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  1. Article ; Online: Fulfilling the promise: Commentary on Schleider et al. (2023).

    Cooper, Zafra / Shafran, Roz

    The International journal of eating disorders

    2023  Volume 56, Issue 5, Page(s) 878–880

    Abstract: In their paper on "Realizing the Untapped Promise of Single-Session Interventions for Eating Disorders" Schleider and colleagues suggest an innovative approach to addressing a much- discussed critical issue in the treatment of eating disorders-how we ... ...

    Abstract In their paper on "Realizing the Untapped Promise of Single-Session Interventions for Eating Disorders" Schleider and colleagues suggest an innovative approach to addressing a much- discussed critical issue in the treatment of eating disorders-how we help more people quickly and with greater efficiency. While building on the feasibility and success of program-led approaches, they make a potentially transformative proposal for the use of single-session, "one-at-a-time" interventions freely accessible to those in need. We suggest that not only does this proposal have the potential to narrow the treatment gap, but its ability to generate informative data at scale may also contribute to improving treatment outcomes overall. We also note the need for further independent support for the claim that single sessions produce meaningful benefit especially in the field of the prevention and treatment of eating disorders. While Schleider and colleagues' proposal is potentially transformative and has heuristic value, some caution needs to be exercised. In our view, single-session interventions should not be regarded as displacing existing treatment provision. Rather they should be seen as complementary and a potential way of improving provision overall.
    MeSH term(s) Humans ; Feeding and Eating Disorders
    Language English
    Publishing date 2023-04-11
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 603170-5
    ISSN 1098-108X ; 0276-3478
    ISSN (online) 1098-108X
    ISSN 0276-3478
    DOI 10.1002/eat.23946
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  2. Article ; Online: Palliative surgery: state of the science and future directions.

    Lilley, Elizabeth J / Farber, Orly N / Cooper, Zara

    The British journal of surgery

    2024  Volume 111, Issue 3

    Abstract: Palliative surgical procedures are operations that aim to alleviate symptoms in a patient with serious, life-limiting illness. They are common, particularly within the field of surgical oncology. However, few high-quality studies have attempted to ... ...

    Abstract Palliative surgical procedures are operations that aim to alleviate symptoms in a patient with serious, life-limiting illness. They are common, particularly within the field of surgical oncology. However, few high-quality studies have attempted to measure the durability of improvements in symptoms and quality of life after palliative surgery. Furthermore, many of the studies that do exist are outdated and employ highly inconsistent definitions of palliative surgery. Consequently, the paucity of robust and reliable evidence on the benefits, risks, and trade-offs of palliative surgery hampers clinical decision-making for patients and their surgeons. The evidence for palliative surgery suggests that, with effective communication about goals of care and careful patient selection, palliative surgery can provide symptomatic relief and reduce healthcare burdens for certain seriously ill patients.
    MeSH term(s) Humans ; Palliative Care/methods ; Quality of Life
    Language English
    Publishing date 2024-03-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znae068
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  3. Article ; Online: Indicated But Not Always Appropriate: Surgery in Terminally Ill Patients With Abdominal Catastrophe.

    Cooper, Zara

    Annals of surgery

    2018  Volume 268, Issue 1, Page(s) e4

    MeSH term(s) Humans ; Palliative Care ; Patients ; Surveys and Questionnaires ; Terminally Ill ; Viscera
    Language English
    Publishing date 2018-05-04
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000002777
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  4. Article ; Online: Politics and health care spending in the United States: A case study from the passage of the 2003 Medicare Modernization Act.

    Cooper, Zack / Kowalski, Amanda / Powell, Eleanor Neff / Wu, Jennifer D

    Journal of health economics

    2024  Volume 95, Page(s) 102878

    Abstract: This paper analyzes the interplay between congressional politics, the actions of the executive branch, and hospitals' regulated Medicare payments. We focus on the 2003 Medicare Modernization Act (MMA) and analyze a provision in the law - Section 508 - ... ...

    Abstract This paper analyzes the interplay between congressional politics, the actions of the executive branch, and hospitals' regulated Medicare payments. We focus on the 2003 Medicare Modernization Act (MMA) and analyze a provision in the law - Section 508 - that raised certain hospitals' regulated payments. We show, via our analysis of the Section 508 program, that Medicare payments are malleable and can be influenced by political dynamics. In the cross-section, hospitals represented by members of Congress who voted "yea" on the MMA were more likely to receive Section 508 payment increases. We interviewed the Secretary of Health and Human Services who oversaw the MMA, and he described how these payment increases were designed to win support for the law. The Section 508 payment increases raised hospitals' activity and spending. Members of Congress representing recipient hospitals received increased campaign contributions after the Section 508 payment increases were extended. Ultimately, our analysis highlights how Medicare payment increases can serve as an appealing tool for legislative leaders working to win votes for wider pieces of legislation.
    Language English
    Publishing date 2024-04-04
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 625797-5
    ISSN 1879-1646 ; 0167-6296
    ISSN (online) 1879-1646
    ISSN 0167-6296
    DOI 10.1016/j.jhealeco.2024.102878
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  5. Article ; Online: Developing a protocol to address co-occurring mental health conditions in the treatment of eating disorders.

    Wade, Tracey D / Shafran, Roz / Cooper, Zafra

    The International journal of eating disorders

    2023  

    Abstract: Objective: While co-occurring mental health conditions are the norm in eating disorders, no testable protocol addresses management of these in psychotherapy.: Method: The literature on managing mental health conditions that co-occur with eating ... ...

    Abstract Objective: While co-occurring mental health conditions are the norm in eating disorders, no testable protocol addresses management of these in psychotherapy.
    Method: The literature on managing mental health conditions that co-occur with eating disorders is outlined and reviewed.
    Results: In the absence of clear evidence to inform managing co-occurring mental health conditions, we advocate for use of an iterative, session-by-session measurement to guide practice and research. We identify three data-driven treatment approaches (focus solely on the eating disorder; multiple sequential interventions either before or after the eating disorder is addressed; integrated interventions), and the indications for their use. Where a co-occurring mental health condition/s impede effective treatment of the eating disorder, and an integrated intervention is required, we outline a four-step protocol for three broad intervention approaches (alternate, modular, transdiagnostic). A research program is suggested to test the usefulness of the protocol.
    Discussion: Guidelines that provide a starting point to improving outcomes for people with eating disorders that can be evaluated/researched are offered in the current paper. These guidelines require further elaboration with reference to: (1) whether any difference in approach is required where the co-occurring mental health condition is a comorbid symptom or condition; (2) the place of biological treatments within these guidelines; (3) precise guidelines for selecting among the three broad intervention approaches when adapting care for co-occurring conditions; (4) optimal approaches to involving consumer input into identifying the most relevant co-occurring conditions; (5) detailed specification on how to determine which adjuncts to add.
    Public significance: Most people with an eating disorder also have another diagnosis or an underlying trait (e.g., perfectionism). Currently no clear guidelines exist to guide treatment in this situation, which often results in a drift away from evidence-based techniques. This paper outlines data-driven strategies for treating eating disorders and the accompanying comorbid conditions and a research program that can test the usefulness of the different approaches suggested.
    Language English
    Publishing date 2023-06-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603170-5
    ISSN 1098-108X ; 0276-3478
    ISSN (online) 1098-108X
    ISSN 0276-3478
    DOI 10.1002/eat.24008
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  6. Article ; Online: The effects of childhood maltreatment on social support, inflammation, and depressive symptoms in adulthood.

    O'Shields, Jay / Mowbray, Orion / Cooper, Zach

    Social science & medicine (1982)

    2023  Volume 340, Page(s) 116481

    Abstract: Rationale: Social Safety Theory (SST) suggests that social threats increase inflammation, exacerbating health risks, but that social support may decrease inflammatory signaling. One of the key health problems affected by both social forces and ... ...

    Abstract Rationale: Social Safety Theory (SST) suggests that social threats increase inflammation, exacerbating health risks, but that social support may decrease inflammatory signaling. One of the key health problems affected by both social forces and inflammation is major depression.
    Objective: The present study sought to test aspects of the SST, to understand how social support and inflammation may mediate the effects of childhood maltreatment on depressive symptoms in adulthood.
    Methods: This study utilized data from the national Midlife Development in the United States study (n = 1969; mean age 53; 77.2% White; 53.6% female) to model the effects of childhood maltreatment on depressive symptoms in adulthood and the potential serial mediating effects of social support and inflammation. Analyses were conducted via structural equation modeling, using the four subscales of the Center for Epidemiologic Studies Depression Scale to indicate depressive symptoms, the five subscales of the Childhood Trauma Questionnaire to indicate childhood maltreatment, and the Positive Relations Scale and a network level measure of support as indicators of social support. Inflammation was indexed using C-reactive protein (CRP). The model was estimated via maximum likelihood with robust standard errors and significance of indirect effects were assessed via a Sobel test.
    Results: Childhood maltreatment was associated with increased depressive symptoms and CRP but decreased social support. Social support was associated with decreased depressive symptoms while CRP was associated with increased depressive symptoms. Assessing indirect effects yielded no serial mediation effect; however, a significant indirect effect from childhood maltreatment to depressive symptoms through social support was identified.
    Conclusions: Analyses indicate mixed support for the SST with respect to depressive symptoms. Results highlight the role of social support in mitigating the effects depressive symptoms in adulthood; although, alternative strategies may be needed to decrease the effects of childhood maltreatment on inflammation as indexed by CRP.
    MeSH term(s) Child ; Humans ; Female ; Middle Aged ; Male ; Depression/epidemiology ; Depression/etiology ; Child Abuse ; Social Support ; Depressive Disorder, Major ; Inflammation ; Psychological Tests ; Self Report
    Language English
    Publishing date 2023-12-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 4766-1
    ISSN 1873-5347 ; 0037-7856 ; 0277-9536
    ISSN (online) 1873-5347
    ISSN 0037-7856 ; 0277-9536
    DOI 10.1016/j.socscimed.2023.116481
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  7. Article ; Online: Breastfeeding and pumping as maladaptive weight control behaviors.

    Bailey-Straebler, Suzanne M / Susser, Leah C / Cooper, Zafra

    The International journal of eating disorders

    2023  Volume 56, Issue 9, Page(s) 1683–1687

    Abstract: It is well recognized by the general public that breastfeeding expends calories. In our clinical practice, a number of postpartum women with a history of or a current eating disorder (ED) report using breastfeeding and/or pumping breast milk to influence ...

    Abstract It is well recognized by the general public that breastfeeding expends calories. In our clinical practice, a number of postpartum women with a history of or a current eating disorder (ED) report using breastfeeding and/or pumping breast milk to influence their body shape and weight. This appears to be either a form of weight control behavior or, in some cases, a compensation for perceived overeating or binge eating. Breastfeeding and pumping have not generally been identified as maladaptive weight control behaviors, nor have they been a subject of research to date. We suggest that this practice should be investigated to determine how common it is, its potential role in maintaining EDs or contributing to relapse in the postpartum period, and to better understand other potential harms it may cause to both the mother and infant/child. PUBLIC SIGNIFICANCE: Breastfeeding and pumping may be used as maladaptive methods of weight control by women with EDs. This behavior is under-recognized in clinical practice and has received little research attention. We argue that maladaptive breastfeeding and pumping warrant further investigation, as the behaviors may play an important role in maintaining an ED or in contributing to relapse during the postpartum period and may also indirectly harm the infant/child.
    MeSH term(s) Infant ; Child ; Female ; Humans ; Breast Feeding ; Mothers ; Postpartum Period ; Health Behavior ; Energy Intake
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603170-5
    ISSN 1098-108X ; 0276-3478
    ISSN (online) 1098-108X
    ISSN 0276-3478
    DOI 10.1002/eat.24006
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  8. Article ; Online: Patient engagement in perioperative settings: A mixed method systematic review.

    Cooper, Zahra / Cleary, Sonja / Stelmach, Wanda / Zheng, Zhen

    Journal of clinical nursing

    2023  Volume 32, Issue 17-18, Page(s) 5865–5885

    Abstract: Background: Patient engagement has emerged as a key focus in the research literature to facilitate patients' recovery. The term is commonly used by researchers, yet without working definitions. This lack of clarity is further complicated by the ... ...

    Abstract Background: Patient engagement has emerged as a key focus in the research literature to facilitate patients' recovery. The term is commonly used by researchers, yet without working definitions. This lack of clarity is further complicated by the interchangeable use of a few terms.
    Objectives: This systematic review aimed at identifying how patient engagement was conceptualised and operationalised in perioperative settings.
    Methods: MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched for publications in English discussing patient engagement during the perioperative phase. Three reviewers conducted study selection and methodological assessment using Joanna Briggs Institute mixed methods review framework. Reflexive thematic analysis was used to analyse qualitative data and descriptive analysis for quantitative data.
    Findings: Twenty-nine studies were included with a total sample of 6289. Study types included qualitative (n = 14) and quantitative (n = 15) with different types of surgery. Sample sizes ranged from n = 7 to n = 1315. Only 38% (n = 11) of included studies offered an explicit definition. Four themes associated with operationalisation included provision of information, which was most studied theme, communication, decision-making and action-taking behaviours. All four themes were interconnected and co-dependent on each other.
    Conclusions: Patient engagement in perioperative settings is a complex and multifaceted concept. The conceptual void in the literature calls for more theoretically informed and comprehensive approaches to researching surgical patient engagement. Future research should aim to better understand the factors that influence patient engagement, as well as the impact of different forms of engagement on patient outcomes through the whole surgical journey of a patient.
    MeSH term(s) Humans ; Patient Participation ; Perioperative Care
    Language English
    Publishing date 2023-04-18
    Publishing country England
    Document type Journal Article ; Systematic Review
    ZDB-ID 1159483-4
    ISSN 1365-2702 ; 0962-1067 ; 1752-9816
    ISSN (online) 1365-2702
    ISSN 0962-1067 ; 1752-9816
    DOI 10.1111/jocn.16709
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  9. Article ; Online: Which Priorities Should Guide Palliative Surgical Research?

    Cooper, Zara / Cauley, Christy

    AMA journal of ethics

    2021  Volume 23, Issue 10, Page(s) E806–810

    Abstract: Research priorities in surgical palliative care should go beyond generating data from traditional surgical morbidity or mortality metrics. Surgical researchers can seek to better understand care management complexities of surgical patients with serious ... ...

    Abstract Research priorities in surgical palliative care should go beyond generating data from traditional surgical morbidity or mortality metrics. Surgical researchers can seek to better understand care management complexities of surgical patients with serious illnesses in order to gather high-quality, patient-centered data; improve surgical patients' experiences; and motivate surgical palliative care as a field.
    MeSH term(s) Humans ; Palliative Care
    Language English
    Publishing date 2021-10-01
    Publishing country United States
    Document type Journal Article
    ISSN 2376-6980
    ISSN (online) 2376-6980
    DOI 10.1001/amajethics.2021.806
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  10. Article ; Online: An Honest Look in the Mirror - Cultivating a Culture of Equity in Surgery.

    Mehtsun, Winta T / Cooper, Zara

    Annals of surgery

    2021  Volume 273, Issue 1, Page(s) e1–e2

    MeSH term(s) Continental Population Groups ; General Surgery ; Health Equity ; Healthcare Disparities ; Humans ; Surgical Procedures, Operative ; United States
    Language English
    Publishing date 2021-01-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000004519
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