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3. Engage for Equity: Development of Community-Based Participatory Research Tools

Author

Parker, Myra, Wallerstein, Nina, Duran, Bonnie, Magarati, Maya, Burgess, Ellen, Sanchez-Youngman, Shannon, Boursaw, Blake, Heffernan, Amanda, Garoutte, Justin, and Koegel, Paul

Abstract

We developed a set of four community-based participatory research (CBPR) partnership tools aimed at supporting community-academic research partnerships in strengthening their research processes, with the ultimate goal of improving research outcomes. The aim of this article is to describe the tools we developed to accomplish this goal: (1) the River of Life Exercise; (2) a Partnership Visioning Exercise; (3) a personalized Partnership Data Report of data from academic and community research partners; and (4) a Promising Practices Guide with aggregated survey data analyses on promising CBPR practices associated with CBPR and health outcomes from two national samples of CBPR projects that completed a series of two online surveys. Relying on Paulo Freire's philosophy of praxis, or the cycles of collective reflection and action, we developed a set of tools designed to support research teams in holding discussions aimed at strengthening research partnership capacity, aligning research partnership efforts to achieve grant aims, and recalling and operationalizing larger social justice goals. This article describes the theoretical framework and process for tool development and provides preliminary data from small teams representing 25 partnerships who attended face-to-face workshops and provided their perceptions of tool accessibility and intended future use.

Published
2020
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4. Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children

Author

Rabi, Doreen M., McBrien, Kerry A., Sapir-Pichhadze, Ruth, Nakhla, Meranda, Ahmed, Sofia B., Dumanski, Sandra M., Butalia, Sonia, Leung, Alexander A., Harris, Kevin C., Cloutier, Lyne, Zarnke, Kelly B., Ruzicka, Marcel, Hiremath, Swapnil, Feldman, Ross D., Tobe, Sheldon W., Campbell, Tavis S., Bacon, Simon L., Nerenberg, Kara A., Dresser, George K., Fournier, Anne, Burgess, Ellen, Lindsay, Patrice, Rabkin, Simon W., Prebtani, Ally P.H., Grover, Steven, Honos, George, Alfonsi, Jeffrey E., Arcand, JoAnne, Audibert, François, Benoit, Geneviève, Bittman, Jesse, Bolli, Peter, Côté, Anne-Marie, Dionne, Janis, Don-Wauchope, Andrew, Edwards, Cedric, Firoz, Tabassum, Gabor, Jonathan Y., Gilbert, Richard E., Grégoire, Jean C., Gryn, Steven E., Gupta, Milan, Hannah-Shmouni, Fady, Hegele, Robert A., Herman, Robert J., Hill, Michael D., Howlett, Jonathan G., Hundemer, Gregory L., Jones, Charlotte, Kaczorowski, Janusz, Khan, Nadia A., Kuyper, Laura M., Lamarre-Cliche, Maxime, Lavoie, Kim L., Leiter, Lawrence A., Lewanczuk, Richard, Logan, Alexander G., Magee, Laura A., Mangat, Birinder K., McFarlane, Philip A., McLean, Donna, Michaud, Andre, Milot, Alain, Moe, Gordon W., Penner, S. Brian, Pipe, Andrew, Poppe, Alexandre Y., Rey, Evelyne, Roerecke, Michael, Schiffrin, Ernesto L., Selby, Peter, Sharma, Mike, Shoamanesh, Ashkan, Sivapalan, Praveena, Townsend, Raymond R., Tran, Karen, Trudeau, Luc, Tsuyuki, Ross T., Vallée, Michel, Woo, Vincent, Bell, Alan D., and Daskalopoulou, Stella S.

Published
2020
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5. Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children

Author

Nerenberg, Kara A., Zarnke, Kelly B., Leung, Alexander A., Dasgupta, Kaberi, Butalia, Sonia, McBrien, Kerry, Harris, Kevin C., Nakhla, Meranda, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, Tremblay, Guy, McLean, Donna, Padwal, Raj S., Tran, Karen C., Grover, Steven, Rabkin, Simon W., Moe, Gordon W., Howlett, Jonathan G., Lindsay, Patrice, Hill, Michael D., Sharma, Mike, Field, Thalia, Wein, Theodore H., Shoamanesh, Ashkan, Dresser, George K., Hamet, Pavel, Herman, Robert J., Burgess, Ellen, Gryn, Steven E., Grégoire, Jean C., Lewanczuk, Richard, Poirier, Luc, Campbell, Tavis S., Feldman, Ross D., Lavoie, Kim L., Tsuyuki, Ross T., Honos, George, Prebtani, Ally P.H., Kline, Gregory, Schiffrin, Ernesto L., Don-Wauchope, Andrew, Tobe, Sheldon W., Gilbert, Richard E., Leiter, Lawrence A., Jones, Charlotte, Woo, Vincent, Hegele, Robert A., Selby, Peter, Pipe, Andrew, McFarlane, Philip A., Oh, Paul, Gupta, Milan, Bacon, Simon L., Kaczorowski, Janusz, Trudeau, Luc, Campbell, Norman R.C., Hiremath, Swapnil, Roerecke, Michael, Arcand, Joanne, Ruzicka, Marcel, Prasad, G.V. Ramesh, Vallée, Michel, Edwards, Cedric, Sivapalan, Praveena, Penner, S. Brian, Fournier, Anne, Benoit, Geneviève, Feber, Janusz, Dionne, Janis, Magee, Laura A., Logan, Alexander G., Côté, Anne-Marie, Rey, Evelyne, Firoz, Tabassum, Kuyper, Laura M., Gabor, Jonathan Y., Townsend, Raymond R., Rabi, Doreen M., and Daskalopoulou, Stella S.

Published
2018
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6. Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults

Author

Leung, Alexander A., Daskalopoulou, Stella S., Dasgupta, Kaberi, McBrien, Kerry, Butalia, Sonia, Zarnke, Kelly B., Nerenberg, Kara, Harris, Kevin C., Nakhla, Meranda, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, Tremblay, Guy, McLean, Donna, Tobe, Sheldon W., Ruzicka, Marcel, Burns, Kevin D., Vallée, Michel, Prasad, G.V. Ramesh, Gryn, Steven E., Feldman, Ross D., Selby, Peter, Pipe, Andrew, Schiffrin, Ernesto L., McFarlane, Philip A., Oh, Paul, Hegele, Robert A., Khara, Milan, Wilson, Thomas W., Penner, S. Brian, Burgess, Ellen, Sivapalan, Praveena, Herman, Robert J., Bacon, Simon L., Rabkin, Simon W., Gilbert, Richard E., Campbell, Tavis S., Grover, Steven, Honos, George, Lindsay, Patrice, Hill, Michael D., Coutts, Shelagh B., Gubitz, Gord, Campbell, Norman R.C., Moe, Gordon W., Howlett, Jonathan G., Boulanger, Jean-Martin, Prebtani, Ally, Kline, Gregory, Leiter, Lawrence A., Jones, Charlotte, Côté, Anne-Marie, Woo, Vincent, Kaczorowski, Janusz, Trudeau, Luc, Tsuyuki, Ross T., Hiremath, Swapnil, Drouin, Denis, Lavoie, Kim L., Hamet, Pavel, Grégoire, Jean C., Lewanczuk, Richard, Dresser, George K., Sharma, Mukul, Reid, Debra, Lear, Scott A., Moullec, Gregory, Gupta, Milan, Magee, Laura A., Logan, Alexander G., Dionne, Janis, Fournier, Anne, Benoit, Geneviève, Feber, Janusz, Poirier, Luc, Padwal, Raj S., and Rabi, Doreen M.

Published
2017
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7. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

Author

Leung, Alexander A., Nerenberg, Kara, Daskalopoulou, Stella S., McBrien, Kerry, Zarnke, Kelly B., Dasgupta, Kaberi, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, Tremblay, Guy, McLean, Donna, Tobe, Sheldon W., Ruzicka, Marcel, Burns, Kevin D., Vallée, Michel, Prasad, G.V. Ramesh, Lebel, Marcel, Feldman, Ross D., Selby, Peter, Pipe, Andrew, Schiffrin, Ernesto L., McFarlane, Philip A., Oh, Paul, Hegele, Robert A., Khara, Milan, Wilson, Thomas W., Penner, S. Brian, Burgess, Ellen, Herman, Robert J., Bacon, Simon L., Rabkin, Simon W., Gilbert, Richard E., Campbell, Tavis S., Grover, Steven, Honos, George, Lindsay, Patrice, Hill, Michael D., Coutts, Shelagh B., Gubitz, Gord, Campbell, Norman R.C., Moe, Gordon W., Howlett, Jonathan G., Boulanger, Jean-Martin, Prebtani, Ally, Larochelle, Pierre, Leiter, Lawrence A., Jones, Charlotte, Ogilvie, Richard I., Woo, Vincent, Kaczorowski, Janusz, Trudeau, Luc, Petrella, Robert J., Hiremath, Swapnil, Drouin, Denis, Lavoie, Kim L., Hamet, Pavel, Fodor, George, Grégoire, Jean C., Lewanczuk, Richard, Dresser, George K., Sharma, Mukul, Reid, Debra, Lear, Scott A., Moullec, Gregory, Gupta, Milan, Magee, Laura A., Logan, Alexander G., Harris, Kevin C., Dionne, Janis, Fournier, Anne, Benoit, Geneviève, Feber, Janusz, Poirier, Luc, Padwal, Raj S., and Rabi, Doreen M.

Published
2016
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8. The 2015 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

Author

Daskalopoulou, Stella S., Rabi, Doreen M., Zarnke, Kelly B., Dasgupta, Kaberi, Nerenberg, Kara, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, McKay, Donald W., Tremblay, Guy, McLean, Donna, Tobe, Sheldon W., Ruzicka, Marcel, Burns, Kevin D., Vallée, Michel, Ramesh Prasad, G.V., Lebel, Marcel, Feldman, Ross D., Selby, Peter, Pipe, Andrew, Schiffrin, Ernesto L., McFarlane, Philip A., Oh, Paul, Hegele, Robert A., Khara, Milan, Wilson, Thomas W., Brian Penner, S., Burgess, Ellen, Herman, Robert J., Bacon, Simon L., Rabkin, Simon W., Gilbert, Richard E., Campbell, Tavis S., Grover, Steven, Honos, George, Lindsay, Patrice, Hill, Michael D., Coutts, Shelagh B., Gubitz, Gord, Campbell, Norman R.C., Moe, Gordon W., Howlett, Jonathan G., Boulanger, Jean-Martin, Prebtani, Ally, Larochelle, Pierre, Leiter, Lawrence A., Jones, Charlotte, Ogilvie, Richard I., Woo, Vincent, Kaczorowski, Janusz, Trudeau, Luc, Petrella, Robert J., Hiremath, Swapnil, Stone, James A., Drouin, Denis, Lavoie, Kim L., Hamet, Pavel, Fodor, George, Grégoire, Jean C., Fournier, Anne, Lewanczuk, Richard, Dresser, George K., Sharma, Mukul, Reid, Debra, Benoit, Geneviève, Feber, Janusz, Harris, Kevin C., Poirier, Luc, and Padwal, Raj S.

Published
2015
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9. The 2011 Canadian Hypertension Education Program Recommendations for the Management of Hypertension: Blood Pressure Measurement, Diagnosis, Assessment of Risk, and Therapy

Author

Rabi, Doreen M., Daskalopoulou, Stella S., Padwal, Raj S., Khan, Nadia A., Grover, Steven A., Hackam, Daniel G., Myers, Martin G., McKay, Donald W., Quinn, Robert R., Hemmelgarn, Brenda R., Cloutier, Lyne, Bolli, Peter, Hill, Michael D., Wilson, Thomas, Penner, Brian, Burgess, Ellen, Lamarre-Cliché, Maxime, McLean, Donna, Schiffrin, Ernesto L., Honos, George, Mann, Karen, Tremblay, Guy, Milot, Alain, Chockalingam, Arun, Rabkin, Simon W., Dawes, Martin, Touyz, Rhian M., Burns, Kevin D., Ruzicka, Marcel, Campbell, Norman R.C., Vallée, Michel, Prasad, G.V. Ramesh, Lebel, Marcel, Campbell, Tavis S., Lindsay, M. Patrice, Herman, Robert J., Larochelle, Pierre, Feldman, Ross D., Arnold, J. Malcolm O., Moe, Gordon W., Howlett, Jonathan G., Trudeau, Luc, Bacon, Simon L., Petrella, Robert J., Lewanczuk, Richard, Stone, James A., Drouin, Denis, Boulanger, Jean-Martin, Sharma, Mukul, Hamet, Pavel, Fodor, George, Dresser, George K., Carruthers, S. George, Pylypchuk, George, Gilbert, Richard E., Leiter, Lawrence A., Jones, Charlotte, Ogilvie, Richard I., Woo, Vincent, McFarlane, Philip A., Hegele, Robert A., Poirier, Luc, and Tobe, Sheldon W.

Published
2011
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10. A comparative post hoc analysis of finerenone and spironolactone in resistant hypertension in moderate-to-advanced chronic kidney disease.

Author

Agarwal, Rajiv, Pitt, Bertram, Palmer, Biff F, Kovesdy, Csaba P, Burgess, Ellen, Filippatos, Gerasimos, Małyszko, Jolanta, Ruilope, Luis M, Rossignol, Patrick, Rossing, Peter, Pecoits-Filho, Roberto, Anker, Stefan D, Joseph, Amer, Lawatscheck, Robert, Wilson, Daniel, Gebel, Martin, and Bakris, George L

Subjects
CHRONIC kidney failure, SPIRONOLACTONE, SYSTOLIC blood pressure, TERMINATION of treatment, MINERALOCORTICOID receptors
Abstract

Background Mineralocorticoid receptor antagonists (MRAs) reduce systolic blood pressure (SBP) and increase serum potassium concentration ([K+]). This indirect comparison investigated any differences in SBP-lowering and hyperkalemia risk between finerenone, a nonsteroidal MRA, and the steroidal MRA spironolactone ± a potassium binder. Methods In FIDELITY (a pooled analysis of FIDELIO-DKD and FIGARO-DKD), a subgroup of patients with treatment-resistant hypertension (TRH) and chronic kidney disease meeting eligibility criteria of the AMBER trial were identified (FIDELITY-TRH). The main outcomes were mean change in SBP, incidence of serum [K+] ≥5.5 mmol/L and hyperkalemia-associated treatment discontinuation. Results at ∼17 weeks were compared with 12 weeks from AMBER. Results In 624 FIDELITY-TRH patients and 295 AMBER patients, the least squares mean change in SBP (mmHg) from baseline was −7.1 for finerenone and −1.3 for placebo {between-group difference −5.74 [95% confidence interval (CI) −7.99 to −3.49], P  < .0001} versus −11.7 for spironolactone + patiromer and −10.8 for spironolactone + placebo [between-group difference −1.0 (95% CI −4.4–2.4), P  = .58]. The incidence of serum [K+] ≥5.5 mmol/L was 12% for finerenone and 3% for placebo versus 35% with spironolactone + patiromer and 64% with spironolactone + placebo. Treatment discontinuation due to hyperkalemia was 0.3% for finerenone and 0% for placebo versus 7% for spironolactone + patiromer and 23% for spironolactone + placebo. Conclusions In patients with TRH and chronic kidney disease compared with spironolactone with or without patiromer, finerenone was associated with a lower SBP reduction and lower risk of hyperkalemia and treatment discontinuation. Trial Registration: AMBER (NCT03071263), FIDELIO-DKD (NCT02540993), FIGARO-DKD (NCT02545049) [ABSTRACT FROM AUTHOR]

Published
2023
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12. The 2010 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2 – therapy

Author

Hackam, Daniel G., Khan, Nadia A., Hemmelgarn, Brenda R., Rabkin, Simon W., Touyz, Rhian M., Campbell, Norman R.C., Padwal, Raj, Campbell, Tavis S., Patrice Lindsay, M., Hill, Michael D., Quinn, Robert R., Mahon, Jeff L., Herman, Robert J., Schiffrin, Ernesto L., Ruzicka, Marcel, Larochelle, Pierre, Feldman, Ross D., Lebel, Marcel, Poirier, Luc, Arnold, J. Malcolm O., Moe, Gordon W., Howlett, Jonathan G., Trudeau, Luc, Bacon, Simon L., Petrella, Robert J., Milot, Alain, Stone, James A., Drouin, Denis, Boulanger, Jean-Martin, Sharma, Mukul, Hamet, Pavel, Fodor, George, Dresser, George K., George Carruthers, S., Pylypchuk, George, Burgess, Ellen D., Burns, Kevin D., Vallée, Michel, Ramesh Prasad, G.V., Gilbert, Richard E., Leiter, Lawrence A., Jones, Charlotte, Ogilvie, Richard I., Woo, Vincent, McFarlane, Philip A., Hegele, Robert A., and Tobe, Sheldon W.

Published
2010
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13. The 2010 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I – blood pressure measurement, diagnosis and assessment of risk

Author

Quinn, Robert R., Hemmelgarn, Brenda R., Padwal, Raj S., Myers, Martin G., Cloutier, Lyne, Bolli, Peter, McKay, Donald W., Khan, Nadia A., Hill, Michael D., Mahon, Jeff, Hackam, Daniel G., Grover, Steven, Wilson, Thomas, Penner, Brian, Burgess, Ellen, McAlister, Finlay A., Lamarre-Cliche, Maxime, McLean, Donna, Schiffrin, Ernesto L., Honos, George, Mann, Karen, Tremblay, Guy, Milot, Alain, Chockalingam, Arun, Rabkin, Simon W., Dawes, Martin, Touyz, Rhian M., Burns, Kevin D., Ruzicka, Marcel, Campbell, Norman R.C., Vallée, Michel, Ramesh Prasad, G.V., Lebel, Marcel, and Tobe, Sheldon W.

Published
2010
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15. The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement, diagnosis and assessment of risk

Author

Padwal, Raj S., Hemmelgarn, Brenda R., Khan, Nadia A., Grover, Steven, McKay, Donald W., Wilson, Thomas, Penner, Brian, Burgess, Ellen, McAlister, Finlay A., Bolli, Peter, Hill, Michael D., Mahon, Jeff, Myers, Martin G., Abbott, Carl, Schiffrin, Ernesto L., Honos, George, Mann, Karen, Tremblay, Guy, Milot, Alain, Cloutier, Lyne, Chockalingam, Arun, Rabkin, Simon W., Dawes, Martin, Touyz, Rhian M., Bell, Chaim, Burns, Kevin D., Ruzicka, Marcel, Campbell, Norman R.C., Vallée, Michel, Prasad, Ramesh, Lebel, Marcel, and Tobe, Sheldon W.

Published
2009
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18. The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement, diagnosis and assessment of risk

Author

Padwal, Raj S., Hemmelgarn, Brenda R., Khan, Nadia A., Grover, Steven, McAlister, Finlay A., McKay, Donald W., Wilson, Thomas, Penner, Brian, Burgess, Ellen, Bolli, Peter, Hill, Michael D., Mahon, Jeff, Myers, Martin G., Abbott, Carl, Schiffrin, Ernesto L., Honos, George, Mann, Karen, Tremblay, Guy, Milot, Alain, Cloutier, Lyne, Chockalingam, Arun, Rabkin, Simon W., Dawes, Martin, Touyz, Rhian M., Bell, Chaim, Burns, Kevin D., Ruzicka, Marcel, Campbell, Norman R.C., Lebel, Marcel, and Tobe, Sheldon W.

Published
2008
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20. The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement, diagnosis and assessment of risk

Author

Padwal, Raj S., Hemmelgarn, Brenda R., McAlister, Finlay A., McKay, Donald W., Grover, Steven, Wilson, Thomas, Penner, Brian, Burgess, Ellen, Bolli, Peter, Hill, Michael, Mahon, Jeff, Myers, Martin G., Abbott, Carl, Schiffrin, Ernesto L., Honos, George, Mann, Karen, Tremblay, Guy, Milot, Alain, Cloutier, Lyne, Chockalingam, Arun, Khan, Nadia A., Rabkin, Simon W., Dawes, Martin, Touyz, Rhian M., and Tobe, Sheldon W.

Published
2007
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26. Improving Sexual and Gender Minority Cancer Care: Patient and Caregiver Perspectives From a Multi-Methods Pilot Study.

Author

Kano, Miria, Jaffe, Shoshana Adler, Rieder, Stephanie, Kosich, Mikaela, Guest, Dolores D., Burgess, Ellen, Hurwitz, Ariel, Pankratz, Vernon Shane, Rutledge, Teresa L., Dayao, Zoneddy, and Myaskovsky, Larissa

Subjects
ONCOLOGISTS, MINORITY stress, SERVICES for caregivers, SEXUAL minorities, CANCER patient care, PATIENTS' attitudes, MEDICALLY underserved persons, PSYCHOLOGICAL adaptation
Abstract

Purpose: Up to 1 million lesbian, gay, bisexual, and transgender (i.e., sexual and gender minority, SGM) individuals in the United States have histories of cancer. This medically underserved population is diverse, with complex sexualities and gender identities, and distinct health concerns. SGM persons experience disproportionate risks for, and rates of, anal, breast, cervical, colorectal, endometrial, lung, and prostate cancers, in addition to cancers affecting transgender persons who have undergone sex-reassignment. SGM individuals are linked by shared experiences of stigmatization as a minority population for which little cancer research has been conducted. SGM cancer patients frequently report reluctance to seek healthcare, have poorer outcomes following diagnosis, engage in elevated risk behaviors (i.e. smoking and alcohol use) even after cancer diagnosis, have difficulty making emotional adjustment to illness, and experience higher rates of psychological distress. They report less satisfaction with cancer care, deficiencies in patient-centeredness and shared decision-making, gaps in care, and social isolation. Minority stress resulting from experiences of anti-SGM sentiment and discrimination affects cancer patients and their informal cancer caregivers. Our paper presents findings from a pilot study to identify gaps and opportunities to improve cancer care for SGM patients and caregivers at the University of New Mexico Comprehensive Cancer Center. Methods: Between June 2020 and July 2021, we used a multi-methods research design informed by ecological theory to collect qualitative and quantitative data regarding cancer patient and caregiver quality of life (QoL) and experiences of cancer and survivorship care. We used PROMIS measures distributed via REDCap to assess QoL (i.e., fatigue, pain interference, pain intensity, anxiety, depression, emotional support, social isolation, and companionship), and conducted in-depth semi-structured interviews. We recruited 10 SGM cancer patients and 8 heterosexual, cisgender (H/C) patient matches, and their self-identified informal cancer caregivers (n=36, dyad total n=18). Interviews ranged from 1 to 2 hours, were audio-recorded and transcribed for analysis. The study was approved by the University of New Mexico Human Research Protections Office Institutional Review Board. Results: Results of the PROMIS QoL assessments indicated that SGM patients reported greater anxiety [mean (SD) = 54.5 (8.8)] and depression [mean (SD) = 49.3 (4.8)] than H/C patients [mean (SD)=51.6 (7.5) and 45.4 (6.8) respectively], while heterosexual, cisgender (H/C) patients reported higher fatigue [mean (SD) =52.04 (8.18)] and stronger pain intensity than SGM patients [mean (SD)=48.3 (9.1) and 37.8 (9.1) respectively]. SGM patients reported higher levels of social isolation [mean (SD) = 48.3 (7.3) vs. 42.1 (7.4) for H/C patients, whereas H/C patients reported more emotional support (mean (SD) =57.5 (9.3) vs. 53.0 (6.9)] and companionship [mean (SD) = 55.2 (8.6) vs. 51.5 (11.0)]. SGM and H/C differences in caregiver QoL were most notable with regards to higher levels of fatigue [mean (SD) = 47.1 (6.0) for SGM, and 42.4 (11.5) for H/C] and companionship [mean (SD) = 55.3 (6.0) for SGM, and 50.9 (5.5) for H/C]. Qualitative interviews supported our quantitative results. SGM patients and caregivers articulated experiences of anti-SGM stigma and discrimination contributing to minority stress that influenced their initial cancer care encounters. SGM dyads had more trepidation and/or medical mistrust during initial cancer care encounters when compared to H/C patients and caregivers. SGM patients questioned care that was not culturally responsive to SGM preferences, while H/C patients were more apt to identify gaps in communication and perceived lack of clarity regarding cancer care delivery. Although SGM patients experienced high satisfaction with their cancer care once they developed trust with their providers, they discussed desires to have more direct conversations with their oncologists about their sexual orientation and gender identities and sexual health. All patients and providers in the study (SGM and H/C) appreciated their oncology care teams. All patients and caregivers relied on social networks comprised of friends and family, although SGM patients and caregivers had smaller social networks and relied less on biological family, and single SGM individuals experienced challenges accessing cancer care and struggled with social isolation. We discovered too, that all caregivers, regardless of Sexual Orientation and Gender Identity (SOGI), perceived a lack of support and information pertaining to their loved one's treatment, side effects and best way to provide care. Conclusions: This study demonstrates that prior stigmatizing experiences contribute to minority stress and medical mistrust for SGM cancer patients and their informal caregivers across the cancer care experience. Findings point to specific gaps in SGM cancer patient care, including lack of conversation about patient SOGI, inadequate staff and oncology provider SGM specific knowledge and cultural competence/cultural humility training, and insufficient patient supports for those who lack social support during cancer care treatment. Further, this study reveals inadequacies in SGM specific support, and overall support services for informal cancer caregivers. Additional research is required to develop targeted interventions to address minority stress and clinic environment concerns to improve cancer care for SGM patients. Importantly, while there were differences between SGM and H/C experiences of cancer treatment, significant similarities also emerged. Caregiver expressed consensus about the current lack of support and guidance for informal caregivers of cancer patients. Future work should focus on providing caregiver-specific resources in the clinic setting and facilitating support groups for caregivers to network with one another, as well as for tailoring SGM specific caregiver support services. Our findings highlight areas for improving cancer care for the SGM community, as well as a broader population of patients and caregivers. [ABSTRACT FROM AUTHOR]

Published
2022
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27. Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes According to Baseline HbA1c and Insulin Use: An Analysis From the FIDELIO-DKD Study.

Author

Rossing, Peter, Burgess, Ellen, Agarwal, Rajiv, Anker, Stefan D., Filippatos, Gerasimos, Pitt, Bertram, Ruilope, Luis M., Gillard, Pieter, MacIsaac, Richard J., Wainstein, Julio, Joseph, Amer, Brinker, Meike, Roessig, Lothar, Scott, Charlie, Bakris, George L., FIDELIO-DKD Investigators:, Augusto Vallejos (Argentina), Richard MacIsaac (Australia), Guntram Schernthaner (Austria), and Pieter Gillard (Belgium)

Abstract

Objective: Finerenone significantly improved cardiorenal outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) in the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease trial. We explored whether baseline HbA1c level and insulin treatment influenced outcomes.Research Design and Methods: Patients with T2D, urine albumin-to-creatinine ratio (UACR) of 30-5,000 mg/g, estimated glomerular filtration rate (eGFR) of 25 to <75 mL/min/1.73 m2, and treated with optimized renin-angiotensin system blockade were randomly assigned to receive finerenone or placebo. Efficacy outcomes included kidney (kidney failure, sustained decrease ≥40% in eGFR from baseline, or renal death) and cardiovascular (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) composite endpoints. Patients were analyzed by baseline insulin use and by baseline HbA1c <7.5% (58 mmol/mol) or ≥7.5%.Results: Of 5,674 patients, 3,637 (64.1%) received insulin at baseline. Overall, 5,663 patients were included in the analysis for HbA1c; 2,794 (49.3%) had baseline HbA1c <7.5% (58 mmol/mol). Finerenone significantly reduced risk of the kidney composite outcome independent of baseline HbA1c level and insulin use (Pinteraction = 0.41 and 0.56, respectively). Cardiovascular composite outcome incidence was reduced with finerenone irrespective of baseline HbA1c level and insulin use (Pinteraction = 0.70 and 0.33, respectively). Although baseline HbA1c level did not affect kidney event risk, cardiovascular risk increased with higher HbA1c level. UACR reduction was consistent across subgroups. Adverse events were similar between groups regardless of baseline HbA1c level and insulin use; few finerenone-treated patients discontinued treatment because of hyperkalemia.Conclusions: Finerenone reduces kidney and cardiovascular outcome risk in patients with CKD and T2D, and risks appear consistent irrespective of HbA1c levels or insulin use. [ABSTRACT FROM AUTHOR]

Published
2022
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29. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II – Therapy

Author

Khan, Nadia A., McAlister, Finlay A., Rabkin, Simon W., Padwal, Raj, Feldman, Ross D., Campbell, Norman R.C., Leiter, Lawrence A., Lewanczuk, Richard Z., Schiffrin, Ernesto L., Hill, Michael D., Arnold, Malcolm, Moe, Gordon, Campbell, Tavis S., Herbert, Carol, Milot, Alain, Stone, James A., Burgess, Ellen, Hemmelgarn, B., Jones, Charlotte, Larochelle, Pierre, Ogilvie, Richard I., Houlden, Robyn, Herman, Robert J., Hamet, Pavel, Fodor, George, Carruthers, George, Culleton, Bruce, deChamplain, Jacques, Pylypchuk, George, Logan, Alexander G., Gledhill, Norm, Petrella, Robert, Tobe, Sheldon, and Touyz, Rhian M.

Published
2006
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30. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I – Blood pressure measurement, diagnosis and assessment of risk

Author

Hemmelgarn, Brenda R., McAlister, Finlay A., Grover, Steven, Myers, Martin G., McKay, Donald W., Bolli, Peter, Abbott, Carl, Schiffrin, Ernesto L., Honos, George, Burgess, Ellen, Mann, Karen, Wilson, Thomas, Penner, Brian, Tremblay, Guy, Milot, Alain, Chockalingam, Arun, Touyz, Rhian M., and Tobe, Sheldon W.

Published
2006
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31. Patterns of change in depressive symptoms during smoking cessation: who's at risk for relapse?

Author

Burgess, Ellen S., Brown, Richard A., Kahler, Christopher W., Niaura, Raymond, Abrams, David B., Goldstein, Michael G., and Miller, Ivan W.

Subjects
Tobacco habit -- Care and treatment, Depression, Mental -- Risk factors, Smokers -- Psychological aspects, Psychology and mental health
Abstract

The authors examined patterns of change in depressive symptoms during smoking cessation treatment in 163 smokers with past major depressive disorder (MDD). Cluster analysis of Beck Depression Inventory (A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) scores identified 5 patterns of change. Although 40% of participants belonged to clusters characterized by increasing depressive symptoms during quitting (rapid increasers, n = 31, and delayed increasers, n = 35), almost 47% were in clusters characterized by decreasing symptoms (delayed decreasers, n = 24, and rapid decreasers, n = 52). Both rapid and delayed increasers had especially poor smoking cessation outcomes. Results suggest that among smokers with an MDD history there is substantial heterogeneity in patterns of depressive symptoms during quitting and that patterns involving increased symptoms are associated with low abstinence rates.

Published
2002

32. Chelation therapy for ischemic heart disease: A randomized controlled trial. (Original Contribution)

Author

Knudtson, Merril L., Wyse, D. George, Galbraith, P. Diane, Brant, Rollin, Hildebrand, Kathy, Paterson, Diana, Richardson, Deborah, Burkart, Connie, and Burgess, Ellen

Subjects
Chelation therapy -- Evaluation, Coronary heart disease -- Care and treatment
Abstract

Chelation therapy using EDTA does not appear to improve the symptoms of coronary artery disease, according to a study of 84 patients. Chelation therapy is most often used to remove toxic metals from the body., Context Chelation therapy using EDTA is an unproven but widely used alternative therapy for ischemic heart disease. Objective To determine if current EDTA protocols have a favorable impact on exercise ischemia threshold and quality of life measures in patients with stable ischemic heart disease. Design Double-blind, randomized, placebo-controlled trial conducted between January 1996 and January 2000. Setting Participants were recruited from a cohort of cardiac catheterization patients and the practices of cardiologists in Calgary, Alberta. Participants We screened 3140 patients, performed a qualifying treadmill test in 171, and enrolled 84. Entry criteria included age at least 21 years with coronary artery disease proven by angiography or a documented myocardial infarction and stable angina while receiving optimal medical therapy. The required treadmill test used a gradual ramping protocol and patients had to demonstrate at least 1-mm ST depression. Interventions Patients were randomly assigned to receive infusion with either weight-adjusted (40 mg/kg) EDTA chelation therapy (n = 41) or placebo (n = 43) for 3 hours per treatment, twice weekly for 15 weeks and once per month for an additional 3 months. Patients in both groups took oral multivitamin therapy as well. Main Outcome Measure Change from baseline to 27-week follow-up in time to ischemia (1-mm ST depression). Results Thirty-nine patients in each group completed the 27-week protocol. One chelation patient had therapy discontinued for a transient rise in serum creatinine. The mean (SD) baseline exercise time to ischemia was 572 (172) and 589 (176) seconds in the placebo and chelation groups, respectively. The corresponding mean changes in time to ischemia at 27 weeks were 54 seconds (95% confidence interval [CI], 23-84 seconds; P Conclusion Based on exercise time to ischemia, exercise capacity, and quality of life measurements, there is no evidence to support a beneficial effect of chelation therapy in patients with ischemic heart disease, stable angina, and a positive treadmill test for schemia.

Published
2002

38. Cognitive-behavioral treatment for depression in alcoholism

Author

Brown, Richard A., Evans, D. Matthew, Miller, Ivan W., Burgess, Ellen S., and Mueller, Timothy L.

Subjects
Alcoholism -- Care and treatment, Behavioral assessment -- Analysis, Depression, Mental -- Care and treatment, Alcoholics -- Care and treatment, Psychology and mental health
Abstract

Alcoholics with depressive symptoms score [greater than or equal to] 10 on the Beck Depression Inventory (A. T Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) received 8 individual sessions of cognitive-behavioral treatment for depression (CBT-D, n = 19) or a relaxation training control (RTC; n = 16) plus standard alcohol treatment. CBT-D patients had greater reductions in somatic depressive symptoms and depressed and anxious mood than RTC patients during treatment. Patients receiving CBT-D had a greater percentage of days abstinent but not greater overall abstinence or fewer drinks per day during the first 3-month follow-up. However, between the 3- and 6-month follow-ups, CBT-D patients had significantly better alcohol use outcomes on total abstinence (47% vs. 13%), percent days abstinent (90.5% vs. 68.3%), and drinks per day (0.46 vs. 5.71). Theoretical and clinical implications of using CBT-D in alcohol treatment are discussed.

Published
1997

40. Thyroid hormone concentrations in depressed and nondepressed adolescents: group differences and behavioral relations

Author

Dorn, Lorah D., Burgess, Ellen S., Dichek, Helen L., Putnam, Frank w., Chrousos, George P., and Gold, Philip W.

Subjects
Depression in adolescence -- Physiological aspects, Thyroid hormones -- Physiological aspects, Behavior disorders in children -- Physiological aspects, Affective disorders -- Physiological aspects, Family and marriage, Psychology and mental health
Published
1996

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