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  • 1
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Developmental & Behavioral Pediatrics Vol. 38, No. 1 ( 2017-01), p. 58-64
    In: Journal of Developmental & Behavioral Pediatrics, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 1 ( 2017-01), p. 58-64
    Abstract: Lower body esteem may decrease self-esteem and lead to adverse health effects in children. This study explored the role of anthropometric, behavioral, and social factors on body esteem in peripubertal girls. Method: We evaluated associations of body esteem (measured by the Revised Body Esteem Scale) with body mass index (BMI), mother's BMI, puberty, physical activity, role models for appearance, and screen time among girls (ages 9 and 10) participating in the Jersey Girl Study (n = 120). Linear models were used to evaluate differences in body esteem scores. Results: Overweight/obese girls had a significantly lower mean body esteem score compared with underweight/healthy weight girls {14.09 (95% confidence interval [CI]: 12.53–15.27) vs. 17.17 (95% CI: 16.87–17.43)}. Girls who were physically active for at least 7 hours per week had a significantly higher body esteem score than those who were less active, after adjusting for BMI (17.00 [95% CI: 16.62–17.32] vs. 16.39 [95% CI: 15.82–16.86]). Girls whose mothers were overweight/obese, who had entered puberty, and who cited girls at school or females in the media as role models had lower body esteem scores, but differences disappeared after adjusting for girl's BMI. A trend of higher body esteem scores was found for girls whose mothers were role models. Conclusion: Lower BMI and higher levels of physical activity are independently associated with higher body esteem score. Having classmates or girls/women in the media as role models may detrimentally affect girls' body esteem, but having mothers as role models may have a positive effect.
    Type of Medium: Online Resource
    ISSN: 0196-206X
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2062814-6
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  • 2
    In: Obstetrical & Gynecological Survey, Ovid Technologies (Wolters Kluwer Health), Vol. 71, No. 9 ( 2016-09), p. 528-530
    Type of Medium: Online Resource
    ISSN: 0029-7828
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2043471-6
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  • 3
    In: British Journal of Cancer, Springer Science and Business Media LLC, Vol. 115, No. 1 ( 2016-6), p. 95-101
    Type of Medium: Online Resource
    ISSN: 0007-0920 , 1532-1827
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2002452-6
    detail.hit.zdb_id: 80075-2
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  • 4
    In: Environmental Health, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1476-069X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2092232-2
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  • 5
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 25, No. 7 ( 2016-07-01), p. 1114-1124
    Abstract: Background: Despite a large body of literature evaluating the association between recreational physical activity and epithelial ovarian cancer (EOC) risk, the extant evidence is inconclusive, and little is known about the independent association between recreational physical inactivity and EOC risk. We conducted a pooled analysis of nine studies from the Ovarian Cancer Association Consortium to investigate the association between chronic recreational physical inactivity and EOC risk. Methods: In accordance with the 2008 Physical Activity Guidelines for Americans, women reporting no regular, weekly recreational physical activity were classified as inactive. Multivariable logistic regression was utilized to estimate the ORs and 95% confidence intervals (CI) for the association between inactivity and EOC risk overall and by subgroups based upon histotype, menopausal status, race, and body mass index. Results: The current analysis included data from 8,309 EOC patients and 12,612 controls. We observed a significant positive association between inactivity and EOC risk (OR = 1.34; 95% CI, 1.14–1.57), and similar associations were observed for each histotype. Conclusions: In this large pooled analysis examining the association between recreational physical inactivity and EOC risk, we observed consistent evidence of an association between chronic inactivity and all EOC histotypes. Impact: These data add to the growing body of evidence suggesting that inactivity is an independent risk factor for cancer. If the apparent association between inactivity and EOC risk is substantiated, additional work via targeted interventions should be pursued to characterize the dose of activity required to mitigate the risk of this highly fatal disease. Cancer Epidemiol Biomarkers Prev; 25(7); 1114–24. ©2016 AACR.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 6
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 15_suppl ( 2021-05-20), p. e18754-e18754
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. e18754-e18754
    Abstract: e18754 Background: The value of using next-generation sequencing (NGS) to inform oncology care decisions is increasingly apparent, yet many challenges persist that may inhibit routine adoption of NGS into clinical care. The purpose of this study was to identify existing barriers to NGS access and possible solutions from the physician perspective. Methods: A cross-sectional online survey, including both closed- and open-ended questions, was sent to a nationally representative sample of oncologists/hematologists, surgeons, and pathologists (N=201). The survey gathered information on physician demographics, practice characteristics, perceived barriers to testing, and strategies for increasing adoption. Results: Over 99% of physicians, 20.5% of whom worked in an academic setting, reported using NGS in the past 12 months, and 73.0% used NGS always or most of the time. Despite this high utilization, 80.1% of physicians experienced at least one barrier to testing. Reimbursement challenges were among the top reported barriers (87.5%), followed by a lack of knowledge of NGS testing methodologies (81.0%), and lacking evidence of clinical utility (80.1%). These barriers were more likely to be reported by pathologists and surgeons compared to oncologists/hematologists. Potential strategies for addressing these differed by specialty: While most oncologists/hematologists (84.0%) reported increased NGS coverage as a top priority, most surgeons (88.0%) prioritized improved multidisciplinary communications, and most pathologists (84.4%) prioritized increased access to educational content on cancer genomics and resources for physicians. Conclusions: Despite the high utilization of NGS among the surveyed stakeholders, several barriers, including limited reimbursement, knowledge gaps, and lack of clinical utility evidence were reported that may impact clinical optimization. Interestingly, the perceived barriers to NGS use varied by specialty, which may be driven by the differing roles these specialists play in patient management. Oncologists/hematologists, who are more likely involved in long-term patient care, were most concerned with identifying strategies to improve coverage of technology, whereas surgeons and pathologists were most concerned with strategies that would improve understanding and education. This research highlights the need for multi-faceted strategies to address barriers to NGS adoption. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. e18087-e18087
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. e18087-e18087
    Abstract: e18087 Background: A critical question in determining long-term prognosis for women with newly diagnosed ovarian cancer (OC) is whether or not their risk of death changes with time. The emergence of large, well-populated real-world datasets permits assessment of conditional survival (CS) given prior overall survival (OS) or progression-free survival (PFS). Methods: The Tempus EMR clinical dataset consists of patients from both National Cancer Institute designated centers and a sample of community oncology centers in the U.S. This study included adult women with a primary diagnosis of ovarian, fallopian tube, or peritoneal cancer from 1982 to 2018; women treated with a poly-ADP ribose polymerase (PARP) inhibitor were excluded due to low numbers & limited follow-up (final n = 2,031). The effects of patient attributes on OS were estimated using Cox regression. We calculated CS as the Kaplan-Meier probability of surviving an additional y years (from first line chemotherapy initiation), given no OS or PFS event in the previous x ( 〈 y) years. Results: Median age was 61 years and 68% of patients were Caucasian. The majority (92%) had epithelial histology, 58% were stage 3 or 4, and 49% were ECOG 0 or 1. Median OS was 37 months (95% CI: 36-39), and OS differed by age, stage, and performance status; adjusted hazard ratios (HRs) for OS were 1.3 (95% CI: 1.0, 1.5) for age 〉 65 versus 〈 45, 2.4 for stage 4 versus stage 1 (95% CI: 1.7, 3.4), and 1.4 for ECOG 2 to 4 versus 0 or 1 (95% CI: 1.2, 1.7). Conditional 1- or 5-year survival rate did not vary based on prior OS. However, CS rates among women alive without disease progression increased with time: 1-year and 5-year survival rates (with 95% CI) were 86% (84-87) and 28% (26-31), respectively, in women alive without progression at 6 months, but increased to 94% (89-97) and 53% (44-62) in women alive without progression at 3 years. Conclusions: Long-term prognosis, as shown by conditional survival rates, did not improve based on time alive since initiation of chemotherapy. However, women with longer time without disease progression had lower rates of death and a better prognosis. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 8
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e17590-e17590
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e17590-e17590
    Abstract: e17590 Background: Along with residual disease after surgery, response to platinum therapy is a key prognostic indicator in patients with advanced OC. It is a prerequisite for receiving PARP inhibitor maintenance therapy and directs future treatment choices. Our objective was to describe differences in characteristics and outcomes between patients with platinum resistance (PR) or PST in a community oncology setting. Methods: This was a retrospective study of adult female patients with advanced OC (Stage III/IV) who received 4+ cycles of a 1L platinum-based regimen during 01/01/2017 to 06/30/2021 (followed until 12/31/2021) and had ≥ 2 visits within The US Oncology Network. Patients who were platinum resistant (PR, relapse 30 days to 〈 6 months after platinum discontinuation) or PST (relapse at 6+ months after platinum discontinuation) were included; refractory patients (relapse during or within 30 days of platinum discontinuation) were excluded. Structured and chart review data were used. Multivariable logistic regression assessed the association of factors with PST vs. PR. Results: In total 142 patient charts (108 PST, 34 PR) were reviewed. In addition to platinum-based chemotherapy, 19% of patients also initiated bevacizumab. Most patients were White (63%), diagnosed at Stage IIIC (55%) or IV (33%), and had epithelial OC (82%). Overall, 52%, 23% and 25% of patients had ECOG performance status scores of 0/1, 2+ and not documented, respectively. BRCA status was positive for 7.7% but not documented for 38%, and Charlson comorbidity score (CCS) was 0 for 63% of patients. PST vs. PR patients were younger, 69 (27-90+) years vs. 71 (51-89) [median (range), p = 0.045]. More PST vs. PR patients were normal weight (40% vs. 29%) or overweight (30% vs. 15%) and fewer were obese (24% vs. 41%) (p = 0.011). In multivariable adjusted analysis (excluding underweight and unreported BMI categories for low counts), Stage IV vs. III (p = 0.003) was associated with significantly higher odds of PR after 1L, while obesity vs. healthy weight (p = 0.067) and ECOG 2+ vs. 0/1 (p = 0.057) were associated with numerically higher odds of PR after 1L; age, CCS and 1L bevacizumab use were not associated with PST. Kaplan-Meier median (95% confidence interval [CI] ) overall survival in PST vs. PR was not reached [NR] (44.6, NR) vs. 16.7 (13.9, 23.6) months while median (95% CI) progression-free survival was 19.6 (17.6,24.9) months vs.7.9 (7.1,8.5) months, respectively. Conclusions: When exploring factors associated with response to 1L platinum-based treatment of OC adjusting for other factors, higher stage was significantly associated with PR, while patients with obesity and poor ECOG status had nonsignificantly greater odds of PR. PR patients have poorer survival and fewer treatment options, and standard of care treatment of 1L OC in these subgroups should be further explored to address this unmet need.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 9
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e17541-e17541
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e17541-e17541
    Abstract: e17541 Background: The COVID-19 pandemic presented challenges for patients with ovarian cancer (OC). The objectives of this study were to compare patient remission outcomes following first-line treatment before and after the onset of the pandemic, and to evaluate potential racial/ethnic disparities in remission outcomes during the pandemic. Methods: This retrospective cohort study was conducted at Kaiser Permanente Southern California (KPSC), a large, integrated healthcare delivery system. Patients diagnosed with Stage I-IV epithelial ovarian cancer 01/01/2017-06/30/2021 were included. Pre and post pandemic periods were designated using 03/04/2020 as the cut-off. Data on cancer characteristics and treatment were obtained from KPSC’s electronic medical records. Chart review was conducted to collect data on complete and clinical remission (complete + partial remission) after first course of treatment. Imaging showing no evidence of disease and normal CA 125 values were used to define complete remission. Partial remission was defined as an incomplete response to therapy documented by the treating physician. Other variables included age and stage at diagnosis, race/ethnicity, Charlson’s comorbidity index, neighborhood deprivation index and prior membership. Modified Poisson regression with robust error variance was used to evaluate the association for the pandemic period and race/ethnicity with the remission outcomes. Results: Of 728 patients included, 531 and 197 patients were diagnosed in the pre-pandemic and pandemic periods, respectively. The distributions of the patients’ age, race, and stage were similar between the pre-pandemic and pandemic period. The cohort was racially/ethnically diverse: 46.0% White, 33.5% Hispanic, 7.4% Black, and 13.1% Asian. Complete remission was observed in 406 (76.5%) patients in the pre-pandemic period compared to 149 (75.6%) patients in the pandemic period (p=0.82). Clinical remission was observed in 473 (89.1%) patients in per-pandemic and 176 (89.34%) patients in pandemic period (p=0.92). No statistically significant associations were found between the remission outcomes and the pandemic in the adjusted models. Black patients had lower complete remission rates (but not lower clinical remission rates) compared to White patients in the pandemic period (p=0.06). Of note, Black patients had 67.6% complete remission rate in the pre-pandemic period whereas only 35.3% achieved complete remission in the pandemic period (p=0.01). However, the number of Black patients in the pandemic period was small (N=17). Conclusions: Overall, patients diagnosed with ovarian cancer achieved similar complete and clinical remission rates between the pre-pandemic and pandemic period. Complete remission varies across subgroups of patients. This finding needs to be further investigated with a larger sample.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 10
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e15063-e15063
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e15063-e15063
    Abstract: e15063 Background: Despite the availability of genomic technologies to inform treatment for oncology patients, widespread adoption of genomic testing in the U.S. has been challenging. Little information is available about the factors that influence clinical decision making regarding the use of TMB testing. The purpose of this study was to identify barriers to the adoption of TMB testing and preferred strategies to increase testing from the physician’s perspective. Methods: Semi-structured video-based interviews were conducted with a sample of U.S. physicians (N = 11), including 6 general medical oncologists, 3 surgical oncologists, and 2 gynecologic oncologists. Physicians were asked about practice characteristics, perceived barriers to testing, and potential strategies for alleviating these barriers. Results: Eighty-two percent (N = 9) of physicians reported utilizing TMB testing in their routine clinical practice. Reimbursement was the most commonly reported barrier (64%) including coverage policy language indicating the testing as “experimental”/“unproven”, patients having to pay out of pocket, and unclear/inconsistent payer policies (27% each) [Table 1]. Knowledge, resource-related, and logistical barriers were reported among the same proportion of physicians (45%). Suggested strategies to improve TMB testing uptake rates among physicians included better understanding of clinical utility of the test and corresponding therapies, integrating results into electronical medical records, incorporating TMB into routine testing, and shorter turnaround time for results. Conclusions: This qualitative study of physicians identified barriers to TMB testing of oncology patients. Results suggest that challenges around reimbursement, knowledge, resources, and logistics are key barriers to use of TMB testing for physicians. The findings of this study provide insights for future research and strategies to increase the adoption of TMB testing. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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