Publications by authors named "Flora D"

Objective: This study investigated biological, psychological, and behavioral aspects of caregivers' responses to toddlers' pain-related distress by measuring caregivers' high-frequency heart rate variability (HRV) responses during toddler vaccination pain and examining associations with caregivers' behavioral responses and psychological stress.

Methods: Participants included caregiver-toddler dyads (N = 194) from a longitudinal cohort-sequential study who were observed during toddlers' 12-, 18-, or 24-month routine vaccinations. Changes in caregiver HRV were analyzed using growth curve modeling.

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The early stages of the COVID-19 pandemic exposed large portions of the global populations to increased daily stressors. Research on risky choice in medical contexts suggests that affect-rich choice options promote less-advantageous decision strategies compared with affect-poor options, causing an "affect gap" in decision making. The current experiments (total  = 437, age range: 21-82) sought to test whether negative pandemic-related affect would lower expected-value (EV) maximisation within individuals.

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Introduction:: Patients with thoracic cancers have one of the highest mortality rates among patients with cancer and COVID-19. Data evaluating the impact of recent anti-cancer therapies on COVID-19 outcomes in patients with thoracic cancers are confined to heterogenous studies with limited follow-up data. We leveraged data from the COVID-19 and Cancer Consortium (CCC19) (NCT04354701) to analyze the impact of recent anti-cancer therapies on the clinical outcomes of COVID-19 in patients with thoracic cancers.

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We explored patient front-line treatment preferences in newly diagnosed stage III/IV classic Hodgkin lymphoma (cHL). The CONNECT patient survey, administered online from 30 December 2020 to 1 March 2021, examined preferences overall and by age at diagnosis in 182 adult patients diagnosed with stage III/IV cHL within the past 10 years in the United States. At diagnosis, patients' median age was 36 years; 66% of patients were younger (aged 16-41 years) and 34% older (aged 42-85 years).

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Coefficient omega indices are model-based composite reliability estimates that have become increasingly popular. A coefficient omega index estimates how reliably an observed composite score measures a target construct as represented by a factor in a factor-analysis model; as such, the accuracy of omega estimates is likely to depend on correct model specification. The current paper presents a simulation study to investigate the performance of omega-unidimensional (based on the parameters of a one-factor model) and omega-hierarchical (based on a bifactor model) under correct and incorrect model misspecification for high and low reliability composites and different scale lengths.

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Background: Past research has established the important role of parent soothing in early childhood pain management. However, limited research has assessed children's own emerging emotion regulation strategies to reduce their pain during vaccination. The purpose of the current study was to understand the relative contributions of child-led emotion-regulation behaviours over and above parent regulatory behaviours and pre-needle distress.

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Background: Early life exposure to lead, mercury, polychlorinated biphenyls (PCBs), polybromide diphenyl ethers (PBDEs), organophosphate pesticides (OPPs), and phthalates have been associated with lowered IQ in children. In some studies, these neurotoxicants impact males and females differently. We aimed to examine the sex-specific effects of exposure to developmental neurotoxicants on intelligence (IQ) in a systematic review and meta-analysis.

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Purpose: As part of the CONNECT study, we evaluated the caregiver role in treatment decision-making when caring for patients with classic Hodgkin lymphoma (cHL) in the USA.

Methods: The CONNECT caregiver survey was administered online December 2020-March 2021 to self-identified adult caregivers of cHL patients recruited from patient referrals and online panels. The caregiver's role in treatment decision-making, health-related quality of life (HRQoL, PROMIS-Global), and work impacts (WPAI:CG) were assessed.

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Article Synopsis
  • This study investigates the impact of COVID-19 on female patients with breast cancer, particularly focusing on underrepresented racial/ethnic populations from March 2020 to June 2021 in the US.
  • The analysis included 1,383 patients, revealing that older age and certain racial/ethnic groups (such as Black and Asian American/Pacific Islanders) showed higher odds of severe COVID-19 outcomes.
  • Key findings noted that factors like worse performance status, pre-existing health conditions, and active cancer significantly contributed to increased severity, while variables like Hispanic ethnicity and anti-cancer therapy type did not impact outcomes as much.
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Introduction: Toddlers rely on their caregivers for regulatory support when faced with pain-related distress. The caregiver's ability to support their toddler relies on their capacity to regulate their own distress and respond effectively to the child's need for support. The aim of the current study was to describe patterns of caregiver-toddler physiological co-regulatory patterns, also known as attunement, during routine vaccinations across the second year of life.

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To understand US physicians' frontline (1L) treatment preferences/decision-making for stage III/IV classic Hodgkin lymphoma (cHL). Medical oncologists and/or hematologists (≥2 years' practice experience) who treat adults with stage III/IV cHL were surveyed online (October-November 2020). Participants (n = 301) most commonly considered trial efficacy/safety data and national guidelines when selecting 1L cHL treatments.

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Importance: Systematic data on the association between anticancer therapies and thromboembolic events (TEEs) in patients with COVID-19 are lacking.

Objective: To assess the association between anticancer therapy exposure within 3 months prior to COVID-19 and TEEs following COVID-19 diagnosis in patients with cancer.

Design, Setting, And Participants: This registry-based retrospective cohort study included patients who were hospitalized and had active cancer and laboratory-confirmed SARS-CoV-2 infection.

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Objective: This study examined associations between Sport Concussion Assessment Tool-5 (SCAT-5) symptom reporting and gold-standard measures of anxiety and depression, and explored the utility SCAT-5 symptom subscales to identify anxiety and depression symptomology.

Design: Prospective cross-sectional study.

Setting: York University in Toronto, Canada.

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Objective: The current study discusses the development and preliminary validation of an observational measure of caregivers' distress-promoting behavior (OUCHIE-RV) in the context of toddler routine vaccination.

Methods: Measure validation was based on a sample of caregiver-toddler dyads (N = 223) from a longitudinal cohort-sequential study who were observed during toddlers' 12-, 18-, or 24-month routine vaccinations. Validity was assessed using correlations and cross-lagged path analysis and associations were tested between OUCHIE-RV composite scores and toddlers' pain-related distress as well as caregivers' state anxiety, soothing behaviors, heart rate, and heart rate variability.

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The development of new approaches allowing for the early assessment of COVID-19 cases that are likely to become critical and the discovery of new therapeutic targets are urgently required. In this prospective cohort study, we performed proteomic and laboratory profiling of plasma from 163 COVID-19 patients admitted to Bauru State Hospital (Brazil) between 4 May 2020 and 4 July 2020. Plasma samples were collected upon admission for routine laboratory analyses and shotgun quantitative label-free proteomics.

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  • A study examined outcomes of cancer patients who got COVID-19, focusing on those with and without existing cardiovascular disease (CVD) or risk factors (CVRF).
  • The research found that over half of the 10,876 patients had CVD/CVRF, which linked to more severe COVID-19 symptoms and complications.
  • Notably, patients without recent cancer treatment experienced worse COVID-19 severity related to CVD/CVRF compared to those under active treatment.
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  • The study investigates the impact of COVID-19 on female breast cancer patients using a large U.S. registry during 2020-2021, focusing on underrepresented racial/ethnic populations.
  • Key findings show that older age, being Black, Asian American/Pacific Islander, and having worse overall health significantly increase the severity of COVID-19 in these patients.
  • The overall hospitalization rate was 37% and mortality rate 9%, but these rates varied depending on the active status of breast cancer in patients.
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This systematic review and narrative synthesis characterized parents' physiological stress responses to child distress and how parents' physiological and behavioural responses relate. The review was pre-registered with PROSPERO (#CRD42021252852). In total, 3607 unique records were identified through Medline, Embase, PsycINFO, and CINAHL.

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Objective: Previous research discerned 3 groups of caregiver-toddler dyads that differed in their physiological coregulatory patterns, also known as physiological attunement, during routine vaccinations in the second year of life. One group of dyads (80% of sample) displayed an attuned regulatory pattern, and 2 groups of dyads (20% of sample) showed maladaptive attunement patterns (ie, a lack of attunement or misattunement). The objective of the current study was to examine how well the pain-related distress of children and caregivers during vaccination predicted these patterns.

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Bone metastases are common in advanced breast cancer (BC) patients and increase the risk for skeletal-related events (SREs), which present a significant health and economic burden. Bone targeting agents (BTAs) can improve health-related quality of life by delaying or preventing SREs; nevertheless, a significant portion of eligible BC patients are not receiving this therapy. A bone health education needs assessment survey was conducted to examine cancer-related bone health awareness and to identify opportunities to improve bone health education.

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Introduction: COVID-19 particularly impacted patients with co-morbid conditions, including cancer. Patients with melanoma have not been specifically studied in large numbers. Here, we sought to identify factors that associated with COVID-19 severity among patients with melanoma, particularly assessing outcomes of patients on active targeted or immune therapy.

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Purpose: We surveyed oncologists who treat classic Hodgkin lymphoma (cHL) as part of the CONNECT study to understand the treatment decision-making process, including the impact of positron emission tomography/computed tomography (PET/CT) imaging.

Methods: US physicians self-identifying as oncologists, hematologists, or hematologists/oncologists with ≥2 years of practice experience who treated ≥1 adult with stage III/IV cHL in the frontline setting in the last year were surveyed (October 19-November 16, 2020). Physician demographics, guideline adherence, and PET/CT utilization, interpretation, and access barriers were assessed.

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