Sophia Ramesar - Academia.edu (original) (raw)
Papers by Sophia Ramesar
Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of re... more Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of recurrence among breast can-
PURPOSE: Gender medicine is a sub-specialty that has gained increased recognition in healthcare i... more PURPOSE: Gender medicine is a sub-specialty that has gained increased recognition in healthcare internationally. The impetus for understanding gender as a complex biopsychosocial system has been driven primarily by a large number of recent studies. In 2001, the influential IOM Report, Exploring the Biological Contributions to Human Health: Does Sex Matter? established gender medicine as a field and documented the robust implications for health. The purpose of this presentation is to give a brief overview, current data in the field of sex and gender medicine and to outline potential areas for research in psychosocial oncology. METHODS: A comprehensive literature review was conducted of the current state of sex and gender medicine, including same and opposite sex relationships. In addition, cross-sectional data was collected (2009 to 2015) from adult outpatients at the City of Hope, a NCI CCC. Each new patient was asked to complete a validated touch screen biopsychosocial screening in...
Biological research for nursing, Jan 5, 2018
Breast cancer survivors (BCS) often experience psychological and physiological symptoms after can... more Breast cancer survivors (BCS) often experience psychological and physiological symptoms after cancer treatment. Mindfulness-based stress reduction (MBSR), a complementary and alternative therapy, has reduced subjective measures of stress, anxiety, and fatigue among BCS. Little is known, however, about how MBSR affects objective markers of stress, specifically the stress hormone cortisol and the pro-inflammatory cytokine interleukin-6 (IL-6). In the present study, BCS ( N = 322) were randomly assigned to a 6-week MBSR program for BC or usual-care control. Measurements of cortisol, IL-6, symptoms, and quality of life were obtained at orientation and 6 weeks. Cortisol and IL-6 were also measured prior to and after the MBSR(BC) class Weeks 1 and 6. The mean age of participants was 56.6 years and 69.4% were White non-Hispanic. Most had Stage I (33.8%) or II (35.7%) BC, and 35.7% had received chemotherapy and radiation. Cortisol levels were reduced immediately following MBSR(BC) class com...
![Research paper thumbnail of Translational genomic research: the role of genetic polymorphisms in MBSR program among breast cancer survivors (MBSR[BC])](https://attachments.academia-assets.com/95408289/thumbnails/1.jpg)
](Translational behavioral medicine, Jan 20, 2018
Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms,... more Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms, such as depression, stress, fatigue, and cognitive impairment. The objective of this study was to investigate whether particular single-nucleotide polymorphisms (SNPs) moderated symptom improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. An overarching goal of personalized medicine is to identify individuals as risk for disease and tailor interventions based on genetic profiles of patients with diseases including cancer. BCS were recruited from Moffitt Cancer Center and University of South Florida's Breast Health Program and were randomized to either the 6-week MBSR(BC) program (n = 92) or Usual Care (n = 93). Measures of symptoms, demographic, and clinical history data were attained at baseline, 6 weeks, and 12 weeks. A total of 10 SNPs from eight genes known to be related to these symptoms were studied using genomic DNA extracted...
Psycho-oncology, Jan 30, 2017
The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-... more The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-Based Stress Reduction for Breast Cancer (mMBSR(BC)) program using an iPad and to evaluate its impact on symptom improvement. A single group, pre-posttest design was implemented among female stages 0-III breast cancer survivors (BCS) who completed treatment. Data were collected at baseline and week 6 on measures of psychological and physical symptoms and quality of life. The mMBSR(BC) program is a standardized, stress-reducing intervention that combines sitting and walking meditation, body scan and yoga and is designed to deliver weekly 2-hour sessions for 6 weeks using an iPad. The mean age of the 15 enrolled BCS was 57 years; one participant was non-Hispanic Black, and 14 were non-Hispanic White. Of the 13 who completed the study, there were significant improvements from baseline to 6 weeks post-mMBSR(BC) in psychological and physical symptoms of depression, state anxiety, stress, fear...
![Research paper thumbnail of A Randomized Controlled Trial of the Effects of Mindfulness-Based Stress Reduction (MBSR[BC]) on Levels of Inflammatory Biomarkers Among Recovering Breast Cancer Survivors](https://attachments.academia-assets.com/95408288/thumbnails/1.jpg)
](Biological research for nursing, Jul 1, 2017
The purpose of this substudy of a large randomized controlled trial was to evaluate the efficacy ... more The purpose of this substudy of a large randomized controlled trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction (Breast Cancer) (MBSR[BC]) program compared to usual care (UC) in normalizing blood levels of pro-inflammatory cytokines among breast cancer survivors (BCS). A total of 322 BCS were randomized to either a 6-week MBSR(BC) program or a UC. At baseline and 6 and 12 weeks, 10 ml of venous blood and demographic and clinical data were collected and/or updated. Plasma cytokines (interleukin [IL]-1β, IL-6, IL-10, tumor necrosis factor [TNF] α, transforming growth factor [TGF] β1, soluble tumor necrosis factor receptor [sTNFR] 1) were assayed. Linear mixed models were used to assess cytokine levels across three time points (baseline and 6 and 12 weeks) by group (MBSR[BC] vs. UC). Of the six measured cytokines, three were nondetectable at rates greater than 50% (IL-10, IL-1β, TGF-β1) and, because of overall low prevalence, were not analyzed further. For th...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Aug 31, 2016
The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress... more The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe. A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects. Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psy...
Nursing economic$
Many breast cancer survivors continue to experience residual symptoms including anxiety, cognitiv... more Many breast cancer survivors continue to experience residual symptoms including anxiety, cognitive impairment, depression, fatigue, and pain. In this study, the cost-effectiveness of a Mindfulness-Based Stress Reduction intervention for breast cancer survivors was examined. The cost of the program was assessed from the societal perspective, accounting for both direct medical and patient opportunity costs. The cost per quality-adjusted life year was relatively low compared to the cost-utility findings of other published breast cancer interventions. The program appears to provide for significantly improved health-related quality of life at a comparativelv low cost.
Biological research for nursing, Jan 15, 2015
Breast cancer (BC) survivors often report cognitive impairment, which may be influenced by single... more Breast cancer (BC) survivors often report cognitive impairment, which may be influenced by single-nucleotide polymorphisms (SNPs). The purpose of this study was to test whether particular SNPs were associated with changes in cognitive function in BC survivors and whether these polymorphisms moderated cognitive improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. BC survivors recruited from Moffitt Cancer Center and the University of South Florida's Breast Health Program, who had completed adjuvant radiation and/or chemotherapy treatment, were randomized to either the 6-week MBSR(BC) program (n = 37) or usual care (UC; n = 35) group. Measures of cognitive function and demographic and clinical history data were attained at baseline and at 6 and 12 weeks. A total of 10 SNPs from eight genes known to be related to cognitive function were analyzed using blood samples. Results showed that SNPs in four genes (ankyrin repeat and kinase ...
Journal of Behavioral Medicine, 2012
To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) includ... more To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0-III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.
Journal of Behavioral Medicine, 2011
To investigate prevalence and severity of symptoms and symptom clustering in breast cancer surviv... more To investigate prevalence and severity of symptoms and symptom clustering in breast cancer survivors who attended MBSR(BC). Women were randomly assigned into MBSR(BC) or Usual Care (UC). Eligible women were C 21 years, had been diagnosed with breast cancer and completed treatment within 18 months of enrollment. Symptoms and interference with daily living were measured pre-and post-MBSR(BC) using the M.D. Anderson Symptom Inventory. Symptoms were reported as highly prevalent but severity was low. Fatigue was the most frequently reported and severe symptom among groups. Symptoms clustered into 3 groups and improved in both groups. At baseline, both MBSR(BC) and the control groups showed similar mean symptom severity and interference; however, after the 6-week post-intervention, the MBSR(BC) group showed statistically-significant reduction for fatigue and disturbed sleep (P \ 0.01) and improved symptom interference items, compared to the control group. For the between-group comparisons, 11 of 13 symptoms and 5 of 6 interference items had lower means in the MBSR(BC) condition than the control condition. These results suggest that MBSR(BC) modestly decreases fatigue and sleep disturbances, but has a greater effect on the degree to which symptoms interfere with many facets of life. Although these results are preliminary, MBSR intervention post-treatment may effectively reduce fatigue and related interference in QOL of breast cancer survivors.
Biological Research For Nursing, 2014
Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of re... more Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of recurrence among breast cancer (BC) survivors. However, the effects of MBSR (BC) on telomere length (TL) and telomerase activity (TA), known markers of cellular aging, psychological stress, and disease risk, are not known. This randomized, wait-listed, controlled study, nested within a larger trial, investigated the effects of MBSR (BC) on TL and TA. BC patients (142) with Stages 0–III cancer who had completed adjuvant treatment with radiation and/or chemotherapy at least 2 weeks prior to enrollment and within 2 years of completion of treatment with lumpectomy and/or mastectomy were randomly assigned to either a 6-week MBSR for BC program or a usual care. Assessments of TA and TL were obtained along with psychological measurements at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) program. The mean age of 142 participants was 55.3 years; 72% were non-Hispanic White; 78% had S...
The Journal of Alternative and Complementary Medicine, 2014
PSTIMÔ, a percutaneously placed microchip-controlled pulsed neurotransmitter that provides electr... more PSTIMÔ, a percutaneously placed microchip-controlled pulsed neurotransmitter that provides electrical pulses to specific peripheral nerves in the ear. The purpose of this study was to examine the efficacy of PSTIMÔ in reducing pain and improving function in patients with chemotherapy-induced peripheral neuropathy (CIPN). Methods: We conducted a mixed-method retrospective chart review of patients receiving PSTIMÔ for CIPN by an integrative oncologist. Charts between Jan/2012 and Nov/2013 were reviewed for a) demographic/clinical variables (e.g., number of PSTIMÔ treatments); b) patient pain ratings pre-post PSTIMÔ (0-10 scale); and c) functional outcomes (e.g., gait/balance). We used a paired-samples t-test to examine pain scores pre-post PSTIMÔ treatment. A qualitative content analysis was used to examine pain and functional outcomes associated with PSTIMÔ in those charts that did not have quantitative pain scores documented. Results: Fifty-eight charts were reviewed. Eighteen patients had pre-post pain scores available for quantitative analyses (Mage = 63 years; 67% female). Pain scores significantly decreased after PSTIMÔ (Mpre = 8.11 vs. Mpost = 3.17; t = 13.52, p < .001), regardless of number of PSTIMÔ treatments (M = 4.5; SD = 2.5). Content analysis was conducted on the additional 40 charts, 8 of which were drop-outs (i.e., PSTIMÔ device placed but no follow-up). Fifty-nine percent of patients with qualitative data (n = 19) reported significant improvements and 25% (n = 8) reported minimal improvements in pain following PSTIMÔ. Functional improvements, including improved gait, balance, and activities of daily living were reported often. Conclusion: PSTIMÔ was associated with significant improvements in pain, and significant functional improvements in patients with CIPN. Preliminary results suggest that PSTIMÔ may be a useful non-pharmacologic treatment for patients with CIPN. Further controlled studies using prospective research designs and active control groups are warranted.
Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of re... more Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of recurrence among breast can-
PURPOSE: Gender medicine is a sub-specialty that has gained increased recognition in healthcare i... more PURPOSE: Gender medicine is a sub-specialty that has gained increased recognition in healthcare internationally. The impetus for understanding gender as a complex biopsychosocial system has been driven primarily by a large number of recent studies. In 2001, the influential IOM Report, Exploring the Biological Contributions to Human Health: Does Sex Matter? established gender medicine as a field and documented the robust implications for health. The purpose of this presentation is to give a brief overview, current data in the field of sex and gender medicine and to outline potential areas for research in psychosocial oncology. METHODS: A comprehensive literature review was conducted of the current state of sex and gender medicine, including same and opposite sex relationships. In addition, cross-sectional data was collected (2009 to 2015) from adult outpatients at the City of Hope, a NCI CCC. Each new patient was asked to complete a validated touch screen biopsychosocial screening in...
Biological research for nursing, Jan 5, 2018
Breast cancer survivors (BCS) often experience psychological and physiological symptoms after can... more Breast cancer survivors (BCS) often experience psychological and physiological symptoms after cancer treatment. Mindfulness-based stress reduction (MBSR), a complementary and alternative therapy, has reduced subjective measures of stress, anxiety, and fatigue among BCS. Little is known, however, about how MBSR affects objective markers of stress, specifically the stress hormone cortisol and the pro-inflammatory cytokine interleukin-6 (IL-6). In the present study, BCS ( N = 322) were randomly assigned to a 6-week MBSR program for BC or usual-care control. Measurements of cortisol, IL-6, symptoms, and quality of life were obtained at orientation and 6 weeks. Cortisol and IL-6 were also measured prior to and after the MBSR(BC) class Weeks 1 and 6. The mean age of participants was 56.6 years and 69.4% were White non-Hispanic. Most had Stage I (33.8%) or II (35.7%) BC, and 35.7% had received chemotherapy and radiation. Cortisol levels were reduced immediately following MBSR(BC) class com...
Translational behavioral medicine, Jan 20, 2018
Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms,... more Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms, such as depression, stress, fatigue, and cognitive impairment. The objective of this study was to investigate whether particular single-nucleotide polymorphisms (SNPs) moderated symptom improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. An overarching goal of personalized medicine is to identify individuals as risk for disease and tailor interventions based on genetic profiles of patients with diseases including cancer. BCS were recruited from Moffitt Cancer Center and University of South Florida's Breast Health Program and were randomized to either the 6-week MBSR(BC) program (n = 92) or Usual Care (n = 93). Measures of symptoms, demographic, and clinical history data were attained at baseline, 6 weeks, and 12 weeks. A total of 10 SNPs from eight genes known to be related to these symptoms were studied using genomic DNA extracted...
Psycho-oncology, Jan 30, 2017
The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-... more The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-Based Stress Reduction for Breast Cancer (mMBSR(BC)) program using an iPad and to evaluate its impact on symptom improvement. A single group, pre-posttest design was implemented among female stages 0-III breast cancer survivors (BCS) who completed treatment. Data were collected at baseline and week 6 on measures of psychological and physical symptoms and quality of life. The mMBSR(BC) program is a standardized, stress-reducing intervention that combines sitting and walking meditation, body scan and yoga and is designed to deliver weekly 2-hour sessions for 6 weeks using an iPad. The mean age of the 15 enrolled BCS was 57 years; one participant was non-Hispanic Black, and 14 were non-Hispanic White. Of the 13 who completed the study, there were significant improvements from baseline to 6 weeks post-mMBSR(BC) in psychological and physical symptoms of depression, state anxiety, stress, fear...
Biological research for nursing, Jul 1, 2017
The purpose of this substudy of a large randomized controlled trial was to evaluate the efficacy ... more The purpose of this substudy of a large randomized controlled trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction (Breast Cancer) (MBSR[BC]) program compared to usual care (UC) in normalizing blood levels of pro-inflammatory cytokines among breast cancer survivors (BCS). A total of 322 BCS were randomized to either a 6-week MBSR(BC) program or a UC. At baseline and 6 and 12 weeks, 10 ml of venous blood and demographic and clinical data were collected and/or updated. Plasma cytokines (interleukin [IL]-1β, IL-6, IL-10, tumor necrosis factor [TNF] α, transforming growth factor [TGF] β1, soluble tumor necrosis factor receptor [sTNFR] 1) were assayed. Linear mixed models were used to assess cytokine levels across three time points (baseline and 6 and 12 weeks) by group (MBSR[BC] vs. UC). Of the six measured cytokines, three were nondetectable at rates greater than 50% (IL-10, IL-1β, TGF-β1) and, because of overall low prevalence, were not analyzed further. For th...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Aug 31, 2016
The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress... more The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe. A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects. Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psy...
Nursing economic$
Many breast cancer survivors continue to experience residual symptoms including anxiety, cognitiv... more Many breast cancer survivors continue to experience residual symptoms including anxiety, cognitive impairment, depression, fatigue, and pain. In this study, the cost-effectiveness of a Mindfulness-Based Stress Reduction intervention for breast cancer survivors was examined. The cost of the program was assessed from the societal perspective, accounting for both direct medical and patient opportunity costs. The cost per quality-adjusted life year was relatively low compared to the cost-utility findings of other published breast cancer interventions. The program appears to provide for significantly improved health-related quality of life at a comparativelv low cost.
Biological research for nursing, Jan 15, 2015
Breast cancer (BC) survivors often report cognitive impairment, which may be influenced by single... more Breast cancer (BC) survivors often report cognitive impairment, which may be influenced by single-nucleotide polymorphisms (SNPs). The purpose of this study was to test whether particular SNPs were associated with changes in cognitive function in BC survivors and whether these polymorphisms moderated cognitive improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. BC survivors recruited from Moffitt Cancer Center and the University of South Florida's Breast Health Program, who had completed adjuvant radiation and/or chemotherapy treatment, were randomized to either the 6-week MBSR(BC) program (n = 37) or usual care (UC; n = 35) group. Measures of cognitive function and demographic and clinical history data were attained at baseline and at 6 and 12 weeks. A total of 10 SNPs from eight genes known to be related to cognitive function were analyzed using blood samples. Results showed that SNPs in four genes (ankyrin repeat and kinase ...
Journal of Behavioral Medicine, 2012
To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) includ... more To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0-III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.
Journal of Behavioral Medicine, 2011
To investigate prevalence and severity of symptoms and symptom clustering in breast cancer surviv... more To investigate prevalence and severity of symptoms and symptom clustering in breast cancer survivors who attended MBSR(BC). Women were randomly assigned into MBSR(BC) or Usual Care (UC). Eligible women were C 21 years, had been diagnosed with breast cancer and completed treatment within 18 months of enrollment. Symptoms and interference with daily living were measured pre-and post-MBSR(BC) using the M.D. Anderson Symptom Inventory. Symptoms were reported as highly prevalent but severity was low. Fatigue was the most frequently reported and severe symptom among groups. Symptoms clustered into 3 groups and improved in both groups. At baseline, both MBSR(BC) and the control groups showed similar mean symptom severity and interference; however, after the 6-week post-intervention, the MBSR(BC) group showed statistically-significant reduction for fatigue and disturbed sleep (P \ 0.01) and improved symptom interference items, compared to the control group. For the between-group comparisons, 11 of 13 symptoms and 5 of 6 interference items had lower means in the MBSR(BC) condition than the control condition. These results suggest that MBSR(BC) modestly decreases fatigue and sleep disturbances, but has a greater effect on the degree to which symptoms interfere with many facets of life. Although these results are preliminary, MBSR intervention post-treatment may effectively reduce fatigue and related interference in QOL of breast cancer survivors.
Biological Research For Nursing, 2014
Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of re... more Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of recurrence among breast cancer (BC) survivors. However, the effects of MBSR (BC) on telomere length (TL) and telomerase activity (TA), known markers of cellular aging, psychological stress, and disease risk, are not known. This randomized, wait-listed, controlled study, nested within a larger trial, investigated the effects of MBSR (BC) on TL and TA. BC patients (142) with Stages 0–III cancer who had completed adjuvant treatment with radiation and/or chemotherapy at least 2 weeks prior to enrollment and within 2 years of completion of treatment with lumpectomy and/or mastectomy were randomly assigned to either a 6-week MBSR for BC program or a usual care. Assessments of TA and TL were obtained along with psychological measurements at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) program. The mean age of 142 participants was 55.3 years; 72% were non-Hispanic White; 78% had S...
The Journal of Alternative and Complementary Medicine, 2014
PSTIMÔ, a percutaneously placed microchip-controlled pulsed neurotransmitter that provides electr... more PSTIMÔ, a percutaneously placed microchip-controlled pulsed neurotransmitter that provides electrical pulses to specific peripheral nerves in the ear. The purpose of this study was to examine the efficacy of PSTIMÔ in reducing pain and improving function in patients with chemotherapy-induced peripheral neuropathy (CIPN). Methods: We conducted a mixed-method retrospective chart review of patients receiving PSTIMÔ for CIPN by an integrative oncologist. Charts between Jan/2012 and Nov/2013 were reviewed for a) demographic/clinical variables (e.g., number of PSTIMÔ treatments); b) patient pain ratings pre-post PSTIMÔ (0-10 scale); and c) functional outcomes (e.g., gait/balance). We used a paired-samples t-test to examine pain scores pre-post PSTIMÔ treatment. A qualitative content analysis was used to examine pain and functional outcomes associated with PSTIMÔ in those charts that did not have quantitative pain scores documented. Results: Fifty-eight charts were reviewed. Eighteen patients had pre-post pain scores available for quantitative analyses (Mage = 63 years; 67% female). Pain scores significantly decreased after PSTIMÔ (Mpre = 8.11 vs. Mpost = 3.17; t = 13.52, p < .001), regardless of number of PSTIMÔ treatments (M = 4.5; SD = 2.5). Content analysis was conducted on the additional 40 charts, 8 of which were drop-outs (i.e., PSTIMÔ device placed but no follow-up). Fifty-nine percent of patients with qualitative data (n = 19) reported significant improvements and 25% (n = 8) reported minimal improvements in pain following PSTIMÔ. Functional improvements, including improved gait, balance, and activities of daily living were reported often. Conclusion: PSTIMÔ was associated with significant improvements in pain, and significant functional improvements in patients with CIPN. Preliminary results suggest that PSTIMÔ may be a useful non-pharmacologic treatment for patients with CIPN. Further controlled studies using prospective research designs and active control groups are warranted.