment in a more specific and frequent time frame.