Publications by authors named "Maryam Qureshi"

11 Publications

  • Page 1 of 1

Missing in Action: Reports of Interdisciplinary Integration in Canadian Palliative Care.

Curr Oncol 2021 07 16;28(4):2699-2707. Epub 2021 Jul 16.

Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB T2N 4N2, Canada.

Palliative care has an interdisciplinary tradition and Canada is a leader in its research and practice. Yet even in Canada, a full interdisciplinary complement is often lacking, with psychosocial presence ranging from 0-67.4% depending on the discipline and region. We sought to examine the most notable gaps in care from the perspective of Canadian palliative professionals. Canadian directors of palliative care programs were surveyed with respect to interdisciplinary integration. Participants responded in writing or by phone interview. We operationalized reports of interdisciplinary professions as either "present" or "under/not-represented". The Vaismoradi, Turunen, and Bondas' procedure was used for content analysis. Our 14 participants consisted of physicians (85.7%), nurses (14.3%), and a social worker (7.1%) from Ontario (35.7%), British Columbia (14.3%), Alberta (14.3%), Quebec (14.3%), Nova Scotia (14.3%), and New Brunswick (7.1%). Psychology and social work were equally and most frequently reported as "under/not represented" (5/14, each). All participants reported the presence of medical professionals (physicians and nurses) and these groups were not reported as under/not represented. Spiritual care and others (e.g., rehabilitation and volunteers) were infrequently reported as "under/not represented". Qualitative themes included Commonly Represented Disciplines, Quality of Multidisciplinary Collaboration, Commonly Under-Represented Disciplines, and Special Concern: Psychosocial Care. Similar to previous reports, we found that (1) psychology was under-represented yet highly valued and (2) despite social work's relative high presence in care, our participants reported a higher need for more. These finding highlight those psychosocial gaps in care are most frequently noted by palliative care professionals, especially psychology and social work. We speculate on barriers and enablers to addressing this need.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/curroncol28040235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293061PMC
July 2021

Reflecting on Palliative Care Integration in Canada: A Qualitative Report.

Curr Oncol 2021 07 19;28(4):2753-2762. Epub 2021 Jul 19.

Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB T2N 4N2, Canada.

Studies have identified integrated interdisciplinary care as a hallmark of effective palliative care. Although models attempt to show how integration may function, there is little literature available that practically explores how integration is fostered and maintained. In this study we asked palliative care clinicians across Canada to comment on how services are integrated across the healthcare system. This is an analysis of qualitative data from a larger study, wherein clinicians provided written responses regarding their experiences. Content analysis was used to identify response categories. Clinicians ( = 14) included physicians, a nurse and a social worker from six provinces. They identified the benefits of formalized relationships and collaboration pathways with other services to streamline referral and consultation. Clinicians perceived a need for better training of residents and primary care physicians in the community and more acceptance, shared understanding, and referrals. Clinicians also described integrating well with oncology departments. Lastly, clinicians considered integration a complex process with departmental, provincial, and national involvement. The needs and strengths identified by the clinicians mirror the qualities of successfully integrated palliative care programs globally and highlight specific areas in policy, education, practice, and research that could benefit those in Canada.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/curroncol28040240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293234PMC
July 2021

DNA methylation profile of genes involved in inflammation and autoimmunity correlates with vascular function in morbidly obese adults.

Epigenetics 2021 Jan 25:1-17. Epub 2021 Jan 25.

Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.

Obesity is a major risk factor for cardiovascular disease. Blood-detected epigenetic profiles may serve as non-invasive clinically relevant biomarkers. Therefore, we investigated DNA methylation of genes involved in inflammation in peripheral blood of obese subjects and lean controls and their correlation with cardiometabolic measurements. We obtained blood and adipose tissue (AT) samples from bariatric patients (n = 24) and control adults (n = 24). AT-isolated arterioles were tested for flow-induced dilation (FID) and production of nitric oxide (NO) and reactive oxygen species (ROS). Brachial artery flow-mediated dilation (FMD) was measured via doppler ultrasound. Promoter methylation of 94 genes involved in inflammation and autoimmunity were analysed in whole-blood DNA in relation to vascular function and cardiometabolic risk factors. 77 genes had ahigher methylated fraction in the controls compare obese subjects and 28 proinflammatory genes were significantly hypomethylated in the obese individuals; on top of these genes are , and . Fifteen of these genes had significantly higher mRNA in obese subjects compared to controls; on top of these genes are , and . Methylation % inversely correlated with BMI, total fat %, visceral fat%, blood pressure, fasting plasma insulin, serum IL6 and C-reactive protein, arteriolar ROS, and alcohol consumption and positive correlations with lean %, HDL, plasma folate and vitamin B12, arteriolar FID and NO production, and brachial FMD. Our results suggest that vascular dysfunction in obese adults may be attributed to asystemic hypomethylation and over expression of the immune-related genes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/15592294.2021.1876285DOI Listing
January 2021

A CT-Scan review of anatomical variants of sinonasal region and its correlation with symptoms of sinusitis (nasal obstruction, facial pain and rhinorrhea).

Pak J Med Sci 2021 Jan-Feb;37(1):195-200

Prof. Dr. Ambreen Usmani, Ph.D. (Anatomy), HOD, Principal, Department of Anatomy, Bahria University Medical and Dental College, Karachi, Pakistan.

Objective: To determine the incidence of anatomical variants of sinonasal region and its correlation with symptoms of sinusitis.

Methods: The study was conducted from January-June 2020 at Radiology Department of PNS Shifa Hospital, Karachi. The study involved 50 symptomatic subjects of sinusitis with age ranges from 18-60 years which were prepared for computed tomography of paranasal sinuses. The scans were reviewed for nasal-septum, turbinates, uncinate process, ethmoid air-cells along with other anatomical variants and were correlated with symptoms of sinusitis.

Results: Out of 50 subjects, 34 were males and 16 were females with mean age of 42.68±18.22 years. Most common anatomical variants observed were agger nasi cells (64%), deviated nasal septum (56%), and concha-bullosa (46%). Statistically significant correlation existed between bilateral agger nasi cells and nasal obstruction (p=0.017, ρ= -0.336).

Conclusion: The anatomy of sinonasal region is highly complex. However, anatomical variants can disturb the sinus mucociliary drainage pathway resulting in patient suffering. Therefore, considering the variable anatomy of sinonasal region, CT-PNS is recommended for every subject in order to avoid surgical hazards.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12669/pjms.37.1.3260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794148PMC
January 2021

Hyperhomocysteinemia and Low Folate and Vitamin B12 Are Associated with Vascular Dysfunction and Impaired Nitric Oxide Sensitivity in Morbidly Obese Patients.

Nutrients 2020 Jul 7;12(7). Epub 2020 Jul 7.

Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.

There is a high prevalence of hyperhomocysteinemia that has been linked to high cardiovascular risk in obese individuals and could be attributed to poor nutritional status of folate and vitamin B12. We sought to examine the association between blood homocysteine (Hcy) folate, and vitamin B12 levels and vascular dysfunction in morbidly obese adults using novel ex vivo flow-induced dilation (FID) measurements of isolated adipose tissue arterioles. Brachial artery flow-mediated dilation (FMD) was also measured. Subcutaneous and visceral adipose tissue biopsies were obtained from morbidly obese individuals and non-obese controls. Resistance arterioles were isolated in which FID, acetylcholine-induced dilation (AChID), and nitric oxide (NO) production were measured in the absence or presence of the NO synthase inhibitor, L-NAME, Hcy, or the superoxide dismutase mimetic, TEMPOL. Our results demonstrated that plasma Hcy concentrations were significantly higher, while folate, vitamin B12, and NO were significantly lower in obese subjects compared to controls. Hcy concentrations correlated positively with BMI, fat %, and insulin levels but not with folate or vitamin B12. Brachial and arteriolar vasodilation were lower in obese subjects, positively correlated with folate and vitamin B12, and inversely correlated with Hcy. Arteriolar NO measurements and sensitivity to L-NAME were lower in obese subjects compared to controls. Finally, Hcy incubation reduced arteriolar FID and NO sensitivity, an effect that was abolished by TEMPOL. In conclusion, these data suggest that high concentrations of plasma Hcy and low concentrations of folate and vitamin B12 could be independent predictors of vascular dysfunction in morbidly obese individuals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu12072014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400872PMC
July 2020

"In the same boat"-a mixed-methods exploration of reasons why male gastrointestinal cancer patients joined a professionally led men-only cancer support group.

J Cancer Surviv 2020 06 18;14(3):261-272. Epub 2019 Dec 18.

Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.

Purpose: Gastrointestinal (GI) cancer patients often suffer high rates of distress and social isolation, partially due to symptoms that are embarrassing or difficult to discuss with family or friends. Group support therapies mitigate illness-related stigma and standardization; however, men, in particular, are more averse to joining. Through an ongoing men-only GI cancer support group, this study sought to understand who joined the groups, what facilitated group uptake, and explore men's reasons for enrolling in the group.

Methods: A mixed-methods study design and analysis were used. A qualitative design utilizing open-ended, semi-structured interviews and thematic analysis were used; Theory of Planned Behavior (TPB) directed the inquiry towards facets of group uptake. Standardized measures were also used to assess distress, coping, and quality of life (QoL) and compared with normative values for cancer and general population. Data from qualitative and quantitative findings were triangulated.

Results: Participants included 35 male GI cancer patients, aged 28-72, at varying stages of illness and treatment. Themes related to group uptake and enrollment were endorsement; composition; and attitudes, and reasons for joining were learning new coping techniques and affiliations with similar others. Men's QoL and psychological distress scores were on par with cancer patient norms. The scores obtained from quantitative scales corroborated with our qualitative findings.

Conclusions: Despite psychosocial, demographic, and clinical variations, participants were keen on joining a male-only Supportive-Expressive Therapy (SET) group to address their emotional, informational, and supportive care needs and express their solidarity for other patients.

Implications For Cancer Survivors: Findings bear clinical relevance for designing GI male-centered group formats that endorse men's needs and facilitate their accessibility to group support interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11764-019-00838-xDOI Listing
June 2020

Effect of different solvent extracted samples from the leaves and fruits of Datura stramonium on the growth of bacteria and fungi.

Pak J Pharm Sci 2019 Jan;32(1):177-184

Department of Agronomy, The University of Agriculture, Peshawar, KPK, Pakistan.

Different solvent extracted samples from the leaves and fruits tissues of D. stramonium were tested against five pathogenic microorganisms by disc diffusion susceptibility method using 1, 2 and 3mg disc concentrations. Methanol and chloroform extracted fractions from both leaves and fruits measured good growth inhibition of all the tested microorganisms at all concentrations. Bacillus subtilis was very resistant to n-butanol and aqueous extracted fractions of fruits tissues at all the tested three concentrations. The growths of Pseudomonas aeruginosa and Klebsiella pnuemonia were efficiently reduced by all the solvent extracted fractions from the fruits while aqueous fraction was unable to restrain the growth of Bacillus subtilis. The growth of Candida albicans was effectively reduced by aqueous extracted fraction from the leaves tissue at the highest concentration. Maximum growth reduction of (77%) was shown by chloroform extracted fractions from the leaves against Klebsiella pneumonia at 3mg disc-1 concentration. Minimum zone of inhibition (35.4%) was measured by n-butanol extracted fractions from the leaves against Pseudomonas aeruginosa at the lowest concentrations of 1mg disc. In case of leaves the most vulnerable bacteria was Bacillus subtilis while in case of fruits Klebsiella pneumonia was the most susceptible while Bacillus subtilis was the most resistant one.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2019

Integrative Oncology Trials in the Real World: Assessing the Pragmatism of an Ongoing Integrative Oncology Trial of Mindfulness and T'ai Chi/Qigong.

J Altern Complement Med 2018 Sep/Oct;24(9-10):926-932

2 Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary , Calgary, Canada .

Objectives: The aim of this study was to highlight features of pragmatic real-world integrative oncology research by applying the PRagmatic Explanatory Continuum Indicator Summary (PRECIS-2) criteria to an ongoing integrative oncology clinical trial. The ongoing trial is a preference-based randomized comparative effectiveness trial of mindfulness-based cancer recovery (MBCR) versus t'ai chi/qigong (TCQ) for cancer survivors (the Mindfulness and T'ai Chi for Cancer Health [MATCH] study). The primary outcome of the MATCH study is distress, and secondary outcomes are quality of life, sleep disturbance, and physical functioning. The clinical trial is being undertaken at tertiary care cancer centers across two sites in Canada: Calgary (AB) and Toronto (ON), with a sample of 600 cancer survivors who have finished all cancer treatments and are distressed.

Methods And Results: The MATCH trial was scored on the explanatory-pragmatic continuum for each of the nine domains of the PRECIS-2 criteria on a scale of 1-5, and was rated as more explanatory than pragmatic, despite initial design efforts being more pragmatic. Areas that were least pragmatic were methods of recruitment, follow-up, and intervention delivery. The more pragmatic areas were setting, outcomes, and data analysis.

Conclusions: More efforts toward conducting pragmatic trials are needed in the field of integrative oncology, as cancer-care institutions and policy makers are looking for sustainable interventions within already established treatment models. The PRECIS-2 criteria can help researchers meet these goals in the planning stages of trial development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/acm.2018.0208DOI Listing
October 2018

Cancer and Complementary Therapies: Current Trends in Survivors' Interest and Use.

Integr Cancer Ther 2018 09 9;17(3):844-853. Epub 2018 Apr 9.

1 University of Calgary, Calgary, AB, Canada.

Background: Cancer survivors use complementary therapies (CTs) for a variety of reasons; however, with interest and use reportedly on the rise and a widening range of products and practices available, there is a need to establish trends in and drivers of interest. We aimed to determine (1) frequencies of use, level of interest, and barriers for 30 specific CTs and (2) whether physical symptoms, perceived stress (PS), or spiritual well-being were related to interest levels.

Method: A total of 212 cancer outpatients were surveyed at the Tom Baker Cancer Centre in Calgary, Canada.

Results: Overall, up to 75% of survivors already used some form of CTs since their diagnosis. The most highly used were the following: vitamins B12 and D, multivitamins, calcium, and breathing and relaxation exercises. Those who had not used CTs indicated highest interest in massage, vitamin B12, breathing and relaxation, mindfulness-based stress reduction, and antioxidants. The most frequently reported barriers for all CTs were not knowing enough about what a therapy was and not having enough evidence on whether it worked. High PS predicted higher interest for all CTs, but spirituality was not significantly related to any. Physical symptoms, anxiety, and depression were significant predictors of interest for some CTs.

Conclusion: These findings provide a blueprint for future clinical efficacy trials and highlight the need for clinical practice guidelines.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1534735418762496DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142098PMC
September 2018

Mind-Body Therapies in Cancer: What Is the Latest Evidence?

Curr Oncol Rep 2017 Aug 18;19(10):67. Epub 2017 Aug 18.

Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.

Purpose Of Review: Many people living with cancer use complementary therapies, and some of the most popular are mind-body therapies (MBTs), including relaxation and imagery, hypnosis, yoga, meditation, tai chi and qigong, and art therapies. The efficacy of these modalities was reviewed by assessing recent findings in the context of cancer care.

Recent Findings: These therapies show efficacy in treating common cancer-related side effects, including nausea and vomiting, pain, fatigue, anxiety, depressive symptoms and improving overall quality of life. Some also have effects on biomarkers such as immune function and stress hormones. Overall studies lack large sample sizes and active comparison groups. Common issues around clearly defining treatments including standardizing treatment components, dose, intensity, duration and training of providers make generalization across studies difficult. MBTs in cancer care show great promise and evidence of efficacy for treating many common symptoms. Future studies should investigate more diverse cancer populations using standardized treatment protocols and directly compare various MBTs to one another.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11912-017-0626-1DOI Listing
August 2017

YfdW and YfdU are required for oxalate-induced acid tolerance in Escherichia coli K-12.

J Bacteriol 2013 Apr 18;195(7):1446-55. Epub 2013 Jan 18.

Department of Chemistry and Biochemistry, Millsaps College, Jackson, MS, USA.

Escherichia coli has several mechanisms for surviving low-pH stress. We report that oxalic acid, a small-chain organic acid (SCOA), induces a moderate acid tolerance response (ATR) in two ways. Adaptation of E. coli K-12 at pH 5.5 with 50 mM oxalate and inclusion of 25 mM oxalate in pH 3.0 minimal challenge medium separately conferred protection, with 67% ± 7% and 87% ± 17% survival after 2 h, respectively. The combination of oxalate adaptation and oxalate supplementation in the challenge medium resulted in increased survival over adaptation or oxalate in the challenge medium alone. The enzymes YfdW, a formyl coenzyme A (CoA) transferase, and YfdU, an oxalyl-CoA decarboxylase, are required for the adaptation effect but not during challenge. Unlike other SCOAs, this oxalate ATR is not a part of the RpoS regulon but appears to be linked to the signal protein GadE. We theorize that this oxalate ATR could enhance the pathogenesis of virulent E. coli consumed with oxalate-containing foods like spinach.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1128/JB.01936-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624534PMC
April 2013
-->