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1.  Mindfulness Meditation Alleviates Fibromyalgia Symptoms in Women: Results of a Randomized Clinical Trial 
Few studies have examined the efficacy of a Mindfulness-Based Stress Reduction (MBSR) intervention on psychological and physiological functioning in patients with fibromyalgia.
We conducted a randomized prospective trial of MBSR among female fibromyalgia patients.
Effects on perceived stress, pain, sleep quality, fatigue, symptom severity, and salivary cortisol were tested in treatment (n=51) versus wait-list control participants (n=40) using data at baseline, post-program, and two-month follow-up.
Analyses revealed MBSR significantly reduced perceived stress, sleep disturbance, and symptom severity, with gains maintained at follow-up. Greater home practice at follow-up was associated with reduced symptom severity. MBSR did not significantly alter pain, physical functioning, or cortisol profiles.
MBSR ameliorated some of the major symptoms of fibromyalgia and reduced subjective illness burden. Further exploration of MBSR effects on physiological stress responses is warranted. These results support use of MBSR as a complementary treatment for women with fibromyalgia. (ISRCTN: 34628811)
PMCID: PMC4802162  PMID: 25425224
Fibromyalgia; mindfulness meditation; perceived stress; sleep; cortisol
2.  Oxyntomodulin Identified as a Marker of Type 2 Diabetes and Gastric Bypass Surgery by Mass-spectrometry Based Profiling of Human Plasma 
EBioMedicine  2016;7:112-120.
Low-abundance regulatory peptides, including metabolically important gut hormones, have shown promising therapeutic potential. Here, we present a streamlined mass spectrometry-based platform for identifying and characterizing low-abundance regulatory peptides in humans. We demonstrate the clinical applicability of this platform by studying a hitherto neglected glucose- and appetite-regulating gut hormone, namely, oxyntomodulin. Our results show that the secretion of oxyntomodulin in patients with type 2 diabetes is significantly impaired, and that its level is increased by more than 10-fold after gastric bypass surgery. Furthermore, we report that oxyntomodulin is co-distributed and co-secreted with the insulin-stimulating and appetite-regulating gut hormone glucagon-like peptide-1 (GLP-1), is inactivated by the same protease (dipeptidyl peptidase-4) as GLP-1 and acts through its receptor. Thus, oxyntomodulin may participate with GLP-1 in the regulation of glucose metabolism and appetite in humans. In conclusion, this mass spectrometry-based platform is a powerful resource for identifying and characterizing metabolically active low-abundance peptides.
•In the pursuit of identifying metabolic peptides in humans we developed a streamlined mass-spectrometry based platform•Our platform was used to investigate a gut derived glucose and appetite regulatory peptide, oxyntomodulin•Levels of oxyntomodulin are reduced in subjects with type 2 diabetes and increased after gastric bypass surgery
The human plasma comprises a variety of peptides with importance for metabolic health. Identification of such peptides has been exploited for developing glucose-lowering therapies, such as incretin-based therapy. We therefore developed a mass-spectrometry based platform for identification of peptides in humans and by applying this platform we characterized a peptide hormone oxyntomodulin secreted from the intestine in response to glucose. Our data suggest that oxyntomodulin is down-regulated in subjects with type 2 diabetes and up-regulated after bariatric surgery. In summary, the collected data indicate that oxyntomodulin may co-orchestrate appetite and glucose regulatory effects together with incretin hormones.
PMCID: PMC4909640  PMID: 27322465
Gut hormones; GLP-1; Low-abundant peptides; Mass-spectrometry; Proteomics
3.  Perceived health in lung cancer patients: the role of positive and negative affect 
Quality of Life Research  2011;21(2):187-194.
To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health.
A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys.
Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated with adaptive social functioning, fewer emotion-based role limitations, and less severe bodily pain. In a full model, positive affect was significantly associated with greater levels of social functioning and general health, over and above the effects of negative affect.
Reduction of negative affect is an important therapeutic goal, but the ability to maintain positive affect may result in greater perceived health. Indeed, engagement in behaviors that result in greater state positive affect may, over time, result in dispositional changes and enhancement of quality of life.
PMCID: PMC3196676  PMID: 21611867
Positive and negative affect; Perceived health; Role limitations; Lung cancer; Oncology
4.  Psychological Health in Cancer Survivors 
Seminars in Oncology Nursing  2008;24(3):193-201.
The prevalence of both negative (distress) and positive responses (growth, well-being) to the cancer experience is examined and difficulties in establishing the prevalence of these responses discussed. A conceptual framework for understanding factors associated with psychological health in cancer survivors is presented. Finally, strategies for promoting psychological health in cancer survivors are examined.
Data Sources
Review of the literature.
Psychological health in cancer survivors is defined by the presence or absence of distress as well as the presence or absence of positive well-being and psychological growth. Furthermore, psychological health in cancer survivors is determined by the balance between two classes of factors: the stress and burden posed by the cancer experience and the resources available for coping with this stress and burden.
Implications for nursing practice
In general, promotion of psychological health is based upon the prevention or treatment of distress as well as the encouragement of growth and well-being. Periodic screening for psychological distress across the cancer trajectory is critical to appropriate management of distress.
PMCID: PMC3321244  PMID: 18687265
5.  Receipt of a False Positive Test Result During Routine Screening for Ovarian Cancer: A Teachable Moment? 
The term "teachable moment" (TM) has been used to describe a life transition or event which motivates an individual to change a behavior or presents an opportunity to intervene to prompt behavior change. We examined whether receipt of a false positive ovarian cancer (OC) screening result may represent a TM.
403 women participating in an OC screening program completed questionnaires assessing demographic, clinical, behavioral, and psychosocial information. The TM was operationalized as expressed interest in receiving health-related information. We hypothesized that among women receiving a false positive screening test result, those women who had experienced greater personal perceived risk for OC as well as distress would be more interested in receiving health-related information than women receiving a normal result.
Analyses revealed that women receiving a false positive screening result were less interested in receiving health-related information than women receiving a normal screening result. For women receiving a false positive result, expressed interest in receipt of health-related information was only modestly related to distress and related even less to perceptions of OC risk.
Our data do not support viewing a false positive OC screening result as a TM. Potential explanations for the current findings as well as recommendations for future research investigating the TM are discussed.
PMCID: PMC3319350  PMID: 21373852
teachable moment; ovarian cancer screening; normal/false positive cancer screening result; cancer risk
6.  Methodological Issues in Exercise Intervention Research in Oncology 
Seminars in oncology nursing  2007;23(4):297-304.
To review randomized controlled trials (RCTs) that offered exercise interventions for adults diagnosed and treated for cancer related to design, sample, type of intervention and outcomes.
Data sources
Several electronic data-bases were searched and recent review papers were scanned to identify relevant publications.
Exercise adoption seems clearly feasible for early-stage cancer patients, particularly breast cancer patients. Data support positive effects for physical functioning, quality of life (QOL), and psychological well-being. Effects for patients with later-stage disease and other cancers are less clear. The impact of exercise adoption on biomarkers of disease status, immune functioning and hormone levels should also be examined.
Implications for nursing practice
There are many opportunities for nurses to promote exercise in clinical care and in a research context.
PMCID: PMC2180155  PMID: 18022057
7.  A population-based study of maternal use of amoxicillin and pregnancy outcome in Denmark 
Amoxicillin is a widely used penicillin, but data on its safety in pregnancy are limited. We examined the association between amoxicillin exposure during pregnancy and birth weight, preterm delivery, congenital malformations, perinatal death, and spontaneous abortion.
We identified all primiparous women with a live birth, or a stillbirth after the 28th gestational week, from 1 January 1991–31 December 2000 in the County of North Jutland, Denmark. Data on prescriptions for amoxicillin and outcome were obtained from population-based registries. Using a follow-up and a case–control design, we compared pregnancy outcomes between women who had been prescribed amoxicillin during pregnancy and those who had not, adjusting for available potentially confounding factors.
We identified 401 primiparous women who redeemed a prescription for amoxicillin during their pregnancy. The control group consisted of 10 237 primiparous women who did not redeem any prescriptions from 3 months before pregnancy until the end of pregnancy. The adjusted mean birth weight of children born to amoxicillin-exposed mothers was 57 g [95% confidence interval (CI) 9, 105] higher than that of children born to controls. Odds ratios among amoxicillin-exposed relative to controls were: low birth weight 0.63 (95% CI 0.26, 1.53), preterm delivery 0.77 (95% CI 0.49, 1.21), congenital malformation 1.16 (95% CI 0.54, 2.50), and spontaneous abortion 0.89 (95% CI 0.66, 1.18). We did not observe any cases of perinatal death in the amoxicillin-exposed women.
We did not find any increased risk of adverse pregnancy outcome associated with amoxicillin exposure during pregnancy, but additional studies are warranted.
PMCID: PMC1894737  PMID: 12580995
amoxicillin; epidemiology; malformations; perinatal mortality; pregnancy; preterm delivery; safety; spontaneous abortion

Results 1-7 (7)