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Werner‐Seidler A, Maston K, Calear AL, Batterham PJ, Larsen ME, Torok M, O’Dea B, Huckvale K, Beames JR, Brown L, Fujimoto H, Bartholomew A, Bal D, Schweizer S, Skinner SR, Steinbeck K, Ratcliffe J, Oei J, Venkatesh S, Lingam R, Perry Y, Hudson JL, Boydell KM, Mackinnon A, Christensen H. The Future Proofing Study: Design, methods and baseline characteristics of a prospective cohort study of the mental health of Australian adolescents. Int J Methods Psychiatr Res 2023; 32:e1954. [PMID: 36444163 PMCID: PMC10485316 DOI: 10.1002/mpr.1954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. METHODS The FPS is an Australian school-based prospective cohort study with an embedded cluster-randomized controlled trial examining the effects of digital prevention programs on mental health. Data sources include self-report questionnaires, cognitive functioning, linkage to health and education records, and smartphone sensor data. Participants are assessed annually for 5 years. RESULTS The baseline cohort (N = 6388, M = 13.9 years) is broadly representative of the Australian adolescent population. The clinical profile of participants is comparable to other population estimates. Overall, 15.1% of the cohort met the clinical threshold for depression, 18.6% for anxiety, 31.6% for psychological distress, and 4.9% for suicidal ideation. These rates were significantly higher in adolescents who identified as female, gender diverse, sexuality diverse, or Aboriginal and/or Torres Strait Islander (all ps < 0.05). CONCLUSIONS This paper provides current and comprehensive data about the status of adolescent mental health in Australia. The FPS cohort is expected to provide significant insights into the risk, protective, and mediating factors associated with development of mental health conditions during adolescence.
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Affiliation(s)
| | - Kate Maston
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Alison L. Calear
- Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Philip J. Batterham
- Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Mark E. Larsen
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Michelle Torok
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Bridianne O’Dea
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Kit Huckvale
- Centre for Digital Transformation of HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Joanne R. Beames
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Lyndsay Brown
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Hiroko Fujimoto
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | | | - Debopriyo Bal
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Susanne Schweizer
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
| | - S. Rachel Skinner
- Discipline of Child and Adolescent HealthFaculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Katharine Steinbeck
- Discipline of Child and Adolescent HealthFaculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Julie Ratcliffe
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Ju‐Lee Oei
- School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Svetha Venkatesh
- Applied Artificial Intelligence InstituteDeakin UniversityBurwoodVictoriaAustralia
| | - Raghu Lingam
- School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Yael Perry
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Jennifer L. Hudson
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Katherine M. Boydell
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- Discipline of Psychiatry and Mental HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Andrew Mackinnon
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Helen Christensen
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- Discipline of Psychiatry and Mental HealthUniversity of New South WalesSydneyNew South WalesAustralia
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Beames JR, Werner-Seidler A, Hodgins M, Brown L, Fujimoto H, Bartholomew A, Maston K, Huckvale K, Zbukvic I, Torok M, Christensen H, Batterham PJ, Calear AL, Lingam R, Boydell KM. Implementing a Digital Depression Prevention Program in Australian Secondary Schools: Cross-Sectional Qualitative Study. JMIR Pediatr Parent 2023; 6:e42349. [PMID: 37307051 DOI: 10.2196/42349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/23/2023] [Accepted: 04/18/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Depression is common during adolescence and is associated with adverse educational, employment, and health outcomes in later life. Digital programs are increasingly being implemented in schools to improve and protect adolescent mental health. Although digital depression prevention programs can be effective, there is limited knowledge about how contextual factors influence real-world delivery at scale in schools. OBJECTIVE The purpose of this study was to examine the contextual factors that influence the implementation of the Future Proofing Program (FPP) from the perspectives of school staff. The FPP is a 2-arm hybrid type 1 effectiveness-implementation trial evaluating whether depression can be prevented at scale in schools, using an evidence-based smartphone app delivered universally to year 8 students (13-14 years of age). METHODS Qualitative interviews were conducted with 23 staff from 20 schools in New South Wales, Australia, who assisted with the implementation of the FPP. The interviews were guided by our theory-driven logic model. Reflexive thematic analysis, using both deductive and inductive coding, was used to analyze responses. RESULTS Staff perceived the FPP as a novel ("innovative approach") and appropriate way to address an unmet need within schools ("right place at the right time"). Active leadership and counselor involvement were critical for planning and engaging; teamwork, communication, and staff capacity were critical for execution ("ways of working within schools"). Low student engagement and staffing availability were identified as barriers for future adoption and implementation by schools ("reflecting on past experiences"). CONCLUSIONS Four superordinate themes pertaining to the program, implementation processes, and implementation barriers were identified from qualitative responses by school staff. On the basis of our findings, we proposed a select set of recommendations for future implementation of digital prevention programs delivered at scale in schools. These recommendations were designed to facilitate an organizational change and help staff to implement digital mental health programs within their schools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-042133.
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Affiliation(s)
- Joanne R Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Michael Hodgins
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Lyndsay Brown
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Hiroko Fujimoto
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Kate Maston
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC, Australia
| | - Isabel Zbukvic
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | - Raghu Lingam
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
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Sanatkar S, Counson I, Mackinnon A, Bartholomew A, Glozier N, Harvey S. Correction: Preliminary Investigation of Shift, a Novel Smartphone App to Support Junior Doctors' Mental Health and Well-being: Examination of Symptom Progression, Usability, and Acceptability After 1 Month of Use. J Med Internet Res 2023; 25:e47277. [PMID: 37011380 PMCID: PMC10131760 DOI: 10.2196/47277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
[This corrects the article DOI: 10.2196/38497.].
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Affiliation(s)
- Samineh Sanatkar
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | - Isabelle Counson
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | | | | | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
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Bartholomew A, Sanatkar S, Counson I, Harvey SB. Junior doctors' mental health and coronavirus disease safety concerns. Aust N Z J Public Health 2022; 46:307-313. [PMID: 35238447 PMCID: PMC9968570 DOI: 10.1111/1753-6405.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/01/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This article aims to assess whether caring for COVID-19 patients impacted junior doctors' COVID-19-related anxieties, general anxiety and depression, and the relative impact of depression, general anxiety and specific COVID-19 anxiety on work and social functioning during the COVID-19 pandemic in 2020. METHODS Recruitment occurred between June and August 2020 in New South Wales, Australia. Demographic information, symptoms of depression (PHQ-9), generalised anxiety (GAD-7), and COVID-19-related anxieties around infections, help-seeking behaviours, and work and social functioning (WSAS) were collected. RESULTS About one third (n=73, 33%) had cared for a patient with overt or covert COVID-19 in the previous month. However, the extent of COVID-19-related anxiety symptoms was largely unrelated to caring for COVID-19 patients. Instead, the presence of other COVID-19 concerns and gender predicted variations in COVID-19 concerns for one's own safety and the safety of loved ones. CONCLUSION COVID-19 anxiety symptoms were largely unrelated to caring for COVID-19 patients, while COVID-19-related anxiety around the safety of family and friends added to impaired functioning in addition to the established impact of depression and general anxiety. IMPLICATIONS FOR PUBLIC HEALTH Provided the replicability of these findings, this research highlights the importance of addressing pandemic-related anxieties in junior doctor populations.
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Affiliation(s)
- Alexandra Bartholomew
- Black Dog Institute, UNSW Sydney, New South Wales,Correspondence to: Ms Alexandra Bartholomew, Black Dog Institute, Hospital Road, Sydney 2031
| | - Samineh Sanatkar
- Black Dog Institute, UNSW Sydney, New South Wales,School of Psychiatry, UNSW Sydney, New South Wales
| | - Isabelle Counson
- Black Dog Institute, UNSW Sydney, New South Wales,School of Psychiatry, UNSW Sydney, New South Wales
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Sanatkar S, Counson I, Mackinnon A, Bartholomew A, Glozier N, Harvey S. Preliminary investigation of Shift, a novel smartphone application to support junior doctors’ mental health and wellbeing: Examination of symptom progression, usability, and acceptability after one month of use (Preprint). J Med Internet Res 2022; 24:e38497. [PMID: 36129745 PMCID: PMC9536518 DOI: 10.2196/38497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Shift is a novel smartphone app for providing a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioral modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues. Objective This study aimed to conduct a preliminary investigation of the use and potential effectiveness of Shift on depressive and anxiety symptoms (primary outcomes) and work and social functioning, COVID-19 safety concerns, and help seeking (secondary outcomes). This study also sought feedback on whether Shift was seen as an acceptable tool. Methods Junior doctors in New South Wales, Australia, were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided web-based baseline data, used the Shift app for 30 days, and were asked to complete a poststudy web-based questionnaire. Outcomes were analyzed under the intention-to-treat principle. Results A total of 222 female (n=156, 70.3%; mean age 29.2, SD 4.61 years) junior doctors provided full baseline data. Of these, 89.2% (198/222) downloaded the app, logged into the app approximately 6 times (mean 5.68, SD 7.51), completed 4 in-app activities (mean 3.77, SD 4.36), and spent a total of 1 hour on in-app activities (mean 52:23, SD 6:00:18) over 30 days. Postintervention and app use data were provided by 24.3% (54/222) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and postassessment points as expected; however, physicians’ COVID-19 safety concerns significantly increased. Work and social functioning, COVID-19 concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app use (number of log-ins, days between first and last log-in, and total activity time). Most poststudy completers (31/54, 57%) rated Shift highly or very highly. Conclusions Despite high levels of nonresponse to the poststudy assessment and increases in COVID-19 safety concerns, junior doctors who used the app reported some improvements in depression and anxiety, which warrant further exploration in a robust manner.
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Affiliation(s)
- Samineh Sanatkar
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | - Isabelle Counson
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | | | | | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
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Counson I, Bartholomew A, Crawford J, Petrie K, Basarkod G, Moynihan V, Pires J, Cohen R, Glozier N, Harvey S, Sanatkar S. Development of the Shift Smartphone App to Support the Emotional Well-Being of Junior Physicians: Design of a Prototype and Results of Usability and Acceptability Testing. JMIR Form Res 2021; 5:e26370. [PMID: 34860662 PMCID: PMC8686399 DOI: 10.2196/26370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/09/2021] [Accepted: 10/21/2021] [Indexed: 01/20/2023] Open
Abstract
Background Junior physicians report higher levels of psychological distress than senior doctors and report several barriers to seeking professional mental health support, including concerns about confidentiality and career progression. Mobile health (mHealth) apps may be utilized to help overcome these barriers to assist the emotional well-being of this population and encourage help-seeking. Objective This study describes the development and pilot trial of the Shift mHealth app to provide an unobtrusive avenue for junior physicians to seek information about, and help for, well-being and mental health concerns, which is sensitive to workplace settings. Methods A 4-phase iterative development process was undertaken to create the content and features of Shift involving junior physicians using the principles of user-centered design. These 4 phases were—needs assessment, on the basis of interviews with 12 junior physicians; prototype development with user experience feedback from 2 junior physicians; evaluation, consisting of a pilot trial with 22 junior physicians to assess the usability and acceptability of the initial prototype; and redesign, including user experience workshops with 51 junior physicians. Results Qualitative results informed the content and design of Shift to ensure that the app was tailored to junior physicians’ needs. The Shift app prototype contained cognitive behavioral, mindfulness, value-based actions, and psychoeducational modules, as well as a tracking function that visualized patterns of daily variations in mood and health behaviors. Pilot-testing revealed possible issues with the organization of the app content, which were addressed through a thorough restructuring and redesign of Shift with the help of junior physicians across 3 user experience workshops. Conclusions This study demonstrates the importance of ongoing end user involvement in the creation of a specialized mHealth app for a unique working population experiencing profession-specific stressors and barriers to help-seeking. The development and pilot trial of this novel Shift mHealth app are the first steps in addressing the mental health and support-seeking needs of junior physicians, although further research is required to validate its effectiveness and appropriateness on a larger scale.
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Affiliation(s)
- Isabelle Counson
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | | | - Joanna Crawford
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Katherine Petrie
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Geetanjali Basarkod
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, Australia
| | | | | | | | - Nicholas Glozier
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Samineh Sanatkar
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
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Grobman WA, Sandoval G, Reddy UM, Tita AT, Silver RM, Mallett G, Hill K, Rice MM, El-Sayed YY, Wapner RJ, Rouse DJ, Saade GR, Thorp JM, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA, Peaceman A, Plunkett B, Paycheck K, Dinsmoor M, Harris S, Sheppard J, Biggio J, Harper L, Longo S, Servay C, Varner M, Sowles A, Coleman K, Atkinson D, Stratford J, Dellermann S, Meadows C, Esplin S, Martin C, Peterson K, Stradling S, Willson C, Lyell D, Girsen A, Knapp R, Gyamfi C, Bousleiman S, Perez-Delboy A, Talucci M, Carmona V, Plante L, Tocci C, Leopanto B, Hoffman M, Dill-Grant L, Palomares K, Otarola S, Skupski D, Chan R, Allard D, Gelsomino T, Rousseau J, Beati L, Milano J, Werner E, Salazar A, Costantine M, Chiossi G, Pacheco L, Saad A, Munn M, Jain S, Clark S, Clark K, Boggess K, Timlin S, Eichelberger K, Moore A, Beamon C, Byers H, Ortiz F, Garcia L, Sibai B, Bartholomew A, Buhimschi C, Landon M, Johnson F, Webb L, McKenna D, Fennig K, Snow K, Habli M, McClellan M, Lindeman C, Dalton W, Hackney D, Cozart H, Mayle A, Mercer B, Moseley L, Gerald J, Fay-Randall L, Garcia M, Sias A, Price J, Hale K, Phipers J, Heyborne K, Craig J, Parry S, Sehdev H, Bishop T, Ferrara J, Bickus M, Caritis S, Thom E, Doherty L, de Voest J. Health resource utilization of labor induction versus expectant management. Am J Obstet Gynecol 2020; 222:369.e1-369.e11. [PMID: 31930993 DOI: 10.1016/j.ajog.2020.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization. OBJECTIVE The objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY DESIGN This is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management. We assessed resource utilization after randomization in 3 time periods: antepartum, delivery admission, and discharge through 8 weeks postpartum. RESULTS Of 6096 women with data available, those in the induction of labor group (n = 3059) were significantly less likely in the antepartum period after randomization to have at least 1 ambulatory visit for routine prenatal care (32.4% vs 68.4%), unanticipated care (0.5% vs 2.6%), or urgent care (16.2% vs 44.3%), or at least 1 antepartum hospitalization (0.8% vs 2.2%, P < .001 for all). They also had fewer tests (eg, sonograms, blood tests) and treatments (eg, antibiotics, intravenous hydration) prior to delivery. During the delivery admission, women in the induction of labor group spent a longer time in labor and delivery (median, 0.83 vs 0.57 days), but both women (P = .002) and their neonates (P < .001) had shorter postpartum stays. Women and neonates in both groups had similar frequencies of postpartum urgent care and hospital readmissions (P > .05 for all). CONCLUSION Women randomized to induction of labor had longer durations in labor and delivery but significantly fewer antepartum visits, tests, and treatments and shorter maternal and neonatal hospital durations after delivery. These results demonstrate that the health outcome advantages associated with induction of labor are gained without incurring uniformly greater health care resource use.
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Ploeg J, Sherifali D, Ali U, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, McAiney C. IMPACT OF INTERNET-BASED INTERVENTIONS ON MENTAL HEALTH OF CAREGIVERS OF ADULTS WITH CHRONIC CONDITIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - U Ali
- Department of Clinical Epidemiology and Biostatistics, McMaster University
| | | | | | | | | | - C McAiney
- Department of Psychiatry and Behavioural Neurosciences, McMaster University
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Markle-Reid M, Valaitis R, Archer N, Bartholomew A, Fisher K, Flek R, Gafni A, Ploeg J. ADVANCING TRANSITIONAL CARE FOR COMMUNITY-BASED ADULTS WITH STROKE AND MULTIPLE CHRONIC CONDITIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | | | - A Gafni
- Centre for Health Economics and Policy Analysis and Department of Health Research Methods, Evidence and Impact (HEI)
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Markle-Reid M, Ploeg J, Fraser K, Fisher K, Akhtar-Danesh N, Bartholomew A, Gafni A. ACHRU—COMMUNITY PARTNERSHIP PROGRAM FOR OLDER ADULTS WITH DIABETES AND MULTIMORBIDITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - J. Ploeg
- McMaster University, Hamilton, Ontario, Canada,
| | - K. Fraser
- University of Alberta, Edmonton, Ontario, Canada
| | - K. Fisher
- McMaster University, Hamilton, Ontario, Canada,
| | | | | | - A. Gafni
- McMaster University, Hamilton, Ontario, Canada,
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Abstract
The incidence of perinatal and neonatal Listeriosis is underestimated due undiagnosed stillbirths, misdiagnosis of NL and underreporting of single case reports. Recent outbreaks reinforce the need for better surveillance and targeted health education in certain population groups especially during pregnancy.
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Bartholomew A, Norman JF, Swindle J, Boswell A, Norman H. Aging and the use of implicit standards in the visual perception of length. J Vis 2010. [DOI: 10.1167/10.7.485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Carr R, Warren R, Towers L, Bartholomew A, Duggal HV, Rehman Y, Harrison TG, Olowokure B. Investigating a cluster of Legionnaires’ cases: Public health implications. Public Health 2010; 124:326-31. [PMID: 20483439 DOI: 10.1016/j.puhe.2010.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 02/04/2010] [Accepted: 03/02/2010] [Indexed: 11/18/2022]
Affiliation(s)
- R Carr
- Health Protection Agency, Shropshire and Staffordshire Health Protection Unit, Shropshire, UK
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Crabtree C, Norman JF, Bartholomew A, Ferrell E. Aging and the perception of slant from optical texture, motion parallax, and binocular disparity. J Vis 2010. [DOI: 10.1167/8.6.859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Norman JF, Bartholomew A. The effects of sex and age upon the perception of 3-D shape from deforming and static boundary contours. J Vis 2010. [DOI: 10.1167/8.6.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ge W, Jiang J, Baroja ML, Arp J, Zassoko R, Liu W, Bartholomew A, Garcia B, Wang H. Infusion of mesenchymal stem cells and rapamycin synergize to attenuate alloimmune responses and promote cardiac allograft tolerance. Am J Transplant 2009; 9:1760-72. [PMID: 19563344 DOI: 10.1111/j.1600-6143.2009.02721.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The inherent immunosuppressive properties and low immunogenicity of mesenchymal stems cells (MSCs) suggested their therapeutic potential in transplantation. We investigated whether MSCs could prolong allograft survival. Treatment involving infusion of MSCs into BALB/c recipients 24 hours after receiving a heart allograft from a C57BL/6 donor significantly abated rejection and doubled graft mean survival time compared to untreated recipients. Furthermore, combination therapy of MSCs and low-dose Rapamycin (Rapa) achieved long-term heart graft survival (>100 days) with normal histology. The treated recipients readily accepted donor skin grafts but rejected third-party skin grafts, indicating the establishment of tolerance. Tolerant recipients exhibited neither intragraft nor circulating antidonor antibodies, but demonstrated significantly high frequencies of both tolerogenic dendritic cells (Tol-DCs) and CD4(+)CD25(+)Foxp3(+)T cells in the spleens. Infusion of GFP(+)C57BL/6-MSCs in combination with Rapa revealed that the GFP-MSCs accumulated in the lymphoid organs and grafts of tolerant recipients. Thus, engraftment of infused MSCs within the recipient's lymphoid organs and allograft appeared to be instrumental in the induction of allograft-specific tolerance when administered in combination with a subtherapeutic dose of Rapamycin. This study supports the clinical applicability of MSCs in transplantation.
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Affiliation(s)
- W Ge
- Department of Surgery, The University of Western Ontario, London, Ontario, Canada
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Bartholomew A, Ascher N, Starzl T. Tribute: Dr. Olga Jonasson. Born in Peoria, Illinois, August 12, 1934. Died in Chicago, Illinois, August 30, 2006. Am J Transplant 2007; 7:1882-3. [PMID: 17578502 DOI: 10.1111/j.1600-6143.2007.01872.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- A Bartholomew
- Department of Surgery, University of Illinois at Chicago, USA
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Bartholomew A, Sher D, Sosler S, Stock W, Lazda V, Koshy M, Devine S, vanBesien K. Stem cell transplantation eliminates alloantibody in a highly sensitized patient. Transplantation 2001; 72:1653-5. [PMID: 11726826 DOI: 10.1097/00007890-200111270-00013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Highly sensitized patients are forced to stay on transplant waiting lists for many years and ultimately may never find a donor. Peripheral blood stem cell (PBSC) transplantation may provide a strategy to decrease host alloreactivity through the production of a chimeric state. We investigated alloreactivity and chimerism in a highly sensitized 40-year-old patient with sickle cell disease who underwent a nonradiation based conditioning regimen consisting of fludarabine, ATG, and high dose melphalan, for allogeneic stem cell transplant. Host monocytes and lymphocytes became donor in origin by day 14. PRA, initially 100% pretransplant, fell to 0 by day 263. Anti-red blood cells antibody became undetectable by day 152. The use of a new nonradiation-based conditioning regimen enabled successful engraftment of allogeneic donor PBSCs and the elimination of alloantibody. As new less toxic conditioning regimens are developed, PBSC transplantation might provide a new solution to allosensitization.
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Affiliation(s)
- A Bartholomew
- University of Illinois at Chicago Department of Surgery, Division of Transplantation (M/C 958), 840 South Wood Street, Chicago, IL 60612, USA
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Bartholomew A, Patil S, Mackay A, Nelson M, Buyaner D, Hardy W, Mosca J, Sturgeon C, Siatskas M, Mahmud N, Ferrer K, Deans R, Moseley A, Hoffman R, Devine SM. Baboon mesenchymal stem cells can be genetically modified to secrete human erythropoietin in vivo. Hum Gene Ther 2001; 12:1527-41. [PMID: 11506695 DOI: 10.1089/10430340152480258] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Human mesenchymal stem cells (MSCs) are capable of differentiating into multiple mesenchymal lineages including chondrocytes, osteocytes, adipocytes, and marrow stromal cells. Using a nonhuman primate model, we evaluated nonhuman primate MSCs as targets for gene therapy. Baboon MSCs (bMSCs) cultured from bone marrow aspirates appeared as a homogeneous population of spindle-shaped cells. bMSCs were capable of differentiating into adipocytes and osteocytes in vitro and chondrocytes in vivo. bMSCs were genetically modified with a bicistronic vector encoding the human erythropoietin (hEPO) gene and the green fluorescent protein (GFP) gene. Transduction efficiencies ranged from 72 to 99% after incubation of MSCs with retroviral supernatant. Transduced cells produced from 1.83 x 10(5) to 7.12 x 10(5) mIU of hEPO per 10(6) cells per 24 hr in vitro before implantation. To determine the capacity of bMSCs to express hEPO in vivo, transduced bMSCs were injected intramuscularly in NOD/SCID mice. In a separate experiment, transduced bMSCs were loaded into immunoisolatory devices (IIDs) and surgically implanted into either autologous or allogeneic baboon recipients. Human EPO was detected in the serum of NOD/SCID mice for up to 28 days and in the serum of five baboons for between 9 and 137 days. NOD/SCID mice experienced sharp rises in hematocrit after intramuscular injection of hEPO-transduced bMSCs. The baboon that expressed hEPO for 137 days experienced a statistically significant (p < 0.04) rise in its hematocrit. These data demonstrate that nonhuman primate MSCs can be engineered to deliver a secreted and biologically active gene product. Therefore, human MSCs may be an effective target for future human gene therapy trials.
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Affiliation(s)
- A Bartholomew
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
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van Besien K, Bartholomew A, Stock W, Peace D, Devine S, Sher D, Sosman J, Chen YH, Koshy M, Hoffman R. Fludarabine-based conditioning for allogeneic transplantation in adults with sickle cell disease. Bone Marrow Transplant 2000; 26:445-9. [PMID: 10982293 DOI: 10.1038/sj.bmt.1702518] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Although allogeneic transplantation can be curative for patients with sickle cell disease, the toxicity of conditioning regimens has precluded its use in adults with significant end-organ damage. Newer conditioning regimens have been developed that are less toxic and that may broaden the applicability of allogeneic transplantation in this disorder. We report two adults with end-stage sickle cell disease, who underwent allogeneic transplantation from an HLA-identical sibling donor after conditioning with fludarabine/melphalan and ATG. Both patients had been extensively transfused and one had multiple RBC antibodies. One of the patients also had end-stage renal disease, and was dialysis dependent. Engraftment occurred promptly in both patients. Both achieved 100% donor chimerism and both were free of pain crises after transplant. The first patient died of a respiratory failure related to chronic graft-versus-host disease (GVHD) on day 335 after transplantation. The second patient developed severe gastro-intestinal GVHD and TTP and died on day 147 after transplantation. Conditioning with fludarabine/melphalan and ATG followed by allogeneic stem cell transplantation resulted in prompt and reliable engraftment in adults with end-stage sickle cell disease. The incidence of severe GVHD was unacceptably high and may be related to the ethnicity of the patients or to the inflammatory state associated with pre-existing sickle cell disease.
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Affiliation(s)
- K van Besien
- Section of Hematology/Oncology University of Illinois College of Medicine, Chicago 60612, USA
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21
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Mahmud N, Devine S, Weller K, Bartholomew A, Hoffman R. Studies of quiescence of hematopoietic stem cells in non-human primates. Exp Hematol 2000. [DOI: 10.1016/s0301-472x(00)00270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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22
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Gojo S, Bartholomew A, Xu Y, Neethling FA, Awwad M, Saidman S, Cosimi AB, Cooper DK. Anti-Galalpha1-3Gal antibody levels in organ transplant recipients receiving immunosuppressive therapy. Transplantation 2000; 69:914-7. [PMID: 10755550 DOI: 10.1097/00007890-200003150-00042] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The effect of long-term pharmacologic immunosuppression (PI) on anti-Galalpha1-3Gal (alphaGal) antibody (Ab) levels has not been determined previously in humans. In this study, we measured alpha Gal Ab levels by ELISA in 14 healthy volunteers (controls) and in 70 patients with grafts (kidney, heart, liver) who had received different combinations of PI (including cyclosporine, tacrolimus, azathioprine, mycophenolate mofetil, and steroids) for >3 months. There was great variation in Gal IgM (<80-fold) and IgG (<160-fold). There was no difference in Gal IgM or Gal IgG between any one group and any other. In kidney patients with either high (mean 68%) or low (mean 6%) panel-reactive alloantibodies, there was no difference in alpha Gal Ab level or serum cytotoxicity to pig cells. In vitro immunoadsorption of alphaGal Ab from the serum did not change panel-reactive alloantibody positivity. Therapy with OKT3, a mouse product that might stimulate alphaGal Ab production, led to no significant change in patient Ab levels. We conclude that long-term (>3 months) PI does not reduce Gal Ab levels sufficiently to be of clinical value in xenotransplantation.
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Affiliation(s)
- S Gojo
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, USA
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23
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Kawai T, Poncelet A, Sachs DH, Mauiyyedi S, Boskovic S, Wee SL, Ko DS, Bartholomew A, Kimikawa M, Hong HZ, Abrahamian G, Colvin RB, Cosimi AB. Long-term outcome and alloantibody production in a non-myeloablative regimen for induction of renal allograft tolerance. Transplantation 1999; 68:1767-75. [PMID: 10609955 DOI: 10.1097/00007890-199912150-00022] [Citation(s) in RCA: 147] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Multilineage chimerism and long-term acceptance of renal allografts has been produced in non-human primates conditioned with a nonmyeloablative regimen. Our study was undertaken to evaluate the immunological and pathological status of long-term survivors and to define the role of splenectomy and of the primarily vascularized kidney in the regimen. METHOD Monkeys were treated with the basic regimen, including: total body irradiation, thymic irradiation, antithymocyte globulin, donor bone marrow transplantation, and a 4-week course of cyclosporine after which no further immunosuppression was given. They were divided into four groups according to the timing of kidney transplantation (KTx) and splenectomy as follows; group A (n=13): KTx and splenectomy on the day of donor bone marrow transplantation (day 0); group B (n=3): KTx on day 0 without splenectomy; group C (n=7): splenectomy on day 0 but delayed KTx until 3 to 16 weeks post-donor bone marrow transplantation; group D (n=3): both splenectomy and KTx delayed until day 120 post-donor bone marrow transplantation. RESULTS In group A, 11 of 13 monkeys developed chimerism and 9 monkeys achieved long-term survival of 4 to 70 months without evidence of chronic vascular rejection. Alloantibodies were detected in only one long-term survivor. In contrast, all three monkeys in group B developed alloantibodies and rejected their allografts. In group C, long-term survival without alloantibody production was observed in two of three monkeys that had developed chimerism. In group D, all three recipients were sensitized and rejected the kidney allografts rapidly after transplantation. CONCLUSIONS 1) Production of anti-donor antibody was prevented in most recipients that developed mixed chimerism in the regimens with splenectomy at the time of donor bone marrow transplantation. 2) If splenectomy is not included in the initial conditioning regimen, induction of B cell tolerance is less likely and the result is late onset of alloantibody production and allograft rejection. 3) Immediate transplantation of the kidney at the time of recipient conditioning is not essential for induction of donor specific hyporesponsiveness by bone marrow transplantation.
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Affiliation(s)
- T Kawai
- Department of Surgery, Harvard Medical School at Massachusetts General Hospital, Boston 02114, USA
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Medin JA, Brandt JE, Rozler E, Nelson M, Bartholomew A, Li C, Turian J, Chute J, Chung T, Hoffman R. Ex vivo expansion and genetic marking of primitive human and baboon hematopoietic cells. Ann N Y Acad Sci 1999; 872:233-40; discussion 240-2. [PMID: 10372126 DOI: 10.1111/j.1749-6632.1999.tb08468.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The achievement of positive outcomes in many clinical protocols involving hematopoietic stem cells (HSCs) has been handicapped by the limited numbers of marrow repopulating cells available to actually bring about therapy. This insufficiency has been especially problematic in stem cell transplantation and gene therapy. A number of studies have been initiated to attempt expansion of HSCs, mainly by manipulation of key cytokines in cell suspension cultures. Unfortunately, these expansion methods usually lead to altered properties in the amplified cells, mainly by reducing their self-renewal and multi-lineage differentiative potentials. Here we discuss our ongoing work, utilizing a unique endothelial cell line that supports primitive hematopoiesis, to attempt to generate expansion of primate HSCs that retain their elementary properties. Genetic marking of early hematopoietic cells to facilitate tracking will be mentioned as will the development and employment of assay systems designed to evaluate the long-term functional attributes of the expanded cells.
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Affiliation(s)
- J A Medin
- Section of Hematology/Oncology, University of Illinois at Chicago 60607-7173, USA
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25
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Benedetti E, Dunn T, Massad MG, Raofi V, Bartholomew A, Gruessner RW, Brecklin C. Successful living related simultaneous pancreas-kidney transplant between identical twins. Transplantation 1999; 67:915-8. [PMID: 10199743 DOI: 10.1097/00007890-199903270-00021] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Simultaneous pancreas-kidney transplant from living donors has been recently proposed as an effective therapeutic option in selected uremic patients with type I diabetes. We report the first simultaneous pancreas-kidney transplant performed between identical twins. Posttransplant, the recipient has been maintained on low dose cyclosporine to avoid recurrent auto-immune insulitis. At the 1-year follow-up, both donor and recipient are well with normal renal function and excellent glucose control. Simultaneous pancreas-kidney transplant between identical twins can be performed successfully using cyclosporine to prevent recurrent auto-immune insulitis.
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Affiliation(s)
- E Benedetti
- Department of Surgery, University of Illinois at Chicago, USA
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26
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Ko DS, Bartholomew A, Poncelet AJ, Sachs DH, Huang C, LeGuern A, Abraham KI, Colvin RB, Boskovic S, Hong HZ, Wee SL, Winn HJ, Cosimi AB. Demonstration of multilineage chimerism in a nonhuman primate concordant xenograft model. Xenotransplantation 1998; 5:298-304. [PMID: 9915258 DOI: 10.1111/j.1399-3089.1998.tb00041.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Prior studies from our laboratory have demonstrated that a nonmyeloablative conditioning regimen can induce transient mixed chimerism and renal allograft tolerance between MHC disparate cynomolgus monkeys. We have also shown that this preparative regimen can be extended to a concordant baboon to cynomolgus xenograft model by adding, to the post transplant protocol, therapy designed to prevent antibody production. Here we examine the use of brequinar (BQR) for this purpose and the efficacy of two new reagents developed to demonstrate the establishment of chimerism in the xenograft recipients. The cynomolgus recipients were conditioned with WBI (300 cGy), TI (700 cGy), ATG, cyclosporine, and brequinar sodium. To detect engraftment of the donor marrow, we prepared a polyclonal cynomolgus anti-baboon antibody (CABA) and a monoclonal antibody (215.1), which distinguish baboon and cynomolgus lymphocytes and granulocytes. We employed flow cytometry analysis to detect multilineage chimerism in the xenograft recipients. Five of the six recipients monitored using our new reagents (CABA and 215.1) developed detectable chimerism and only one of these animals lost its kidney to rejection. However, other complications have not permitted assessment of long-term outcome. The features of the multilineage chimerism included the detection of donor granulocytes (1.8-77.4%) and lymphocytes (2.4-22.2%) for 9 to 37 days. Our new reagents permit the detection of multilineage mixed chimerism, which may be a predictor of xenograft tolerance. We also conclude that brequinar may be effective in preventing antibody formation, but because of its toxicity, it is probably not the drug of choice for extension of the mixed chimerism protocol to concordant xenografts.
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Affiliation(s)
- D S Ko
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
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Bartholomew A, Latshaw D, Swayne DE. Changes in blood chemistry, hematology, and histology caused by a selenium/vitamin E deficiency and recovery in chicks. Biol Trace Elem Res 1998; 62:7-16. [PMID: 9630419 DOI: 10.1007/bf02820016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Exudative diathesis, a condition caused by a selenium (Se)/vitamin E deficiency, was studied in chicks. Trios of chicks that showed clinical signs of exudative diathesis were matched for severity. One was injected subcutaneously with 0.5 mL distilled water, and the other two received 15 microg of Se in 0.5 mL distilled water. A chick fed a diet with supplemental Se also received 0.5 mL distilled water. Blood was collected from three chicks 2 d after injection, and from the other chick, 6 d after injection. After blood was collected, pectoral muscle and bone marrow were collected. Deficient chicks showed varying degrees of necrosis in pectoral muscle, whereas recovering chicks had extensive fibrosis in pectoral muscle. An analysis of blood showed differences in CO2, glucose, Se, glutathione peroxidase, alanine aminotransferase, aspartate aminotransferase, and creatine kinase. Heterophils and monocytes were increased in deficient chicks; lymphocytes, basophils, and hemoglobin decreased. After 6 d of recovery, all of the changes noted above were correcting toward normal. Eosinophils, in contrast, were unaffected by a deficiency, but increased in recovering chicks. It is hypothesized that cytokines associated with the inflammatory response accentuate the clinical signs of exudative diathesis.
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Affiliation(s)
- A Bartholomew
- Department of Animal Sciences, Ohio State University, Columbus 43210, USA
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Hoffman R, Rozler E, Chute J, Nelson M, Chen L, Turian J, Bartholomew A, Brandt JE. Ex vivo expansion of human hematopoietic stem cells: implications for the modern blood bank. Vox Sang 1998; 74 Suppl 2:259-64. [PMID: 9704454 DOI: 10.1111/j.1423-0410.1998.tb05429.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pluripotent hematopoietic stem cells (PHSC) are rare cells within the marrow that are capable of self-renewal and differentiation into multiple hematopoietic lineages. Following myeloablative chemotherapy and radiation therapy and marrow transplantation, hematological reconstitution occurs after a period of 2-3 weeks. Recently, a number of laboratories have shown that both early and delayed phases of engraftment are mediated by PHSC within a graft and that engraftment can be accelerated by transplanting greater numbers of PHSC. Increasing efforts have been directed, therefore, towards developing methods to expand PHSC ex vivo. In this report, we describe an endothelial cell-based culture system to which exogenous cytokines are added which appears to permit the ex vivo expansion of PHSC. Refinement of these technologies will potentially have a major impact on the ability of blood banks to improve the quality of hematopoietic stem cell grafts.
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Affiliation(s)
- R Hoffman
- Hematology/Oncology Section, University of Illinois at Chicago 60607, USA.
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Kimikawa M, Sachs DH, Colvin RB, Bartholomew A, Kawai T, Cosimi AB. Modifications of the conditioning regimen for achieving mixed chimerism and donor-specific tolerance in cynomolgus monkeys. Transplantation 1997; 64:709-16. [PMID: 9311707 DOI: 10.1097/00007890-199709150-00008] [Citation(s) in RCA: 164] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND We demonstrated previously that a nonmyeloablative preparative regimen can induce mixed chimerism and allograft tolerance in cynomolgus monkeys. METHODS The current studies were designed to clarify the importance and toxicity of various elements of the allotolerance conditioning regimen by: fractionating or reducing the whole-body irradiation (WBI) dosage; adding deoxyspergualine; or deleting donor bone marrow, cyclosporine, irradiation, or splenectomy. RESULTS Monkeys treated without donor bone marrow, cyclosporine, or irradiation did not develop chimerism or long-term allograft survival. One of three monkeys treated without splenectomy developed chimerism but died of a surgical complication. The other two did not develop chimerism and rejected by day 117. Six of six monkeys treated with 300 cGy of fractionated WBI developed chimerism. Five of these recipients had long-term graft survival. Only two of four monkeys treated with 250 cGy developed chimerism, so a 2-week course of deoxyspergualine was added. This led to chimerism in two monkeys, but one died of ureteral stenosis and the other died of allograft rejection. An unanticipated high incidence of ureteral complications felt to be secondary to rejection episodes and ischemic injury was observed in the long-term surviving animals. CONCLUSIONS All parameters of the original preparative regimen seem to be essential for consistent success. The degree of lymphocyte depletion was proportional to the WBI dose. Long-term graft survival was observed only in recipients achieving lymphocyte chimerism of > 1.5%. In this model, lymphocyte depletion seems to be the best predictor of chimerism, and significant lymphocyte chimerism seems to be important in achieving tolerance.
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Affiliation(s)
- M Kimikawa
- Transplantation Unit, Massachusetts General Hospital, Boston 02114, USA
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Kimikawa M, Kawai T, Sachs DH, Colvin RB, Bartholomew A, Cosimi AB. Mixed chimerism and transplantation tolerance induced by a nonlethal preparative regimen in cynomolgus monkeys. Transplant Proc 1997; 29:1218. [PMID: 9123281 DOI: 10.1016/s0041-1345(96)00642-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M Kimikawa
- Massachusetts General Hospital, Boston, USA
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31
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Bartholomew A, Latinne D, Sachs D, Arn JS, Gianello P, Bruyere ML, Sokal G, Squifflet J, Alexandre G, Comerford C, Saidman S, Cosimi A. Utility of xenografts: Lack of correlation between PRA and natural antibodies to swine. Xenotransplantation 1997. [DOI: 10.1111/j.1399-3089.1997.tb00162.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Powelson J, Bailin M, Bartholomew A, Boskebick S, Colvin R, Hong HZ, Johnson M, Kimikawa M, Sablinski T, Wee SL, Sachs D, Cosimi AB. A mixed chimerism approach to renal transplantation between concordant nonhuman primate species. Transplant Proc 1996; 28:761. [PMID: 8623387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- J Powelson
- Massachusetts General Hospital, Boston 02114, USA
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Bartholomew A, Sawyer WT, Coats L. Task analysis of Air Force pharmacy practice. Am J Health Syst Pharm 1995; 52:174-83. [PMID: 12879544 DOI: 10.1093/ajhp/52.2.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The frequency with which United States Air Force pharmacists perform specific professional tasks and the pharmacists' views as to the importance of those tasks were studied. A questionnaire was prepared that asked recipients to rate each of 36 tasks selected as representing the spectrum of practice activities. There were four categories of tasks: managerial tasks, dispensing tasks, drug information tasks, and patient care tasks. Recipients rated the tasks with respect to frequency of performance and importance on separate 6-point scales. The questionnaire was mailed in May 1991 to the 225 pharmacists then serving in the Air Force worldwide. Of the 225 questionnaires, 150 usable questionnaires were returned (response rate, 67%). All the tasks in the survey were performed by at least one Air Force pharmacy officer, although the frequency of task performance varied. In particular, the frequency of many patient care tasks was low. All the tasks were perceived to have some importance, but drug information tasks were rated as being significantly more important than tasks in the other categories; patient care tasks were rated lowest in importance. The results varied with the respondents' demographic characteristics. Pharmacy officers with more years of service, more senior positions, higher rank, or an advanced degree in a field other than pharmacy tended to give responses that diverged from those of the population. A 1991 survey showed an awareness among Air Force pharmacists of the need to orient practice around patient care; however, they were not spending substantial time on patient care and tended to view it as less important than more traditional pharmacy tasks.
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Affiliation(s)
- A Bartholomew
- Department of Pharmacy, 1st Medical Group, Langley Air Force Base, 45 Pine Street, Langley Air Force Base, Langley, VA 23665, USA
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Bartholomew A. Psychiatry and the concept of evil. Br J Psychiatry 1995; 166:113; author reply 116-7. [PMID: 7741922 DOI: 10.1192/bjp.166.1.113a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Bartholomew A. Video tape and patients' rights. Aust N Z J Psychiatry 1994; 28:524-6. [PMID: 7893250 DOI: 10.3109/00048679409075883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Wang J, Pollak R, Bartholomew A. Sustained reduction of serum cholesterol levels following allo-transplantation of parenchymal hepatocytes in Watanabe rabbits. Transplant Proc 1991; 23:894-5. [PMID: 1990718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- J Wang
- Department of Surgery, University of Illinois, Chicago 60680
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