Browsing by Author "Stewart, J."

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    Non-fatal suicidal behaviour, depression and poverty among young men living in low-resource communities in South Africa
    (BMC (part of Springer Nature), 2018-10-22) Bantjes, J.; Tomlinson, M.; Weiss, R. E.; Yen, P. K.; Goldstone, D.; Stewart, J.; Qondela, T.; Rabie, S.; Rotheram-Borus, M. J.
    Background: Suicide is a serious public health problem in low- and middle-income countries. Understanding the context- and gender-specific risk factors for non-fatal suicidal behaviour is the cornerstone of evidence-based public health interventions to reduce suicide. Poverty and symptoms of depression are well established risk factors for suicidal behaviour. However, little is understood about how proximal economic factors (such as losing one’s job, or food insecurity) may confound the effects of symptoms of depression to increase the risk of non-fatal suicidal behaviour in vulnerable populations, such as young men living under conditions of endemic poverty. The aim of this study was to explore the extent to which a wide range of poverty-related variables account for non-fatal suicidal behaviour independent of, or in addition to, symptoms of depression among young men living in low-resource communities in South Africa (SA). Methods: Data were collected from a clustered sample of 647 young men living in low-resource communities in the Western Cape province of SA. Multivariate regressions were used to identify the associations between poverty-related measures, symptoms of depression, and past-month prevalence of non-fatal suicidal behaviour. Results: Non-fatal suicidal behaviour in the last month was reported by 47 (6.13%) participants: suicidal ideation (n = 43; 5.97%); suicide plan (n = 5; 0.77%); suicide attempt (n = 4; 0.62%), and deliberate self-harm without intent to die (n = 4; 0.62%). Past-month prevalence of non-fatal suicidal behaviour was significantly associated with particular dimensions of poverty (living in a home without a toilet on the premises, having previously been fired, and food insecurity), but not with other dimensions of poverty (such as prolonged unemployment and low levels of income). However, symptoms of depression were a more significant predictor of non-fatal suicidal behaviour than any measure of poverty (aOR=1.093, 95% CI=1.058-1.129, p < .000). Conclusions: Depressive symptoms are more strongly associated with non-fatal suicidal behaviour than a range of proximal and distal economic factors among young men living under conditions of endemic poverty in South Africa. This has important public health implications and highlights the importance of increasing young men’s access to psychiatric services and targeting depression as an integral component of suicide prevention in low resource communities.
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    Oral ibandronate for the treatment of metastatic bone disease in breast cancer: Efficacy and safety results from a randomized, double-blind, placebo-controlled trial
    (2004) Tripathy, D.; Lichinitzer, M.; Lazarev, A.; MacLachlan, S. A.; Apffelstaedt, J.; Budde, M.; Bergstrom, B.; Abdi, E.; Abramson, N.; Baker, T. M.; Kirkegaard, L. W.; Schmidt, J. R.; Bell, D.; Bell, R.; Belt, R. J.; Bernstein, J. I.; Just, R. G.; Burningham, R. A.; Trafficante, B.; Caggiano, V.; Cartwright, T.; Chernozemsky, I. N.; Clingan, P.; Conkling, P.; Craig, J. B.; Grosbach, A. B.; Decker, D.; Dickman, E.; Duga, Jr. W.; Dunlap, W.; Eisenberg, P. D.; Ellerton, J.; Ettinger, M.; Ey, F.; Falkson, G.; Falkson, C.; Fink, K.; Fleagle, J.; Forlenza, T.; Gorbunova, V. A.; Gross, G. E.; Grotes, T.; Grygiel, J.; Gudgeon, A.; Werner, I. D.; Hacking, D.; Harrer, G. W.; Harvey, V.; Hirsch, R.; Koletsky, A.; Jordaan, J. P.; Cash, D. K.; Khasanov, R. Sh.; LaFata, J. A.; Lafollette, S.; Koshla, P.; Landers, G.; Lebos, H. C.; Wade, J. L.; Lowenthal, T.; Lyons, R.; McLachlan, S. A.; Murray, R.; Perez, D.; Phadke, K.; Rapoport, B.; Rausch, P. G.; Robinson, B.; Sarna, G.; Saven, A.; Schwartz, M.; Semiglazov, V. F.; Stewart, J.; Sunderland, K.; Thomas, L.; Vogel, C. L.; Martinez Rio, M.; Vorobiof, D. A.; Wilks, S.; Woolley, P.
    Background: We report the first results of a randomized trial assessing a new oral aminobisphosphonate, ibandronate, in patients with bone metastases from breast cancer. Patients and methods: Patients (n = 435) received placebo, or oral ibandronate 20 mg or 50 mg once-daily for 96 weeks. The primary efficacy measure was the number of 12-week periods with new bone complications [skeletal morbidity period rate (SMPR)]. Multivariate Poisson regression analysis assessed the relative risk reduction of skeletal-related events. Secondary efficacy analyses included bone pain and analgesic use. Adverse events were monitored. Results: SMPR was significantly reduced with oral ibandronate [placebo 1.2, 20 mg group 0.97 (P = 0.024), 50 mg group 0.98 (P = 0.037)]. Ibandronate 50 mg significantly reduced the need for radiotherapy (P = 0.005 versus placebo). The relative risk of skeletal events was reduced by 38% (20 mg dose) and 39% (50 mg dose) versus placebo (P = 0.009 and P = 0.005). The tolerability profile of ibandronate was similar to placebo. Conclusions: Oral ibandronate is an effective and well-tolerated treatment for metastatic bone disease. The 50 mg dose is being further evaluated in clinical trials, and this dose was recently approved in the European Union for the prevention of skeletal events in patients with breast cancer and bone metastases. © 2004 European Society for Medical Oncology.