Linda Carlson

Publications (103) View all

• Article: A prospective phase II study of RICE re-induction, then high-dose fludarabine and busulfan, followed by autologous or allogeneic blood stem cell transplantation for indolent b-cell lymphoma.

  Douglas A Stewart, Qiuli Duan, Linda Carlson, James A Russell, Nizar J Bahlis, Peter Duggan, Wanda Hasegawa, Michael Voralia
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  ABSTRACT: Optimal high dose conditioning and relative roles of autologous stem cell transplantation (autoSCT) or allogeneic (alloSCT) for indolent lymphoma are uncertain. A prospective phase II study evaluated autoSCT and alloSCT depending on availability of sibling donor after uniform rituximab, ifosfamide, carboplatin, etoposide (RICE) re-induction and novel myeloablative fludarabine, busulfan (FluBu) conditioning for patients with mantle cell lymphoma in first remission or first relapse, or indolent lymphoma in first or second relapse. The 68 patients (autoSCT, 36; syngeneic [syn], 1; alloSCT, 31) who were accrued had a 10-month median progression-free survival (PFS) after their last chemotherapy treatment. After RICE, the overall response rate was 69%, and 24 of 39 patients (62%) cleared marrow of lymphoma. Treatment-related mortality at 100 days and 1 year after FluBu were both 0% post-auto/synSCT, but were 6% and 26% post-alloSCT, respectively. At a median follow-up of 60 months, the respective 5-year overall survival and PFS rates were 71% and 46% for auto/synSCT, and were 58% and 47% for alloSCT. Quality of life assessment 1-year post-SCT favoured auto/synSCT. The protocol was feasible, FluBu was well-tolerated, and both auto/synSCT and alloSCT conferred similar 5-year PFS following the RICE-FluBu protocol.
  Clinical lymphoma, myeloma & leukemia 08/2011; 11(6):475-82.
• Article: Facilitating the implementation of empirically valid interventions in psychosocial oncology and supportive care.

  Thomas F Hack, Linda Carlson, Lorna Butler, Lesley F Degner, Fabijana Jakulj, Tom Pickles, J Dean Ruether, Lorna Weir
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  ABSTRACT: Over the past two decades, the fields of psychosocial oncology and supportive care have seen clinically effective tools as underutilized despite proven benefits to cancer patients and their families. The purpose of this paper is to discuss the reasons for the failure of psychosocial and supportive care interventions in oncology to realize broad clinical implementation and to demonstrate how a knowledge management framework offers several advantages for increasing the probability of successful implementation. This paper is based on a systematic review of the literature pertaining to efforts to implement psychosocial oncology and supportive care interventions. The struggle to develop, implement, and evaluate promising psychosocial oncology and supportive care innovations has moved academic thought toward the development of models and theories concerning the best ways to move new knowledge into clinical practice. There are critical and common barriers to the successful transfer and implementation of promising interventions, and implementation efforts may be maximized by using knowledge management frameworks to systematically identify and address these barriers. The successful implementation of empirically promising interventions requires research networks and practice groups to work together in a concerted, theory-guided effort to identify and address the contextual factors most relevant to any particular intervention. The growing support of knowledge implementation activities by research funders, policy-makers, opinion leaders, and advocates of psychosocial and supportive care interventions is a positive move in this direction.
  Supportive Care in Cancer 04/2011; 19(8):1097-105. · 2.09 Impact Factor
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  Available from: Linda Carlson

  Article: Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR)

  Kathryn Birnie, Michael Speca, Linda Carlson
  Stress and Health 12/2010; 26(5):359. · 1.23 Impact Factor
• Article: Mindfulness-informed therapy.

  Shauna L. Shapiro, Linda E. Carlson
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  ABSTRACT: Now we turn to a second pathway for integrating mindfulness into psychotherapy: mindfulness-informed therapy. Mindfulness-informed therapy offers a framework for integrating wisdom and insights from Buddhist literature, the psychological mindfulness literature, and one’s own personal practice into therapeutic work; however, the therapist does not explicitly teach mindfulness meditation practice (Germer, Siegel, & Fulton, 2005). Often clinical psychologists and others in the helping professions believe the teachings of Buddhism and the practice of mindfulness have value for their clients, but the nature of the clinical work, the client, or the setting makes it inappropriate or impractical to explicitly teach formal mindfulness practice. Whether formal meditation practice is an appropriate intervention is an individual clinical decision made by the therapist or by the therapist and client together, which takes into account all of the variables involved in the individual case. The research literature has not definitively identified specific patient populations that are contraindicated; however, it is also clear that formal mindfulness practice should not be considered a panacea for all people, all conditions, and all circumstances. There are many situations in which meditation may not be the most effective intervention. For example, Johanson (2006) suggested that persons with personality disorders require “counseling in ordinary consciousness” before they are taught formal meditation practice that requires them to look deeply inside themselves (p. 23). He went on to suggest that persons “on the edges of psychosis do not have sufficient psychic structures in place to allow them to study themselves mindfully” (p. 23). Others have suggested that persons diagnosed with major depressive disorder may be so severely depressed that they do not have the concentration capacity to engage in formal meditation, and further, attempts at formal meditation may lead to rumination, which can perpetuate the depressive episode. Similarly, there is controversy about the application of formal meditation in cases of traumatic stress. In light of the many circumstances in which formal practice may not be effective or appropriate, it is helpful to consider applications of mindfulness-informed therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  10/2012;
• Article: Mindfulness-Based Stress Reduction for the Treatment of Irritable Bowel Syndrome Symptoms: A Randomized Wait-list Controlled Trial.

  Kristin A Zernicke, Tavis S Campbell, Philip K Blustein, Tak S Fung, Jillian A Johnson, Simon L Bacon, Linda E Carlson
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  ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is a functional disorder of the lower gastrointestinal (GI) tract affected by stress, which may benefit from a biopsychosocial treatment approach such as mindfulness-based stress reduction (MBSR). PURPOSE: A treatment as usual (TAU) wait-list controlled trial was conducted in Calgary, Canada to investigate the impact of MBSR on IBS symptoms. It was hypothesized that MBSR patients would experience greater reduction in overall IBS symptom severity and self-reported symptoms of stress relative to control patients. METHOD: Ninety patients diagnosed with IBS using the Rome III criteria were randomized to either an immediate MBSR program (n = 43) or to wait for the next available program (n = 47). Patients completed IBS symptom severity, stress, mood, quality of life (QOL), and spirituality scales pre- and post-intervention or waiting period and at 6-month follow-up. Intent-to-treat linear mixed model analyses for repeated measures were conducted, followed by completers analyses. RESULTS: While both groups exhibited a decrease in IBS symptom severity scores over time, the improvement in the MBSR group was greater than the controls and was clinically meaningful, with symptom severity decreasing from constantly to occasionally present. Pre- to post-intervention dropout rates of 44 and 23 % for the MBSR and control groups, respectively, were observed. At 6-month follow-up, the MBSR group maintained a clinically meaningful improvement in overall IBS symptoms compared to the wait-list group, who also improved marginally, resulting in no statistically significant differences between groups at follow-up. Improvements in overall mood, QOL, and spirituality were observed for both groups over time. CONCLUSIONS: The results of this trial provide preliminary evidence for the feasibility and efficacy of a mindfulness intervention for the reduction of IBS symptom severity and symptoms of stress and the maintenance of these improvements at 6 months post-intervention. Attention and self-monitoring and/or anticipation of MBSR participation may account for smaller improvements observed in TAU patients.
  International Journal of Behavioral Medicine 05/2012; · 2.63 Impact Factor