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Runions KC, Morandini HAE, Rao P, Wong JWY, Kolla NJ, Pace G, Mahfouda S, Hildebrandt CS, Stewart R, Zepf FD. Serotonin and aggressive behaviour in children and adolescents: a systematic review. Acta Psychiatr Scand 2019; 139:117-144. [PMID: 30446991 DOI: 10.1111/acps.12986] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The role of serotonin (5-HT) in human aggression has been the subject of a large number of studies, mostly with adults. Meta-analyses indicate a small but significant inverse relationship between central nervous 5-HT availability and aggression, but genetically informed studies suggest two pathways: one to reactive aggression and the other to proactive aggression. METHOD We conducted a systemic review on central nervous 5-HT function in children and adolescents, with attention to the function of aggression. RESULTS In total, 675 articles were screened for relevance, with 45 reviewed. These included blood assays (e.g. plasma, 5-HIAA; platelet 5-HTR2A ), epigenetic studies, retrospective PET studies and 5-HT challenge paradigms (e.g. tryptophan depletion). Overall, findings were mixed, with support both for negative and for positive associations of central nervous 5-HT function with aggression in children and adolescents. CONCLUSION We propose factors that may be blurring the picture, including problems in the conceptualization and measurement of aggression in young people, the lack of prospective designs and the bias towards clinical samples of boys. Research needs to account for variance in the both motivation for and implementation of aggression, and look to the behavioural economics literature to consider the roles of reward, vengeance and self-control more clearly.
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Lourenco J, Kieran T, McCann J, Glenn T, Stewart R, Callaway T. 95 Analysis Of The Gastrointestinal Tract-Associated Microbiome Of Calves Supplemented During The Suckling Phase. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Heradstveit O, Skogen JC, Hetland J, Stewart R, Hysing M. Alcohol/drug use across psychiatric diagnoses. Population-based data merged with a patient registry. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.662] [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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Olszowka M, Wallentin L, Eriksson N, Hagstrom E, Held C, Stewart R, White H, Siegbahn A. P625Screening multiple biomarkers for associations with major coronary events. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kadra G, Stewart R, Shetty H, MacCabe JH, Chang C, Taylor D, Hayes RD. Long-term antipsychotic polypharmacy prescribing in secondary mental health care and the risk of mortality. Acta Psychiatr Scand 2018; 138:123-132. [PMID: 29845597 PMCID: PMC6099447 DOI: 10.1111/acps.12906] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate the association between long-term antipsychotic polypharmacy use and mortality; and determine whether this risk varies by cause of death and antipsychotic dose. METHODS Using data from a large anonymised mental healthcare database, we identified all adult patients with serious mental illness (SMI) who had been prescribed a single antipsychotic or polypharmacy, for six or more months between 2007 and 2014. Multivariable Cox regression models were constructed, adjusting for sociodemographic, socioeconomic, clinical factors and smoking, to examine the association between APP use and the risk of death. RESULTS We identified 10 945 adults with SMI who had been prescribed long-term antipsychotic monotherapy (76.9%) or APP (23.1%). Patients on long-term APP had a small elevated risk of mortality, which was significant in some but not all models. The adjusted hazard ratios for death from natural and unnatural causes associated with APP were 1.2 (0.9-1.4, P = 0.111) and 1.1 (0.7-1.9, P = 0.619) respectively. The strengths of the associations between APP and mortality outcomes were similar after further adjusting for % BNF antipsychotic dose (P = 0.031) or olanzapine equivalence (P = 0.088). CONCLUSION The findings suggest that the effect of long-term APP on mortality is not clear-cut, with limited evidence to indicate an association, even after controlling for the effect of dose.
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Mahon B, Sasse A, Stewart R. P5454The development and validation of a clinical priority system score for cardiac surgery used throughout New Zealand. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Olszowka M, Siegbahn A, Eriksson N, Held C, Stewart R, White H, Wallentin L, Hagstrom E. P6249Screening multiple biomarkers for associations with acute ischemic stroke in patients with stable coronary heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Olszowka M, Wallentin L, Eriksson N, Hagstrom E, Stewart R, White H, Siegbahn A, Held C. 2170Screening multiple biomarkers for associations with cardiovascular death in patients with stable coronary heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Flokstra MG, Stewart R, Satchell N, Burnell G, Luetkens H, Prokscha T, Suter A, Morenzoni E, Langridge S, Lee SL. Observation of Anomalous Meissner Screening in Cu/Nb and Cu/Nb/Co Thin Films. PHYSICAL REVIEW LETTERS 2018; 120:247001. [PMID: 29957008 DOI: 10.1103/physrevlett.120.247001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Indexed: 06/08/2023]
Abstract
We have observed the spatial distribution of magnetic flux in Nb, Cu/Nb, and Cu/Nb/Co thin films using muon-spin rotation. In an isolated 50-nm-thick Nb film, we find a weak flux expulsion (Meissner effect) which becomes significantly enhanced when adding an adjacent 40 nm layer of Cu. The added Cu layer exhibits a Meissner effect (due to induced superconducting pairs) and is at least as effective as the Nb to expel flux. These results are confirmed by theoretical calculations using the quasiclassical Green's function formalism. An unexpected further significant enhancement of the flux expulsion is observed when adding a thin (2.4 nm) ferromagnetic Co layer to the bottom side of the Nb. This observed cooperation between superconductivity and ferromagnetism, by an unknown mechanism, forms a key ingredient for developing superconducting spintronics.
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Stewart R, McDonald K, Adair A. Knife to Skin Time in Orthopaedics- A New Sub-Speciality Selection Tool. IRISH MEDICAL JOURNAL 2018; 111:741. [PMID: 30488685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Several selection methods have been used to aid selection into orthopaedic training programs but no process exists to aid in sub-speciality selection. A process which is continuous, unbiased and encompasses technical skill and decision making would be the gold standard. This paper analyses the use of a daily clinical task that assesses many of the desirable traits of a prospective trainee. A retrospective review of 13,474 orthopaedic procedures was under taken. The results showed a clear distinction between orthopaedic sub-specialities in time taken to perform this task. The authors suggest that this could provide a low cost insight into the appropriate subspecialty for orthopaedic trainees.
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Liu B, Stewart R, Somaratne J. Left Ventricular Thrombus After ST-Elevation Myocardial Infarction (STEMI) in Auckland Region STEMI Network. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lesiawan E, Stewart R, Webster M. Impact of Outcome Measure and Duration of Follow-Up on the Reliability of Clinical Trials Assessing the Efficacy and Safety of Coronary Artery Stents. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stewart R, Maguire S, Hanley K, Armstrong P. Donegal Going against the Flow: National Differences in Long-Term Urinary Catheterisation Rates in Men (> 65 Years) With Benign Prostatic Hypertrophy. IRISH MEDICAL JOURNAL 2017; 110:640. [PMID: 29372955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An analysis of Primary Care Reimbursement Service (PCRS, 2013) data demonstrated high rates of urinary catheter changes in Donegal compared to other regions of Ireland. There is a catheter change rate of 10.2% in Donegal men over 65 with medical cards (GMS) compared to rates of 2.7% and 0.17% in Waterford and South Dublin, respectively1. This 60-fold difference between an area with perceived good access to services (South Dublin) and Donegal an area that does not, prompted a survey of general practitioners in each of these areas to assess whether true male catheterisation rates were similarly disproportionate in Donegal. Based on this, data was collected from a population of 23,794 GMS patients in GP training practices in Donegal (Rural), Leinster (Urban) and Waterford (Suburban). The data sampled for Donegal demonstrated 19 long-term catheters (LTCs per 8603 GMS) compared to four LTCs (per 5,800 GMS) in Leinster and 3 LTCs (per 9,391 GMS) in Waterford (Table 1). This anomaly in LTC rates may be a proxy for lack of access to basic Urology services.
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Martin A, Stewart R, Gaskins J, Medlin E. A systematic assessment of Google search queries and readability of online gynecologic oncology patient education materials. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Leyrer C, Balagamwala E, Reddy C, Berriochoa C, Shah C, Cherian S, Donaldson A, Calhoun B, Stewart R, Moore H, Tendulkar R. The Importance of Treatment and Timing in Metaplastic Breast Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Singh N, Stewart R. P6219Impact of lifestyle interventions on body weight and mortality: a meta-analysis of randomized controlled trials. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Das‐Munshi J, Ashworth M, Dewey ME, Gaughran F, Hull S, Morgan C, Nazroo J, Petersen I, Schofield P, Stewart R, Thornicroft G, Prince MJ. Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross-sectional analysis of 588 408 records from the UK. Diabet Med 2017; 34:916-924. [PMID: 27973692 PMCID: PMC5484374 DOI: 10.1111/dme.13298] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 12/13/2022]
Abstract
AIMS To investigate whether the association of severe mental illness with Type 2 diabetes varies by ethnicity and age. METHODS We conducted a cross-sectional analysis of data from an ethnically diverse sample of 588 408 individuals aged ≥18 years, registered to 98% of general practices (primary care) in London, UK. The outcome of interest was prevalent Type 2 diabetes. RESULTS Relative to people without severe mental illness, the relative risk of Type 2 diabetes in people with severe mental illness was greatest in the youngest age groups. In the white British group the relative risks were 9.99 (95% CI 5.34, 18.69) in those aged 18-34 years, 2.89 (95% CI 2.43, 3.45) in those aged 35-54 years and 1.16 (95% CI 1.04, 1.30) in those aged ≥55 years, with similar trends across all ethnic minority groups. Additional adjustment for anti-psychotic prescriptions only marginally attenuated the associations. Assessment of estimated prevalence of Type 2 diabetes in severe mental illness by ethnicity (absolute measures of effect) indicated that the association between severe mental illness and Type 2 diabetes was more marked in ethnic minorities than in the white British group with severe mental illness, especially for Indian, Pakistani and Bangladeshi individuals with severe mental illness. CONCLUSIONS The relative risk of Type 2 diabetes is elevated in younger populations. Most associations persisted despite adjustment for anti-psychotic prescriptions. Ethnic minority groups had a higher prevalence of Type 2 diabetes in the presence of severe mental illness. Future research and policy, particularly with respect to screening and clinical care for Type 2 diabetes in populations with severe mental illness, should take these findings into account.
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Stewart R, Lako M, Horrocks GM, Przyborski SA. Neural Development by Transplanted Human Embryonal Carcinoma Stem Cells Expressing Green Fluorescent Protein. Cell Transplant 2017; 14:339-51. [PMID: 16180653 DOI: 10.3727/000000005783982945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
For many years, researchers have investigated the fate and potential of neuroectodermal cells during the development of the central nervous system. Although several key factors that regulate neural differentiation have been identified, much remains unknown about the molecular mechanisms that control the fate and specification of neural subtypes, especially in humans. Human embryonal carcinoma (EC) stem cells are valuable research tools for the study of neural development; however, existing in vitro experiments are limited to inducing the differentiation of EC cells into only a handful of cell types. In this study, we developed and characterized a novel EC cell line (termed TERA2.cl.SP12-GFP) that carries the reporter molecule, green fluorescent protein (GFP). We demonstrate that TERA2.cl.SP12-GFP stem cells and their differentiated neural derivatives constitutively express GFP in cells grown both in vitro and in vivo. Cellular differentiation does not appear to be affected by insertion of the transgene. We propose that TERA2.cl.SP12-GFP cells provide a valuable research tool to track the fate of cells subsequent to transplantation into alternative environments and that this approach may be particularly useful to investigate the differentiation of human neural tissues in response to local environmental signals.
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Jayatilleke N, Hayes RD, Dutta R, Shetty H, Hotopf M, Chang CK, Stewart R. Contributions of specific causes of death to lost life expectancy in severe mental illness. Eur Psychiatry 2017; 43:109-115. [PMID: 28391102 DOI: 10.1016/j.eurpsy.2017.02.487] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/23/2017] [Accepted: 02/26/2017] [Indexed: 12/21/2022] Open
Abstract
The life expectancy gap between people with severe mental illness (SMI) and the general population persists and may even be widening. This study aimed to estimate contributions of specific causes of death to the gap. Age of death and primary cause of death were used to estimate life expectancy at birth for people with SMI from a large mental healthcare case register during 2007-2012. Using data for England and Wales in 2010, death rates in the SMI cohort for each primary cause of death category were replaced with gender- and age-specific norms for that cause. Life expectancy in SMI was then re-calculated and, thus, the contribution of that specific cause of death estimated. Natural causes accounted for 79.2% of lost life-years in women with SMI and 78.6% in men. Deaths from circulatory disorders accounted for more life-years lost in women than men (22.0% versus 17.4%, respectively), as did deaths from cancer (8.1% versus 0%), but the contribution from respiratory disorders was lower in women than men (13.7% versus 16.5%). For women, cancer contributed more in those with non-affective than affective disorders, while suicide, respiratory and digestive disorders contributed more in those with affective disorders. In men, respiratory disorders contributed more in non-affective disorders. Other contributions were similar between gender and affective/non-affective groups. Loss of life expectancy in people with SMI is accounted for by a broad range of causes of death, varying by gender and diagnosis. Interventions focused on multiple rather than individual causes of death should be prioritised accordingly.
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Stewart R. A Clinical Presentation of Tuberculoid Leprosy in a Rural GP Setting. IRISH MEDICAL JOURNAL 2017; 110:540. [PMID: 28657253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Senturk V, Abas M, Dewey M, Berksun O, Stewart R. Antenatal depressive symptoms as a predictor of deterioration in perceived social support across the perinatal period: a four-wave cohort study in Turkey. Psychol Med 2017; 47:766-775. [PMID: 27873558 PMCID: PMC5426317 DOI: 10.1017/s0033291716002865] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 10/02/2016] [Accepted: 10/13/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND In a perinatal cohort of women in urban and rural Turkey, we investigated associations between antenatal depressive symptoms and subsequent changes in perceived quality of key family relationships. METHOD Of 730 women recruited in their third trimester (94.6% participation), 578 (79.2%) were reassessed at a mean of 4.1 (s.d. = 3.3) months after childbirth, 488 (66.8%) were reassessed at 13.7 (s.d. = 2.9) months, and 448 (61.4%) at 20.8 (s.d. = 2.7) months. At all four examinations, self-reported quality of relationship with the husband, mother and mother-in-law was ascertained using the Close Persons Questionnaire with respect to emotional support, practical support and negative aspects of the relationship. Antenatal depressive symptoms were defined using the Edinburgh Postnatal Depression Scale. A range of covariates in mixed models was considered including age, education, number of children, family structure, physical health, past emotional problems and stressful life events. RESULTS Key findings were as follows: (i) reported emotional and practical support from all three relationships declined over time in the cohort overall; (ii) reported emotional support from the husband, and emotional and practical support from the mother-in-law, declined more strongly in women with antenatal depressive symptoms; (iii) associations between depressive symptoms and worsening spouse relationship were more pronounced in traditional compared with nuclear families. CONCLUSIONS Antenatal depressive symptoms predicted marked decline in the quality of key relationships over the postnatal period. This may account for some of the contemporaneous associations between depression and worse social support, and may compound the risk of perinatal depression in subsequent pregnancies.
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Benatar J, Stewart R. Cardiometabolic Risk Factors and Plasma Fatty Acids in Vegans – Results of an Observational Study. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bauer PJ, Stewart R, Sirkin RE, Larkina M. Robust memory of where from way back when: evidence from behaviour and visual attention. Memory 2016; 25:1089-1109. [PMID: 28029057 DOI: 10.1080/09658211.2016.1265130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Retention of events typically exhibits a sharp initial decrease followed by levelling off of forgetting. In an apparent exception to this general rule, college students have robust memory for their own locations in obscured versions of photographs of their entering classes taken during orientation-related activities, whether tested 2 months or 42 months after the event. Experiment 1 of the present research was a test for conceptual replication of this finding in photographs depicting more than twice the number of students (and thus potential distracters). There was no difference in memory accuracy for personal spatial location across retention intervals of 6-30 months. Experiment 2 featured 40-h and 2-month retention intervals, thereby providing a more fine-grained test of the forgetting function. The findings replicated Experiment 1. In Experiment 3, eye-tracking measures of visual attention revealed that participants rapidly fixated their own spatial locations within the photographs, even in the absence of explicit awareness. In all three experiments, memory for temporal features of the orientation activities (e.g., day and time the photograph was taken) followed the typical forgetting function. The findings suggest differential preservation of episodic memory for where relative to other aspects of events and experiences, such as when.
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Alarhayem A, Myers J, Dent D, Liao L, Muir M, Mueller D, Nicholson S, Cestero R, Johnson M, Stewart R, O'Keefe G, Eastridge B. Time is the enemy: Mortality in trauma patients with hemorrhage from torso injury occurs long before the “golden hour”. Am J Surg 2016; 212:1101-1105. [DOI: 10.1016/j.amjsurg.2016.08.018] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/24/2016] [Indexed: 10/20/2022]
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Stewart R, McDonald K. The time taken to wash your hands-a predictor of orthopaedic sub-speciality. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Feighan J, Stewart R, Singh S, Abisaleh T. Spray Foam Beyond HCFC-141b. J CELL PLAST 2016. [DOI: 10.1106/alb0-55x1-e0cc-g809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Sprayed rigid foam is a significant segment of the polyurethane industry, and as in other rigid foam segments, spray foam formulators need to find ways to meet current product requirements when the use of HCFC-141b is phased out in January 2003. Due to some of the unique characteristics of the spray foam industry, though, the choice of a replacement blowing agent is perhaps more complex than in any other rigid foam sector. The alternatives receiving the most consideration today are HFC-245fa, hydrocarbons, and water. All of these potential blowing agents have significant hurdles to overcome before they could serve as satisfactory replacements for HCFC-141b in the spray foam market. As of May 1999, a firm commitment to commercialize HFC-245fa has not been made. The use of hydrocarbons in spray would require significant improvements in safe handling procedures and modifications to spray equipment due to flammability issues. And with water-blown systems, dimensional stability and adhesion are two technical hurdles that must be overcome. It is conceded as well that insulation performance (as measured by initial k-factor) will not be as good for a water-blown foam as with HCFC-141b. It was because of the lack of an obvious HCFC-141b replacement for the spray foam industry that Huntsman Polyurethanes decided to investigate possible solutions. Any alternative would need to meet the processing and handling requirements that are currently met with HCFC-141b systems. The objective of this work is to develop zero-ODP (ozone depletion potential) technology that meets the performance characteristics that are currently achieved with HCFC-141b spray foam roofing systems. The focus of this paper is on the development of water-blown technology for roofing systems. Foams were processed via high-pressure spray equipment in a controlled environment. The study looked at the effect of polyol, catalyst, blowing agent, and processing variables on foam quality.
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Kolliakou A, Ball M, Derczynski L, Chandran D, Gkotsis G, Deluca P, Jackson R, Shetty H, Stewart R. Novel psychoactive substances: An investigation of temporal trends in social media and electronic health records. Eur Psychiatry 2016; 38:15-21. [PMID: 27611330 DOI: 10.1016/j.eurpsy.2016.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/09/2016] [Accepted: 05/16/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Public health monitoring is commonly undertaken in social media but has never been combined with data analysis from electronic health records. This study aimed to investigate the relationship between the emergence of novel psychoactive substances (NPS) in social media and their appearance in a large mental health database. METHODS Insufficient numbers of mentions of other NPS in case records meant that the study focused on mephedrone. Data were extracted on the number of mephedrone (i) references in the clinical record at the South London and Maudsley NHS Trust, London, UK, (ii) mentions in Twitter, (iii) related searches in Google and (iv) visits in Wikipedia. The characteristics of current mephedrone users in the clinical record were also established. RESULTS Increased activity related to mephedrone searches in Google and visits in Wikipedia preceded a peak in mephedrone-related references in the clinical record followed by a spike in the other 3 data sources in early 2010, when mephedrone was assigned a 'class B' status. Features of current mephedrone users widely matched those from community studies. CONCLUSIONS Combined analysis of information from social media and data from mental health records may assist public health and clinical surveillance for certain substance-related events of interest. There exists potential for early warning systems for health-care practitioners.
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Lee E, Eagle J, Sandison G, Cao N, Stewart R, Marsh S, Meyer J. SU-F-T-671: Effects of Collimator Material On Proton Minibeams. Med Phys 2016. [DOI: 10.1118/1.4956857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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81
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Saini J, St. James S, Traneus E, Wong T, Stewart R, Bloch C. SU-F-T-155: Validation of a Commercial Monte Carlo Dose Calculation Algorithm for Proton Therapy. Med Phys 2016. [DOI: 10.1118/1.4956291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Moskvin V, Pirlepesov F, Stewart R, Farr J. MO-FG-CAMPUS-TeP3-05: Limitations of the Dose Weighted LET Concept for Intensity Modulated Proton Therapy in the Distal Falloff Region and Beyond. Med Phys 2016. [DOI: 10.1118/1.4957385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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83
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Stewart R. WE-DE-202-02: Are Track Structure Simulations Truly Needed for Radiobiology at the Cellular and Tissue Levels? Med Phys 2016. [DOI: 10.1118/1.4957843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Stewart R, Smith W, Hendrickson K, Meyer J, Cao N, Lee E, Gopan O, Sandison G, Parvathaneni U, Laramore G. SU-F-T-128: Dose-Volume Constraints for Particle Therapy Treatment Planning. Med Phys 2016. [DOI: 10.1118/1.4956264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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St. James S, Moffitt G, Argento D, DeWitt D, Miyaoka R, Stewart R. SU-F-J-196: A Prototype System for Portal Imaging for Intensity Modulated Neutron Therapy. Med Phys 2016. [DOI: 10.1118/1.4956104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Stewart R, Streitmatter S, Traneus E, Moskvin V, Schuemann J. MO-FG-CAMPUS-TeP3-02: Benchmarks of a Proton Relative Biological Effectiveness (RBE) Model for DNA Double Strand Break (DSB) Induction in the FLUKA, MCNP, TOPAS, and RayStation™ Treatment Planning System. Med Phys 2016. [DOI: 10.1118/1.4957382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Saleeb R, Faragalla H, Yousef GM, Stewart R, Streutker CJ. Malignancies in a renal transplant population: The St. Michael's Hospital experience. Urol Ann 2016; 8:163-7. [PMID: 27141185 PMCID: PMC4839232 DOI: 10.4103/0974-7796.165712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Previous publications have shown an increased incidence of various malignancies amongst renal transplant populations. The objective of this study was to analyze the rate and types of malignancies occurring in the St. Michael's Hospital renal transplant population and to determine whether our results were comparable to those previously published. METHODS After approval by the hospital's research ethic board, review of the records and pathology of the 1584 patients in the renal transplant clinic database patients was performed. The reports dated back to the year 1970. RESULTS Amongst the 1584 renal transplant patients, 106 patients with 132 dysplastic and malignant posttransplant lesions were identified. The highest incidence amid the malignancies was in nonmelanoma skin malignancies squamous cell carcinoma (SCC), basal cell carcinoma, and Kaposi sarcoma, with a total of 32 patients having 54 separate tumors (2.02% of all patients, 43.2% of tumors). Following skin tumors in incidence were genitourinary (28 tumors), gastrointestinal tract (GIT) lesions (8 adenocarcinomas, 14 dysplastic lesions, 1 low grade neuroendocrine tumor/carcinoid), posttransplant lymphoproliferative disorders (PTLDs) (10 cases), gynecologic (6 carcinomas), cervical/anal/vulvar dysplasia and invasive (SCCs) (4), and thyroid (3 papillary tumors). Nine patients had tumors of multiple sites/types. With respect to outcome, 14 patients died of malignancy, with the highest mortality being in the GIT malignancies (six patients). Second in mortality were the PTLD and skin tumor groups. DISCUSSION Information on the incidence and outcome of various malignancies in renal transplant patients is important in designing guidelines for the follow-up of these patients regarding tumor screening and prevention. The rate of malignancies in our group is comparable to that reported in other centers.
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Hu K, Stewart R, Jacobson A, Persky M, Schantz S, Tran T, Urken M, Culliney B, Li Z, Harrison L. Prognostic Value of Midtreatment Nodal Response to Chemoradiation in Oropharyngeal Squamous Cell Carcinomas: Implications for Treatment Modification. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Patel R, Reiss P, Shetty H, Broadbent M, Stewart R, McGuire P, Taylor M. Which antidepressants are associated with increased risk of developing mania? A retrospective electronic case register cohort study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionThe symptoms of bipolar disorder are sometimes misrecognised for unipolar depression and inappropriately treated with antidepressants. This may be associated with increased risk of developing mania. However, the extent to which this depends on what type of antidepressant is prescribed remains unclear.AimsTo investigate the association between different classes of antidepressants and subsequent onset of mania/bipolar disorder in a real-world clinical setting.MethodsData on prior antidepressant therapy were extracted from 21,012 adults with unipolar depression receiving care from the South London and Maudsley NHS Foundation Trust (SLaM). multivariable Cox regression analysis (with age and gender as covariates) was used to investigate the association of antidepressant therapy with risk of developing mania/bipolar disorder.ResultsIn total, 91,110 person-years of follow-up data were analysed (mean follow-up: 4.3 years). The overall incidence rate of mania/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania/bipolar disorder was seen in patients aged between 26 and 35 years (12.3 per 1000 person-years). The most frequently prescribed antidepressants were SSRIs (35.5%), mirtazapine (9.4%), venlafaxine (5.6%) and TCAs (4.7%). Prior antidepressant treatment was associated with an increased incidence of mania/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with SSRIs (hazard ratio 1.34, 95% CI 1.18–1.52) and venlafaxine (1.35, 1.07–1.70).ConclusionsIn people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Patel R, Shetty H, Jackson R, Broadbent M, Stewart R, Boydell J, McGuire P, Taylor M. Delays to diagnosis and treatment in patients presenting to mental health services with bipolar disorder. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionThere are often substantial delays before diagnosis and initiation of treatment in people bipolar disorder. Increased delays are a source of considerable morbidity among affected individuals.AimsTo investigate the factors associated with delays to diagnosis and treatment in people with bipolar disorder.MethodsRetrospective cohort study using electronic health record data from the South London and Maudsley NHS Foundation Trust (SLaM) from 1364 adults diagnosed with bipolar disorder. The following predictor variables were analysed in a multivariable Cox regression analysis on diagnostic delay and treatment delay from first presentation to SLaM: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder.ResultsThe median diagnostic delay was 62 days (interquartile range: 17–243) and median treatment delay was 31 days (4–122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18–3.06) and treatment delay (4.40, 3.63–5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33–0.41) and substance misuse disorders (0.44, 0.31–0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.ConclusionsSome individuals experience a significant delay in diagnosis and treatment of bipolar disorder, particularly those with alcohol/substance misuse disorders. These findings highlight a need to better identify the symptoms of bipolar disorder and offer appropriate treatment sooner in order to facilitate improved clinical outcomes. This may include the development of specialist early intervention services.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Massarweh S, Romond E, Stewart R, Sun J, Chmielecki J, Mehdi M, Black EP. Abstract P3-05-06: Evolution of genomic alterations on endocrine therapy and mTOR inhibition in estrogen receptor (ER)-positive breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-05-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Endocrine therapy (ET) and mTOR inhibition are important treatment strategies in ER-positive breast cancer, but no specific genomic alterations reliably predict benefit. Because tumors are tested pretreatment, we hypothesized that this may not capture tumor interaction with therapy.
Methods: We studied tumors from protocol NCT00570921 using fulvestrant and everolimus for metastatic ER-positive breast cancer after aromatase inhibitor (AI) failure. DNA from FFPE tumor tissue was subjected to next-generation genomic profiling using the FoundationOne® assay and alterations were then compared between available paired samples: primary/metastatic, before/after everolimus, and upon progression on everolimus.
Results: The most common alterations encountered were in the PI3K/AKT/mTOR pathway with increased frequency of PIK3CA in endocrine-sensitive disease but no specific association with everolimus benefit (Massarweh et al, ASCO 2015). One patient with lobular carcinoma relapse on ET and a new contralateral primary, had PIK3CA, CDH1, and MAP3K1 in both tumors with no new alterations detected. Her disease was everolimus sensitive. Another patient with PIK3CA at baseline acquired a CTNNA1 mutation upon relapse with no everolimus benefit. Interestingly, one patient with liver metastasis and complete response to everolimus lasting 3 years had no known alterations reported in the primary tumor but had a PIK3CA mutation in one of two simultaneous biopsies of separate liver lesions. Another patient with liver metastasis and a GATA3 mutation at baseline had response to everolimus lasting 18 months, then developed a PIK3R2_c.1936A>T mutation on progression reported as a variant of unknown significance (VUS). Another patient with metastatic lobular carcinoma to skin and bone had PIK3CA, CDH1, and ERBB2 mutations at baseline, and acquired KRAS and MCL1 amplification on two sequential skin biopsies in the first month on everolimus. She remained on therapy for 1 year. One patient with locally advanced disease and de novo bone metastasis had TP53 and GATA3 mutations at baseline with resistance to multiple chemotherapy and endocrine treatments. Upon progression on AI, her tumor acquired PDGFRA and SMAD4, detected on day 1 biopsy of everolimus treatment. Repeat biopsy on day 28 revealed loss of PDGFRA and SMAD4 with emergence of PIK3CA and MLL2 mutations and loss of STK11. After 1 year on everolimus her tumor progressed and repeat breast biopsy revealed loss of the PIK3CA, STK11, and MLL2 events, with appearance of AKT1 and NF1 mutations. Interestingly, her tumor also acquired ESR1_c.1607T>G, MTOR_c.6104C>T, and NSD1_c.5938G>A mutations, all classified as VUS but were not previously encountered in her course. Further analysis and biologic relevance of these changes will be presented.
Conclusion: This small study suggests that ER-positive breast cancer is a dynamic disease with genomic evolution on endocrine therapy and mTOR inhibition. In some patients, this change occurs early on therapy, possibly through clonal selection, but may also be related to tumor heterogeneity. The significance of this change is not fully understood, but study of early on-treatment biopsies may help us better understand tumor response to therapy.
Citation Format: Massarweh S, Romond E, Stewart R, Sun J, Chmielecki J, Mehdi M, Black EP. Evolution of genomic alterations on endocrine therapy and mTOR inhibition in estrogen receptor (ER)-positive breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-05-06.
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Zepf F, Rao P, Moore J, Stewart R, Ladino YM, Hartmann B. Human breast milk and adipokines – A potential role for the soluble leptin receptor (sOb-R) in the regulation of infant energy intake and development. Med Hypotheses 2016; 86:53-5. [DOI: 10.1016/j.mehy.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/19/2015] [Indexed: 11/29/2022]
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Fusar-Poli P, Díaz-Caneja CM, Patel R, Valmaggia L, Byrne M, Garety P, Shetty H, Broadbent M, Stewart R, McGuire P. Services for people at high risk improve outcomes in patients with first episode psychosis. Acta Psychiatr Scand 2016; 133:76-85. [PMID: 26358300 PMCID: PMC4950045 DOI: 10.1111/acps.12480] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services. METHOD Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders. RESULTS FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: -33.7 to (-0.3)], had a shorter referral-to-diagnosis time [B coefficient -74.5 days, 95% CI: -101.9 to -(47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.39-0.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34-0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services. CONCLUSION Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.
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Das-Munshi J, Ashworth M, Gaughran F, Hull S, Morgan C, Nazroo J, Roberts A, Rose D, Schofield P, Stewart R, Thornicroft G, Prince MJ. Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:627-38. [PMID: 26846127 PMCID: PMC4823321 DOI: 10.1007/s00127-016-1185-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/18/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE People with severe mental illnesses (SMI) experience a 17- to 20-year reduction in life expectancy. One-third of deaths are due to cardiovascular disease. This study will establish the relationship of SMI with cardiovascular disease in ethnic minority groups (Indian, Pakistani, Bangladeshi, black Caribbean, black African and Irish), in the UK. METHODS E-CHASM is a mixed methods study utilising data from 1.25 million electronic patient records. Secondary analysis of routine patient records will establish if differences in cause-specific mortality, cardiovascular disease prevalence and disparities in accessing healthcare for ethnic minority people living with SMI exist. A nested qualitative study will be used to assess barriers to accessing healthcare, both from the perspectives of service users and providers. RESULTS In primary care, 993,116 individuals, aged 18+, provided data from 186/189 (98 %) practices in four inner-city boroughs (local government areas) in London. Prevalence of SMI according to primary care records, ranged from 1.3-1.7 %, across boroughs. The primary care sample included Bangladeshi [n = 94,643 (10 %)], Indian [n = 6086 (6 %)], Pakistani [n = 35,596 (4 %)], black Caribbean [n = 45,013 (5 %)], black African [n = 75,454 (8 %)] and Irish people [n = 13,745 (1 %)]. In the secondary care database, 12,432 individuals with SMI over 2007-2013 contributed information; prevalent diagnoses were schizophrenia [n = 6805 (55 %)], schizoaffective disorders [n = 1438 (12 %)] and bipolar affective disorder [n = 4112 (33 %)]. Largest ethnic minority groups in this sample were black Caribbean [1432 (12 %)] and black African (1393 (11 %)). CONCLUSIONS There is a dearth of research examining cardiovascular disease in minority ethnic groups with severe mental illnesses. The E-CHASM study will address this knowledge gap.
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Bauer PJ, Stewart R, White EA, Larkina M. A Place for Every Event and Every Event in Its Place: Memory for Locations and Activities by 4-Year-Old Children. JOURNAL OF COGNITION AND DEVELOPMENT 2015. [DOI: 10.1080/15248372.2014.959521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mace S, Dzahini O, Cornelius V, Anthony D, Stewart R, Taylor D. Antipsychotic use and unexpected death: a hospital-based case-control study. Acta Psychiatr Scand 2015; 132:479-88. [PMID: 26403992 DOI: 10.1111/acps.12507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the risk of unexpected death in patients prescribed an antipsychotic. Unexpected death was defined as death occurring within 7 days of the onset of acute symptoms. METHOD A case-control study conducted on events occurring between July 2009 and January 2011 in a UK mental health trust providing in-patient and out-patient services. RESULTS The study included 100 cases (deaths) and 436 unmatched controls. Current users of antipsychotics had a lower risk of unexpected death than non-users--adjusted odds ratio (OR) 0.48 (95% CI 0.24-0.94, P = 0.033). A significant reduction in risk was seen for second-generation [adjusted OR 0.42 (95% CI 0.21-0.86, P = 0.018)], but not first-generation agents [adjusted OR 0.83 (95% CI 0.31-2.20, P = 0.706)]. Treatment with antipsychotics for any duration was associated with reduced risk. Dose and route of administration did not affect risk. In a planned secondary analysis not adjusting for cardiovascular disease, prescription of an antipsychotic was not associated with increased risk of unexpected death [adjusted OR 0.56 (95% CI 0.28-1.08, P = 0.084)]. CONCLUSION Our findings do not support an association between current antipsychotic use and increased risk of unexpected death.
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Rao P, Moore JK, Stewart R, Hood SD, Runions K, Zepf FD. Diagnostic inexactitude - Reframing and relabelling Disruptive Mood Dysregulation Disorder for ICD-11 does not solve the problem. Med Hypotheses 2015; 85:1035-6. [PMID: 26545314 DOI: 10.1016/j.mehy.2015.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/18/2015] [Accepted: 10/11/2015] [Indexed: 11/26/2022]
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Berriochoa C, Leyrer C, Agrawal S, Donaldson A, Stewart R, Moore H, Tendulkar R, Calhoun B. Metaplastic Breast Cancer: A Clinicopathologic Correlation of Histologic Subtype on Disease Control. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.653] [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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