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Clarke D, Williams S, Jahiruddin M, Parks K, Salehin M. Projections of on-farm salinity in coastal Bangladesh. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2015; 17:1127-1136. [PMID: 25790459 DOI: 10.1039/c4em00682h] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper quantifies the expected impacts of climate change, climate variability and salinity accumulation on food production in coastal Bangladesh during the dry season. This forms part of a concerted series of actions on agriculture and salinity in Bangladesh under the UK funded Ecosystems for Poverty Alleviation programme and the British Council INSPIRE scheme. The work was undertaken by developing simulation models for soil water balances, dry season irrigation requirements and the effectiveness of the monsoon season rainfall at leaching accumulated salts. Simulations were run from 1981 to 2098 using historical climate data and a daily climate data set based on the Met Office Hadley Centre HadRM3P regional climate model. Results show that inter-seasonal and inter-annual variability are key factors that affect the viability of dry season vegetable crop growing. By the end of the 21(st) century the dry season is expected to be 2-3 weeks longer than now (2014). Monsoon rainfall amounts will remain the same or possibly slightly increase but it will occur over a slightly shorter wet season. Expectations of sea level rise and additional saline intrusion into groundwater aquifers mean that dry season irrigation water is likely to become more saline by the end of the 21(st) century. A study carried out at Barisal indicates that irrigating with water at up to 4 ppt can be sustainable. Once the dry season irrigation water quality goes above 5 ppt, the monsoon rainfall is no longer able to leach the dry season salt deposits so salt accumulation becomes significant and farm productivity will reduce by as a much as 50%, threatening the livelihoods of farmers in this region.
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Wamboldt M, Cordaro A, Clarke D. Parent-child relational problem: field trial results, changes in DSM-5, and proposed changes for ICD-11. FAMILY PROCESS 2015; 54:33-47. [PMID: 25581470 DOI: 10.1111/famp.12123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Caregiving relationships are significant factors in the development, mediation, or moderation of childhood mental health problems. However, epidemiological and clinical research has been limited by lack of reliable, succinct, and standardized methods of assessing parent-child relationship constructs. The Relational Processes Workgroup (ad hoc to the DSM-5 process) proposed more specific criteria to define a parent-child relational problem (PCRP). These criteria were field tested in one of the DSM-5 Field trial sites, utilizing a similar research design as DSM-5. Participants included 133 symptomatic children (5-17 years) in active treatment for a mental health problem and their primary caregiver (86% mothers). Two separate clinicians, each blinded to the assessment of the other clinician as well as the DSM-5 diagnoses, interviewed the dyads within a 2-week period, utilizing the proposed PCRP criteria. Prior to each interview, parents were asked to write about their relationship with their child, and children (over the age of 10 years) filled out the Parental Bonding Instrument, Brief Current, and the Perceived Criticism Measure. Clinicians were able to read the narratives and see results of the child report measures before assessing the dyad. The weighted prevalence of a PCRP in this sample was 34%. The interclass kappa for overall agreement between clinicians was 0.58 (0.40, 0.72), which indicates good interrater reliability. Further, clinicians found the PCRP diagnostic criteria clinically useful and an improvement over the brief description of PCRP that was presented in DSM-IV. Relationships between children and their primary caregiver can be assessed in a reliable manner, based on clinical interview with the child-caregiver dyad and several self-report measures.
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Clarke D, Usick R, Sanderson A, Giles-Smith L, Baker J. Emergency department staff attitudes towards mental health consumers: a literature review and thematic content analysis. Int J Ment Health Nurs 2014; 23:273-84. [PMID: 23980913 DOI: 10.1111/inm.12040] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Visits to the emergency department (ED) for mental health reasons account for 10-15% of all visits. Consumers of mental health ED services, however, report that they often feel sent to the back of the queue and that their mental health concerns are not taken seriously, suggesting that societal stigma has impacted their care in the ED. In this study, we systematically explore the research concerning the attitudes of ED professional staff towards those who present with issues related to mental health. Four themes emerge from the literature: consumer perspectives, whose tenor is generally one of negativity; staff-reported attitudes and influencing factors, such as age, experience, and confidence in working with mental health presentations; the environmental climate of the ED, which might not be conducive to good mental health care; and interventions that have been used to evaluate changes in attitudes.
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Kong V, Khan Z, Cacala S, Oosthuizen G, Clarke D. Retained weapon injuries: experience from a civilian metropolitan trauma service in South Africa. Eur J Trauma Emerg Surg 2014; 41:161-6. [PMID: 26038260 DOI: 10.1007/s00068-014-0405-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Retained weapon (RW) injuries are uncommon, but there is no current consensus on the best management approach. METHODS We reviewed our experience of 102 consecutive patients with non-missile RWs in a high-volume metropolitan trauma service managed over a 10-year period. RESULTS Of the 102 patients, 95 were males (93%), 7 were females (7%), and median age was 24 (21-28) years. Weapons: 73% (74/102) knives, 17% (17/102) screwdrivers, 5% spears, 6% (6/102) others [axe (1), glass fragment (1), stick (1), sickle blade (1), wire (1) and stone (1)]. LOCATION 8% (8/102) head, 20% (20/102) in the face, 9% (9/102) neck, 14% (14/102) thorax, 25% (26/102) abdomen, 23% (23/102) upper limb, 2% (2/102) lower limb. Four per cent (4/102) were haemodynamically unstable and proceed immediately to the operating theatre for operative exploration and weapon extraction. Imagining: 88 (86%) plain radiographs, 65 (64%) non-contrast CT scans, 41 (40%) contrast CT angiography, 4 (4%) formal angiography. Seventy-two underwent simple extraction, and 29 underwent extract plus open operation. One patient absconded. Specialist surgeons involved in extraction: trauma surgeons (74), neurosurgeons (10), ophthalmic surgeons (11) and ENT surgeons (4). Overall, 92% (94/102) survived to discharge. CONCLUSIONS The vast majority of patients with RWs will be admitted in a stable condition and haemodynamic instability was almost exclusively seen in the anterior thorax. The most common site was the posterior abdomen. Detailed imagining should be used liberally in stable patients and unplanned extraction in an uncontrolled environment should be strongly discouraged.
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Scott SWM, Bowrey S, Clarke D, Choke E, Bown MJ, Thompson JP. Factors influencing short- and long-term mortality after lower limb amputation. Anaesthesia 2014; 69:249-58. [PMID: 24548355 DOI: 10.1111/anae.12532] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2013] [Indexed: 11/28/2022]
Abstract
Mortality after lower limb amputation is high, with UK 30-day mortality rates of 9-17%. We performed a retrospective analysis of factors affecting early and late outcome after lower limb amputation for peripheral vascular disease or diabetic complications at a UK tertiary referral vascular centre between 2003 and 2010. Three hundred and thirty-nine patients (233 male), of median (IQR [range]) age 73 (62-79 [26-92]) years underwent amputation. Thirty-day mortality was 12.4%. On regression modelling, the risk of 30-day mortality was increased in patients of ASA grade ≥ 4 (OR 4.23, 95% CI 2.07-8.63), p < 0.001 and age between 74 and 79 years (OR 3.8, 95% CI 1.10-13.13), p = 0.04 and older than 79 years (OR 4.08, 95% CI 1.25-13.25), p = 0.02. Peri-operative (30-day) mortality for these groups was 23.2%, 13.7% and 18.8%, respectively. Survival and Cox regression analysis demonstrated that long-term mortality was associated with: age 74-79 years (HR 2.15, 95% CI 1.38-3.35), p = 0.001; age > 79 years (HR 2.78, 95% CI 1.82-4.25), p < 0.001; ASA grade ≥ 4 (HR 2.04, 95% CI 1.51-2.75), p < 0.001; out-of-hours operating (HR 1.51, 95% CI 1.08-2.10), p = 0.02; and chronic kidney disease stage 4-5 (1.57, 95% CI 1.07-2.30), p = 0.02. Anaesthetic technique was associated with long-term mortality on survival analysis (p = 0.04), but not when analysed using regression modelling. Mortality after lower limb amputation relates to patient age, ASA, out-of-hours surgery and renal dysfunction. These data support lower limb amputations' being performed during daytime hours and after modification replace with 'of ' correctable risk factors.
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Abstract
Sentinel node biopsy of breast cancer is becoming an increasingly popular topic. The concept of the sentinel node being the first lymph node to contain metastatic cancer within a tumor's lymphatic basin was introduced by Cabanas, a South American surgeon, following his work on carcinoma of the penis. Morton and his colleagues then applied this principle to malignant melanomas, and more recently this concept has gained popularity for carcinoma of the breast. In breast cancer patients, the fact that a sentinel node can be localized and the suggestion that the sentinel node is representative of the axillary nodal status has been confirmed by a number of studies across the world. Most authors writing on this subject, however, end with a caution that the results of randomized trials are needed before this new surgical technique can be accepted as part of routine breast cancer management. The Medical Research Council of the United Kingdom has funded the audit phase of a multicenter, two phase, randomized trial called the Axillary Lymphatic Mapping Against Nodal Axillary Clearance (ALMANAC) trial, which will compare standard axillary management with sentinel node-guided axillary management. The aims and protocol of the trial are discussed in detail here.
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Islam J, Clarke D, Thomson SR, Wilson D, Dawood H. A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis. Surg Endosc 2014; 28:1895-901. [DOI: 10.1007/s00464-013-3410-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 12/20/2013] [Indexed: 11/27/2022]
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Parkinson F, Kent SJW, Aldous C, Oosthuizen G, Clarke D. The hospital cost of road traffic accidents at a South African regional trauma centre: a micro-costing study. Injury 2014; 45:342-5. [PMID: 23731494 DOI: 10.1016/j.injury.2013.04.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/27/2013] [Accepted: 04/06/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Road traffic crashes are responsible for a vast amount of death and disability in developing countries. This study uses a bottom up, micro-costing approach to determine the cost of road traffic related crashes in South Africa. METHODS Using the data from one hundred consecutive RTC related admissions to a regional hospital in South Africa we performed a bottom up costing study. To calculate costs patients were reviewed every 48 h and all interventions were recorded for each individual patient. Prices of interventions were obtained from hospital pricelists. A total cost was calculated on an individual basis. RESULTS The total cost of in-patient care for these patients was US $6,98,850. Upper limb injuries were the most expensive, and the total cost increased with the number of body regions injured. The biggest expenditure was on ward overheads ($2,81,681). Ninety operations were performed - the total cost of theatre time was $1,48,230 and the cost of orthopaedic implants was $1,26,487. CONCLUSION The cost of care of a RTC victim is significant. In light of the high numbers of RTC victims admitted over the course of the year this is a significant cost burden for a regional hospital to bear. This cost must be taken into account when allocating hospital budgets.
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Preiss K, Brennan L, Clarke D. A systematic review of variables associated with the relationship between obesity and depression. Obes Rev 2013; 14:906-18. [PMID: 23809142 DOI: 10.1111/obr.12052] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 05/19/2013] [Accepted: 05/20/2013] [Indexed: 12/18/2022]
Abstract
Obesity is one of the leading causes of preventable diseases and disability worldwide, and depression is among the leading causes of burden of disease. Both disorders are increasingly prevalent and comorbid. This comorbidity compounds associated health. While there is consistent evidence of a bidirectional obesity depression relationship, little is known about the biopsychosocial variables associated with this relationship. A systematic review was undertaken to identify variables associated with the relationship between obesity (Body mass index > 30 kg m(-2) ) and depression. Forty-six studies were identified. Obesity, educational attainment, body image, binge eating, physical health, psychological characteristics and interpersonal effectiveness were consistently associated with the relationship between obesity and depression. The current review identified potential biopsychosocial variables associated with the relationship between obesity and depression. This knowledge can inform future research examining moderators, mediators and mechanisms of the relationship between obesity and depression. Improved understanding of this relationship will inform identification, prevention and intervention efforts.
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Heng HS, Lim M, Absoud M, Austin C, Clarke D, Wraige E, Reid C, Robb SA, Jungbluth H. Outcome of children with acetylcholine receptor (AChR) antibody positive juvenile myasthenia gravis following thymectomy. Neuromuscul Disord 2013; 24:25-30. [PMID: 24239058 DOI: 10.1016/j.nmd.2013.09.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 09/16/2013] [Accepted: 09/23/2013] [Indexed: 11/18/2022]
Abstract
Most evidence supporting the benefit of thymectomy in juvenile myasthenia gravis (JMG) is extrapolated from adult studies, with only little data concerning paediatric populations. Here we evaluate the outcome of children with generalized JMG who underwent thymectomy between 1996 and 2010 at 2 tertiary paediatric neurology referral centres in the United Kingdom. Twenty patients (15 female, 5 male), aged 13months to 15.5years (median 10.4years) at disease onset, were identified. Prior to thymectomy, disease severity was graded as IIb in 3, III in 11, and IV in 6 patients according to the Osserman classification. All demonstrated positive anti-acetylcholine receptor (AChR) antibody titres. All patients received pyridostigmine and 14 received additional steroid therapy. Transternal thymectomy was performed at the age of 2.7-16.6years (median 11.1years). At the last follow-up (10months to 10.9years, median 2.7years, after thymectomy), the majority of children demonstrated substantial improvement, although some had required additional immune-modulatory therapies. About one third achieved complete remission. The postoperative morbidity was low. No benefit was observed in one patient with thymoma. We conclude that thymectomy should be considered as a treatment option early in the course of generalised AChR antibody-positive JMG.
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Gaedtke C, Williams G, Janssens S, Raymond S, Clarke D. Photoluminescence and radioluminescence study of Eu and Mn doped RbMgF3 nanoparticles. RADIAT MEAS 2013. [DOI: 10.1016/j.radmeas.2013.01.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cepanec D, Clarke D, Plohman J, Gerard J. Engaging Undergraduate Nursing Students in Research: The Students’ Experience of a Summer Internship Program Pilot Project. J Nurs Educ 2013; 52:466-9. [DOI: 10.3928/01484834-20130718-03] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 02/20/2013] [Indexed: 11/20/2022]
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Doherty C, Wallock D, Doherty L, Clarke D, Govan J, Campopiano D. WS17.3 Allicin revisited: Antimicrobial activity against the Burkholderia cepacia complex and interaction with a peroxidase target. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60105-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kong V, Aldous C, Handley J, Clarke D. The cost effectiveness of early management of acute appendicitis underlies the importance of curative surgical services to a primary healthcare programme. Ann R Coll Surg Engl 2013; 95:280-4. [PMID: 23676814 PMCID: PMC4132504 DOI: 10.1308/003588413x13511609958415] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2012] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Appendicitis in the developing world is a cause of significant preventable morbidity. This prospective study from a regional hospital in South Africa constructs a robust cost model that demonstrates the cost effectiveness of an efficient curative surgical service in a primary healthcare-orientated system. METHODS A prospective audit of all patients with acute appendicitis admitted to Edendale Hospital was undertaken from September 2010 to September 2011. A microcosting approach was used to construct a cost model based on the estimated cost of operative and perioperative interventions together with the associated hospital stay. For cost analysis, patients were divided into the following cohorts: uncomplicated appendicitis, complicated appendicitis with localised intra-abdominal sepsis, complicated appendicitis with generalised intra-abdominal sepsis, with and without intensive care unit admission. RESULTS Two hundred patients were operated on for acute appendicitis. Of these, 36% (71/200) had uncomplicated appendicitis and 57% (114/200) had perforation. Pathologies other than appendicitis were present in 8% (15/200) and these patients were excluded. Of the perforated appendices, 45% (51/114) had intra-abdominal contamination that was localised while 55% (63/114) generalised sepsis. The mean cost for each patient was: 6,578 ZAR (£566) for uncomplicated appendicitis; 14,791 ZAR (£1,272) for perforation with localised intra-abdominal sepsis and 34,773 ZAR (£2,990) for perforation with generalised intra-abdominal sepsis without intensive care admission. With intensive care admission it was 77,816 ZAR (£6,692). The total cost of managing acute appendicitis was 4,272,871 ZAR (£367,467). Almost 90% of this total cost was owing to advanced disease with abdominal sepsis and therefore potentially preventable. CONCLUSIONS Early uncomplicated appendicitis treated appropriately carries little morbidity and is relatively inexpensive to treat. As the pathology progresses, the cost rises exponentially. An efficient curative surgical service must be regarded as a cost effective component of a primary healthcare orientated system.
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Zanetti-Domingues L, Webb S, Tynan C, Rolfe D, Hirsch M, Coles B, Needham S, Roberts S, Clarke D, Martin-Fernandez M. Simultaneous, Multicolour Single Molecule Imaging of the Entire Human Epidermal Growth Factor Receptor (HER) Family in Live Breast Cancer Cells. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt086.3] [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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Mansel RE, MacNeill F, Horgan K, Goyal A, Britten A, Townson J, Clarke D, Newcombe RG, Keshtgar M, Kissin M, Layer G, Hilson A, Ell P, Wishart G, Brown D, West N. Results of a national training programme in sentinel lymph node biopsy for breast cancer. Br J Surg 2013; 100:654-61. [PMID: 23389843 DOI: 10.1002/bjs.9058] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND New Start, a structured, validated, multidisciplinary training programme in sentinel lymph node biopsy (SLNB), was established to allow the introduction and rapid transfer of appropriate knowledge and technical skills to ensure safe and competent practice across the UK. METHODS Multidisciplinary teams attended a theory/skills laboratory course, following which they performed 30 consecutive SLNBs, either concurrently with their standard axillary staging procedure (training model A) or as stand-alone SLNB (training model B). SLNB was performed according to a standard protocol using the combined technique of isotope ((99m) Tc-labelled albumin colloid) and blue dye. An accredited New Start trainer mentored the first five procedures in the participant's hospital, or all 30 if stand-alone. Validation standards for model A and B were a localization rate of at least 90 per cent. In addition, for model A only, in which a minimum of ten patients were required to be node-positive, a false-negative rate (FNR) of 10 per cent or less was required. RESULTS From October 2004 to December 2008, 210 SLNB-naive surgeons, in 103 centres, performed 6685 SLNB procedures. The overall sentinel lymph node (SLN) localization rate was 98·9 (95 per cent confidence interval 98·6 to 99·1) per cent (6610 of 6685) and the FNR 9·1 (7·9 to 10·5) per cent (160 of 1757). The FNR was related to nodal yield, ranging from 14·8 per cent for one node and declining to 9·7, 6·6, 4·7 and 4·1 per cent for two, three, four and more than four SLNs respectively. No learning curve was identified for localization or FNR. CONCLUSION The programme successfully trained a wide range of UK breast teams to perform safe SLNB and suggested that a standard injection protocol and structured multidisciplinary training can abolish learning curves.
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Clarke D, Glen D. Peter McDermott. Assoc Med J 2013. [DOI: 10.1136/bmj.f269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Colquhoun D, Bunker S, Clarke D, Glozier N, Hare D, Hickie I, Tatoulis J, Thompson D, Tofler G, Wilson A, Branagan M. National Heart Foundation of Australia Consensus Statement on Depression in Patients with Coronary Heart Disease: Recommendations for Screening, Referral and Treatment. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Glozier N, Tofler G, Colquhoun D, Bunker S, Clarke D, Hare D, Hickie I, Tatoulis J, Thompson D, Wilson A, Branagan M. The National Heart Foundation of Australia Consensus Statement on Psychosocial Risk Factors for Coronary Heart Disease. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schmid A, Grasso JR, Clarke D, Ferrazzini V, Bachèlery P, Staudacher T. Eruption forerunners from multiparameter monitoring and application for eruptions time predictability (Piton de la Fournaise). ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012jb009167] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Fuchs JD, Frank I, Kochar N, Elizaga M, Allen M, Carter D, Frahm N, Kalams SA, Mulligan M, Sheets R, Pensiero M, Clarke D, Eldridge J. First-in-human phase I clinical trial of a recombinant vesicular stomatitis virus (rVSV)-based preventive HIV-1 vaccine. Retrovirology 2012. [PMCID: PMC3441647 DOI: 10.1186/1742-4690-9-s2-p134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Mecci A, Kneeland C, Stanton D, Whisker L, Iqbal M, Sandhu F, Harries S, Jones L, Clarke D. 267. Impact of Introducing Intra-operative Assessment of Sentinel Lymph Node (SLN) with OSNA (One Step Nucleic Acid Amplification) – Single Centre Series. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Simmons GS, Young PR, Hanger JJ, Jones K, Clarke D, McKee JJ, Meers J. Prevalence of koala retrovirus in geographically diverse populations in Australia. Aust Vet J 2012; 90:404-9. [PMID: 23004234 DOI: 10.1111/j.1751-0813.2012.00964.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence of koala retrovirus (KoRV) in selected koala populations and to estimate proviral copy number in a subset of koalas. METHODS Blood or tissue samples from 708 koalas in Queensland, New South Wales, Victoria and South Australia were tested for KoRV pol provirus gene using standard polymerase chain reaction (PCR), nested PCR and real-time PCR (qPCR). RESULTS Prevalence of KoRV provirus-positive koalas was 100% in four regions of Queensland and New South Wales, 72.2% in mainland Victoria, 26.6% on four Victorian islands and 14.8% on Kangaroo Island, South Australia. Estimated proviral copy number per cell in four groups of koalas from Queensland and Victoria showed marked variation, ranging from a mean of 165 copies per cell in the Queensland group to 1.29 × 10(-4) copies per cell in one group of Victorian koalas. CONCLUSIONS The higher prevalence of KoRV-positive koalas in the north of Australia and high proviral loads in Queensland koalas may indicate KoRV entered and became endogenous in the north and is spreading southwards. It is also possible there are genetic differences between koalas in northern and southern Australia that affect susceptibility to KoRV infection or endogenisation, or that environmental factors affecting transmission in northern states are absent or uncommon in southern regions. Although further studies are required, the finding of proviral copy numbers orders of magnitude lower than what would be expected for the presence of a single copy in every cell for many Victorian animals suggests that KoRV is not endogenous in these animals and likely reflects ongoing exogenous infection.
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Doherty C, Wallock D, Doherty L, Clarke D, Campopiano D, Govan J. 72 Antimicrobial activity of stable allicin against multiresistant cystic fibrosis pathogens. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McCann PA, Clarke D, Amirfeyz R, Bhatia R. The cadaveric anatomy of the distal radius: implications for the use of volar plates. Ann R Coll Surg Engl 2012; 94:116-20. [PMID: 22391383 DOI: 10.1308/003588412x13171221501186] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Fractures of the distal radius are common upper limb injuries, representing a substantial proportion of the trauma workload in orthopaedic units. With ever increasing advancements in implant technology, operative intervention is becoming more frequent. As growing numbers of surgeons are performing operative fixation of distal radial fractures, an accurate understanding of the relevant surgical anatomy is paramount. The flexor carpi radialis (FCR) tendon forms the cornerstone of the Henry approach to the volar cortex of the distal radius. A number of key neurovascular structures around the wrist are potentially at risk during this approach, especially when the FCR is mobilised and placed under retractors. METHODS In order to clarify the safe margins of the FCR approach, ten fresh frozen human cadaver limbs were dissected. The location of the radial artery, the median nerve, the palmar cutaneous branch of the median nerve and the superficial branch nerve were measured with respect to the FCR tendon. Measurements were taken on a centre-to-centre basis in the coronal plane at the watershed level. In addition, the distances between the tendons of brachioradialis, abductor pollicis longus and flexor pollicis longus, and the radial artery and median nerve were measured to create a complete picture of the anatomy of the FCR approach to the distal radius. RESULTS The structure most at risk was the palmar cutaneous branch of the median nerve. It was located on average 3.4mm from the FCR tendon. The radial artery and the main trunk of the median nerve were located 7.8mm and 8.9mm from the tendon. The superficial branch of the radial nerve was 24.4mm from the FCR tendon and 11.1mm from the brachioradialis tendon. CONCLUSIONS Operative intervention is not without complication. We believe a more accurate understanding of the surgical anatomy is key to the prevention of neurovascular damage arising from the surgical management of distal radial fractures.
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