Identification of Sensory Processing and Integration Symptom Clusters: A Preliminary Study

Rationale. This study explored subtypes of sensory processing disorder (SPD) by examining the clinical presentations of cluster groups that emerged from scores of children with SPD on the Sensory Processing 3-Dimension (SP-3D) Inventory. Method. A nonexperimental design was used involving data extraction from the records of 252 children with SPD. Exploratory cluster analyses were conducted with scores from the SP-3D Inventory which measures sensory overresponsivity (SOR), sensory underresponsivity (SUR), sensory craving (SC), postural disorder, dyspraxia, and sensory discrimination. Scores related to adaptive behavior, social-emotional functioning, and attention among children with different sensory modulation patterns were then examined and compared. Results. Three distinct cluster groups emerged from the data: High SOR only, High SUR with SOR, and High SC with SOR. All groups showed low performance within multiple domains of adaptive behavior. Atypical behaviors associated with social-emotional functioning and attention varied among the groups. Implications. The SP-3D Inventory shows promise as a tool for assisting in identifying patterns of sensory dysfunction and for guiding intervention. Better characterization can guide intervention precision and facilitate homogenous samples for research

The Sensory Processing 3-Dimensions Scale: Initial Studies of Reliability and Item Analyses

Background: The Sensory Processing 3-Dimensions Scale (SP-3D) is a performance-based measure for assessing sensory processing abilities and challenges, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Initial studies of reliability were conducted, and item response theory was applied to assist in refining the measure. Methods: Descriptive and correlational methods were used to examine internal consistency of the scales and inter-rater reliability. Item response theory using Rasch analyses was applied to examine unidimensionality of scales, model fit, and item difficulty. Results: Internal consistency for most measures was acceptable, demonstrating the subtests, domains, and behavior scales as distinct constructs. Inter-rater reliability results were mixed, with fair to strong reliability coefficients for most sensory discrimination and postural and praxis subtests. Scales measuring sensory modulation and motor behaviors had moderate to poor inter-observer agreement. Rasch analyses supported subtests as unidimensional and identified the most rigorous items in the subtests. Conclusions: Preliminary results show promise of the SP-3D as a stable, reliable tool. A need for refinement of some operational definitions for behavior ratings was identified, and items to consider for elimination because of redundancy or ill-fit were exposed. Directions for research include refinement of the SP-3D and the need for further reliability and validity studies

Blessing or Burden? The Impact of PTSD Service Dogs on Military Families

While PTSD service dogs are specifically trained to interact with their veterans, emerging evidence suggests that service dogs may also have an impact on other members of veteran households. To our knowledge, only one study quantifies these effects focused on veteran spouses (McCall et al., 2020). Our study aimed to quantitatively measure the impact of PTSD service dogs on military family wellbeing. Data was collected from survey responses of 88 veteran spouses who rated their experiences on standardized outcome measures. Each spouse answered the surveys at two time points: (1) baseline, and (2) three months post-baseline (follow-up). Spouses in the control group (n=40) were on the waitlist for a service dog for both baseline and follow-up, while the service dog group (n=48) received a service dog after baseline. Multiple regression analysis yielded statistically significant differences between the waitlist and service dog groups which suggested that service dogs may increase caregiver burden and decrease caregiver satisfaction, but potentially encourage increased participation in activities for veteran spouses. Small effect sizes suggested service dogs may also foster increased companionship and positive affect in veteran spouses. Analyses indicated no notable impact on veteran children. These findings suggest that the impact of PTSD service dogs may extend to veteran spouses, potentially encouraging interest and investment in this complementary intervention option. Two statistically significant negative effects emphasize the need to inform the military family of practical strategies to minimize possible detrimental effects, which would likely lead to an improved family experience with the service dog

Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial

PURPOSE: Breast cancer is the leading cause of cancer mortality in women worldwide. With medical advances, metastatic breast cancer (MBC) patients often live for years with many symptoms that interfere with activities. However, there is a paucity of efficacious interventions to address symptom-related suffering and functional interference. Thus, this study examined the feasibility and preliminary efficacy of telephone-based acceptance and commitment therapy (ACT) for symptom interference with functioning in MBC patients. METHODS: Symptomatic MBC patients (N = 47) were randomly assigned to six telephone sessions of ACT or six telephone sessions of education/support. Patients completed measures of symptom interference and measures assessing the severity of pain, fatigue, sleep disturbance, depressive symptoms, and anxiety. RESULTS: The eligibility screening rate (64%) and high retention (83% at 8 weeks post-baseline) demonstrated feasibility. When examining within-group change, ACT participants showed decreases in symptom interference (i.e., fatigue interference and sleep-related impairment; Cohen's d range = - 0.23 to - 0.31) at 8 and 12 weeks post-baseline, whereas education/support participants showed minimal change in these outcomes (d range = - 0.03 to 0.07). Additionally, at 12 weeks post-baseline, ACT participants showed moderate decreases in fatigue and sleep disturbance (both ds = - 0.43), whereas education/support participants showed small decreases in these outcomes (ds = - 0.24 and - 0.18 for fatigue and sleep disturbance, respectively). Both the ACT and education/support groups showed reductions in depressive symptoms (ds = - 0.27 and - 0.28) at 12 weeks post-baseline. Group differences in all outcomes were not statistically significant. CONCLUSIONS: ACT shows feasibility and promise in improving fatigue and sleep-related outcomes in MBC patients and warrants further investigation

The Sensory Processing 3-Dimensions Scale: Initial Studies of Reliability and Item Analyses

Background: The Sensory Processing 3-Dimensions Scale (SP 3D) is a performance-based measure for assessing sensory processing abilities and challenges, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Initial studies of reliability were conducted, and item response theory was applied to assist in refining the measure. Methods: Descriptive and correlational methods were used to examine internal consistency of the scales and inter-rater reliability. Item response theory using Rasch analyses was applied to examine unidimensionality of scales, model fit, and item difficulty. Results: Internal consistency for most measures was acceptable, demonstrating the subtests, domains, and behavior scales as distinct constructs. Inter-rater reliability results were mixed, with fair to strong reliability coefficients for most sensory discrimination and postural and praxis subtests. Scales measuring sensory modulation and motor behaviors had moderate to poor inter observer agreement. Rasch analyses supported subtests as unidimensional and identified the most rigorous items in the subtests. Conclusions: Preliminary results show promise of the SP-3D as a stable, reliable tool. A need for refinement of some operational definitions for behavior ratings was identified, and items to consider for elimination because of redundancy or ill-fit were exposed. Directions for research include refinement of the SP-3D and the need for further reliability and validity studies

Chemistry and the Science of Transformation in Mary Shelley’s Frankenstein

This essay reads the novel in a new way, examining the way that Victor Frankenstein's chemical education (he does not train to be a doctor!) enables his creation of the monster. It reveals that chemists of the period had a different worldview to others where they saw the world in constant transformation and flux. I have written this essay co-written the introduction to the special issue, and co-edited the whole

Factors underlying metastatic breast cancer patients' perceptions of symptom importance: a qualitative analysis

The symptom literature in cancer has primarily examined symptom severity, frequency and distress. Assessing cancer patients' perceptions of symptom importance-how important it is for them to see improvement in a symptom following an intervention-and factors influencing these judgments would also inform patient-centred care, but this analysis has not been undertaken. This qualitative study aimed to identify factors underlying perceptions of symptom importance among 25 symptomatic metastatic breast cancer (MBC) patients. Participants were recruited from a cancer centre in the Midwestern USA. Semi-structured interviews focused on patients' rationale for considering common symptoms (i.e., anxiety, sadness, sleep problems, pain or fatigue) to be important. Thematic analyses revealed five interrelated factors underlying MBC patients' perceptions of symptom importance: activity restriction, concentration difficulties, exacerbation of other physical symptoms, symptom-related long-term health concerns and negative impact on their relationships with others. Patients most frequently stated that a physical or psychological symptom was important because of the resulting activity restriction. Additionally, some patients considered pain to be important because it signalled potential long-term health concerns, such as worsening metastatic disease. Findings suggest that clinicians should take into account MBC patients' perceptions of symptom importance and factors underlying these judgments when making shared treatment decisions

Symptom experiences in metastatic breast cancer patients: relationships to activity engagement, value-based living, and psychological inflexibility

OBJECTIVE: This study examined symptom-based subgroups of metastatic breast cancer (MBC) patients and the extent to which they differed across key constructs of acceptance and commitment therapy (ACT). METHODS: Eighty women with MBC completed self-report surveys assessing 10 common symptoms and several ACT variables (ie, activity engagement, psychological inflexibility, value obstruction, and value progress) during a single time point. RESULTS: A cluster analysis yielded 3 patient subgroups: low symptoms, low-moderate symptoms, and moderate-high symptoms. Relative to the subgroup with low symptoms, the other subgroups reported less activity engagement. In addition, compared with patients with low symptoms, the subgroup with moderate-high symptoms reported greater psychological inflexibility (ie, avoidance of unwanted internal experiences) and greater difficulty living consistently with their values. CONCLUSIONS: Women with MBC show heterogeneity in their symptom profiles, and those with higher symptom burden are more likely to disengage from valued activities and avoid unwanted experiences (eg, thoughts, feelings, and bodily sensations). Findings are largely consistent with the ACT model and provide strong justification for testing ACT to address symptom interference in MBC patients

Metastatic breast cancer patients' expectations and priorities for symptom improvement

PURPOSE: Little research has examined cancer patients' expectations, goals, and priorities for symptom improvement. Thus, we examined these outcomes in metastatic breast cancer patients to provide patients' perspectives on clinically meaningful symptom improvement and priorities for symptom management. METHODS: Eighty women with metastatic breast cancer participated in a survey with measures of comorbidity, functional status, engagement in roles and activities, distress, quality of life, and the modified Patient-Centered Outcomes Questionnaire that focused on 10 common symptoms in cancer patients. RESULTS: On average, patients reported low to moderate severity across the 10 symptoms and expected symptom treatment to be successful. Patients indicated that a 49% reduction in fatigue, 48% reduction in thinking problems, and 43% reduction in sleep problems would represent successful symptom treatment. Cluster analysis based on ratings of the importance of symptom improvement yielded three clusters of patients: (1) those who rated thinking problems, sleep problems, and fatigue as highly important, (2) those who rated pain as moderately important, and (3) those who rated all symptoms as highly important. The first patient cluster differed from other subgroups in severity of thinking problems and education. CONCLUSIONS: Metastatic breast cancer patients report differing symptom treatment priorities and criteria for treatment success across symptoms. Considering cancer patients' perspectives on clinically meaningful symptom improvement and priorities for symptom management will ensure that treatment is consistent with their values and goals

Dihydrodinophysistoxin-1 produced by Dinophysis norvegica in the Gulf of Maine, USA and its accumulation in shellfish

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Deeds, J. R., Stutts, W. L., Celiz, M. D., MacLeod, J., Hamilton, A. E., Lewis, B. J., Miller, D. W., Kanwit, K., Smith, J. L., Kulis, D. M., McCarron, P., Rauschenberg, C. D., Burnell, C. A., Archer, S. D., Borchert, J., & Lankford, S. K. Dihydrodinophysistoxin-1 produced by Dinophysis norvegica in the Gulf of Maine, USA and its accumulation in shellfish. Toxins, 12(9), (2020): E533, doi:10.3390/toxins12090533.Dihydrodinophysistoxin-1 (dihydro-DTX1, (M-H)−m/z 819.5), described previously from a marine sponge but never identified as to its biological source or described in shellfish, was detected in multiple species of commercial shellfish collected from the central coast of the Gulf of Maine, USA in 2016 and in 2018 during blooms of the dinoflagellate Dinophysis norvegica. Toxin screening by protein phosphatase inhibition (PPIA) first detected the presence of diarrhetic shellfish poisoning-like bioactivity; however, confirmatory analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) failed to detect okadaic acid (OA, (M-H)−m/z 803.5), dinophysistoxin-1 (DTX1, (M-H)−m/z 817.5), or dinophysistoxin-2 (DTX2, (M-H)−m/z 803.5) in samples collected during the bloom. Bioactivity-guided fractionation followed by liquid chromatography-high resolution mass spectrometry (LC-HRMS) tentatively identified dihydro-DTX1 in the PPIA active fraction. LC-MS/MS measurements showed an absence of OA, DTX1, and DTX2, but confirmed the presence of dihydro-DTX1 in shellfish during blooms of D. norvegica in both years, with results correlating well with PPIA testing. Two laboratory cultures of D. norvegica isolated from the 2018 bloom were found to produce dihydro-DTX1 as the sole DSP toxin, confirming the source of this compound in shellfish. Estimated concentrations of dihydro-DTX1 were >0.16 ppm in multiple shellfish species (max. 1.1 ppm) during the blooms in 2016 and 2018. Assuming an equivalent potency and molar response to DTX1, the authority initiated precautionary shellfish harvesting closures in both years. To date, no illnesses have been associated with the presence of dihydro-DTX1 in shellfish in the Gulf of Maine region and studies are underway to determine the potency of this new toxin relative to the currently regulated DSP toxins in order to develop appropriate management guidance.Partial support for this research was received from the National Oceanic and Atmospheric Administration, National Centers for Coastal Ocean Science Competitive Research, Ecology and Oceanography of Harmful Algal Blooms Program under awards NA17NOS4780184 and NA19NOS4780182 to Juliette Smith (VIMS) and Jonathan Deeds (US FDA), and Prevention, Control, and Mitigation of Harmful Algal Blooms program award NA17NOS4780179 to Stephen Archer. This paper is ECOHAB publication number EC0956