Quality of life and pain in premenopausal women with major depressive disorder: The POWER Study

BACKGROUND: Whereas it is established that organic pain may induce depression, it is unclear whether pain is more common in healthy subjects with depression. We assessed the prevalence of pain in premenopausal women with major depression (MDD). Subjects were 21- to 45-year-old premenopausal women with MDD (N = 70; age: 35.4 +/- 6.6; mean +/- SD) and healthy matched controls (N = 36; age 35.4 +/- 6.4) participating in a study of bone turnover, the P.O.W.E.R. (Premenopausal, Osteopenia/Osteoporosis, Women, Alendronate, Depression) Study. METHODS: Patients received a clinical assessment by a pain specialist, which included the administration of two standardized forms for pain, the Brief Pain Inventory – Short Form, and the Initial Pain Assessment Tool, and two scales of everyday stressors, the Hassles and Uplifts Scales. In addition, a quality-of-life instrument, the SF-36, was used. The diagnosis of MDD was established by a semi-structured interview, according to the DSM-IV criteria. Substance P (SP) and calcitonin-gene-related-peptide (CGRP), neuropeptides which are known mediators of pain, were measured every hour for 24 h in a subgroup of patients (N = 17) and controls (N = 14). RESULTS: Approximately one-half of the women with depression reported pain of mild intensity. Pain intensity was significantly correlated with the severity of depression (r(2 )= 0.076; P = 0.04) and tended to be correlated with the severity of anxiety, (r(2 )= 0.065; P = 0.07), and the number of depressive episodes (r(2 )= 0.072; P = 0.09). Women with MDD complained of fatigue, insomnia, and memory problems and experienced everyday negative stressors more frequently than controls. Quality of life was decreased in women with depression, as indicated by lower scores in the emotional and social well-being domains of the SF-36. SP (P < 0.0003) and CGRP (P < 0.0001) were higher in depressed subjects. CONCLUSION: Women with depression experienced pain more frequently than controls, had a lower quality of life, and complained more of daily stressors. Assessment of pain may be important in the clinical evaluation of women with MDD. SP and CGRP may be useful biological markers in women with MDD

L’informatique comme soutien à l’opérationnalisation des procédures analytiques en phénoménologie : un modèle de développement et de collaboration

La recherche qualitative de type phénoménologique détient des prémisses philosophiques qui demandent certaines prédispositions fondamentales chez le chercheur afin d’assurer la scientificité des résultats. Dans le cadre d’une recherche doctorale en santé publique, un outil informatique spécifique à celle-ci appelé, « Analyse phénoménologique – Caring », est venu soutenir les principes d’analyse phénoménologique de Giorgi (1997) utilisée. Le propos de cet article consiste à faire valoir la façon dont l’informatique par l’entremise d’un Système d’Information (SI) de type Système Informatique d’Aide à la Décision (SIAD) peut s’avérer utile et pertinent dès la collecte jusqu’à l’analyse des données en phénoménologie. Ces constats mettent ainsi à jour un modèle de développement d’un système d’analyse des données et d’étroite collaboration entre l’expert-informaticien et le chercheur utilisant une approche qualitative

Concours des Prix du Ministre de l'éducation. Enseignement collégial

"Concours des Prix du Ministre de l'éducation. Enseignement collégial"Bibliogr.: p. 355-357Index: p. 359-38

Use of the National Cancer Institute Community Cancer Centers Program screening and accrual log to address cancer clinical trial accrual

PURPOSE: Screening logs have the potential to help oncology clinical trial programs at the site level, as well as trial leaders, address enrollment in real time. Such an approach could be especially helpful in improving representation of racial/ethnic minority and other underrepresented populations in clinical trials. Use of the National Cancer Institute Community Cancer Centers Program screening and accrual log to address cancer clinical trial accrual. The National Cancer Institute Community Cancer Centers Program (NCCCP) developed a screening log. Log data collected from March 2009 through May 2012 were analyzed for number of patients screened versus enrolled, including for demographic subgroups; screening methods; and enrollment barriers, including reasons for ineligibility and provider and patient reasons for declining to offer or participate in a trial. User feedback was obtained to better understand perceptions of log utility. RESULTS: Of 4,483 patients screened, 18.4% enrolled onto NCCCP log trials. Reasons for nonenrollment were ineligibility (51.6%), patient declined (25.8%), physician declined (15.6%), urgent need for treatment (6.6%), and trial suspension (0.4%). Major reasons for patients declining were no desire to participate in trials (43.2%) and preference for standard of care (39%). Major reasons for physicians declining to offer trials were preference for standard of care (53%) and concerns about tolerability (29.3%). Enrollment rates onto log trials did not differ between white and black (P = .15) or between Hispanic and non-Hispanic patients (P = .73). Other races had lower enrollment rates than whites and blacks. Sites valued the ready access to log data on enrollment barriers, with some sites changing practices to address those barriers. CONCLUSION: Use of screening logs to document enrollment barriers at the local level can facilitate development of strategies to enhance clinical trial accrual