Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Population Health
Total Results:
12781
Smartphone-based migraine behavioral therapy: a single-arm study with assessment of mental health predictors
Progressive muscle relaxation (PMR) is an under-utilized Level A evidence-based treatment for migraine prevention. We studied the feasibility and acceptability of smartphone application (app)-based PMR for migraine in a neurology setting, explored whether app-based PMR might reduce headache (HA) days, and examined potential predictors of app and/or PMR use. In this single-arm pilot study, adults with ICHD3 migraine, 4+ HA days/month, a smartphone, and no prior behavioral migraine therapy in the past year were asked to complete a daily HA diary and do PMR for 20 min/day for 90 days. Outcomes were: adherence to PMR (no. and duration of audio plays) and frequency of diary use. Predictors in the models were baseline demographics, HA-specific variables, baseline PROMIS (patient-reported outcomes measurement information system) depression and anxiety scores, presence of overlapping pain conditions studied and app satisfaction scores at time of enrollment. Fifty-one patients enrolled (94% female). Mean age was 39 ± 13 years. The majority (63%) had severe migraine disability at baseline (MIDAS). PMR was played 22 ± 21 days on average. Mean/session duration was 11 ± 7 min. About half (47%) of uses were 1+ time/week and 35% of uses were 2+ times/week. There was a decline in use/week. On average, high users (PMR 2+ days/week in the first month) had 4 fewer days of reported HAs in month 2 vs. month 1, whereas low PMR users (PMR < 2 days/week in the first month) had only 2 fewer HA days in month 2. PROMIS depression score was negatively associated with the log odds of using the diary at least once (vs. no activity) in a week (OR = 0.70, 95% CI = [0.55, 0.85]) and of doing the PMR at least once in a week (OR = 0.77, 95% CI = [0.68, 0.91]). PROMIS anxiety was positively associated with using the diary at least once every week (OR = 1.33, 95% CI = [1.09, 1.73]) and with doing the PMR at least once every week (OR = 1.14 [95% CI = [1.02, 1.31]). In conclusion, about half of participants used smartphone-based PMR intervention based upon a brief, initial introduction to the app. App use was associated with reduction in HA days. Higher depression scores were negatively associated with diary and PMR use, whereas higher anxiety scores were positively associated.
PMCID:6550263
PMID: 31304392
ISSN: 2398-6352
CID: 4136202
Ambient PM2.5 exposure and risk of lung cancer incidence in North America and Europe
ORIGINAL:0014663
ISSN: 2515-7620
CID: 4501752
Setting ambitious targets for surveillance and treatment rates among patients with hepatitis C related cirrhosis impacts the cost-effectiveness of hepatocellular cancer surveillance and substantially increases life expectancy: A modeling study
BACKGROUND:Hepatocelluar cancer (HCC) is the leading cause of death among people with hepatitis C virus (HCV)-related cirrhosis. Our aim was to determine the optimal surveillance frequency for patients with HCV-related compensated cirrhosis. METHODS:We developed a decision analytic Markov model and validated it against data from the Veterans Outcomes and Costs Associated with Liver Disease (VOCAL) study group and published epidemiologic studies. Four strategies of different surveillance intervals were compared: no surveillance and ultrasound surveillance every 12, 6, and 3 months. We estimated lifetime survival, life expectancy, quality adjusted life years (QALY), total costs associated with each strategy, and incremental cost effectiveness ratios. We applied a willingness to pay threshold of $100,000. Analysis was conducted for two scenarios: a scenario reflecting current HCV and HCC surveillance compliance rates and treatment use and an aspirational scenario. RESULTS:In the current scenario the preferred strategy was 3-month surveillance with an incremental cost-effectiveness ratio (ICER) of $7,159/QALY. In the aspirational scenario, 6-month surveillance was preferred with an ICER of $82,807/QALY because treating more people with HCV led to a lower incidence of HCC. Sensitivity analyses suggested that surveillance every 12 months would suffice in the particular circumstance when patients are very likely to return regularly for testing and when appropriate HCV and HCC treatment is readily available. Compared with the current scenario, the aspirational scenario resulted in a 1.87 year gain in life expectancy for the cohort because of large reductions in decompensated cirrhosis and HCC incidence. CONCLUSIONS:HCC surveillance has good value for money for patients with HCV-related compensated cirrhosis. Investments to improve adherence to surveillance should be made when rates are suboptimal. Surveillance every 12 months will suffice when patients are very likely to return regularly for testing and when appropriate HCV and HCC treatment is readily available.
PMID: 31449554
ISSN: 1932-6203
CID: 4054222
Qualitative evidence of crimes against humanity: the August 2017 attacks on the Rohingya in northern Rakhine State, Myanmar
Background/UNASSIGNED:The Rohingya ethnic minority population in northern Rakhine state, Myanmar, have experienced some of the most protracted situations of persecution. Government-led clearance operations in August 2017 were one of many, but notably one of the most devastating, attacks on the population. The study aimed to conduct a multiphase mixed-methods assessment of the prevalence and contexts of violence and mortality across affected hamlets in northern Rakhine State during the August 2017 attacks. This publication describes qualitative accounts by Rohingya community leaders from affected hamlets, with a focus on the events and environment leading up to and surrounding the attacks. Methods/UNASSIGNED:Qualitative in-depth interviews were conducted with Rohingya community leaders representing 88 northern Rakhine state hamlets across three townships affected by the August 2017 attacks (Maungdaw, n = 34; Buthidaung, n = 42; Rathedaung, n = 12). Prior quantitative surveys conducted among representative hamlet leaders allowed for preliminary screening and identification of interview candidates: interviewees were then selected based on prior reports of 10 or more deaths among Rohingya hamlet community members, mass rape, and/or witness of mass graves in a hamlet or during displacement. Recorded interviews were transcribed, translated, and thematically coded. Results/UNASSIGNED:), consisting of the Army, Navy, and Border Guard Police continued to pursue, assault, and obstruct civilians in flight to Bangladesh. Conclusions/UNASSIGNED:Qualitative findings corroborate previously published evidence of widespread and systematic violence by the Myanmar security forces against the Rohingya. The accounts describe intentional oppression of Rohingya civilians leading up to the August 2017 attacks and coordinated and targeted persecution of Rohingya by state forces spanning geographic distances, and ultimately provide supporting evidence for investigations of crimes against humanity and acts of genocide.
PMCID:6745777
PMID: 31534472
ISSN: 1752-1505
CID: 4220902
Acceptability of smartphone applications for global positioning system (GPS) and ecological momentary assessment (EMA) research among sexual minority men
BACKGROUND:Emerging research is using global positioning system (GPS) and ecological momentary assessment (EMA) methods among sexual minority men (SMM), a population that experiences multiple health disparities. However, we are not aware of any research that has combined these approaches among SMM, highlighting the need for acceptability and feasibility research. The purpose of this study was to examine the acceptability of implementing GPS and EMA research protocols using smartphone applications among SMM as well as related socio-demographic correlates. METHODS:Data come from a sample of SMM on a popular geosocial-networking app in Paris, France (n = 580). We assessed the acceptability of implementing GPS and EMA research protocols on smartphone apps as well as socio-demographic characteristics (i.e., age, sexual orientation, country of origin, employment status, and relationship status). We examined the anticipated acceptability of GPS and EMA data collection methods as well as socio-demographic correlates of acceptability of GPS and EMA methods. RESULTS:We found that over half (54.1%) of the sample was willing to download a smartphone app for GPS-based research and we found that almost 60% of the participants were willing to download a smartphone app for EMA-based research. In total, 44.0% reported that they were willing to download both GPS and EMA apps. In addition, we found that older participants were less willing to download a smartphone app for EMA research than younger participants aged 18-24 (40-49 years: aPR = 0.40; 95% CI = 0.20, 0.78) and students were more willing to download smartphone apps for both GPS and EMA research (aPR = 1.41; 95% CI = 1.02, 1.95). CONCLUSION/CONCLUSIONS:Results from this study suggest that using smartphone apps to implement GPS and EMA methods among some SMM are acceptable. However, care should be taken as segments of SMM are less likely to be willing to engage in this type of research.
PMID: 30689651
ISSN: 1932-6203
CID: 3626432
Neighborhoods and Sleep
New York, NY : Oxford University Press, [2019]
pp. ?-
ISBN: 9780190930448
CID: 5403972
Novel Clinical Trial to Improve the Quality of PSA Screening Decisions for Black Men and Their Healthcare Providers: NYU Case of the Month, November 2019
PMCID:7020276
PMID: 32071568
ISSN: 1523-6161
CID: 4312252
Prevention, Treatment, and Harm Reduction Approaches to Opioid Overdoses
New York : McGraw-Hill Education, [2019]
pp. ?-?
ISBN: 1259859614
CID: 3699792
Altered dynamics of visual contextual interactions in Parkinson's disease
Over the last decades, psychophysical and electrophysiological studies in patients and animal models of Parkinson's disease (PD), have consistently revealed a number of visual abnormalities. In particular, specific alterations of contrast sensitivity curves, electroretinogram (ERG), and visual-evoked potentials (VEP), have been attributed to dopaminergic retinal depletion. However, fundamental mechanisms of cortical visual processing, such as normalization or "gain control" computations, have not yet been examined in PD patients. Here, we measured electrophysiological indices of gain control in both space (surround suppression) and time (sensory adaptation) in PD patients based on steady-state VEP (ssVEP). Compared with controls, patients exhibited a significantly higher initial ssVEP amplitude that quickly decayed over time, and greater relative suppression of ssVEP amplitude as a function of surrounding stimulus contrast. Meanwhile, EEG frequency spectra were broadly elevated in patients relative to controls. Thus, contrary to what might be expected given the reduced contrast sensitivity often reported in PD, visual neural responses are not weaker; rather, they are initially larger but undergo an exaggerated degree of spatial and temporal gain control and are embedded within a greater background noise level. These differences may reflect cortical mechanisms that compensate for dysfunctional center-surround interactions at the retinal level.
PMCID:6609710
PMID: 31286057
ISSN: 2373-8057
CID: 4090962
Multimodal Hippocampal Subfield Grading For Alzheimer's Disease Classification
ISI:000487586600036
ISSN: 2045-2322
CID: 4155602
