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Mohr-Holland E, Apolisi I, Reuter A, de Azevedo V, Hill J, Matthee S, Seddon JA, Isaakidis P, Furin J, Trivino-Duran L. Barriers and solutions to finding rifampicin-resistant tuberculosis cases in older children and adolescents. Public Health Action 2019; 9:174-176. [PMID: 32042611 DOI: 10.5588/pha.19.0050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/12/2019] [Indexed: 11/10/2022] Open
Abstract
Little is known about the barriers to post-exposure management of rifampicin-resistant tuberculosis (RR-TB) in older children and adolescents. We report on implementation lessons from a pilot programme targeting household-exposed individuals aged 6-18 years in Khayelitsha, South Africa. Barriers included misperceptions regarding risk of exposure, multiple research and implementation stakeholders, additional workload for an overburdened healthcare system, logistical issues faced by families, and insufficient human and financial resources. Solutions to these barriers are possible, but creativity and persistence are required. Our experience can guide others looking to roll-out care for children and adolescents exposed to RR-TB.
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Manca M, Pessoa V, Myers P, Pickles A, Hill J, Sharp H, Murgatroyd C, Bubb VJ, Quinn JP. Distinct chromatin structures at the monoamine oxidase-A promoter correlate with allele-specific expression in SH-SY5Y cells. GENES, BRAIN, AND BEHAVIOR 2019; 18:e12483. [PMID: 29667298 PMCID: PMC6617726 DOI: 10.1111/gbb.12483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/19/2018] [Accepted: 04/13/2018] [Indexed: 11/30/2022]
Abstract
Monoamine oxidase-A (MAOA) metabolises monoamines and is implicated in the pathophysiology of psychiatric disorders. A polymorphic repetitive DNA domain, termed the uVNTR (upstream variable number tandem repeat), located at the promoter of the MAOA gene is a risk factor for many of these disorders. MAOA is on the X chromosome suggesting gender could play a role in regulation. We analysed MAOA regulation in the human female cell line, SH-SY5Y, which is polymorphic for the uVNTR. This heterozygosity allowed us to correlate allele-specific gene expression with allele-specific transcription factor binding and epigenetic marks for MAOA. Gene regulation was analysed under basal conditions and in response to the mood stabiliser sodium valproate. Both alleles were transcriptionally active under basal growth conditions; however, the alleles showed distinct transcription factor binding and epigenetic marks at their respective promoters. Exposure of the cells to sodium valproate resulted in differential allelic expression which correlated with allele-specific changes in distinct transcription factor binding and epigenetic marks at the region encompassing the uVNTR. Biochemically our model for MAOA promoter function has implications for gender differences in gene × environment responses in which the uVNTR has been implicated as a genetic risk.
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Burgess R, Bishop A, Lewis M, Hill J. Models used for case-mix adjustment of patient reported outcome measures (PROMs) in musculoskeletal healthcare: A systematic review of the literature. Physiotherapy 2019; 105:137-146. [DOI: 10.1016/j.physio.2018.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 10/07/2018] [Indexed: 10/27/2022]
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Young N, Achieng F, Desai M, Phillips-Howard P, Hill J, Aol G, Bigogo G, Laserson K, Ter Kuile F, Taegtmeyer M. Integrated point-of-care testing (POCT) for HIV, syphilis, malaria and anaemia at antenatal facilities in western Kenya: a qualitative study exploring end-users' perspectives of appropriateness, acceptability and feasibility. BMC Health Serv Res 2019; 19:74. [PMID: 30691447 PMCID: PMC6348645 DOI: 10.1186/s12913-018-3844-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 12/19/2018] [Indexed: 11/17/2022] Open
Abstract
Background HIV, syphilis, malaria and anaemia are leading preventable causes of adverse pregnancy outcomes in sub-Saharan Africa yet testing coverage for conditions other than HIV is low. Availing point-of-care tests (POCTs) at rural antenatal health facilities (dispensaries) has the potential to improve access and timely treatment. Fundamental to the adoption of and adherence to new diagnostic approaches are healthcare workers’ and pregnant women’s (end-users) buy-in. A qualitative approach was used to capture end-users’ experiences of using POCTs for HIV, syphilis, malaria and anaemia to assess the appropriateness, acceptability and feasibility of integrated testing for ANC. Methods Seven dispensaries were purposively selected to implement integrated point-of-care testing for eight months in western Kenya. Semi-structured interviews were conducted with 18 healthcare workers (14 nurses, one clinical officer, two HIV testing counsellors, and one laboratory technician) who were trained, had experience doing integrated point-of-care testing, and were still working at the facilities 8–12 months after the intervention began. The interviews explored acceptability and relevance of POCTs to ANC, challenges with testing, training and supervision, and healthcare workers’ perspectives of client experiences. Twelve focus group discussions with 118 pregnant women who had attended a first ANC visit at the study facilities during the intervention were conducted to explore their knowledge of HIV, syphilis, malaria, and anaemia, experience of ANC point-of-care testing services, treatments received, relationships with healthcare workers, and experience of talking to partners about HIV and syphilis results. Results Healthcare workers reported that they enjoyed gaining new skills, were enthusiastic about using POCTs, and found them easy to use and appropriate to their practice. Initial concerns that performing additional testing would increase their workload in an already strained environment were resolved with experience and proficiency with the testing procedures. However, despite having the diagnostic tools, general health system challenges such as high client to healthcare worker volume ratio, stock-outs and poor working conditions challenged the delivery of adequate counselling and management of the four conditions. Pregnant women appreciated POCTs, but reported poor healthcare worker attitudes, drug stock-outs, and fear of HIV disclosure to their partners as shortcomings to their ANC experience in general. Conclusion This study provides insights on the acceptability, appropriateness, and feasibility of integrating POCTs into ANC services among end-users. While the innovation was desired and perceived as beneficial, future scale-up efforts would need to address health system weaknesses if integrated testing and subsequent effective management of the four conditions are to be achieved. Electronic supplementary material The online version of this article (10.1186/s12913-018-3844-9) contains supplementary material, which is available to authorized users.
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Moate PJ, Williams SRO, Deighton MH, Hannah MC, Ribaux BE, Morris GL, Jacobs JL, Hill J, Wales WJ. Effects of feeding wheat or corn and of rumen fistulation on milk production and methane emissions of dairy cows. ANIMAL PRODUCTION SCIENCE 2019. [DOI: 10.1071/an17433] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
There has been little research that has quantified methane (CH4) yields when dairy cows consume diets containing wheat grain. Furthermore, although rumen-fistulated animals have been used in many experiments concerned with measuring CH4 emissions, no research has examined the effect of rumen fistulation on in vivo CH4 emissions and yield. This experiment examined the effects of including either wheat or corn grain in the diet and the effects of rumen fistulation on yields of milk and milk components, CH4 emissions, yields, and intensities. Eight rumen-fistulated and six non-fistulated Holstein dairy cows in late lactation were offered a wheat-based diet (WHT) and a corn-based diet (CRN) in a crossover design. For the WHT diet, cows were offered daily, 22.4 kg DM containing 45.5% lucerne hay, 8.9% canola meal, 0.5% mineral mix, 0.5% molasses powder and 44.6% rolled wheat. The CRN diet was similar to the WHT diet except that rolled corn replaced the wheat. There was no difference between the WHT and CRN diets on mean milk yields (27.8 vs 27.9 kg/day), but the WHT diet substantially reduced milk fat concentration (2.76 vs 4.23%) and milk fat yield (0.77 vs 1.18 kg/day). Methane emissions (218 vs 424 g/day), CH4 yield (11.1 vs 19.5 g/kg dry matter intake) and CH4 intensity (7.6 vs 15.7 g/kg milk) were all reduced ~45% by the WHT diet compared with the CRN diet. Rumen fistulation did not affect dry matter intake, milk production, milk composition or CH4 emissions, but decreased CH4 yield and intensity. Including wheat in the diet of dairy cows has the potential to be an effective strategy to reduce their greenhouse gas emissions. In addition, rumen fistulation was associated with a small reduction in CH4 yield and intensity, and this should be considered when using rumen-fistulated cows in research concerned with CH4 emissions.
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Cooper A, Kanumilli N, Hill J, Holt RIG, Howarth D, Lloyd CE, Kar P, Nagi D, Naik S, Nash J, Nelson H, Owen K, Swindell B, Walker R, Whicher C, Wilmot E. Language matters. Addressing the use of language in the care of people with diabetes: position statement of the English Advisory Group. Diabet Med 2018; 35:1630-1634. [PMID: 29888553 DOI: 10.1111/dme.13705] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Abstract
The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language, both verbal and written, can lower anxiety, build confidence, educate and help to improve self-care. Conversely, poor communication can be stigmatizing, hurtful and undermining of self-care and can have a detrimental effect on clinical outcomes. The language used in the care of those with diabetes has the power to reinforce negative stereotypes, but it also has the power to promote positive ones. The use of language is controversial and has many perspectives. The development of this position statement aimed to take account of these as well as the current evidence base. A working group, representing people with diabetes and key organizations with an interest in the care of people with diabetes, was established to review the use of language. The work of this group has culminated in this position statement for England. It follows the contribution of Australia and the USA to this important international debate. The group has set out practical examples of language that will encourage positive interactions with those living with diabetes and subsequently promote positive outcomes. These examples are based on a review of the evidence and are supported by a simple set of principles.
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Brown SR, Fearnhead NS, Faiz OD, Abercrombie JF, Acheson AG, Arnott RG, Clark SK, Clifford S, Davies RJ, Davies MM, Douie WJP, Dunlop MG, Epstein JC, Evans MD, George BD, Guy RJ, Hargest R, Hawthorne AB, Hill J, Hughes GW, Limdi JK, Maxwell-Armstrong CA, O'Connell PR, Pinkney TD, Pipe J, Sagar PM, Singh B, Soop M, Terry H, Torkington J, Verjee A, Walsh CJ, Warusavitarne JH, Williams AB, Williams GL, Wilson RG. The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease. Colorectal Dis 2018; 20 Suppl 8:3-117. [PMID: 30508274 DOI: 10.1111/codi.14448] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/17/2018] [Indexed: 12/14/2022]
Abstract
AIM There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. METHODS Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. RESULTS All aspects of surgical care for IBD have been included along with 157 recommendations for management. CONCLUSION These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.
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Tan D, Ng M, Subbiah V, Messersmith W, Teneggi V, Diermayr V, Ethirajulu K, Yeo P, Gan B, Lee L, Blanchard S, Nellore R, Yasin M, Umrani D, Lee M, Hill J, Madan B, Virshup D, Matter A. Phase I extension study of ETC-159 an oral PORCN inhibitor administered with bone protective treatment, in patients with advanced solid tumours. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy430.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wang J, Li J, Tantiworawit A, Izuka S, Yamada S, Hill J, Shima Rich E, Bahceci E. A phase III randomized study of gilteritinib versus salvage chemotherapy in FLT3 mutation-positive subjects with relapsed or refractory acute myeloid leukemia. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy437.019] [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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Hill J, Nagrial A, Hui R. P3.01-35 Outcomes in Advanced Non-Small Cell Lung Cancer After Discontinuation of PD-1 Checkpoint Inhibitor Due to Toxicity. A Retrospective Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1595] [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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Hoyt J, Landuwulang CUR, Ansariadi, Ahmed R, Burdam FH, Bonsapia I, Poespoprodjo JR, Syafruddin D, Ter Kuile FO, Webster J, Hill J. Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women. Malar J 2018; 17:341. [PMID: 30261877 PMCID: PMC6161378 DOI: 10.1186/s12936-018-2490-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 09/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The control of malaria in pregnancy in much of Asia relies on screening asymptomatic women for malaria infection, followed by passive case detection and prevention with insecticide-treated nets. In 2012, Indonesia introduced screening for malaria by microscopy or rapid diagnostic tests (RDTs) at pregnant women's first antenatal care (ANC) visit to detect and treat malaria infections regardless of the presence of symptoms. Acceptability among health providers and pregnant women of the current 'single screen and treat' (SSTp) strategy compared to two alternative strategies that were intermittent preventive treatment (IPTp) and intermittent screening and treatment (ISTp) was assessed in the context of a clinical trial in two malaria endemic provinces of Eastern Indonesia. METHODS Qualitative data were collected through in-depth interviews with 121 health providers working in provision of antenatal care, heads of health facilities and District Health Office staff. Trial staff were also interviewed. Focus group discussions were conducted with 16 groups of pregnant women (N = 106) to discuss their experiences of each intervention in the trial. RESULTS Health providers and pregnant women were receptive to screening for malaria at every ANC visit due to the increased opportunity to detect and treat asymptomatic infections. A primary concern for providers was the accuracy and availability of RDTs used for screening in the SSTp and ISTp arms, which they considered less accurate than microscopy. Providers had reservations about giving anti-malarials presumptively as IPTp, due to concerns of causing potential harm to mother and baby and as a possible driver of drug resistance. Pregnant women were accepting of all three interventions. Women in the IPTp arm were happy to take anti-malarials presumptively to protect themselves and their babies against malaria. CONCLUSIONS The findings indicate that, within a trial context, malaria screening of pregnant women at every ANC visit ISTp was an acceptable strategy among both health providers and pregnant women owing to an existing culture of screening and treatment. The adoption of IPTp however would require a considerable shift in health provider attitudes and a clear communication strategy. By contrast, pregnant women welcomed the opportunity to prevent malaria infections during pregnancy.
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Jorgenson CJ, Hill J, Halkovich J. ISQUA18-2566Using Robust Process Improvement (RPI®) to Develop Criteria for Determining Submission of a Strategic Improvement Plan (SIP) in Place of a Follow-up Survey When a Decision Rule (DR) is Tripped. Int J Qual Health Care 2018. [DOI: 10.1093/intqhc/mzy167.39] [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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Li Z, Abe K, Bronner C, Hayato Y, Ikeda M, Iyogi K, Kameda J, Kato Y, Kishimoto Y, Marti L, Miura M, Moriyama S, Nakahata M, Nakajima Y, Nakano Y, Nakayama S, Orii A, Pronost G, Sekiya H, Shiozawa M, Sonoda Y, Takeda A, Takenaka A, Tanaka H, Tasaka S, Tomura T, Akutsu R, Kajita T, Nishimura Y, Okumura K, Tsui K, Fernandez P, Labarga L, Blaszczyk F, Gustafson J, Kachulis C, Kearns E, Raaf J, Stone J, Sulak L, Berkman S, Tobayama S, Elnimr M, Kropp W, Locke S, Mine S, Weatherly P, Smy M, Sobel H, Takhistov V, Ganezer K, Hill J, Kim J, Lim I, Park R, Himmel A, O’Sullivan E, Scholberg K, Walter C, Ishizuka T, Nakamura T, Jang J, Choi K, Learned J, Matsuno S, Smith S, Amey J, Litchfield R, Ma W, Uchida Y, Wascko M, Cao S, Friend M, Hasegawa T, Ishida T, Ishii T, Kobayashi T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Abe KE, Hasegawa M, Suzuki A, Takeuchi Y, Yano T, Hayashino T, Hiraki T, Hirota S, Huang K, Jiang M, Mori M, Nakamura KE, Nakaya T, Patel N, Wendell R, Anthony L, McCauley N, Pritchard A, Fukuda Y, Itow Y, Murase M, Muto F, Mijakowski P, Frankiewicz K, Jung C, Li X, Palomino J, Santucci G, Vilela C, Wilking M, Yanagisawa C, Yang G, Ito S, Fukuda D, Ishino H, Kibayashi A, Koshio Y, Nagata H, Sakuda M, Xu C, Kuno Y, Wark D, Di Lodovico F, Richards B, Sedgwick S, Tacik R, Kim S, Cole A, Thompson L, Okazawa H, Choi Y, Ito K, Nishijima K, Koshiba M, Suda Y, Yokoyama M, Calland R, Hartz M, Martens K, Murdoch M, Quilain B, Simpson C, Suzuki Y, Vagins M, Hamabe D, Kuze M, Okajima Y, Yoshida T, Ishitsuka M, Martin J, Nantais C, Tanaka H, Towstego T, Konaka A, Chen S, Wan L, Zhang Y, Minamino A, Wilkes R. Measurement of the tau neutrino cross section in atmospheric neutrino oscillations with Super-Kamiokande. Int J Clin Exp Med 2018. [DOI: 10.1103/physrevd.98.052006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Webster J, Ansariadi, Burdam FH, Landuwulang CUR, Bruce J, Poespoprodjo JR, Syafruddin D, Ahmed R, Hill J. Evaluation of the implementation of single screening and treatment for the control of malaria in pregnancy in Eastern Indonesia: a systems effectiveness analysis. Malar J 2018; 17:310. [PMID: 30143047 PMCID: PMC6108152 DOI: 10.1186/s12936-018-2448-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Indonesia introduced single screening and treatment (SST) of pregnant women for the control of malaria in pregnancy in 2012. Under this policy pregnant women are screened for malaria at their first antenatal clinic (ANC) visit and on subsequent visits are tested for malaria only if symptomatic. The implementation of this policy in two districts of Indonesia was evaluated. Cross sectional survey structured observations of the ANC visit and exit interviews with pregnant women were conducted to assess health provider compliance with SST guidelines. Systems effectiveness analysis was performed on components of the strategy. Multiple logistic regression was used to test for predictors of women being screened at their first ANC visit. Results A total of 865 and 895 ANC visits in Mimika and West Sumba across seven and ten health facilities (plus managed health posts) respectively, were included in the study. Adherence to malaria screening at first ANC visit among pregnant women was 51.4% (95% CI 11.9, 89.2) in health facilities in Mimika (94.8% in health centres) and 24.8% (95% CI 10.3, 48.9) in West Sumba (60.0% in health centres). Reported fever was low amongst women presenting for their second and above ANC visit (2.8% in Mimika and 3.5% in West Sumba) with 89.5% and 46.2% of these women tested for malaria in Mimka and West Sumba, respectively. Cumulative systems effectiveness for SST on first visit to ANC was 7.6% for Mimika and 0.1% for West Sumba; and for second or above visits to ANC was 0.7% in Mimika and 0% in West Sumba. Being screened on a 1st visit to ANC was associated with level of health facility in both sites. Conclusion Cumulative systems effectiveness of the SST strategy was poor in both sites. Both elements of the SST strategy, screening on first visit and passive case detection on second and above visits, was driven by the difference in implementation of malaria testing in health centres and health posts, and by low malaria transmission levels and reported fever.
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Hill J, Landuwulang CUR, Ansariadi, Hoyt J, Burdam FH, Bonsapia I, Syafruddin D, Poespoprodjo JR, Ter Kuile FO, Ahmed R, Webster J. Evaluation of the national policy of single screening and treatment for the prevention of malaria in pregnancy in two districts in Eastern Indonesia: health provider perceptions. Malar J 2018; 17:309. [PMID: 30143041 PMCID: PMC6108151 DOI: 10.1186/s12936-018-2426-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/21/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Malaria in pregnancy has devastating consequences for both the expectant mother and baby. Annually, 88.2 (70%) of the 125.2 million pregnancies in malaria endemic regions occur in the Asia-Pacific region. The control of malaria in pregnancy in most of Asia relies on passive case detection and prevention with long-lasting insecticide-treated nets. Indonesia was the first country in the region to introduce, in 2012, malaria screening at pregnant women's first antenatal care visit to reduce the burden of malaria in pregnancy. The study assessed health providers' acceptability and perceptions on the feasibility of implementing the single screening and treatment (SST) strategy in the context of the national programme in two endemic provinces of Indonesia. METHODS Qualitative data were collected through in-depth interviews with 86 health providers working in provision of antenatal care (midwives, doctors, laboratory staff, pharmacists, and heads of drug stores), heads of health facilities and District Health Office staff in West Sumba and Mimika districts in East Nusa Tenggara and Papua provinces, respectively. RESULTS Health providers of all cadres were accepting of SST as a preventive strategy, showing a strong preference for microscopy over rapid diagnostic tests (RDTs) as the method of screening. Implementation of the policy was inconsistent in both sites, with least extensive implementation reported in West Sumba compared to Mimika. SST was predominantly implemented at health centre level using microscopy, whereas implementation at community health posts was said to occur in less than half the selected health facilities. Lack of availability of RDTs was cited as the major factor that prevented provision of SST at health posts, however as village midwives cannot prescribe medicines women who test positive are referred to health centres for anti-malarials. Few midwives had received formal training on SST or related topics. CONCLUSIONS The study findings indicate that SST was an acceptable strategy among health providers, however implementation was inconsistent with variation across different localities within the same district, across levels of facility, and across different cadres within the same health facility. Implementation should be re-invigorated through reorientation and training of health providers, stable supplies of more sensitive RDTs, and improved data capture and reporting.
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Ekmejian A, Lee A, Firoozi S, Sapontis J, Bhindi R, Hansen P, Ward M, Kaura A, Hill J, Dwokarowski R, MacCarthy P, Melikian N, Webb I, Shah A, Byrne J. P3585Comparison of 3 year outcomes between medical therapy and percutaneous revascularisation for surgically ineligible patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3585] [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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Gilliam J, Woods J, Hill J, Shearer J, Reynolds J, Taylor J. Evaluation of the CASH Dispatch Kit combined with alternative shot placement landmarks as a single-step euthanasia method for cattle of various ages. Anim Welf 2018. [DOI: 10.7120/09627286.27.3.225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Young N, Taegtmeyer M, Aol G, Bigogo GM, Phillips-Howard PA, Hill J, Laserson KF, Ter Kuile F, Desai M. Integrated point-of-care testing (POCT) of HIV, syphilis, malaria and anaemia in antenatal clinics in western Kenya: A longitudinal implementation study. PLoS One 2018; 13:e0198784. [PMID: 30028852 PMCID: PMC6054376 DOI: 10.1371/journal.pone.0198784] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 05/28/2018] [Indexed: 11/24/2022] Open
Abstract
Background In sub-Saharan Africa, HIV, syphilis, malaria and anaemia are leading preventable causes of adverse pregnancy outcomes. In Kenya, policy states women should be tested for all four conditions (malaria only if febrile) at first antenatal care (ANC) visit. In practice, while HIV screening is conducted, coverage of screening for the others is suboptimal and early pregnancy management of illnesses is compromised. This is particularly evident at rural dispensaries that lack laboratories and have parallel programmes for HIV, reproductive health and malaria, resulting in fractured and inadequate care for women. Methods A longitudinal eight-month implementation study integrating point-of-care diagnostic tests for the four conditions into routine ANC was conducted in seven purposively selected dispensaries in western Kenya. Testing proficiency of healthcare workers was observed at initial training and at three monthly intervals thereafter. Adoption of testing was compared using ANC register data 8.5 months before and eight months during the intervention. Fidelity to clinical management guidelines was determined by client exit interviews with success defined as ≥90% adherence. Findings For first ANC visits at baseline (n = 529), testing rates were unavailable for malaria, low for syphilis (4.3%) and anaemia (27.8%), and near universal for HIV (99%). During intervention, over 95% of first attendees (n = 586) completed four tests and of those tested positive, 70.6% received penicillin or erythromycin for syphilis, 65.5% and 48.3% received cotrimoxazole and antiretrovirals respectively for HIV, and 76.4% received artemether/lumefantrine, quinine or dihydroartemisinin–piperaquine correctly for malaria. Iron and folic supplements were given to nearly 90% of women but often at incorrect doses. Conclusions Integrating point-of-care testing into ANC at dispensaries with established HIV testing programmes resulted in a significant increase in testing rates, without disturbing HIV testing rates. While more cases were detected and treated, treatment fidelity still requires strengthening and an integrated monitoring and evaluation system needs to be established.
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Lea EJ, Doherty K, Page K, Hill J, Robinson A. O4‐03‐03: THE DEMENTIA CARE SUPPORT WORKER: A NEW ROLE FOR CARE WORKER GRADUATES WITH THE BACHELOR OF DEMENTIA CARE DEGREE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2923] [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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Vallance AE, van der Meulen J, Kuryba A, Charman SC, Botterill ID, Prasad KR, Hill J, Jayne DG, Walker K. The timing of liver resection in patients with colorectal cancer and synchronous liver metastases: a population-based study of current practice and survival. Colorectal Dis 2018; 20:486-495. [PMID: 29338108 DOI: 10.1111/codi.14019] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/12/2017] [Indexed: 12/13/2022]
Abstract
AIM There is uncertainty regarding the optimal sequence of surgery for patients with colorectal cancer (CRC) and synchronous liver metastases. This study was designed to describe temporal trends and inter-hospital variation in surgical strategy, and to compare long-term survival in a propensity score-matched analysis. METHOD The National Bowel Cancer Audit dataset was used to identify patients diagnosed with primary CRC between 1 January 2010 and 31 December 2015 who underwent CRC resection in the English National Health Service. Hospital Episode Statistics data were used to identify those with synchronous liver-limited metastases who underwent liver resection. Survival outcomes of propensity score-matched groups were compared. RESULTS Of 1830 patients, 270 (14.8%) underwent a liver-first approach, 259 (14.2%) a simultaneous approach and 1301 (71.1%) a bowel-first approach. The proportion of patients undergoing either a liver-first or simultaneous approach increased over the study period from 26.8% in 2010 to 35.6% in 2015 (P < 0.001). There was wide variation in surgical approach according to hospital trust of diagnosis. There was no evidence of a difference in 4-year survival between the propensity score-matched cohorts according to surgical strategy: bowel first vs simultaneous [hazard ratio (HR) 0.92 (95% CI: 0.80-1.06)] or bowel first vs liver first [HR 0.99 (95% CI: 0.82-1.19)]. CONCLUSION There is evidence of wide variation in surgical strategy in dealing with CRC and synchronous liver metastases. In selected patients, the simultaneous and liver-first strategies have comparable long-term survival to the bowel-first approach.
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Kachulis C, Abe K, Bronner C, Hayato Y, Ikeda M, Iyogi K, Kameda J, Kato Y, Kishimoto Y, Marti L, Miura M, Moriyama S, Nakahata M, Nakano Y, Nakayama S, Okajima Y, Orii A, Pronost G, Sekiya H, Shiozawa M, Sonoda Y, Takeda A, Takenaka A, Tanaka H, Tasaka S, Tomura T, Akutsu R, Kajita T, Kaneyuki K, Nishimura Y, Okumura K, Tsui KM, Labarga L, Fernandez P, Blaszczyk FDM, Gustafson J, Kearns E, Raaf JL, Stone JL, Sulak LR, Berkman S, Tobayama S, Goldhaber M, Elnimr M, Kropp WR, Mine S, Locke S, Weatherly P, Smy MB, Sobel HW, Takhistov V, Ganezer KS, Hill J, Kim JY, Lim IT, Park RG, Himmel A, Li Z, O'Sullivan E, Scholberg K, Walter CW, Ishizuka T, Nakamura T, Jang JS, Choi K, Learned JG, Matsuno S, Smith SN, Amey J, Litchfield RP, Ma WY, Uchida Y, Wascko MO, Cao S, Friend M, Hasegawa T, Ishida T, Ishii T, Kobayashi T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Abe KE, Hasegawa M, Suzuki AT, Takeuchi Y, Yano T, Hayashino T, Hiraki T, Hirota S, Huang K, Jiang M, Nakamura KE, Nakaya T, Quilain B, Patel ND, Wendell RA, Anthony LHV, McCauley N, Pritchard A, Fukuda Y, Itow Y, Murase M, Muto F, Mijakowski P, Frankiewicz K, Jung CK, Li X, Palomino JL, Santucci G, Vilela C, Wilking MJ, Yanagisawa C, Ito S, Fukuda D, Ishino H, Kibayashi A, Koshio Y, Nagata H, Sakuda M, Xu C, Kuno Y, Wark D, Di Lodovico F, Richards B, Tacik R, Kim SB, Cole A, Thompson L, Okazawa H, Choi Y, Ito K, Nishijima K, Koshiba M, Totsuka Y, Suda Y, Yokoyama M, Calland RG, Hartz M, Martens K, Simpson C, Suzuki Y, Vagins MR, Hamabe D, Kuze M, Yoshida T, Ishitsuka M, Martin JF, Nantais CM, Tanaka HA, Konaka A, Chen S, Wan L, Zhang Y, Wilkes RJ, Minamino A. Search for Boosted Dark Matter Interacting with Electrons in Super-Kamiokande. PHYSICAL REVIEW LETTERS 2018; 120:221301. [PMID: 29906152 DOI: 10.1103/physrevlett.120.221301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/23/2018] [Indexed: 06/08/2023]
Abstract
A search for boosted dark matter using 161.9 kt yr of Super-Kamiokande IV data is presented. We search for an excess of elastically scattered electrons above the atmospheric neutrino background, with a visible energy between 100 MeV and 1 TeV, pointing back to the Galactic center or the Sun. No such excess is observed. Limits on boosted dark matter event rates in multiple angular cones around the Galactic center and Sun are calculated. Limits are also calculated for a baseline model of boosted dark matter produced from cold dark matter annihilation or decay. This is the first experimental search for boosted dark matter from the Galactic center or the Sun interacting in a terrestrial detector.
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Vallance AE, van der Meulen J, Kuryba A, Braun M, Jayne DG, Hill J, Cameron IC, Walker K. Socioeconomic differences in selection for liver resection in metastatic colorectal cancer and the impact on survival. Eur J Surg Oncol 2018; 44:1588-1594. [PMID: 29895508 DOI: 10.1016/j.ejso.2018.05.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/02/2018] [Accepted: 05/17/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in colorectal cancer (CRC) survival are well recognised. The aim of this study was to describe the impact of socioeconomic deprivation on survival in patients with synchronous CRC liver-limited metastases, and to investigate if any survival inequalities are explained by differences in liver resection rates. METHODS Patients in the National Bowel Cancer Audit diagnosed with CRC between 2010 and 2016 in the English National Health Service were included. Linked Hospital Episode Statistics data were used to identify the presence of liver metastases and whether a liver resection had been performed. Multivariable random-effects logistic regression was used to estimate the odds ratio (OR) of liver resection by Index of Multiple Deprivation (IMD) quintile. Cox-proportional hazards model was used to compare 3-year survival. RESULTS 13,656 patients were included, of whom 2213 (16.2%) underwent liver resection. Patients in the least deprived IMD quintile were more likely to undergo liver resection than those in the most deprived quintile (adjusted OR 1.42, 95% confidence interval (CI) 1.18-1.70). Patients in the least deprived quintile had better 3-year survival (least deprived vs. most deprived quintile, 22.3% vs. 17.4%; adjusted hazard ratio (HR) 1.20, 1.11-1.30). Adjusting for liver resection attenuated, but did not remove, this effect. There was no difference in survival between IMD quintile when restricted to patients who underwent liver resection (adjusted HR 0.97, 0.76-1.23). CONCLUSIONS Deprived CRC patients with synchronous liver-limited metastases have worse survival than more affluent patients. Lower rates of liver resection in more deprived patients is a contributory factor.
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Goodall R, Claireaux H, Hill J, Wilson E, Monsell F, BOAST 11 Collaborative, Tarassoli P. Comparison between a multicentre, collaborative, closed-loop audit assessing management of supracondylar fractures and the British Orthopaedic Association Standard for Trauma 11 (BOAST 11) guidelines. Bone Joint J 2018; 100-B:346-351. [DOI: 10.1302/0301-620x.100b3.bjj-2017-0780.r2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims Supracondylar fractures are the most frequently occurring paediatric fractures about the elbow and may be associated with a neurovascular injury. The British Orthopaedic Association Standards for Trauma 11 (BOAST 11) guidelines describe best practice for supracondylar fracture management. This study aimed to assess whether emergency departments in the United Kingdom adhere to BOAST 11 standard 1: a documented assessment, performed on presentation, must include the status of the radial pulse, digital capillary refill time, and the individual function of the radial, median (including the anterior interosseous), and ulnar nerves. Materials and Methods Stage 1: We conducted a multicentre, retrospective audit of adherence to BOAST 11 standard 1. Data were collected from eight hospitals in the United Kingdom. A total of 433 children with Gartland type 2 or 3 supracondylar fractures were eligible for inclusion. A centrally created data collection sheet was used to guide objective analysis of whether BOAST 11 standard 1 was adhered to. Stage 2: We created a quality improvement proforma for use in emergency departments. This was piloted in one of the hospitals used in the primary audit and was re-audited using equivalent methodology. In all, 102 patients presenting between January 2016 and July 2017 were eligible for inclusion in the re-audit. Results Stage 1: Of 433 patient notes audited, adherence to BOAST 11 standard 1 was between 201 (46%) and 232 (54%) for the motor and sensory function of the individual nerves specified, 318 (73%) for radial pulse, and 247 (57%) for digital capillary refill time. Stage 2: Of 102 patient notes audited, adherence to BOAST 11 standard 1 improved to between 72 (71%) and 80 (78%) for motor and sensory function of the nerves, to 84 (82%) for radial pulse, and to 82 (80%) for digital capillary refill time. Of the 102 case notes reviewed in stage 2, only 44 (43%) used the quality improvement proforma; when the proforma was used, adherence improved to between 40 (91%) and 43 (98%) throughout. Conclusion Adherence to BOAST 11 standard 1 is poor in hospitals across the country. This is concerning as neurovascular deficit may be an indication for emergent surgery, and missed neurovascular injury can cause long-term, or even permanent, functional impairment. We present a simple proforma that improves adherence to this standard, can easily be implemented into emergency departments, and may improve patient safety. Cite this article: Bone Joint J 2018;100-B:346–51.
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D'Alessandro U, Hill J, Tarning J, Pell C, Webster J, Gutman J, Sevene E. Treatment of uncomplicated and severe malaria during pregnancy. THE LANCET. INFECTIOUS DISEASES 2018; 18:e133-e146. [PMID: 29395998 DOI: 10.1016/s1473-3099(18)30065-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 07/19/2017] [Accepted: 10/13/2017] [Indexed: 12/13/2022]
Abstract
Over the past 10 years, the available evidence on the treatment of malaria during pregnancy has increased substantially. Owing to their relative ease of use, good sensitivity and specificity, histidine rich protein 2 based rapid diagnostic tests are appropriate for symptomatic pregnant women; however, such tests are less appropriate for systematic screening because they will not detect an important proportion of infections among asymptomatic women. The effect of pregnancy on the pharmacokinetics of antimalarial drugs varies greatly between studies and class of antimalarial drugs, emphasising the need for prospective studies in pregnant and non-pregnant women. For the treatment of malaria during the first trimester, international guidelines are being reviewed by WHO. For the second and third trimester of pregnancy, results from several trials have confirmed that artemisinin-based combination treatments are safe and efficacious, although tolerability and efficacy might vary by treatment. It is now essential to translate such evidence into policies and clinical practice that benefit pregnant women in countries where malaria is endemic. Access to parasitological diagnosis or appropriate antimalarial treatment remains low in many countries and regions. Therefore, there is a pressing need for research to identify quality improvement interventions targeting pregnant women and health providers. In addition, efficient and practical systems for pharmacovigilance are needed to further expand knowledge on the safety of antimalarial drugs, particularly in the first trimester of pregnancy.
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Ramirez-Garzon O, Satake N, Hill J, Holland MK, McGowan M. 63 Impact of Endometrial Biopsy on Corpus Luteum Function. Reprod Fertil Dev 2018. [DOI: 10.1071/rdv30n1ab63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Reproductive procedures involving uterine manipulation (UM), such as transcervical embryo transfer (TET) or the collection of an endometrial biopsy (EB) may cause trauma to the endometrium resulting in release of endogenous prostaglandin F2α (PGF2α) causing premature regression of the corpus luteum (CL). This study aimed to evaluate the effect of UM and EB on corpus luteum lifespan in tropically adapted beef heifers. In Experiment 1, pre-synchronised Droughtmaster heifers (n = 9; 25.8 ± 0.4 m, live weight 391 ± 21.5 kg) were randomly selected either at Day 4 (UM4 = 5) or at Day 7 (UM7 = 4) post-oestrus for transrectal uterine manipulation and transcervical passage of the biopsy Storz® device without sample collection. In Experiment 2, pre-synchronised Charbray heifers (n = 13, 2 to 3 years old, live weight 439.8 ± 17.2) were biopsied in the horn ipsilateral to the CL at Day 4 (B4 = 6) or at Day 7 (B7 = 7) post-oestrus. In both experiments, blood samples were taken from jugular/coccygeal vein throughout the oestrus cycle on Days 3, 4, 6, 7, 9, 11, 13, 16 and 19 (Day 0 = synchronised oestrous) for progesterone (P4) analysis. Signs of heat were visually detected daily and confirmed by ovarian ultrasound. For the PGF2α metabolite 13,14-dihydro-15-keto-PGF2α (PGFM) assessment, blood samples were collected before and after uterine trauma at –24, –12, 0 h and +6, +18, +24 h (Hour 0 = UM or EB either at Day 4 or Day 7). Progesterone was assessed by liquid chromatography-mass spectrometry (LC-MS) and PGFM using an enzyme immunoassay DetectX® kit (Arbor Assays, Ann Arbor, MI, USA). The intra- and interassay coefficients of variations were 3.7% and 12.8%, respectively. A series of generalized additive mixed effect models (GAMM) were created to quantify P4 differences for UM and EB. The results showed that oestrous cycle length was not affected by UM or EB conducted at Day 4 or at Day 7, because P4 concentration remained above 1 ng mL−1 after uterine trauma during dioestrus. Also, UM and EB did not induce the release of luteolytic pulses of PGF2α. Although P4 concentration followed the normal cycling pattern throughout the oestrus cycle, the shape of the curve in EB4 and UM4 heifers showed higher concentrations of P4 compared with EB7 and UM7 heifers. In conclusion, UM and EB with Storz® device during metoestrus or early dioestrus had minimal or nil effects on CL activity. Whether lower P4 profiles affect embryo development after uterine trauma needs to be further elucidated.
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