Steven Verhulst

Southern Illinois University School of Medicine, Springfield, Illinois, United States

Are you Steven Verhulst?

Claim your profile

Publications (117)325.83 Total impact

  • Journal of Surgical Education 11/2015; 72(6):e212-e217. DOI:10.1016/j.jsurg.2015.05.002 · 1.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Social cognitive theory (SCT) measures related to exercise adherence in head and neck cancer (HNCa) patients were developed. Enrolling 101 HNCa patients, psychometric properties and associations with exercise behavior were examined for barriers self-efficacy, perceived barriers interference, outcome expectations, enjoyment, and goal setting. Cronbach's alpha ranged from .84 to .95; only enjoyment demonstrated limited test-retest reliability. Subscales for barriers self-efficacy (motivational, physical health) and barriers interference (motivational, physical health, time, environment) were identified. Multiple SCT constructs were cross-sectional correlates and prospective predictors of exercise behavior. These measures can improve the application of the SCT to exercise adherence in HNCa patients.
    Journal of Psychosocial Oncology 07/2015; 33(5). DOI:10.1080/07347332.2015.1067277 · 1.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Tobramycin is a critical cystic fibrosis treatment however it causes ototoxicity. This study tested d-methionine protection from tobramycin-induced ototoxicity and potential antimicrobial interference. Auditory brainstem responses (ABRs) and outer hair cell (OHC) quantifications measured protection in guinea pigs treated with tobramycin and a range of d-methionine doses. In vitro antimicrobial interference studies tested inhibition and post antibiotic effect assays. In vivo antimicrobial interference studies tested normal and neutropenic Escherichia coli murine survival and intraperitoneal lavage bacterial counts. d-Methionine conferred significant ABR threshold shift reductions. OHC protection was less robust but significant at 20kHz in the 420mg/kg/day group. In vitro studies did not detect d-methionine-induced antimicrobial interference. In vivo studies did not detect d-methionine-induced interference in normal or neutropenic mice. d-Methionine protects from tobramycin-induced ototoxicity without antimicrobial interference. The study results suggest d-met as a potential otoprotectant from clinical tobramycin use in cystic fibrosis patients. Published by Elsevier B.V.
    Journal of cystic fibrosis: official journal of the European Cystic Fibrosis Society 07/2015; DOI:10.1016/j.jcf.2015.06.005 · 3.48 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To improve mechanistic understanding, this pilot randomized controlled trial examined mediators of an exercise intervention effects on sleep in breast cancer survivors (BCS).Methods Forty-six postmenopausal BCS (≤Stage II, off primary treatment) were randomized to a 3-month exercise intervention or control group. Intervention included 160 min/week of moderate intensity aerobic walking, twice weekly resistance training (resistance bands), and six discussion groups (to improve adherence). Blinded assessments at baseline and post-intervention included sleep disturbance (PSQI and PROMIS®), objective sleep quality (accelerometer), serum cytokines, accelerometer physical activity, cardiorespiratory fitness, body composition, fatigue, and psychosocial factors. Mediation was tested using Freedman-Schatzkin difference-in-coefficients tests.ResultsWhen compared with control, the intervention group demonstrated a significant increase in PSQI sleep duration (i.e., fewer hours of sleep/night) (d = 0.73, p = .03). Medium to large but non-significant standardized effect sizes were noted for PSQI daytime somnolence (d = −0.63, p = .05) and accelerometer latency (d = −0.49, p = .14). No statistically significant mediators were detected for PSQI sleep duration score or accelerometer latency. Daytime somnolence was mediated by tumor necrosis factor-alpha (mediated 23% of intervention effect, p < .05), interleukin (IL)-6:IL-10 (16%, p < .01), IL-8:IL-10 (26%, p < .01), and fatigue (38%, p < .05). Mediating or enhancing relationships for several of the sleep outcomes were noted for accelerometer physical activity, PROMIS® fatigue, exercise social support, and/or physical activity enjoyment.Conclusions Inflammation and psychosocial factors may mediate or enhance sleep response to our exercise intervention. Further study is warranted to confirm our results and translate our findings into more effective interventions aimed at improving sleep quality in BCS.
    Psycho-Oncology 03/2015; 24(3). DOI:10.1002/pon.3594 · 2.44 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Most breast cancer survivors (BCS) are not meeting recommended physical activity guidelines. Here, we report the effects of the Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention on physical activity, aerobic fitness, and quality of life (QoL). We randomized 222 post-primary treatment BCS to the 3-month intervention (BEAT Cancer) or usual care (UC). BEAT Cancer combined supervised exercise, face-to-face counseling, and group discussions with tapering to home-based exercise. Assessments at baseline, immediately post-intervention (month 3; M3), and 3 months post-intervention (month 6; M6) included accelerometer and self-reported physical activity, submaximal treadmill test, and QoL [Functional Assessment of Cancer Therapy (FACT)-Breast scale]. Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer compared to UC on weekly minutes of ≥moderate intensity physical activity at M3 by accelerometer [mean between group difference (M) = +41; 95 % confidence interval (CI) = 10-73; p = 0.010] and self-report (M = +93; CI = 62-123; p < 0.001). Statistical significance remained at M6 for self-reported physical activity (M = +74; CI = 43-105; p < 0.001). BEAT Cancer participants were significantly more likely to meet physical activity recommendations at both time points [accelerometer M3 adjusted odds ratio (OR) = 2.2; CI = 1.0-4.8 and M6 adjusted OR = 2.4; CI = 1.1-5.3; self-report M3 adjusted OR = 5.2; CI = 2.6-10.4 and M6 adjusted OR = 4.8; CI = 2.3-10.0]. BEAT Cancer significantly improved fitness at M6 (M = +1.8 ml/kg/min; CI = 0.8-2.8; p = 0.001) and QoL at M3 and M6 (M = +6.4; CI = 3.1-9.7; p < 0.001 and M = +3.8; CI = 0.5-7.2; p = 0.025, respectively). The BEAT Cancer intervention significantly improved physical activity, fitness, and QoL with benefits continuing 3 months post-intervention.
    Breast Cancer Research and Treatment 11/2014; 149(1). DOI:10.1007/s10549-014-3216-z · 3.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To examine the contribution of social cognitive constructs to meeting physical activity (PA) recommendations in rural breast cancer survivors (BCS). Methods: Rural BCS (N = 483) completed a mail-based survey. PA, fatigue, barriers and exercise self-efficacy, environment, social support, and perceived barriers to PA were assessed. PA was dichotomized into either meeting guidelines (150+minutes/week) or not. Results: Our model fit the data well with less fatigue, greater efficacy, and lower barriers being associated with PA (χ²=804.532(418), p < .001, CFI=.948, RMSEA=.044, SRMR=.046). Conclusions: Fatigue, self-efficacy, and perceived barriers are key targets for future interventions designed to increase PA in rural BCS. Enhancing self-efficacy and overcoming barriers will require strategies unique and relevant to BCS living in rural settings.
    American journal of health behavior 11/2014; 38(6):890-9. DOI:10.5993/AJHB.38.6.11 · 1.31 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the diagnostic justification proficiency of senior medical students across a broad spectrum of cases with common chief complaints and diagnoses. The authors gathered diagnostic justification exercise data from the Senior Clinical Comprehensive Examination taken by Southern Illinois University School of Medicine's students from the classes of 2011 (n = 67), 2012 (n = 66), and 2013 (n = 79). After interviewing and examining standardized patients, students listed their key findings and diagnostic possibilities considered, and provided a written explanation of how they used key findings to move from their initial differential diagnoses to their final diagnosis. Two physician judges blindly rated responses. Student diagnostic justification performance was highly variable from case to case and often rated below expectations. Of the students in the classes of 2011, 2012, and 2013, 57% (38/67), 23% (15/66), and 33% (26/79) were judged borderline or poor on diagnostic justification performance for more than 50% of the cases on the examination. Student diagnostic justification performance was inconsistent across the range of cases, common chief complaints, and underlying diagnoses used in this study. More than 20% of students exhibited borderline or poor diagnostic justification performance on more than 50% of the cases. If these results are confirmed in other medical schools, attention needs to be directed to investigating new curricular methods that ensure deliberate practice of these competencies across the spectrum of common chief complaints and diagnoses and do not depend on the available mix of patients.
    Academic medicine: journal of the Association of American Medical Colleges 03/2014; 89(5). DOI:10.1097/ACM.0000000000000215 · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This study aims to describe the effect of 0.9% saline (NS) versus 0.45% saline (half NS) when used during recovery phase of diabetic ketoacidosis (DKA) in children. Methods: A retrospective analysis of all children (1-18 years old) with DKA admitted in the pediatric intensive care unit (PICU) from 2005 to 2009 was undertaken. The primary end point was effect on serum electrolytes and acidosis. Results: Compared to 47 patients who received only NS (group A) throughout the recovery period and 33 patients who received NS but were switched to half NS (group B) at some point during recovery, 41 who received only half NS (group C) had a significant decrease in corrected serum sodium (P < .01). Hyperchloremia leading to nonanion gap acidosis was significantly greater in NS groups A and B than in half NS group C (P < .01). This led to increased duration of insulin infusion and length of stay in the PICU in the NS groups. Conclusions: Hyperchloremia resulting in nonanion gap acidosis can occur and may prolong the duration of insulin infusion and length of PICU stay in patients receiving NS as post-bolus rehydration fluid. Alternatively, the use of half NS may result in a decrease in serum-corrected sodium. Providers need to be vigilant toward this while using higher or lower sodium chloride when managing children with DKA. Larger trials are required to study the clinical significance of the results of this study.
    Journal of Intensive Care Medicine 01/2014; 29(1):38-42. DOI:10.1177/0885066612467149 · 7.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Examine mediators of fatigue response to an exercise intervention for breast cancer survivors (BCS) in a pilot randomized controlled trial. Postmenopausal BCS (n=46; ≤ Stage II), off primary treatment, and reporting fatigue and/or sleep dysfunction were randomized to a 3-month exercise intervention (160 minutes/week of moderate intensity aerobic walking, twice weekly resistance training with resistance bands) or control group. Six discussion group sessions provided behavioral support to improve adherence. Fatigue, serum cytokines, accelerometer physical activity, cardiorespiratory fitness, sleep dysfunction, and psychosocial factors were assessed at baseline and 3 months. Exercise intervention effect sizes for fatigue were: fatigue intensity d=0.30 (p=.34), interference d=-0.38 (p=.22), and general fatigue d=-0.49 (p=.13). Using Freedman-Schatzkin difference-in-coefficients tests, increase in fatigue intensity was significantly mediated by interleukin (IL)-6 (82%), IL-10 (94%), IL-6:IL-10 (49%), and tumor necrosis factor (TNF)-alpha:IL-10 (78%) with reduced sleep dysfunction increasing the relationship between intervention and fatigue intensity rather than mediating intervention effects (-88%). Decrease in fatigue interference was mediated by sleep dysfunction (35%) while IL-10 and pro:anti-inflammatory cytokine ratios increased the relationship between intervention and interference (-25% to -40%). The reduction in general fatigue was significantly mediated by minutes of physical activity (76%), sleep dysfunction (45%), and physical activity enjoyment (40%) with IL-10 (-40%) and IL-6:IL-10 (-11%) increasing the intervention-fatigue relationship. In the intervention group, higher baseline fatigue, anxiety, depression, and perceived exercise barriers interference predicted a greater decline in fatigue interference and/or general fatigue during the intervention. Biobehavioral factors mediated and enhanced intervention effects on fatigue while psychosocial factors predicted fatigue response. Further study is warranted to confirm our results and improve understanding of relationships that mediate and strengthen the intervention-fatigue association.
    Medicine and science in sports and exercise 11/2013; 46(6). DOI:10.1249/MSS.0000000000000210 · 3.98 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This study tested multiple dosing epochs of pre-loaded D-methionine (D-met) for otoprotection from noise-induced hearing loss (NIHL). Design: Auditory brainstem response (ABR) thresholds were measured at baseline, 1 day, and 21 days following a 6-hour 105 dB sound pressure level (SPL) octave band noise (OBN) exposure. Outer hair cell (OHC) counts were measured after day 21 sacrifice. Study sample: Three groups of five Chinchillas laniger each were given a 2-day regimen comprising five doses of D-met (200 mg/kg/dose) intraperitoneally (IP) starting 2, 2.5, or 3 days prior to noise exposure. A control group (n = 5) received five doses of equivalent volume saline IP starting 2.5 days prior to noise exposure. Results: ABR threshold shifts from baseline to day-21 post-noise exposure were reduced in all D-met groups versus controls, reaching significance (p < 0.05) in the 3-day group. D-met groups showed reduced OHC loss relative to controls at day-21 post-noise exposure, reaching significance (p < 0.05) at all frequency regions in the 3-day group and at the 2, 4, and 8 kHz frequency regions in the 2.5-day group. Conclusions: D-met administration in advance of noise-exposure, without further administration, significantly protects from noise-induced ABR threshold shift and OHC loss.
    International journal of audiology 10/2013; 52(12). DOI:10.3109/14992027.2013.840933 · 1.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The purpose of this study was to determine the feasibility of a randomized trial of resistance exercise in patients with head and neck cancer receiving radiation. Methods: Fifteen patients with head and neck cancer receiving radiation were randomized to resistance exercise (using resistance bands) or control group. Resistance exercise occurred at the radiation therapy site (weeks 1-6) and home (weeks 7-12). Results: No serious adverse events occurred related to resistance exercise. Medium to large effect size differences favoring resistance exercise versus control group were noted for perceived fatigue at 6 weeks (smaller increase in fatigue for resistance exercise group; 7.4 vs 15.4, effect size [d] = -0.64), quality of life at 6 weeks (-7.0 vs -14.4, d = 0.52), and chair rise time (seconds) at 6 and 12 weeks (-1.6 vs 0.4, d = -.63 and -1.9 vs 0.1, d = -0.60, respectively). Conclusions: Resistance exercise is safe and feasible in patients with head and neck cancer receiving radiation; a definitive trial is warranted.
    Head & Neck 08/2013; 35(8). DOI:10.1002/hed.23118 · 2.64 Impact Factor
  • Melanie Rylander · Steven Verhulst ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The extraskeletal effects of vitamin D have gained increasing attention with the discovery of receptors in a variety of organ systems. Previous work has identified associations between vitamin D insufficiency and a variety of mental illnesses, including affective, cognitive, and psychotic spectrum disorders. We attempted to determine the point prevalence of vitamin D insufficiency among psychiatric inpatients and determine if there was a relationship between vitamin D insufficiency and specific diagnoses and pharmacological treatments. Methods: This was a retrospective chart review of all adult patients (N=544) admitted to the psychiatric ward of a community hospital in central Illinois between December, 2010 and June, 2011. Results: The mean vitamin D level on admission was 22.3 ng/mL, with a range of 4-79.2 ng/mL. The incidence of vitamin D insufficiency (defined as levels < 30 ng/mL) was 75%. Of those with insufficient levels of vitamin D, only 37% received treatment. Vitamin D insufficiency was not correlated with age, gender, month of admission, length of stay, score on the Global Assessment of Functioning (GAF) scale at admission, diagnosis, or psychotropic medication usage. Conclusions: Vitamin D insufficiency is highly prevalent in psychiatric inpatients. It is unclear whether this is the result of severe mental illness and resultant social isolation, or if vitamin D has a regulatory role on upstream genes involved in neural networks that influence affect, cognition, and perception.
    07/2013; 19(4):296-300. DOI:10.1097/01.pra.0000432599.24761.c1
  • [Show abstract] [Hide abstract]
    ABSTRACT: Opsoclonus-myoclonus syndrome (OMS) is a neuroinflammatory disorder associated with remote cancer. To understand more clearly the role of inflammatory mediators, the concentration of CXCR3 ligands CXCL10, CXCL9 and CXCL11 was measured in 245 children with OMS and 81 paediatric controls using enzyme-linked immunosorbent assay (ELISA), and CXCR3 expression on CD4(+) T cells was measured by flow cytometry. Mean cerebrospinal fluid (CSF) CXCL10 was 2·7-fold higher in untreated OMS than controls. Intrathecal production was demonstrated by significantly different CXCL10 CSF : serum ratios. The dichotomized 'high' CSF CXCL10 group had higher CSF leucocyte count (P = 0·0007) and B cell activating factor (BAFF) and CXCL13 concentrations (P < 0·0001). CSF CXCL10 did not correlate with clinical severity or relapse using grouped data, although it did in some patients. Among seven types of immunotherapy, including rituximab or chemotherapy, only adrenocorticotrophic hormone (ACTH) monotherapy showed reduced CSF CXCL10, but prospective longitudinal studies of ACTH combination therapies indicated no reduction in CXCL10 despite clinical improvement (P < 0·0001). CXCL10 concentrations were 11-fold higher in CSF and twofold higher in serum by multiplexed fluorescent bead-based immunoassay than enzyme-linked immunosorbent assay, but the two correlated (r = 0·7 and 0·83). In serum, no group differences for CXCL9 or CXCL11 were found. CXCR3 expression on CD4(+) T cells was fivefold higher in those from CSF than blood, but was not increased in OMS or altered by conventional immunotherapy. These data suggest alternative roles for CXCL10 in OMS. Over-expression of CXCL10 was not reduced by clinical immunotherapies as a whole, indicating the need for better therapeutic approaches.
    Clinical & Experimental Immunology 06/2013; 172(3):427-36. DOI:10.1111/cei.12065 · 3.04 Impact Factor
  • Jerry A Colliver · Anna T Cianciolo · Steven J Verhulst · Melinda J Conlee ·

    Teaching and Learning in Medicine 01/2013; 25(1):1-2. DOI:10.1080/10401334.2013.758576 · 0.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Using a panel of seven brain cell-specific biomarkers in cerebrospinal fluid (CSF), pediatric opsoclonus-myoclonus syndrome (OMS) (n = 234) was compared to pediatric non-inflammatory neurological controls (n = 84) and other inflammatory neurological disorders (OIND) (n = 44). Only CSF NFL was elevated in untreated OMS versus controls (+ 83%). It was 87% higher in OIND than in OMS. On combination treatment with front-loaded ACTH, IVIg, rituximab, median CSF NFL decreased by 60% to control levels. These biochemical data suggest neuronal/axonal injury in some children with OMS without indicators of astrogliosis, and reduction on sufficient immunotherapy.
    Journal of neuroimmunology 01/2013; 266(1). DOI:10.1016/j.jneuroim.2013.11.004 · 2.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Operative performance rating (OPR) instruments have been developed to assess operative performance (OP). To guide program implementation, this study determined: 1) Appropriate intervals for OP progress decisions, 2) Number of OPRs and raters required per interval to achieve reproducible results. 21 surgeons rated 897 OPs (3 procedures) by 36 residents. Six-month PGY intervals were compared to determine length of stable operative performance intervals. Variance component analyses established rating factor importance. Generalizability analyses and decision studies determined number of OPRs required for reproducible OP decisions (reliabilities = 0.80). Resident OPRs are stable across single PGY years. 2.3 OPRs/resident/month provided a dependable basis for annual or semi-annual resident OP decisions. Results were similar for all procedures and training years. Rater idiosyncrasies accounted for most score variation (63% when interaction effects involving rater idiosyncrasies were included). Resident ability was the next most important source of variation (12%). Procedure was a less important source (5%). Annual resident OP decisions are supported. 2.3 OPRs per month provide a dependable basis for judging resident OP. These numbers are sufficient regardless of training year or procedure mix though efforts should be made to balance procedure mix. Multiple raters should rate each resident to control for rater idiosyncrasies.
    Surgery 08/2012; 152(4):517-27. DOI:10.1016/j.surg.2012.07.004 · 3.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The goal of this pilot study was to determine the magnitude and direction of intervention effect sizes for inflammatory-related serum markers and relevant health outcomes among breast cancer survivors (BCSs) receiving a physical activity behavior change intervention compared with usual care. Methods: This randomized controlled trial enrolled 28 stage I, II, or IIIA BCSs who were post-primary treatment and not regular exercisers. Participants were assigned to either a 3-month physical activity behavior change intervention group (ING) or usual care group (UCG). Intervention included supervised aerobic (150 weekly minutes, moderate-intensity) and resistance (2 sessions per week) exercise that gradually shifted to home-based exercise. Outcomes were assessed at baseline and 3 months. Results: Cardiorespiratory fitness significantly improved in the ING versus the UCG (between-group difference = 3.8 mL/kg/min; d = 1.1; P = .015). Self-reported sleep latency was significantly reduced in the ING versus the UCG (between group difference = -0.5; d = -1.2; P = .02) as was serum leptin (between-group difference = -9.0 ng/mL; d = -1.0; P = .031). Small to medium nonsignificant negative effect sizes were noted for interleukin (IL)-10 and tumor necrosis factor (TNF)-α and ratios of IL-6 to IL-10, IL-8 to IL-10, and TNF-α to IL-10, whereas nonsignificant positive effect sizes were noted for IL-6 and high-molecular-weight adiponectin. Conclusions: Physical activity behavior change interventions in BCSs can achieve large effect size changes for several health outcomes. Although effect sizes for inflammatory markers were often small and not significant, changes were in the hypothesized direction for all except IL-6 and IL-10.
    Integrative Cancer Therapies 07/2012; 12(4). DOI:10.1177/1534735412449687 · 2.36 Impact Factor
  • Source
    Jerry A Colliver · Melinda J Conlee · Steven J Verhulst ·
    [Show abstract] [Hide abstract]
    ABSTRACT: CONTEXT:   Major changes in thinking about validity have occurred during the past century, shifting the focus in thinking from the validity of the test to the validity of test score interpretations. These changes have resulted from the 'new' thinking about validity in which construct validity has emerged as the central or unifying idea of validity today. Construct validity was introduced by Cronbach and Meehl in the mid-1950s in an attempt to address the validity of those many psychological concepts that have no clear referent in reality. To do this, construct validity theory required a nomological network--an elaborate theoretical network of constructs and observations connected by scientific laws--to validate the constructs. However, nomological networks are hard to come by and none that would do the job required by construct validity has been forthcoming to date. Thus, the current construct validity approach has retreated to one of simply 'interpretation and argument', but this seems to be too general to tie down the constructs in the way a nomological network would do to give credibility to the validity of the construct. As a result, the concept of validity seems to have been watered down and the credibility of validity claims weakened. OBJECTIVES:  The purpose of this paper is to encourage a discussion of the use of construct validity in medical education, and to suggest that test developers and users reconsider the use of abstract theoretical constructs that have no referent apart from theory. METHODS:  We present a critical review of these concerns about construct validity and provide for contrast a brief overview of a recently proposed view of measurement based on scientific realism and causality analysis.
    Medical Education 04/2012; 46(4):366-71. DOI:10.1111/j.1365-2923.2011.04194.x · 3.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To test the efficacy and safety of corticotropin-based immunotherapies in pediatric opsoclonus-myoclonus syndrome, 74 children received corticotropin alone or with intravenous immunoglobulin (groups 1 and 2, active controls); or both with rituximab (group 3) or cyclophosphamide (group 4); or with rituximab plus chemotherapy (group 5) or steroid sparers (group 6). There was 65% improvement in motor severity score across groups (P < .0001), but treatment combinations were more effective than corticotropin alone (P = .0009). Groups 3, 4, and 5 responded better than group 1; groups 3 and 5 responded better than group 2. The response frequency to corticotropin was higher than to prior corticosteroids (P < .0001). Fifty-five percent had adverse events (corticosteroid excess), more so with multiagents (P = .03); and 10% had serious adverse events. This study demonstrates greater efficacy of corticotropin-based multimodal therapy compared with conventional therapy, greater response to corticotropin than corticosteroid-based therapy, and overall tolerability.
    Journal of child neurology 02/2012; 27(7):875-84. DOI:10.1177/0883073811428816 · 1.72 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating physical activity behavior change. Here, we report the rationale, design, and methods for a two-site, randomized controlled trial comparing the effects of the BEAT Cancer physical activity behavior change intervention to usual care on short and longer term physical activity adherence among breast cancer survivors. Secondary aims include examining social cognitive theory mechanisms of physical activity behavior change and health benefits of the intervention. Study recruitment goal is 256 breast cancer survivors with a history of ductal carcinoma in situ or Stage I, II, or IIIA disease who have completed primary cancer treatment. Outcome measures are obtained at baseline, 3 months (i.e., immediately post-intervention), 6 months, and 12 months and include physical activity, psychosocial factors, fatigue, sleep quality, lower extremity joint dysfunction, cardiorespiratory fitness, muscle strength, and waist-to-hip ratio. Confirming behavior change effectiveness, health effects, and underlying mechanisms of physical activity behavior change interventions will facilitate translation to community settings for improving the health and well-being of breast cancer survivors.
    Contemporary clinical trials 01/2012; 33(1):124-37. DOI:10.1016/j.cct.2011.09.004 · 1.94 Impact Factor

Publication Stats

2k Citations
325.83 Total Impact Points


  • 1984-2015
    • Southern Illinois University School of Medicine
      • • Department of Surgery
      • • Department of Neurology
      • • Department of Medical Education
      • • Department of Pediatrics
      • • Department of Pharmacology
      • • Department of Obstetrics and Gynecology
      Springfield, Illinois, United States
  • 1982-2014
    • University of Illinois Springfield
      Спрингфилд, Florida, United States
  • 2013
    • Southern Illinois University Carbondale
      Illinois, United States
  • 1995
    • University of Baltimore
      Baltimore, Maryland, United States