ORCID Profile
0000-0001-8477-1432
Current Organisations
University of Toronto - Mississauga
,
Ronald Reagan UCLA Medical Center
,
University of Toronto
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Publications
International variation in use of oral anticoagulation among heart failure patients with atrial fibrillation
Publisher: Elsevier BV
Date: 05-2012
Early intravenous heart failure therapy and outcomes among older patients hospitalized for acute decompensated heart failure: Findings from the Acute Decompensated Heart Failure Registry Emergency Mod
Publisher: Elsevier BV
Date: 08-2013
DOI: 10.1016/J.AHJ.2013.05.014
Abstract: Timing of initial treatment for acute decompensated heart failure (ADHF) varies across hospitals and its impact on outcomes remains poorly defined. We examined the association between time to first intravenous (IV) heart failure (HF) therapy and patient outcomes. Using the ADHERE-EM linked to Medicare claims data, we identified patients ≥65 years old who were hospitalized for ADHF and received IV HF therapy during index admission. Cox proportional hazard model was used to assess the association of time to treatment with a composite of 30-day all-cause mortality or re-admission. Generalized linear mixed models were used to examine the association of time to treatment with in-hospital all-cause mortality, index hospitalization length of stay, and total days alive and out-of-hospital at 30 days. Of 6,971 patients, the median time to first IV HF therapy was 2.3-hours (interquartile range 1.1, 4.4). The cumulative incidence of 30-day all-cause mortality or readmission was 27.4%. After adjusting for covariates, time to treatment was not associated with increased risk of composite 30-day all-cause mortality or re-admission (HR 1.00 95% CI 1.00-1.00 P = .221). However, every hour delay in treatment was associated with a modest increased risk of in-hospital mortality (adjusted OR 1.01 95% CI 1.00-1.02 P = .001) and an approximately 1.4-hour increase in index admission length of stay (P < .001). Among older patients presenting with ADHF, delay in initiating IV HF therapy was associated with modestly higher risk for in-hospital mortality and longer length of stay, but was not associated with 30-day outcomes.
A Biological Approach to Building Resilience and Wellness Capacity Among Police Exposed to Posttraumatic Stress Injuries: Protocol for a Randomized Controlled Trial (Preprint)
Publisher: JMIR Publications Inc.
Date: 15-02-2023
Abstract: aw enforcement officers are routinely exposed to hazardous, disturbing events that can impose severe stress and long-term psychological trauma. As a result, police and other public safety personnel (PSP) are at increased risk of developing posttraumatic stress injuries (PTSIs) and disruptions to the autonomic nervous system (ANS). ANS functioning can be objectively and noninvasively measured by heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA). Traditional interventions aimed at building resilience among PSP have not adequately addressed the physiological ANS dysregulations that lead to mental and physical health conditions, as well as burnout and fatigue following potential psychological trauma. n this study, we will investigate the efficacy of a web-based Autonomic Modulation Training (AMT) intervention on the following outcomes: (1) reducing self-reported symptoms of PTSI, (2) strengthening ANS physiological resilience and wellness capacity, and (3) exploring how sex and gender are related to baseline differences in psychological and biological PTSI symptoms and response to the AMT intervention. he study is comprised of 2 phases. Phase 1 involves the development of the web-based AMT intervention, which includes 1 session of baseline survey measures, 6 weekly sessions that integrate HRV biofeedback (HRVBF) training with meta-cognitive skill practice, and 1 session of follow-up survey measures. Phase 2 will use a cluster randomized control design to test the effectiveness of AMT on the following prepost outcomes: (1) self-report symptoms of PTSI and other wellness measures (2) physiological indicators of health and resilience including resting HR, HRV, and RSA and (3) the influence of sex and gender on other outcomes. Participants will be recruited for an 8-week study across Canada in rolling cohorts. he study received grant funding in March 2020 and ethics approval in February 2021. Due to delays related to COVID-19, phase 1 was completed in December 2022, and phase 2 pilot testing began in February 2023. Cohorts of 10 participants in the experimental (AMT) and control (prepost assessment only) groups will continue until a total of 250 participants are tested. Data collection from all phases is expected to conclude in December 2025 but may be extended until the intended s le size is reached. Quantitative analyses of psychological and physiological data will be conducted in conjunction with expert coinvestigators. here is an urgent need to provide police and PSP with effective training that improves physical and psychological functioning. Given that help-seeking for PTSI is reduced among these occupational groups, AMT is a promising intervention that can be completed in the privacy of one’s home. Importantly, AMT is a novel program that uniquely addresses the underlying physiological mechanisms that support resilience and wellness promotion and is tailored to the occupational demands of PSP. linicalTrials.gov NCT05521360 t2/show/NCT05521360 RR1-10.2196/33492
A Biological Approach to Building Resilience and Wellness Capacity Among Police Exposed to Posttraumatic Stress Injuries: Protocol for a Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 24-05-2023
DOI: 10.2196/33492
Abstract: Law enforcement officers are routinely exposed to hazardous, disturbing events that can impose severe stress and long-term psychological trauma. As a result, police and other public safety personnel (PSP) are at increased risk of developing posttraumatic stress injuries (PTSIs) and disruptions to the autonomic nervous system (ANS). ANS functioning can be objectively and noninvasively measured by heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA). Traditional interventions aimed at building resilience among PSP have not adequately addressed the physiological ANS dysregulations that lead to mental and physical health conditions, as well as burnout and fatigue following potential psychological trauma. In this study, we will investigate the efficacy of a web-based Autonomic Modulation Training (AMT) intervention on the following outcomes: (1) reducing self-reported symptoms of PTSI, (2) strengthening ANS physiological resilience and wellness capacity, and (3) exploring how sex and gender are related to baseline differences in psychological and biological PTSI symptoms and response to the AMT intervention. The study is comprised of 2 phases. Phase 1 involves the development of the web-based AMT intervention, which includes 1 session of baseline survey measures, 6 weekly sessions that integrate HRV biofeedback (HRVBF) training with meta-cognitive skill practice, and 1 session of follow-up survey measures. Phase 2 will use a cluster randomized control design to test the effectiveness of AMT on the following prepost outcomes: (1) self-report symptoms of PTSI and other wellness measures (2) physiological indicators of health and resilience including resting HR, HRV, and RSA and (3) the influence of sex and gender on other outcomes. Participants will be recruited for an 8-week study across Canada in rolling cohorts. The study received grant funding in March 2020 and ethics approval in February 2021. Due to delays related to COVID-19, phase 1 was completed in December 2022, and phase 2 pilot testing began in February 2023. Cohorts of 10 participants in the experimental (AMT) and control (prepost assessment only) groups will continue until a total of 250 participants are tested. Data collection from all phases is expected to conclude in December 2025 but may be extended until the intended s le size is reached. Quantitative analyses of psychological and physiological data will be conducted in conjunction with expert coinvestigators. There is an urgent need to provide police and PSP with effective training that improves physical and psychological functioning. Given that help-seeking for PTSI is reduced among these occupational groups, AMT is a promising intervention that can be completed in the privacy of one’s home. Importantly, AMT is a novel program that uniquely addresses the underlying physiological mechanisms that support resilience and wellness promotion and is tailored to the occupational demands of PSP. ClinicalTrials.gov NCT05521360 t2/show/NCT05521360 PRR1-10.2196/33492
Advancing police use of force research and practice: urgent issues and prospects
Publisher: Wiley
Date: 05-05-2021
DOI: 10.1111/LCRP.12191
Abstract: Leading police scholars and practitioners were asked to reflect on the most urgent issues that need to be addressed on the topic of use of force. Four themes emerged from their contributions: use of force and de‐escalation training needs to improve and be evaluated new ways of conceptualizing use of force encounters and better use of force response models need to be developed the inequitable application of force, and how to remediate biases, needs to be more fully understood and misconceptions about police use of force need to be identified and corrected. The highlighted topics serve as an agenda for future research. Such research should provide greater insight into when, where, and why force is used by police officers, and how it can be applied appropriately. If implemented, the practical recommendations included in the contributions should have a positive impact on police performance, public trust and confidence in the police, and citizen and officer safety.
Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study
Publisher: Frontiers Media SA
Date: 18-01-2023
DOI: 10.3389/FPSYG.2022.1017675
Abstract: The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure. International experts were recruited from four performance domains [(i) Defense (ii) Competitive Sport (iii) Civilian High-stakes and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance. Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention (2) Cognitive Control—Performance Monitoring (3) Arousal and Regulatory Systems—Arousal (4) Cognitive Control—Goal Selection, Updating, Representation, and Maintenance (5) Cognitive Control—Response Selection and Inhibition/Suppression (6) Working memory—Flexible Updating (7) Working memory—Active Maintenance (8) Perception and Understanding of Self—Self-knowledge (9) Working memory—Interference Control, and (10) Expert-suggested—Shifting. Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.
Related Organisations
University Of California Los Angeles David Geffen School Of Medicine
Location: United States of America
Related Funding Activities
No related grants have been discovered for Judith Andersen.