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  1. Article ; Online: Sleepless behind bars: the connection between mental health, environment, and sleep among women in jail.

    Tussey, Emma J / Perez, Gabriela R / Lynch, Shannon M

    Sleep advances : a journal of the Sleep Research Society

    2024  Volume 5, Issue 1, Page(s) zpae012

    Abstract: Study objectives: Given the barriers to good sleep in corrections facilities and the lack of research in this area, the current study aimed to characterize sleep quality and insomnia incidence in women in jail. Furthermore, we aimed to investigate the ... ...

    Abstract Study objectives: Given the barriers to good sleep in corrections facilities and the lack of research in this area, the current study aimed to characterize sleep quality and insomnia incidence in women in jail. Furthermore, we aimed to investigate the relation of sleep to depression, posttraumatic stress disorder (PTSD), and trauma exposure in incarcerated women. Lastly, we examined self-reports of environmental and individual factors that impaired sleeping in this population.
    Methods: Participants included 176 women incarcerated in two jails in southeast Idaho. Participants were randomly selected to complete several self-report questionnaires, including the Pittsburgh Sleep Quality Index and the Insomnia Severity Index, verbally administered by interviewers.
    Results: A majority of participants endorsed poor sleep quality (76%) and subthreshold or higher levels of insomnia (70%). Multiple regression analyses found that depressive symptoms and PTSD symptoms were both significantly related to insomnia and poor sleep quality. Excessive noise, poor bedding, and mental health were commonly cited factors that disrupted sleep.
    Conclusions: These results are consistent with previous literature that has examined these outcomes in prison populations and incarcerated populations in other countries. Correctional facilities can consider altering environmental factors that impair sleep to not only promote better overall health but also as a way to address common manifestations of poor mental health in their inmate populations. Screening for and treating mental health problems, namely depression and PTSD, is another way these facilities can improve inmate health and promote better sleep.
    Language English
    Publishing date 2024-02-14
    Publishing country United States
    Document type Journal Article
    ISSN 2632-5012
    ISSN (online) 2632-5012
    DOI 10.1093/sleepadvances/zpae012
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  2. Article ; Online: Disparities in care of older adults of color with cancer: A narrative review.

    Dotan, Efrat / Lynch, Shannon M / Ryan, Joanne C / Mitchell, Edith P

    Cancer medicine

    2024  Volume 13, Issue 3, Page(s) e6790

    Abstract: This review describes the barriers and challenges faced by older adults of color with cancer and highlights methods to improve their overall care. In the next decade, cancer incidence rates are expected to increase in the United States for people aged ≥ ... ...

    Abstract This review describes the barriers and challenges faced by older adults of color with cancer and highlights methods to improve their overall care. In the next decade, cancer incidence rates are expected to increase in the United States for people aged ≥65 years. A large proportion will be older adults of color who often have worse outcomes than older White patients. Many issues contribute to racial disparities in older adults, including biological factors and social determinants of health (SDOH) related to healthcare access, socioeconomic concerns, systemic racism, mistrust, and the neighborhood where a person lives. These disparities are exacerbated by age-related challenges often experienced by older adults, such as decreased functional status, impaired cognition, high rates of comorbidities and polypharmacy, poor nutrition, and limited social support. Additionally, underrepresentation of both patients of color and older adults in cancer clinical research results in a lack of adequate data to guide the management of these patients. Use of geriatric assessments (GA) can aid providers in uncovering age-related concerns and personalizing interventions for older patients. Research demonstrates the ability of GA-directed care to result in fewer treatment-related toxicities and improved quality of life, thus supporting the routine incorporation of validated GA into these patients' care. GA can be enhanced by including evaluation of SDOH, which can help healthcare providers understand and address the needs of older adults of color with cancer who face disparities related to their age and race.
    MeSH term(s) Humans ; Aged ; Quality of Life ; Cognitive Dysfunction ; Geriatric Assessment ; Health Facilities ; Neoplasms/epidemiology ; Neoplasms/therapy
    Language English
    Publishing date 2024-01-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.6790
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  3. Article ; Online: Factors Associated With Racial and Ethnic Disparities in Locally Advanced Rectal Cancer Outcomes.

    Shulman, Rebecca M / Deng, Mengying / Handorf, Elizabeth A / Meyer, Joshua E / Lynch, Shannon M / Arora, Sanjeevani

    JAMA network open

    2024  Volume 7, Issue 2, Page(s) e240044

    Abstract: Importance: Hispanic and non-Hispanic Black patients receiving neoadjuvant therapy and surgery for locally advanced rectal cancer (LARC) achieve less favorable clinical outcomes than non-Hispanic White patients, but the source of this disparity is ... ...

    Abstract Importance: Hispanic and non-Hispanic Black patients receiving neoadjuvant therapy and surgery for locally advanced rectal cancer (LARC) achieve less favorable clinical outcomes than non-Hispanic White patients, but the source of this disparity is incompletely understood.
    Objective: To assess whether racial and ethnic disparities in treatment outcomes among patients with LARC could be accounted for by social determinants of health and demographic, clinical, and pathologic factors known to be associated with treatment response.
    Design, setting, and participants: The National Cancer Database was interrogated to identify patients with T3 to T4 or N1 to N2 LARC treated with neoadjuvant therapy and surgery. Patients were diagnosed between January 1, 2004, and December 31, 2017. Data were culled from the National Cancer Database from July 1, 2022, through December 31, 2023.
    Exposure: Neoadjuvant therapy for rectal cancer followed by surgical resection.
    Main outcomes and measures: The primary outcome was the rate of pathologic complete response (pCR) following neoadjuvant therapy. Secondary outcomes were rate of tumor downstaging and achievement of pN0 status.
    Results: A total of 34 500 patient records were reviewed; 21 679 of the patients (62.8%) were men and 12 821 (37.2%) were women. The mean (SD) age at diagnosis was 59.7 (12.0) years. In terms of race and ethnicity, 2217 patients (6.4%) were Hispanic, 2843 (8.2%) were non-Hispanic Black, and 29 440 (85.3%) were non-Hispanic White. Hispanic patients achieved tumor downstaging (48.9% vs 51.8%; P = .01) and pN0 status (66.8% vs 68.8%; P = .02) less often than non-Hispanic White patients. Non-Hispanic Black race, but not Hispanic ethnicity, was associated with less tumor downstaging (odds ratio [OR], 0.86 [95% CI, 0.78-0.94]), less frequent pN0 status (OR, 0.91 [95% CI, 0.83-0.99]), and less frequent pCR (OR, 0.81 [95% CI, 0.72-0.92]). Other factors associated with reduced rate of pCR included rural location (OR, 0.80 [95% CI, 0.69-0.93]), lack of or inadequate insurance (OR for Medicaid, 0.86 [95% CI, 0.76-0.98]; OR for no insurance, 0.65 [95% CI, 0.54-0.78]), and treatment in a low-volume center (OR for first quartile, 0.73 [95% CI, 0.62-0.87]; OR for second quartile, 0.79 [95% CI, 0.70-0.90]; OR for third quartile, 0.86 [95% CI, 0.78-0.94]). Clinical and pathologic variables associated with a decreased pCR included higher tumor grade (OR, 0.58 [95% CI, 0.49-0.70]), advanced tumor stage (OR for T3, 0.56 [95% CI, 0.42-0.76]; OR for T4, 0.30 [95% CI, 0.22-0.42]), and lymph node-positive disease (OR for N1, 0.83 [95% CI, 0.77-0.89]; OR for N2, 0.73 [95% CI, 0.65-0.82]).
    Conclusions and relevance: The findings of this cohort study suggest that disparate treatment outcomes for Hispanic and non-Hispanic Black patients are likely multifactorial in origin. Future investigation into additional social determinants of health and biological variables is warranted.
    MeSH term(s) Female ; Humans ; Male ; Middle Aged ; Cohort Studies ; Ethnicity ; Hispanic or Latino ; Rectal Neoplasms/therapy ; United States/epidemiology ; Black or African American ; Social Determinants of Health ; Health Status Disparities ; Racial Groups ; Aged
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2024.0044
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  4. Article ; Online: A Novel Approach for Conducting a Catchment Area Analysis of Breast Cancer by Age and Stage for a Community Cancer Center.

    Siegel, Scott D / Zhang, Yuchen / Lynch, Shannon M / Rowland, Jennifer / Curriero, Frank C

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2024  Volume 33, Issue 5, Page(s) 646–653

    Abstract: Background: The U.S. Preventive Services Task Force recently issued an updated draft recommendation statement to initiate breast cancer screening at age 40, reflecting well-documented disparities in breast cancer-related mortality that ... ...

    Abstract Background: The U.S. Preventive Services Task Force recently issued an updated draft recommendation statement to initiate breast cancer screening at age 40, reflecting well-documented disparities in breast cancer-related mortality that disproportionately impact younger Black women. This study applied a novel approach to identify hotspots of breast cancer diagnosed before age 50 and/or at an advanced stage to improve breast cancer detection within these communities.
    Methods: Cancer registry data for 3,497 women with invasive breast cancer diagnosed or treated between 2012 and 2020 at the Helen F. Graham Cancer Center and Research Institute (HFGCCRI) and who resided in the HFGCCRI catchment area, defined as New Castle County, Delaware, were geocoded and analyzed with spatial intensity. Standardized incidence ratios stratified by age and race were calculated for each hotspot.
    Results: Four hotspots were identified, two for breast cancer diagnosed before age 50, one for advanced breast cancer, and one for advanced breast cancer diagnosed before age 50. Younger Black women were overrepresented in these hotspots relative to the full-catchment area.
    Conclusions: The novel use of spatial methods to analyze a community cancer center catchment area identified geographic areas with higher rates of breast cancer with poor prognostic factors and evidence that these areas made an outsized contribution to racial disparities in breast cancer.
    Impact: Identifying and prioritizing hotspot breast cancer communities for community outreach and engagement activities designed to improve breast cancer detection have the potential to reduce the overall burden of breast cancer and narrow racial disparities in breast cancer.
    MeSH term(s) Humans ; Female ; Breast Neoplasms/epidemiology ; Breast Neoplasms/diagnosis ; Middle Aged ; Adult ; Aged ; Registries/statistics & numerical data ; Catchment Area, Health/statistics & numerical data ; Age Factors ; Early Detection of Cancer/statistics & numerical data ; Early Detection of Cancer/methods ; Cancer Care Facilities/statistics & numerical data ; Incidence ; Neoplasm Staging ; Delaware/epidemiology ; Black or African American/statistics & numerical data
    Language English
    Publishing date 2024-03-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-23-1125
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    Zs.A 3693: Show issues Location:
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  5. Article ; Online: Geographic Disparities in Cancer Incidence in the US Population Aged 20 to 49 Years, 2016-2020.

    DuBois, Tesla D / Henry, Kevin A / Siegel, Scott D / Lynch, Shannon M

    Preventing chronic disease

    2024  Volume 21, Page(s) E32

    MeSH term(s) Humans ; Incidence ; United States/epidemiology ; Adult ; Middle Aged ; Male ; Female ; Neoplasms/epidemiology ; Young Adult ; Health Status Disparities ; SEER Program
    Language English
    Publishing date 2024-05-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2135684-1
    ISSN 1545-1151 ; 1545-1151
    ISSN (online) 1545-1151
    ISSN 1545-1151
    DOI 10.5888/pcd21.230335
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  6. Article ; Online: Cumulative Trauma Exposure, Emotion Regulation, and Posttraumatic Stress Disorder Among Incarcerated Women.

    Konecky, Emily M / Lynch, Shannon M

    Journal of traumatic stress

    2019  Volume 32, Issue 5, Page(s) 806–811

    Abstract: Incarcerated women report high rates of trauma exposure and posttraumatic stress disorder (PTSD). Emotion regulation has been identified as a potential mechanism that contributes to the association between trauma exposure and PTSD severity. The present ... ...

    Abstract Incarcerated women report high rates of trauma exposure and posttraumatic stress disorder (PTSD). Emotion regulation has been identified as a potential mechanism that contributes to the association between trauma exposure and PTSD severity. The present study examined associations among cumulative trauma exposure, emotion regulation difficulties, and current (30-day) PTSD in 152 randomly selected women in prison. Utilizing structural equation modeling (SEM), results indicated cumulative trauma was significantly associated with emotion regulation difficulties, β = .31, SE = .13, p  = .005; and PTSD symptom severity, β = .41, SE = .14, p  = .005. We identified a significant indirect effect, 0.11, z = 2.37, p = .018, of emotion regulation on the association between cumulative trauma exposure and severity of current PTSD symptoms. These findings are consistent with previous longitudinal research suggesting that emotion regulation is significantly affected by trauma exposure, and they support previously identified associations between emotion regulation difficulties and severity of PTSD. Further, these findings have the potential to inform current efforts to identify and implement effective PTSD-focused interventions with incarcerated women. In particular, it appears that emotion regulation skills may be an important component of effective PTSD focused interventions for this population.
    MeSH term(s) Accidents/psychology ; Adult ; Emotional Regulation ; Exposure to Violence/psychology ; Female ; Humans ; Middle Aged ; Prisoners/psychology ; Rape/psychology ; Severity of Illness Index ; Stress Disorders, Post-Traumatic/psychology ; Surveys and Questionnaires ; Symptom Assessment ; Young Adult
    Language English
    Publishing date 2019-08-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639478-4
    ISSN 1573-6598 ; 0894-9867
    ISSN (online) 1573-6598
    ISSN 0894-9867
    DOI 10.1002/jts.22435
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    Zs.A 2386: Show issues Location:
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  7. Article ; Online: Not good enough and on a tether: exploring how violent relationships impact women's sense of self.

    Lynch, Shannon M

    Psychodynamic psychiatry

    2013  Volume 41, Issue 2, Page(s) 219–246

    Abstract: There is general agreement among researchers that partner violence and self-esteem are significantly inversely correlated. Several qualitative researchers have examined women's narratives within small samples for self statements and discovered references ...

    Abstract There is general agreement among researchers that partner violence and self-esteem are significantly inversely correlated. Several qualitative researchers have examined women's narratives within small samples for self statements and discovered references to lost or damaged sense of self. However, the process by which partner violence impacts women's sense of self and the extent of its influence on women's sense of self remains unclear. To further our understanding, the current study explored 100 women's sense of self in the context of their relationships. Women responded to open ended questions about how they describe themselves, influences on their sense of self, and perceived self changes. Participants in troubled relationships were recruited with fliers and advertisements. Over half of the women reported physically or psychologically abusive partners (n = 57) in the prior 12 months while 43 women reported no physical violence and little to no psychological abuse in the past year. All women made positive self references, but women with violent partners also included more numerous negative self descriptions. Women with violent partners also described more negative self-change (decreased assertiveness, confidence), loss of identity or a sense of themselves as different in different contexts; themes not commonly found in the comparison sample. For both groups, however, other influences, such as work and friends, appeared to provide opportunities for positive and affirming self-perceptions.
    MeSH term(s) Adolescent ; Adult ; Female ; Humans ; Interpersonal Relations ; Middle Aged ; Qualitative Research ; Self Concept ; Sexual Partners/psychology ; Spouse Abuse/psychology ; Young Adult
    Language English
    Publishing date 2013
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2633567-0
    ISSN 2162-2604 ; 2162-2590
    ISSN (online) 2162-2604
    ISSN 2162-2590
    DOI 10.1521/pdps.2013.41.2.219
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    Zs.A 1454: Show issues Location:
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  8. Article ; Online: Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area-level risk factors.

    Siegel, Scott D / Brooks, Madeline M / Berman, Jesse D / Lynch, Shannon M / Sims-Mourtada, Jennifer / Schug, Zachary T / Curriero, Frank C

    Cancer medicine

    2023  Volume 12, Issue 10, Page(s) 11760–11772

    Abstract: Background: Despite similar incidence rates among Black and White women, breast cancer mortality rates are 40% higher among Black women. More than half of the racial difference in breast cancer mortality can be attributed to triple negative breast ... ...

    Abstract Background: Despite similar incidence rates among Black and White women, breast cancer mortality rates are 40% higher among Black women. More than half of the racial difference in breast cancer mortality can be attributed to triple negative breast cancer (TNBC), an aggressive subtype of invasive breast cancer that disproportionately affects Black women. Recent research has implicated neighborhood conditions in the etiology of TNBC. This study investigated the relationship between cumulative neighborhood-level exposures and TNBC risk.
    Methods: This single-institution retrospective study was conducted on a cohort of 3316 breast cancer cases from New Castle County, Delaware (from 2012 to 2020), an area of the country with elevated TNBC rates. Cases were stratified into TNBC and "Non-TNBC" diagnosis and geocoded by residential address. Neighborhood exposures included census tract-level measures of unhealthy alcohol use, metabolic dysfunction, breastfeeding, and environmental hazards. An overall cumulative risk score was calculated based on tract-level exposures.
    Results: Univariate analyses showed each tract-level exposure was associated with greater TNBC odds. In multivariate analyses that controlled for patient-level race and age, tract-level exposures were not associated with TNBC odds. However, in a second multivariate model that included patient-level variables and considered tract-level risk factors as a cumulative exposure risk score, each one unit increase in cumulative exposure was significantly associated with a 10% increase in TNBC odds. Higher cumulative exposure risk scores were found in census tracts with relatively high proportions of Black residents.
    Conclusions: Cumulative exposure to neighborhood-level risk factors that disproportionately affect Black communities was associated with greater TNBC risk.
    MeSH term(s) Female ; Humans ; Black People/statistics & numerical data ; Residence Characteristics ; Retrospective Studies ; Risk Factors ; Triple Negative Breast Neoplasms/epidemiology ; Triple Negative Breast Neoplasms/etiology ; Triple Negative Breast Neoplasms/metabolism
    Language English
    Publishing date 2023-03-14
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.5808
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  9. Article ; Online: Effect of neighborhood and individual-level socioeconomic factors on breast cancer screening adherence in a multi-ethnic study.

    Kasper, Gillian / Momen, Mahsa / Sorice, Kristen A / Mayhand, Kiara N / Handorf, Elizabeth A / Gonzalez, Evelyn T / Devlin, Amie / Brownstein, Kirsten / Esnaola, Nestor / Fisher, Susan G / Lynch, Shannon M

    BMC public health

    2024  Volume 24, Issue 1, Page(s) 63

    Abstract: Background: Although mammography can significantly reduce breast cancer mortality, many women do not receive their annual breast cancer screening. Differences in screening adherence exist by race/ethnicity, socioeconomic status (SES), and insurance ... ...

    Abstract Background: Although mammography can significantly reduce breast cancer mortality, many women do not receive their annual breast cancer screening. Differences in screening adherence exist by race/ethnicity, socioeconomic status (SES), and insurance status. However, more detailed investigations into the impact of neighborhood disadvantage and access to resources on screening adherence are lacking.
    Methods: We comprehensively examined the effect of individual social, economic, and demographic factors (n = 34 variables), as well as neighborhood level SES (nSES) indicators (n = 10 variables) on breast cancer screening adherence across a multi-ethnic population (n = 472). In this cross-sectional study, participants were surveyed from 2017 to 2018. The data was analyzed using univariate regression and LASSO for variable reduction. Significant predictors were carried forward into final multivariable mixed-effect logistic regression models where odds ratios (OR), 95% confidence intervals and p-values were reported.
    Results: Nineteen percent of participants were non-adherent to breast screening guidelines. Race/ethnicity was not associated with adherence; however, increasing age (OR = 0.97, 95%CI = 0.95-0.99, p = 0.01), renting a home (OR = 0.53, 95%CI = 0.30-0.94, p = 0.04), food insecurity (OR 0.46, 95%CI = 0.22-0.94, p = 0.01), and overcrowding (OR = 0.58, 95% CI = 0.32-0.94, p = 0.01) were significantly associated with lower breast cancer screening adherence.
    Conclusion: Socioeconomic indicators at the individual and neighborhood levels impact low breast cancer screening adherence and may help to inform future screening interventions.
    MeSH term(s) Female ; Humans ; Breast Neoplasms/diagnosis ; Breast Neoplasms/prevention & control ; Cross-Sectional Studies ; Early Detection of Cancer ; Socioeconomic Factors ; Social Class
    Language English
    Publishing date 2024-01-02
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2041338-5
    ISSN 1471-2458 ; 1471-2458
    ISSN (online) 1471-2458
    ISSN 1471-2458
    DOI 10.1186/s12889-023-17252-9
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  10. Article ; Online: Emotional reactivity, trauma-related distress, and suicidal ideation among adolescent inpatient survivors of sexual abuse.

    DeCou, Christopher R / Lynch, Shannon M

    Child abuse & neglect

    2019  Volume 89, Page(s) 155–164

    Abstract: Adolescent psychiatric inpatients suffer high rates of childhood sexual abuse, trauma-related distress, and suicidality. This study evaluated the hypothesis that three domains of resiliency (i.e., Sense of Mastery, Sense of Relatedness, and Emotional ... ...

    Abstract Adolescent psychiatric inpatients suffer high rates of childhood sexual abuse, trauma-related distress, and suicidality. This study evaluated the hypothesis that three domains of resiliency (i.e., Sense of Mastery, Sense of Relatedness, and Emotional Reactivity) would mediate the effect of trauma-related distress upon suicidal ideation, while accounting for symptoms of depression, and that the indirect effect of trauma-related distress upon suicidal ideation would be greater among survivors of childhood sexual abuse. Chart review patients included 550 adolescents admitted to a public psychiatric hospital in a Northwestern US State from 2010 to 2015. Adolescents completed self-report measures of trauma-related distress, depression, resiliency, and suicidal ideation. Half of the adolescents in this study reported past history of childhood sexual abuse, and more than half disclosed history of attempted suicide. There was a group noninvariant indirect effect of trauma-related distress upon suicidal ideation via emotional reactivity among survivors of childhood sexual abuse (β = 0.10, 95% ACI: 0.04 to .17), as well as a group invariant direct effect of depression symptoms (β = 0.88, p < .001). The other two domains of resiliency, sense of mastery and sense of relatedness did not mediate the association between trauma-related distress and suicidal ideation. These findings demonstrate the importance of emotional reactivity with regard to suicidal ideation, as well as the association between depression symptoms and suicidal ideation in this clinical population, and suggest the potential utility of skills-based interventions, and the need for trauma-informed policy and procedures in adolescent psychiatric inpatient settings.
    MeSH term(s) Adolescent ; Adult Survivors of Child Abuse/psychology ; Child ; Child Abuse, Sexual/psychology ; Depressive Disorder/psychology ; Female ; Humans ; Inpatients/psychology ; Male ; Retrospective Studies ; Self Report ; Stress Disorders, Traumatic/psychology ; Suicidal Ideation ; Suicide, Attempted/psychology ; Young Adult
    Language English
    Publishing date 2019-01-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 799143-5
    ISSN 1873-7757 ; 0145-2134
    ISSN (online) 1873-7757
    ISSN 0145-2134
    DOI 10.1016/j.chiabu.2019.01.012
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