The Effect of Alcohol Treatment on Social Costs of Alcohol Dependence: Results From the COMBINE Study

The COMBINE (Combined Pharmacotherapies and Behavioral Intervention) clinical trial recently evaluated the efficacy of pharmacotherapies, behavioral therapies, and their combinations for the treatment of alcohol dependence. Previously, the cost and cost-effectiveness of COMBINE have been studied. Policy makers, patients, and nonalcohol-dependent individuals may be concerned not only with alcohol treatment costs but also with the impact of alcohol interventions on broader social costs and outcomes

A genome-wide association study of aging

AbstractHuman longevity and healthy aging show moderate heritability (20%–50%). We conducted a meta-analysis of genome-wide association studies from 9 studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium for 2 outcomes: (1) all-cause mortality, and (2) survival free of major disease or death. No single nucleotide polymorphism (SNP) was a genome-wide significant predictor of either outcome (p < 5 × 10−8). We found 14 independent SNPs that predicted risk of death, and 8 SNPs that predicted event-free survival (p < 10−5). These SNPs are in or near genes that are highly expressed in the brain (HECW2, HIP1, BIN2, GRIA1), genes involved in neural development and function (KCNQ4, LMO4, GRIA1, NETO1) and autophagy (ATG4C), and genes that are associated with risk of various diseases including cancer and Alzheimer's disease. In addition to considerable overlap between the traits, pathway and network analysis corroborated these findings. These findings indicate that variation in genes involved in neurological processes may be an important factor in regulating aging free of major disease and achieving longevity

Researching Depression in Prostate Cancer Patients: Factors, Timing, and Measures

Background: Due to the pressing need to understand the causal and associative factors of depression among prostate cancer (PCa) patients, a comprehensive research protocol for investigating depression in prostate cancer patients is suggested as a way of furthering the collection of data in consistent and informative ways. Methods: A detailed review of a range of predictors of, and buffers against, depression, plus methods of assessing depressive symptomatology and optimum time to collect data were used to develop a model for a comprehensive research protocol. Results: A model protocol is described that includes socioeconomic, genetic, endocrinal, immunological, physiological, psychological, relationship, and socioeconomic pathways to depression. In addition, methods of assessing depressive symptomatology are described, plus comorbidity of anxiety with depression, male depression, and the construct of Individual Burden of Illness for Depression. The need to collect multiple measures over time in order to describe variability in symptoms and the relationships between symptoms and other variables is emphasized. Conclusion: This model protocol of research into depression in prostate cancer patients allows for a comprehensive approach that includes predictors, symptoms, and time for observation. Use of this protocol will enhance the understanding and treatment of depression in PCa patients from a 'personalized medicine' perspective

The practical challenges of recruitment and retention when providing psychotherapy to advanced breast cancer patients

Goals of work The goal of the present study was to investigate recruitment issues relevant to psychotherapy trials for metastatic cancer patients. First, we undertook a literature review of the psychotherapy intervention research for metastatic cancer patients. Second, we piloted pragmatic recruitment methods for a couples' intervention for women with metastatic breast cancer and their partners. Methods An extensive literature search was conducted to identify psychotherapy trials involving people with metastatic cancer published in peer-reviewed journals. Study characteristics and recruitment methodologies were examined. In the pilot study, we trialled the recruitment strategies of approaching participants at outpatients' appointments, via letter, referral from the treating team and through direct advertising using two community support services. Results The literature search identified 1,905 potentially relevant articles, which were narrowed to 18 studies specifically involving metastatic cancer patients involving a professionally trained facilitator and a specified theoretical orientation. Limited information was found on recruitment rates and the success of recruitment strategies. Barriers to recruitment identified in the literature included degree of patient illness, lack of interest/perceived benefit, insufficient time, socio-demographic factors and negative clinician attitudes. Our pilot study identified 72 eligible couples of which 66 were approached. Our recruitment strategies resulted in six couples consenting (9.1%) but only three couples completing the study (4.5%). The main reasons for study refusal were the intervention was not needed, lack of interest, insufficient time, patient illness and travel distance. Conclusions Recruitment for couple-based psychotherapy interventions is challenging. More work is required on developing acceptable and feasible recruitment processes for metastatic cancer patients to be able to access support

Researching depression in prostate cancer patients: factors, timing, and measures

Background: Due to the pressing need to understand the causal and associative factors of depression among prostate cancer (PCa) patients, a comprehensive research protocol for investigating depression in prostate cancer patients is suggested as a way of furthering the collection of data in consistent and informative ways. Methods: A detailed review of a range of predictors of, and buffers against, depression, plus methods of assessing depressive symptomatology and optimum time to collect data were used to develop a model for a comprehensive research protocol. Results: A model protocol is described that includes socioeconomic, genetic, endocrinal, immunological, physiological, psychological, relationship, and socioeconomic pathways to depression. In addition, methods of assessing depressive symptomatology are described, plus comorbidity of anxiety with depression, male depression, and the construct of Individual Burden of Illness for Depression. The need to collect multiple measures over time in order to describe variability in symptoms and the relationships between symptoms and other variables is emphasized. Conclusion: This model protocol of research into depression in prostate cancer patients allows for a comprehensive approach that includes predictors, symptoms, and time for observation. Use of this protocol will enhance the understanding and treatment of depression in PCa patients from a "personalized medicine" perspective