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O'Brien H, Hyland C, Schoeman E, Millard G, Hyett J, Flower R, Gardener G. Droplet digital PCR for the determination of fetal red cell antigens in pregnancy. Pathology 2018. [DOI: 10.1016/j.pathol.2017.12.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gordon LG, Hyland CA, Hyett JA, O'Brien H, Millard G, Flower RL, Gardener GJ. Noninvasive fetalRHDgenotyping of RhD negative pregnant women for targeted anti-D therapy in Australia: A cost-effectiveness analysis. Prenat Diagn 2017; 37:1245-1253. [DOI: 10.1002/pd.5176] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/07/2017] [Accepted: 10/23/2017] [Indexed: 12/19/2022]
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Lopez GH, Turner RM, McGowan EC, Schoeman EM, Scott SA, O'Brien H, Millard GM, Roulis EV, Allen AJ, Liew YW, Flower RL, Hyland CA. A DEL phenotype attributed to RHD Exon 9 sequence deletion: slipped-strand mispairing and blood group polymorphisms. Transfusion 2017; 58:685-691. [PMID: 29214630 DOI: 10.1111/trf.14439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The RhD blood group antigen is extremely polymorphic and the DEL phenotype represents one such class of polymorphisms. The DEL phenotype prevalent in East Asian populations arises from a synonymous substitution defined as RHD*1227A. However, initially, based on genomic and cDNA studies, the genetic basis for a DEL phenotype in Taiwan was attributed to a deletion of RHD Exon 9 that was never verified at the genomic level by any other independent group. Here we investigate the genetic basis for a Caucasian donor with a DEL partial D phenotype and compare the genomic findings to those initial molecular studies. STUDY DESIGN AND METHODS The 3'-region of the RHD gene was amplified by long-range polymerase chain reaction (PCR) for massively parallel sequencing. Primers were designed to encompass a deletion, flanking Exon 9, by standard PCR for Sanger sequencing. Targeted sequencing of exons and flanking introns was also performed. RESULTS Genomic DNA exhibited a 1012-bp deletion spanning from Intron 8, across Exon 9 into Intron 9. The deletion breakpoints occurred between two 25-bp repeat motifs flanking Exon 9 such that one repeat sequence remained. CONCLUSION Deletion mutations bordered by repeat sequences are a hallmark of slipped-strand mispairing (SSM) event. We propose this genetic mechanism generated the germline deletion in the Caucasian donor. Extensive studies show that the RHD*1227A is the most prevalent DEL allele in East Asian populations and may have confounded the initial molecular studies. Review of the literature revealed that the SSM model explains some of the extreme polymorphisms observed in the clinically significant RhD blood group antigen.
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Hyland CA, Millard GM, O'Brien H, Schoeman EM, Lopez GH, McGowan EC, Tremellen A, Puddephatt R, Gaerty K, Flower RL, Hyett JA, Gardener GJ. Non-invasive fetal RHD genotyping for RhD negative women stratified into RHD gene deletion or variant groups: comparative accuracy using two blood collection tube types. Pathology 2017; 49:757-764. [PMID: 29096879 DOI: 10.1016/j.pathol.2017.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/17/2017] [Accepted: 08/27/2017] [Indexed: 12/19/2022]
Abstract
Non-invasive fetal RHD genotyping in Australia to reduce anti-D usage will need to accommodate both prolonged sample transport times and a diverse population demographic harbouring a range of RHD blood group gene variants. We compared RHD genotyping accuracy using two blood sample collection tube types for RhD negative women stratified into deleted RHD gene haplotype and RHD gene variant cohorts. Maternal blood samples were collected into EDTA and cell-free (cf)DNA stabilising (BCT) tubes from two sites, one interstate. Automated DNA extraction and polymerase chain reaction (PCR) were used to amplify RHD exons 5 and 10 and CCR5. Automated analysis flagged maternal RHD variants, which were classified by genotyping. Time between sample collection and processing ranged from 2.9 to 187.5 hours. cfDNA levels increased with time for EDTA (range 0.03-138 ng/μL) but not BCT samples (0.01-3.24 ng/μL). For the 'deleted' cohort (n=647) all fetal RHD genotyping outcomes were concordant, excepting for one unexplained false negative EDTA sample. Matched against cord RhD serology, negative predictive values using BCT and EDTA tubes were 100% and 99.6%, respectively. Positive predictive values were 99.7% for both types. Overall 37.2% of subjects carried an RhD negative baby. The 'variant' cohort (n=15) included one novel RHD and eight hybrid or African pseudogene variants. Review for fetal RHD specific signals, based on one exon, showed three EDTA samples discordant to BCT, attributed to high maternal cfDNA levels arising from prolonged transport times. For the deleted haplotype cohort, fetal RHD genotyping accuracy was comparable for samples collected in EDTA and BCT tubes despite higher cfDNA levels in the EDTA tubes. Capacity to predict fetal RHD genotype for maternal carriers of hybrid or pseudogene RHD variants requires stringent control of cfDNA levels. We conclude that fetal RHD genotyping is feasible in the Australian environment to avoid unnecessary anti-D immunoglobulin prophylaxis.
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Schoeman EM, Roulis EV, Liew YW, Martin JR, Powley T, Wilson B, Millard GM, McGowan EC, Lopez GH, O'Brien H, Condon JA, Flower RL, Hyland CA. Targeted exome sequencing defines novel and rare variants in complex blood group serology cases for a red blood cell reference laboratory setting. Transfusion 2017; 58:284-293. [PMID: 29119571 DOI: 10.1111/trf.14393] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND We previously demonstrated that targeted exome sequencing accurately defined blood group genotypes for reference panel samples characterized by serology and single-nucleotide polymorphism (SNP) genotyping. Here we investigate the application of this approach to resolve problematic serology and SNP-typing cases. STUDY DESIGN AND METHODS The TruSight One sequencing panel and MiSeq platform was used for sequencing. CLC Genomics Workbench software was used for data analysis of the blood group genes implicated in the serology and SNP-typing problem. Sequence variants were compared to public databases listing blood group alleles. The effect of predicted amino acid changes on protein function for novel alleles was assessed using SIFT and PolyPhen-2. RESULTS Among 29 unresolved samples, sequencing defined SNPs in blood group genes consistent with serologic observation: 22 samples exhibited SNPs associated with varied but known blood group alleles and one sample exhibited a chimeric RH genotype. Three samples showed novel variants in the CROM, LAN, and RH systems, respectively, predicting respective amino acid changes with possible deleterious impact. Two samples harbored rare variants in the RH and FY systems, respectively, not previously associated with a blood group allele or phenotype. A final sample comprised a rare variant within the KLF1 transcription factor gene that may modulate DNA-binding activity. CONCLUSION Targeted exome sequencing resolved complex serology problems and defined both novel blood group alleles (CD55:c.203G>A, ABCB6:c.1118_1124delCGGATCG, ABCB6:c.1656-1G>A, and RHD:c.452G>A) and rare variants on blood group alleles associated with altered phenotypes. This study illustrates the utility of exome sequencing, in conjunction with serology, as an alternative approach to resolve complex cases.
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Pinheiro LB, O'Brien H, Druce J, Do H, Kay P, Daniels M, You J, Burke D, Griffiths K, Emslie KR. Interlaboratory Reproducibility of Droplet Digital Polymerase Chain Reaction Using a New DNA Reference Material Format. Anal Chem 2017; 89:11243-11251. [PMID: 28968098 DOI: 10.1021/acs.analchem.6b05032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Use of droplet digital PCR technology (ddPCR) is expanding rapidly in the diversity of applications and number of users around the world. Access to relatively simple and affordable commercial ddPCR technology has attracted wide interest in use of this technology as a molecular diagnostic tool. For ddPCR to effectively transition to a molecular diagnostic setting requires processes for method validation and verification and demonstration of reproducible instrument performance. In this study, we describe the development and characterization of a DNA reference material (NMI NA008 High GC reference material) comprising a challenging methylated GC-rich DNA template under a novel 96-well microplate format. A scalable process using high precision acoustic dispensing technology was validated to produce the DNA reference material with a certified reference value expressed in amount of DNA molecules per well. An interlaboratory study, conducted using blinded NA008 High GC reference material to assess reproducibility among seven independent laboratories demonstrated less than 4.5% reproducibility relative standard deviation. With the exclusion of one laboratory, laboratories had appropriate technical competency, fully functional instrumentation, and suitable reagents to perform accurate ddPCR based DNA quantification measurements at the time of the study. The study results confirmed that NA008 High GC reference material is fit for the purpose of being used for quality control of ddPCR systems, consumables, instrumentation, and workflow.
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Lopez GH, McGowan EC, Condon JA, Schoeman EM, Millard GM, O'Brien H, Roulis EV, Ochoa-Garay G, Liew YW, Flower RL, Hyland CA. Genotyping by sequencing defines independent novel RHD variants for an antenatal patient and a blood donor. Transfusion 2017; 57:2281-2283. [PMID: 28714065 DOI: 10.1111/trf.14250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/01/2017] [Accepted: 06/04/2017] [Indexed: 12/23/2022]
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Schoeman EM, Lopez GH, McGowan EC, Millard GM, O'Brien H, Roulis EV, Liew YW, Martin JR, McGrath KA, Powley T, Flower RL, Hyland CA. Evaluation of targeted exome sequencing for 28 protein-based blood group systems, including the homologous gene systems, for blood group genotyping. Transfusion 2017; 57:1078-1088. [PMID: 28338218 DOI: 10.1111/trf.14054] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 11/22/2016] [Accepted: 12/02/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Blood group single nucleotide polymorphism genotyping probes for a limited range of polymorphisms. This study investigated whether massively parallel sequencing (also known as next-generation sequencing), with a targeted exome strategy, provides an extended blood group genotype and the extent to which massively parallel sequencing correctly genotypes in homologous gene systems, such as RH and MNS. STUDY DESIGN AND METHODS Donor samples (n = 28) that were extensively phenotyped and genotyped using single nucleotide polymorphism typing, were analyzed using the TruSight One Sequencing Panel and MiSeq platform. Genes for 28 protein-based blood group systems, GATA1, and KLF1 were analyzed. Copy number variation analysis was used to characterize complex structural variants in the GYPC and RH systems. RESULTS The average sequencing depth per target region was 66.2 ± 39.8. Each sample harbored on average 43 ± 9 variants, of which 10 ± 3 were used for genotyping. For the 28 samples, massively parallel sequencing variant sequences correctly matched expected sequences based on single nucleotide polymorphism genotyping data. Copy number variation analysis defined the Rh C/c alleles and complex RHD hybrids. Hybrid RHD*D-CE-D variants were correctly identified, but copy number variation analysis did not confidently distinguish between D and CE exon deletion versus rearrangement. CONCLUSION The targeted exome sequencing strategy employed extended the range of blood group genotypes detected compared with single nucleotide polymorphism typing. This single-test format included detection of complex MNS hybrid cases and, with copy number variation analysis, defined RH hybrid genes along with the RHCE*C allele hitherto difficult to resolve by variant detection. The approach is economical compared with whole-genome sequencing and is suitable for a red blood cell reference laboratory setting.
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O'Brien H, O'Leary N, Scarlett S, O'Hare C, Kenny RA. 182HOSPITALIZATION AND SURGERY: ARE THERE HIDDEN COGNITIVE CONSEQUENCES? EVIDENCE FROM THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA). Age Ageing 2016. [DOI: 10.1093/ageing/afw159.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Scarlett S, O'Connell M, Nolan H, O'Brien H, Kenny RA. 191AN INVESTIGATION OF THE RELATIONSHIP BETWEEN SLEEP DURATION AND COGNITIVE FUNCTION IN OLDER ADULTS. Age Ageing 2016. [DOI: 10.1093/ageing/afw159.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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O'Brien H, Scarlett S, Brady A, Harkin K, Kenny RA, Moriarty J. 197DO-NOT-ATTEMPT-RESUSCITATION (DNAR): THE IMPORTANCE OF PHYSICIAN AND NURSE UNDERSTANDING OF DNAR ORDERS IN A UNIVERSITY HOSPITAL AND ITS COMMUNITY. Age Ageing 2016. [DOI: 10.1093/ageing/afw159.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lopez GH, McGowan EC, McGrath KA, Abaca‐Cleopas ME, Schoeman EM, Millard GM, O'Brien H, Liew Y, Flower RL, Hyland CA. A D+ blood donor with a novelRHD*D‐CE(5‐6)‐Dgene variant exhibits the low‐frequency antigen RH23 (DW) characteristic of the partial DVa phenotype. Transfusion 2016; 56:2322-30. [DOI: 10.1111/trf.13713] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 05/23/2016] [Accepted: 05/24/2016] [Indexed: 12/28/2022]
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Guilfoyle P, O'Brien H, O'Keeffe ST. Delusions of pregnancy in older women: a case series. Age Ageing 2015; 44:1058-61. [PMID: 26404613 DOI: 10.1093/ageing/afv127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/05/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Delusions of pregnancy have been reported in a wide variety of functional and organic psychiatric conditions but rarely with dementia. Most such delusions arise in women of child-bearing age. We report five cases in older women all of whom had severe constipation that probably precipitated this delusion. CASE REPORTS Of the five women (age 74-89 years), two had dementia, two had delirium and one had both. All patients had borne healthy children. Three women reported that they were in labour, and one was concerned that the baby was not moving. All had severe constipation on examination or imaging, and three had faecal impaction. All were treated with laxatives or enemas, and only one patient required brief antipsychotic therapy. The delusions lasted from a few hours to 5 days. In general, resolution of the delusion occurred in concert with improvement in bowel function, although in one case a large bowel movement was followed by the delusion that a baby had been born. CONCLUSION These cases suggest that misinterpretation of abdominal symptoms due to severe constipation in cognitively impaired women may trigger the delusion of being pregnant and that treatment of constipation often leads to resolution of the delusion.
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Brown P, Whiteside BJ, Beek TJ, Fox P, Horbury TS, Oddy TM, Archer MO, Eastwood JP, Sanz-Hernández D, Sample JG, Cupido E, O'Brien H, Carr CM. Space magnetometer based on an anisotropic magnetoresistive hybrid sensor. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2014; 85:125117. [PMID: 25554336 DOI: 10.1063/1.4904702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report on the design and development of a low resource, dual sensor vector magnetometer for space science applications on very small spacecraft. It is based on a hybrid device combining an orthogonal triad of commercial anisotropic magnetoresistive (AMR) sensors with a totem pole H-Bridge drive on a ceramic substrate. The drive enables AMR operation in the more sensitive flipped mode and this is achieved without the need for current spike transmission down a sensor harness. The magnetometer has sensitivity of better than 3 nT in a 0-10 Hz band and a total mass of 104 g. Three instruments have been launched as part of the TRIO-CINEMA space weather mission, inter-calibration against the International Geomagnetic Reference Field model makes it possible to extract physical signals such as field-aligned current deflections of 20-60 nT within an approximately 45,000 nT ambient field.
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Hyland CA, Gardener GJ, O'Brien H, Millard G, Gibbons K, Tremellen A, Ochoa-Garay G, Flower RL, Hyett JA. Strategy for managing maternal variant RHD
alleles in Rhesus D negative obstetric populations during fetal RHD
genotyping. Prenat Diagn 2013; 34:56-62. [DOI: 10.1002/pd.4253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 09/30/2013] [Accepted: 10/01/2013] [Indexed: 11/10/2022]
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Nápoles AM, Ortíz C, O'Brien H, Sereno AB, Kaplan CP. Coping resources and self-rated health among Latina breast cancer survivors. Oncol Nurs Forum 2011; 38:523-31. [PMID: 21875840 PMCID: PMC3556482 DOI: 10.1188/11.onf.523-531] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine relationships between coping resources and self-rated health among Latina breast cancer survivors. DESIGN Cross-sectional telephone survey. SETTING Four northern California counties. SAMPLE 330 Latina breast cancer survivors within one to five years of diagnosis. METHODS Telephone survey conducted by bilingual and bicultural interviewers. MAIN RESEARCH VARIABLES Predictors were sociodemographic and clinical factors, cancer self-efficacy, spirituality, and social support from family, friends, and oncologists. Outcomes were functional limitations and self-rated health. FINDINGS Twenty-two percent of women reported functional limitations (n = 73) and 27% reported poor or fair self-rated health (n = 89). Unemployment (adjusted odds ratio [AOR] = 7.06; 95% confidence interval [CI] [2.04, 24.46]), mastectomy (AOR = 2.67; 95% CI [1.06, 6.77]), and comorbidity (AOR = 4.09; 95% CI [1.69, 9.89]) were associated with higher risk of functional limitations; cancer self-efficacy had a protective effect (AOR = 0.4, 95% CI [0.18, 0.9]). Comorbidity was associated with higher risk of poor or fair self-rated health (AOR = 4.95; 95% CI [2.13, 11.47]); cancer self-efficacy had a protective effect (AOR = 0.3; 95% CI [0.13, 0.66]). CONCLUSIONS Comorbidities place Latina breast cancer survivors at increased risk for poor health. Cancer self-efficacy deserves more attention as a potentially modifiable protective factor. IMPLICATIONS FOR NURSING Nurses need to assess the impact of comorbidity on functioning and can reinforce patients' sense of control over cancer and clinician support.
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Ní Chróinín D, O'Brien H, Stafford M, Power D. THE EFFECT OF NUTRITIONAL SUPPLEMENTATION ON FUNCTIONAL OUTCOME: COMBINATION WITH PHYSICAL EXERCISE MAY PROVE TO BE THE WINNING FORMULA. J Am Geriatr Soc 2010; 58:1396-8. [DOI: 10.1111/j.1532-5415.2010.02929.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nápoles AM, Santoyo-Olsson J, Karliner LS, O'Brien H, Gregorich SE, Pérez-Stable EJ. Clinician ratings of interpreter mediated visits in underserved primary care settings with ad hoc, in-person professional, and video conferencing modes. J Health Care Poor Underserved 2010; 21:301-17. [PMID: 20173271 PMCID: PMC3576468 DOI: 10.1353/hpu.0.0269] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Linguistic interpretation ameliorates health disparities disfavoring underserved limited English-proficient patients, yet few studies have compared clinician satisfaction with these services. Self-administered clinician post-visit surveys compared the quality of interpretation and communication, visit satisfaction, degree of patient engagement, and cultural competence of visits using untrained people acting as interpreters (ad hoc), in-person professional, or video conferencing professional interpretation for 283 visits. Adjusting for clinician and patient characteristics, the quality of interpretation of in-person and video conferencing modes were rated similarly (OR 1.79, 95% CI 0.74, 4.33). The quality of in-person (OR 5.55, 95% CI 1.50, 20.51) and video conferencing (OR 3.10, 95% CI 1.16, 8.31) were rated higher than ad hoc interpretation. Self-assessed cultural competence was better for in-person versus video conferencing interpretation (OR 2.32, 95% CI 1.11, 4.86). Video conferencing interpretation increases access without compromising quality, but cultural nuances may be better addressed by in-person interpreters. Professional interpretation is superior to ad hoc (OR 4.15, 95% CI 1.43, 12.09).
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Nápoles AM, Gregorich SE, Santoyo-Olsson J, O'Brien H, Stewart AL. Interpersonal processes of care and patient satisfaction: do associations differ by race, ethnicity, and language? Health Serv Res 2009; 44:1326-44. [PMID: 19490162 DOI: 10.1111/j.1475-6773.2009.00965.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Describe association of patient satisfaction with interpersonal processes of care (IPC) by race/ethnicity. DATA SOURCES/STUDY SETTING Interview with 1,664 patients (African Americans, English- and Spanish-speaking Latinos, and non-Latino Whites). STUDY DESIGN/METHODS Cross-sectional study of seven IPC measures (communication, patient-centered decision making, and interpersonal style) and three satisfaction measures (satisfaction with physicians, satisfaction with health care, and willingness to recommend physicians). Regression models explored associations, controlling for patient characteristics. PRINCIPAL FINDINGS In all groups: patient-centered decision making was positively associated with satisfaction with physicians (B=0.10, p<.0001) and health care (B=0.07, p<.001), and "recommend physicians" (OR=1.23, 95 percent CI 1.06, 1.43); discrimination was negatively associated with satisfaction with physicians (B=0.09, p<.05) and health care (B=0.17, p<.001). Unclear communication was associated with less satisfaction with physicians among Spanish-speaking Latinos. Explaining results was positively associated with all satisfaction outcomes for all groups with one exception (no association with satisfaction with physicians for Latino Spanish-speakers). Compassion/respect was positively associated with all outcomes for all groups with two exceptions (no association with satisfaction with health care among English-speaking Latinos and Whites). CONCLUSIONS All IPC measures were associated with at least one satisfaction outcome for all groups except for unclear communication.
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Nápoles-Springer AM, Ortíz C, O'Brien H, Díaz-Méndez M. Developing a culturally competent peer support intervention for Spanish-speaking Latinas with breast cancer. J Immigr Minor Health 2008; 11:268-80. [PMID: 18340533 DOI: 10.1007/s10903-008-9128-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Accepted: 02/26/2008] [Indexed: 10/22/2022]
Abstract
Little research exists on the need for, barriers to, and acceptability and effectiveness of psychosocial support services among Latinas with breast cancer, despite their increased risks of psychosocial distress. This formative research study identifies barriers to and benefits and components of an effective peer support counselor intervention for Spanish-speaking Latinas recently diagnosed with breast cancer. Analysis was based on interviews of 89 Latino cancer patients referred to psychosocial services; 29 Spanish-speaking survivors of breast cancer; and 17 culturally competent advocates for Latinos with cancer. Results indicate that interventions should begin close to diagnosis; build self-care skills; be culturally competent and emotionally supportive; provide language appropriate cancer information; encourage self-expression; and address lack of access to and knowledge of services. Creating such psychosocial programs with input from survivors and advocates who have similar self-identities to patients would improve quality of life in diverse and underserved populations.
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Nápoles-Springer AM, Santoyo-Olsson J, O'Brien H, Stewart AL. Using cognitive interviews to develop surveys in diverse populations. Med Care 2007; 44:S21-30. [PMID: 17060830 DOI: 10.1097/01.mlr.0000245425.65905.1d] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Conceptual equivalence of measures is essential in research that compares health across diverse racial/ethnic groups. Cognitive interviews are pretest methods to explore the conceptual equivalence of survey items. Systematic approaches for using these methods are emerging. OBJECTIVE We describe an interaction analysis (IA) approach using qualitative data analysis software to analyze transcripts of cognitive interviews in a study to develop a survey instrument of the quality of interpersonal processes of care of diverse patients. Cognitive interviews included standard administration of the survey followed by retrospective probes for selected items. SUBJECTS Interviews were completed with 48 Latino, black, and non-Latino white respondents 18 years of age or older with at least one doctor's visit in the past 12 months. Participants averaged 45.8 years in age (standard deviation [SD] = 18.4), 58% were women, and mean education was 14.7 years (SD = 4.0). RESULTS Problems were identified in 126 of 159 items (79%). Behavior coding identified 32 problematic items (20%). IA of the transcript of the survey and retrospective probes identified 94 additional problematic items (59%). IA often revealed the nature of the problems, enabling decisions to modify or drop items based on respondents' comments. Behavior coding and IA identified ethnic and language similarities and differences in the use of response sets and the interpretation of items. CONCLUSIONS IA and behavior coding of cognitive interview transcripts can identify efficiently problems with items and their source to increase the likelihood of the revised items being conceptually equivalent across ethnic groups.
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Qasim A, O'Brien H, Sebastian S, O'Sullivan M, Buckley M, O'Moran C. Platelet activation in patients with irritable bowel syndrome may reflect a subclinical inflammatory response. Gut 2003; 52:1799-800. [PMID: 14633969 PMCID: PMC1773872 DOI: 10.1136/gut.52.12.1799-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Duffy CJ, Tetewsky SJ, O'Brien H. Cortical motion blindness in visuospatial AD. Neurobiol Aging 2000; 21:867-9; discussion 875-7. [PMID: 11124432 DOI: 10.1016/s0197-4580(00)00187-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Coulthard SA, Rabello C, Robson J, Howell C, Minto L, Middleton PG, Gandhi MK, Jackson G, McLelland J, O'Brien H, Smith S, Reid MM, Pearson AD, Hall AG. A comparison of molecular and enzyme-based assays for the detection of thiopurine methyltransferase mutations. Br J Haematol 2000; 110:599-604. [PMID: 10997970 DOI: 10.1046/j.1365-2141.2000.02218.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
S-Methylation by thiopurine methyltransferase (TPMT) is an important route of metabolism for the thiopurine drugs. About one in 300 individuals are homozygous for a TPMT mutation associated with very low enzyme activity and severe myelosuppression if treated with standard doses of drug. To validate the use of molecular genetic techniques for the detection of TPMT deficiency, we have determined red blood cell TPMT activity in 240 adult blood donors and 55 normal children. Genotype was determined by restriction fragment length analysis of polymerase chain reaction products in a cohort of 79 of the blood donors and five cases of azathioprine-induced myelosupression, and this confirmed a close relationship between genotype and phenotype. In 17 of the 24 cases in which mutations were found, DNA was also available from remission bone marrow. In one of these cases, DNA from the remission marrow sample indicated the presence of a non-mutated allele that had not been seen in the blast DNA sample obtained at presentation. These results indicate that polymerase chain reaction-based assays give reliable and robust results for the detection of TPMT deficiency, but that caution should be exercised in relying exclusively on DNA obtained from lymphoblasts in childhood leukaemia.
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O'Brien H, Matthew JA, Gee JM, Watson M, Rhodes M, Speakman CT, Stebbings WS, Kennedy HJ, Johnson IT. K-ras mutations, rectal crypt cells proliferation, and meat consumption in patients with left-sided colorectal carcinoma. Eur J Cancer Prev 2000; 9:41-7. [PMID: 10777009 DOI: 10.1097/00008469-200002000-00006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
It has been suggested that N-nitroso compounds derived from meat may increase the risk of K-ras mutations in the human colon. We sought evidence of associations between red meat consumption, frequency and type of K-ras mutations in resected tumours, and the rate of crypt cell proliferation (CCP) in the normal mucosa of patients with left-sided colorectal carcinoma. Meat consumption was assessed by food frequency questionnaire, and CCP was determined in rectal biopsies obtained prior to surgery. K-ras mutations in the resected tumours were determined using a PCR-based oligonucleotide hybridization assay. Fifteen K-ras mutations were detected in tumours from 43 patients; 13/15 in codon 12, 3/15 in codon 13, and 1/15 in both codons 12 and 13. All mutations were G-->A or G-->T transitions. There was no statistically significant difference between intakes of red meat in patients with a K-ras mutation (92.4 +/- 9.7 g/day) and those without (82.3 +/- 7.7 g/day). Rectal CCP was significantly higher in patients than in healthy controls, but there was no correlation with meat consumption or K-ras mutation. These data do not support the hypothesis that meat consumption is a risk factor for acquisition of K-ras mutations during colorectal carcinogenesis.
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