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Moore Simas TA, Whelan A, Byatt N. Screening Recommendations and Treatments for Postpartum Depression-Reply. JAMA 2024; 331:1154. [PMID: 38563838 DOI: 10.1001/jama.2024.1634] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester
| | - Anna Whelan
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester
| | - Nancy Byatt
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester
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Moore Simas TA, Whelan A, Byatt N. Postpartum Depression-New Screening Recommendations and Treatments. JAMA 2023; 330:2295-2296. [PMID: 38010647 DOI: 10.1001/jama.2023.21311] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
This Insights in the Women’s Health series describes perinatal depression (occurring prepregnancy through postpartum periods) and new recommendations and treatment guidelines for this condition.
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Affiliation(s)
- Tiffany A Moore Simas
- University of Massachusetts Chan Medical School, Worcester
- UMass Memorial Health, Worcester, Massachusetts
| | - Anna Whelan
- University of Massachusetts Chan Medical School, Worcester
- UMass Memorial Health, Worcester, Massachusetts
| | - Nancy Byatt
- University of Massachusetts Chan Medical School, Worcester
- UMass Memorial Health, Worcester, Massachusetts
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Whelan A, Ho Z, Rasiah SS, Brown BP. Immediate Postpartum Long-acting Reversible Contraceptives (LARC) Among Low- versus High-Risk Obstetric Populations. R I Med J (2013) 2023; 106:26-28. [PMID: 37643338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Anna Whelan
- Division of Maternal-Fetal Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI
| | - Zandra Ho
- Department of Medical Education, Alpert Medical School of Brown University, Providence, RI
| | - Stephen S Rasiah
- Division of Maternal-Fetal Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI
| | - Benjamin P Brown
- Division of Maternal-Fetal Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI
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Kumar R, Dada TK, Whelan A, Cannon P, Sheehan M, Reeves L, Antunes E. Microbial and thermal treatment techniques for degradation of PFAS in biosolids: A focus on degradation mechanisms and pathways. J Hazard Mater 2023; 452:131212. [PMID: 36934630 DOI: 10.1016/j.jhazmat.2023.131212] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 05/03/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are persistent organic chemicals detected in biosolids worldwide, which have become a significant concern for biosolids applications due to their increasing environmental risks. Hence, it is pivotal to understand the magnitude of PFAS contamination in biosolids and implement effective technologies to reduce their contamination and prevent hazardous aftermaths. Thermal techniques such as pyrolysis, incineration and gasification, and biodegradation have been regarded as impactful solutions to degrade PFAS and transform biosolids into value-added products like biochar. These techniques can mineralize PFAS compounds under specific operating parameters, which can lead to unique degradation mechanisms and pathways. Understanding PFAS degradation mechanisms can pave the way to design the technology and to optimize the process conditions. Therefore, in this review, we aim to review and compare PFAS degradation mechanisms in thermal treatment like pyrolysis, incineration, gasification, smouldering combustion, hydrothermal liquefaction (HTL), and biodegradation. For instance, in biodegradation of perfluorooctane sulfonic acid (PFOS), firstly C-S bond cleavage occurs which is followed by hydroxylation, decarboxylation and defluorination reactions to form perfluoroheptanoic acid. In HTL, PFOS degradation is carried through OH-catalyzed series of nucleophilic substitution and decarboxylation reactions. In contrast, thermal PFOS degradation involves a three-step random-chain scission pathway. The first step includes C-S bond cleavage, followed by defluorination of perfluoroalkyl radical, and radical chain propagation reactions. Finally, the termination of chain propagation reactions produces very short-fluorinated units. We also highlighted important policies and strategies employed worldwide to curb PFAS contamination in biosolids.
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Affiliation(s)
- Ravinder Kumar
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Tewodros Kassa Dada
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Anna Whelan
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia; Townsville City Council, Wastewater Operations, Townsville, QLD 4810, Australia
| | | | - Madoc Sheehan
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Louise Reeves
- Queensland Water Directorate, Brisbane, QLD 4009, Australia
| | - Elsa Antunes
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia.
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Kumar R, Whelan A, Cannon P, Sheehan M, Reeves L, Antunes E. Occurrence of emerging contaminants in biosolids in northern Queensland, Australia. Environ Pollut 2023; 330:121786. [PMID: 37156436 DOI: 10.1016/j.envpol.2023.121786] [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] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/10/2023]
Abstract
This study aims to identify and quantify different classes of emerging contaminants (ECs), such as pharmaceutical and personal care products (PPCPs), per-and polyfluoroalkyl substances (PFAS), heavy metals (HMs), polycyclic musks (PMs) in biosolids from different sewage treatment plants (STPs) from regional councils across Northern Queensland, Australia. Biosolids samples were named BS1 to BS7 for each council. The results revealed significant variations in the concentrations of different ECs in biosolids which could be explained in some instances by the characteristics of the upstream sewage network. For instance, BS4-biosolids from a small agricultural shire (largely sugarcane) showed the highest concentration of zinc and copper, which were 2430 and 1050 mg/kg, respectively. Among PPCPs, the concentration of ciprofloxacin was found to be the highest in BS3 and BS5, two large regional council areas which are a mix of domestic and industrial (predominantly domestic) biosolids of 1010 and 1590 ng/g, respectively. In addition, the quantity of sertraline was consistently high in all biosolids except from BS7, one of the smaller regional councils, which is indicative of the domestic catchments attached. PFAS compounds were detected in all biosolids samples except in BS6, one of the small (agricultural and tourist) catchments. Two PFAS compounds emerged as the most common pollutants that were perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). The largest industrial catchment biosolids, BS2 showed the highest concentration of PFOS at 253 ng/g, while the smallest regional council, BS7 showed the maximum concentration of 7.90 ng/g of PFOA. Overall, this study concludes that certain ECs such as HMs, antibiotics, PFOS and PFOA in biosolids may pose high environmental risks.
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Affiliation(s)
- Ravinder Kumar
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Anna Whelan
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia; Townsville City Council, Wastewater Operations, Townsville, QLD, 4810, Australia
| | | | - Madoc Sheehan
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Louise Reeves
- Queensland Water Directorate, Brisbane, QLD, 4009, Australia
| | - Elsa Antunes
- College of Science & Engineering, James Cook University, Townsville, QLD 4811, Australia.
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6
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Whelan A, Recabo O, Clark MA, Lewkowitz AK, Ayala NK. Understanding patient experience following unplanned operative delivery. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.751] [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: 01/09/2023]
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Cheng C, Byrne JJ, Hernandez BS, Michalek JE, Pierce CM, Martinez M, Whelan A, Kerns JL, Ramsey PS, Premkumar A. Fellow perspectives of abortion-related training in maternal-fetal medicine fellowship: Regional differences in a post-Roe world. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.220] [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: 01/09/2023]
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Polnaszek B, Whelan A, Recabo O, Rossen J, Lewkowitz AK, Ayala NK. Patient’s Perception of control: Does the presence of internal or external fetal monitoring matter intrapartum? Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.217] [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: 01/09/2023]
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Soehl JR, Whelan A, Smith MM, Savitz DA, Esposito MA, Lord MG. Fetal abdominal adiposity score and the prediction of large for gestational age infants. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.587] [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: 01/09/2023]
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10
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Young A, Rasiah SS, Recabo O, Ayala NK, Lewkowitz AK, Whelan A. Patient race and experience of control over labor. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.743] [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: 01/09/2023]
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Soehl JR, Whelan A, Murphy L, Savitz DA, Esposito MA, Lord MG. Disproportionate fetal abdominal growth and risk of neonatal hypoglycemia in pregnancies with fetal growth restriction. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.1119] [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: 01/09/2023]
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12
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Lewkowitz AK, Allen E, Sakowicz A, Ayala NK, Whelan A, Battle CL, Miller ES. Association between potentially traumatic birthing experience and worsening postpartum depression or anxiety trajectories. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.175] [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: 01/09/2023]
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13
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Whelan A, Ho ZV, Rasiah SS, Brown B. Immediate postpartum LARC use in a low versus high-risk academic practice. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.1031] [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: 01/08/2023]
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14
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Whelan A, Murphy R, Shiel E, Griffith V, Mannion K, Neachtain MN, Mannion E, Conry M, Geoghegan J, Waters R, O'Donnell M, Robinson S, Canavan M. 355 PREDICTORS OF HOME SUPPORT SERVICES AND THE CONSEQUENCES OF MISMATCH BETWEEN ALLOCATED AND RECEIVED SERVICES IN COGNITIVELY-IMPAIRED OLDER ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.312] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Home support services aim to support older people to remain at home. Despite substantial investment in home support hours (€600 million), this has not translated into increased carers on the ground for older people. We aimed to report patterns of home support service utilisation in older patients with memory problems, and identify any mis-matches between allocated and received hours, and the impact on patients and caregivers.
Methods
Retrospective analysis of consecutive patients referred to community geriatric clinic from January 2021 to May 2022. 95/104 patients who were identified were suitable for inclusion.
Results
Participants had a median age of 82 (IQR 78-86) of whom 57% were female (n=54). 80% (n=76) were frail (CFS ≥4), with 82% dependent for IADLs (Lawton-Brody IADL Scale ≤6). Median MOCA score was 18, with 44% having moderate to severe cognitive impairment (MOCA ≤17). 40% of patients lived with alone (n=38). 52% (n=49) received formal home supports while 80% (n=76) had an informal carer. 37% (n=18) had a mismatch between hours allocated and hours received. There was a significant difference between median hours of care allocated (7) and median hours of care received (5), p <0.001. Increasing age and frailty, worsening cognitive and functional impairment and living status (living alone) predicted allocation of home supports. Patients who lived with family members were 3 times more likely not to receive allocated hours (OR 3.84 (95% CI 1.2–13.7))
Conclusion
In this vulnerable population with cognitive and functional decline, just over half received formal home support hours. A large proportion experienced significant mismatch between allocated and received hours. Family and informal caregivers often have to fill gaps, adding to existing carer strain. Future models of home support should prioritise early intervention for people with IADL loss to remain independent at home and broaden of the scope of practice of carers to facilitate this.
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Affiliation(s)
- A Whelan
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
| | - R Murphy
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- School of Medicine, National University of Ireland, Galway , Galway, Ireland
| | - E Shiel
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- University Hospital Galway Department of Nursing, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - V Griffith
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
| | - K Mannion
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- University Hospital Galway Department of Nursing, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - M Ní Neachtain
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- University Hospital Galway Department of Nursing, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - E Mannion
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- University Hospital Galway Department of Nursing, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - M Conry
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
- University Hospital Galway Department of Social Work, , Galway, Ireland
| | - J Geoghegan
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - R Waters
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - M O'Donnell
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - S Robinson
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
| | - M Canavan
- University Hospital Galway Department of Geriatric and Stroke Medicine, , Galway, Ireland
- Galway Integrated Care Team, Community Healthcare West , Galway, Ireland
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Thomas HM, Runions KC, Lester L, Lombardi K, Epstein M, Mandzufas J, Barrow T, Ang S, Leahy A, Mullane M, Whelan A, Coffin J, Mitrou F, Zubrick SR, Bowen AC, Gething PW, Cross D. Western Australian adolescent emotional wellbeing during the COVID-19 pandemic in 2020. Child Adolesc Psychiatry Ment Health 2022; 16:4. [PMID: 35027061 PMCID: PMC8756750 DOI: 10.1186/s13034-021-00433-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/13/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family's financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic. METHODS We report on data from 32,849 surveys from Year 7-12 students in 40 schools over two 2020 survey cycles (June/July: 19,240; October: 13,609), drawn from a study of 79 primary and secondary schools across Western Australia, Australia. The Child Health Utility Index (CHU9D) was used to measure difficulties and distress in responding secondary school students only. Using comparable Australian data collected six years prior to the pandemic, the CHU9D was calibrated against the Kessler-10 to establish a reliable threshold for CHU9D-rated distress. RESULTS Compared to 14% of responding 12-18-year-olds in 2013/2014, in both 2020 survey cycles almost 40% of secondary students returned a CHU9D score above a threshold indicative of elevated difficulties and distress. Student distress increased significantly between June and October 2020. Female students, those in older Grades, those with few friendships or perceived poor quality friendships, and those with poor connectedness to school were more likely to score above the threshold. CONCLUSIONS In a large dataset collected during the first year of the COVID-19 pandemic, the proportion of secondary school students with scores indicative of difficulties and distress was substantially higher than a 2013/2014 benchmark, and distress increased as the pandemic progressed, despite the low local prevalence of COVID-19. This may indicate a general decline in social and emotional wellbeing exacerbated by the events of the pandemic. TRIAL REGISTRATION ANZCTRN (ACTRN12620000922976). Retrospectively registered 17/08/2020. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380429&isReview=true .
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Affiliation(s)
- H. M. Thomas
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - K. C. Runions
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - L. Lester
- grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
| | - K. Lombardi
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1038.a0000 0004 0389 4302Edith Cowan University, Perth, Australia
| | - M. Epstein
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - J. Mandzufas
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - T. Barrow
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - S. Ang
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. Leahy
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - M. Mullane
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. Whelan
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - J. Coffin
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
| | - F. Mitrou
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - S. R. Zubrick
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. C. Bowen
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia ,grid.410667.20000 0004 0625 8600Perth Children’s Hospital, Perth, Australia
| | - P. W. Gething
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1032.00000 0004 0375 4078Curtin University, Perth, Australia
| | - D. Cross
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
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16
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Othman F, Doost A, Marangou J, Whelan A, Rankin J, Ihdayhid A. Local Experience Using Intravascular Lithotripsy Treatment for Severe Calcific Coronary Disease in Acute Coronary Syndrome. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.602] [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: 10/16/2022]
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17
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Whelan A, Esposito MA, Lord MG. Impact of maternal obesity on neonatal outcomes of pregnancies complicated by fetal growth restriction. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.939] [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: 11/25/2022]
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18
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Campbell AJ, Dotel R, Braddick M, Britton PN, Eisen DP, Francis JR, Lynar S, McMullan B, Meagher N, Nelson J, O’Sullivan MVN, Price DJ, Robinson JO, Whelan A, Tong SYC, Bowen AC, Davis JS. OUP accepted manuscript. JAC Antimicrob Resist 2022; 4:dlac014. [PMID: 35237755 PMCID: PMC8884362 DOI: 10.1093/jacamr/dlac014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Combination antibiotic therapy with an antitoxin agent, such as clindamycin, is included in some guidelines for severe, toxin-mediated Staphylococcus aureus infections. The evidence to support this practice is currently limited to in vitro, animal and observational human case-series data, with no previous randomized controlled trials (RCTs). Objectives This pilot RCT aimed to determine the feasibility of conducting a clinical trial to examine if adjunctive clindamycin with standard therapy has greater efficacy than standard therapy alone for S. aureus infections. Methods We performed an investigator-initiated, open-label, multicentre, pilot RCT (ACTRN12617001416381p) in adults and children with severe S. aureus infections, randomized to standard antibiotic therapy with or without clindamycin for 7 days. Results Over 28 months, across nine sites, 127 individuals were screened and 34 randomized, including 11 children (32%). The primary outcome—number of days alive and free of systemic inflammatory response syndrome ≤14 days—was similar between groups: clindamycin (3 days [IQR 1–6]) versus standard therapy (4 days [IQR 0–8]). The 90 day mortality was 0% (0/17) in the clindamycin group versus 24% (4/17) in the standard therapy group. Secondary outcomes—microbiological relapse, treatment failure or diarrhoea—were similar between groups. Conclusions As the first clinical trial assessing adjunctive clindamycin for S. aureus infections, this study indicates feasibility and that adults and children can be incorporated into one trial using harmonized endpoints, and there were no safety concerns. The CASSETTE trial will inform the definitive S. aureus Network Adaptive Platform (SNAP) trial, which includes an adjunctive clindamycin domain and participants with non-severe disease.
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Affiliation(s)
- A. J. Campbell
- Department of Infectious Diseases, Perth Children’s Hospital, Perth, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- School of Medicine, University of Western Australia, Perth, Australia
- Corresponding author. E-mail:
| | - R. Dotel
- Department of Infectious Diseases, Blacktown Hospital, Sydney, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, University of Sydney, Sydney, Australia
| | - M. Braddick
- Department of Infectious Diseases, Townsville University Hospital, Townsville, Queensland, Australia
| | - P. N. Britton
- Department of Infectious Diseases and Microbiology, Children’s Hospital Westmead, Sydney, Australia
- University of Sydney, Discipline of Child and Adolescent Health, Sydney Medical School, Sydney, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - D. P. Eisen
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - J. R. Francis
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
- Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia
| | - S. Lynar
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
- Infectious Diseases, Royal Darwin Hospital, Northern Territory, Australia
| | - B. McMullan
- Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, Sydney, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
- National Centre for Infections in Cancer, University of Melbourne, Melbourne, Australia
| | - N. Meagher
- Department of Infectious Diseases, Doherty Institute for Infection & Immunity, The University of Melbourne & Royal Melbourne Hospital, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia
| | - J. Nelson
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - M. V. N. O’Sullivan
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, University of Sydney, Sydney, Australia
- New South Wales Health Pathology, Newcastle, Australia
| | - D. J. Price
- Department of Infectious Diseases, Doherty Institute for Infection & Immunity, The University of Melbourne & Royal Melbourne Hospital, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia
| | - J. O. Robinson
- Department of Infectious Diseases, Royal Perth Hospital, Perth, Australia
- Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Australia
- Department of Microbiology, Pathwest Laboratory Medicine, Perth, Australia
- College of Science, Health, Engineering and Education, Discipline of Health, Murdoch University, Perth, Australia
| | - A. Whelan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - S. Y. C. Tong
- Department of Infectious Diseases, Doherty Institute for Infection & Immunity, The University of Melbourne & Royal Melbourne Hospital, Melbourne, Australia
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - A. C. Bowen
- Department of Infectious Diseases, Perth Children’s Hospital, Perth, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- School of Medicine, University of Western Australia, Perth, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - J. S. Davis
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
- John Hunter Hospital, University of Newcastle, Newcastle, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Whelan A, Doyle P, Ryan C, Kaur I, Mulroy M. 125 WARD-BASED MEDICAL TEAMS: IMPACT ON THE CARE OF THE OLDER PERSON WARD. Age Ageing 2021. [PMCID: PMC8690061 DOI: 10.1093/ageing/afab219.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The COVID-19 pandemic forced healthcare management to make structural adaptations in the interest of infection control. One such adaptation is the introduction of ward-based medical teams. The multidisciplinary team (MDT) is one of the cornerstones of geriatric medicine. Therefore, we aimed to explore the perception of the care of the older person MDT on the introduction of ward-based medical teams. Methods Qualitative data was collected on a geriatric ward in October 2020 via written questionnaire. The questionnaire analysed how the transition to ward based medical teams was perceived in terms of inter-professional collaboration and clinical service delivered to patients. Results There were 14 respondents, 10 of whom were nursing staff (71%). 86% strongly agreed that the medical team was more accessible, with most interactions occurring face-to-face. Patient care and safety was thought to have improved, 79% and 71% of respondents respectively. 93% felt they had a better rapport with the medical team. 71% felt the MDT meeting is more effective, 57% believed the meeting had greater impact on patient care. However, 93% felt there was less workspace. 21% believed there were more daily admissions and 57% felt the majority of patient transfers from other wards were inappropriate. Overall 86% favoured ward-based medical teams, with 57% of staff reporting that the change led to increased personal job satisfaction. Conclusion By increasing the geographic proximity of doctors to other professionals, doctors were more accessible, issues were tackled quicker, and there was less time wasted bleeping medical teams. Overall staff favoured a ward-based system. However, there are challenges implementing this system. Particular attention should be paid to the availability of adequate workspace, including telephones and computers. Ward transfers should be minimized as continuity of care can be compromised. Strategies should be implemented so medical charts are available to the MDT during consultant-led ward rounds.
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Affiliation(s)
- A Whelan
- Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - P Doyle
- Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - C Ryan
- Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - I Kaur
- Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - M Mulroy
- Our Lady of Lourdes Hospital, Drogheda, Ireland
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20
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Tempest N, Hill CJ, Whelan A, De Silva A, Drakeley AJ, Phelan MM, Hapangama DK. Symptomatology and Serum Nuclear Magnetic Resonance Metabolomics; Do They Predict Endometriosis in Fertile Women Undergoing Laparoscopic Sterilisation? A Prospective Cross-sectional Study. Reprod Sci 2021; 28:3480-3490. [PMID: 34524640 PMCID: PMC8580895 DOI: 10.1007/s43032-021-00725-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
Endometriosis is a common, chronic inflammatory condition, thought to have a higher incidence in symptomatic women, yet, commonly associated symptoms do not always correlate with the presence or severity of disease and diagnosis requires surgery. We prospectively collected data and assessed symptomology and NMR spectroscopy-based metabolomics of 102 women undergoing laparoscopic sterilisation at a tertiary referral centre in a cross-sectional study. Twelve women were incidentally diagnosed with endometriosis (11.7%). According to the pre-operative questionnaire, presence and absence of many symptoms usually attributed to endometriosis were declared at similar frequencies in women with or without endometriosis. Women with endometriosis reported apparently more persistent heavy periods (50% vs 18.9%), prolonged periods (25% versus 7.8%) and problems conceiving (27.3% versus 9%) than those without endometriosis. NMR could not discern any distinguishable differences in the serum metabolome between those with and without endometriosis. Our paper highlights the complex symptomology experienced by women, regardless of a surgical diagnosis of endometriosis. Previous literature and the current study failed to identify clear, distinguishable symptoms or biomarkers pertinent to surgically confirmed endometriosis in the general population. Therefore, development of effective, non-invasive tests for identifying this heterogenous benign condition, endometriosis, is likely to be challenging.
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Affiliation(s)
- Nicola Tempest
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University Department, Liverpool Women's Hospital, University of Liverpool, Member of Liverpool Health Partners, Crown Street, Liverpool, L8 7SS, UK. .,Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK. .,Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital NHS Foundation Trust, Liverpool, L8 7SS, UK.
| | - C J Hill
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University Department, Liverpool Women's Hospital, University of Liverpool, Member of Liverpool Health Partners, Crown Street, Liverpool, L8 7SS, UK
| | - A Whelan
- Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - A De Silva
- Department of Obstetrics, Gynaecology and Women's Health, University of Otago, 23A Mein Street, Newtown, Wellington, 6021, New Zealand
| | - A J Drakeley
- Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital NHS Foundation Trust, Liverpool, L8 7SS, UK
| | - M M Phelan
- HLS Technology Directorate, University of Liverpool, Liverpool, L69 3BX, UK.,Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - D K Hapangama
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University Department, Liverpool Women's Hospital, University of Liverpool, Member of Liverpool Health Partners, Crown Street, Liverpool, L8 7SS, UK.,Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
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21
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Drane K, Huerlimann R, Power M, Whelan A, Ariel E, Sheehan M, Kinobe R. Testudines as Sentinels for Monitoring the Dissemination of Antibiotic Resistance in Marine Environments: An Integrative Review. Antibiotics (Basel) 2021; 10:antibiotics10070775. [PMID: 34202175 PMCID: PMC8300651 DOI: 10.3390/antibiotics10070775] [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: 05/28/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/12/2022] Open
Abstract
Dissemination of antibiotic resistance (AR) in marine environments is a global concern with a propensity to affect public health and many ecosystems worldwide. We evaluated the use of sea turtles as sentinel species for monitoring AR in marine environments. In this field, antibiotic-resistant bacteria have been commonly identified by using standard culture and sensitivity tests, leading to an overrepresentation of specific, culturable bacterial classes in the available literature. AR was detected against all major antibiotic classes, but the highest cumulative global frequency of resistance in all represented geographical sites was against the beta-lactam class by a two-fold difference compared to all other antibiotics. Wastewater facilities and turtle rehabilitation centres were associated with higher incidences of multidrug-resistant bacteria (MDRB) accounting for an average of 58% and 49% of resistant isolates, respectively. Furthermore, a relatively similar prevalence of MDRB was seen in all studied locations. These data suggest that anthropogenically driven selection pressures for the development of AR in sea turtles and marine environments are relatively similar worldwide. There is a need, however, to establish direct demonstrable associations between AR in sea turtles in their respective marine environments with wastewater facilities and other anthropogenic activities worldwide.
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Affiliation(s)
- Kezia Drane
- Centre for Molecular Therapeutics, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
- Correspondence: (K.D.); (R.K.); Tel.: +61-0747814061 (R.K.)
| | - Roger Huerlimann
- Centre for Sustainable Tropical Fisheries and Aquaculture, Centre for Tropical Bioinformatics and Molecular Biology, College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia;
| | - Michelle Power
- Department of Biological Sciences, Macquarie University, Sydney, NSW 2109, Australia;
| | - Anna Whelan
- Townsville Water and Waste, Wastewater Operations, Townsville, QLD 4810, Australia;
| | - Ellen Ariel
- Centre for Molecular Therapeutics, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
| | - Madoc Sheehan
- College of Science, Technology and Engineering, James Cook University, Townsville, QLD 4811, Australia;
| | - Robert Kinobe
- Centre for Molecular Therapeutics, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
- Correspondence: (K.D.); (R.K.); Tel.: +61-0747814061 (R.K.)
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22
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Walsh NM, O’Brien EC, Geraghty AA, Byrne DF, Whelan A, Reilly S, Murray S, Reilly C, Adams E, Farnan PM, McAuliffe FM. Taking guidance from parents involved in a longitudinal birth cohort - the ROLO family advisory committee. Res Involv Engagem 2020; 6:16. [PMID: 32368350 PMCID: PMC7189585 DOI: 10.1186/s40900-020-00200-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The ROLO Study (Randomised cOntrol trial of a Low glycaemic index diet in pregnancy to prevent macrosomia) was a randomised control trial conducted between 2007 and 2011 to examine if a low glycaemic index (GI) diet could reduce the incidence of macrosomia. The ROLO Family Advisory Committee is a self-selected group of parents who are involved in the longitudinal follow-up of the ROLO Study. The committee was established in 2017 and the goal is to achieve a partnership between ROLO families and researchers, leading to improved research quality, relevance, and outcomes. This research method is termed "Public and patient involvement (PPI)" and describes how researchers collaborate and engage with the public in order to make research more relevant to them. METHODS The ROLO study mothers and children have been prospectively followed-up at multiple time points post-pregnancy. In October 2017, all women were invited to join the ROLO Family Advisory Committee via email or via advertisement on the ROLO Study Facebook page. Fathers and other guardians of the study children were also invited to join. Two annual meetings with the research team and parents were held in 2018 and 2019. The meetings were recorded, transcribed verbatim by researchers, and thematically analysed. RESULTS Parents provided opinions on the areas they felt should be explored within the ROLO study using information that was collected up to the current follow-up point. They also shared views on research interests which were of importance to them. These topics included; child mental health, fussy eating in childhood and healthy eating policies in schools. Mothers were much more concerned about factors which influenced their child's health rather than their own. Incorporating an element of PPI to this study was found to be a positive learning experience for participants and researchers. CONCLUSION The involvement of parents has enriched the research agenda at the UCD Perinatal Research Centre. We will continue to engage with the parents of the ROLO Study and plan to involve the children to explore their opinions at the next opportunity.
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Affiliation(s)
- N. M. Walsh
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - E. C. O’Brien
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - A. A. Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - D. F. Byrne
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - A. Whelan
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - S. Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - S. Murray
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - C. Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - E. Adams
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - P. M. Farnan
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - F. M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Chandrasekhar J, Chowdhury E, Eccleston D, Whelan A, Camuglia A, Delacroix S, Worthley S. 875 Re-Examining the Obesity Paradox in Women and Men Undergoing PCI. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.882] [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]
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24
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Chandrasekhar J, Eccleston D, Chowdhury E, Whelan A, Camuglia A, DelaCroix S, Worthley S. 789 Are There Sex Differences in Outcomes of Patients With Chronic Kidney Disease Undergoing PCI? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.796] [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: 10/23/2022]
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25
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Eccleston D, Chandrasekar J, Chowdhury E, Rafter T, Delacroix S, Whelan A, Worthley S. 800 Changing Practice and Impact of Radial vs Femoral Access on Outcomes After Percutaneous Coronary Intervention: Analysis From a Large Multi-Centre Registry. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.807] [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: 11/28/2022]
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26
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House C, Mackie K, Whelan A. 226 Learnings from STEMI Door-to-Balloon Time Outliers – Why Reporting Mean DTBT Doesn’t Tell the Whole Story. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.233] [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: 11/16/2022]
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27
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Conradie A, Chowdhury E, Whelan A, Worthley S, Rafter T, Eccleston D. P5491Gender differences in long-term outcomes and predictors of all-cause mortality after percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0444] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Gender disparities have been consistently reported in the nature, presentation, and treatment of coronary artery disease, leading to significant outcome differences. Previous reports have suggested that after adjusting for differing baseline and procedural characteristics female gender was an independent predictor of all-cause mortality after Percutaneous Coronary Intervention (PCI). We examined this issue using data from the Genesis Cardiovascular Outcomes Registry (GCOR).
Methods
We prospectively collected data on 10,989 PCI procedures from January 2009 to January 2018 from 12 Australian Hospitals, and compared the baseline patient and procedural characteristics and 1-year mortality by gender.
Results
Female patients were more likely than males to present with NSTEMI (23.0% vs. 21.1%, p=0.042), however less likely to have prior MI (19.5% vs. 24.2%, p<0.001) or PCI (28.8% vs 33.6%, p<0.001). Procedural success rates were similar between females and males (97.2%). On multivariate logistic regression, female gender had a higher rate of all cause mortality (OR 0.58, 95% CI 0.31 to 1.07; P=0.08) but similar rates of MACE (OR 0.84, 95% CI 0.55 to 1.07, P=0.42). Variables contributing to an increased risk of mortality in female patients, included a history of previous heart failure (OR 2.45, 95% CI 1.15 to 5.22; p=0.02), myocardial infarction (OR 2.06, 95% CI 1.09 to 3.90; p=0.026), and peripheral vascular disease (OR 2.69, 95% CI 1.32 to 5.47; p=0.006). Performing PCI to the LMCA significantly increased the risk of mortality in female patients (OR 3.84, 95% CI 1.14 to 12.9; p=0.029), and the use of BMS vs DES contributed to a worse outcome in women compared to men (OR 0.46, 95% CI 0.25 to 0.84; p=0.012). The presence of hypercholesterolaemia in women significantly increased the risk of mortality (OR 0.44, 95% CI 0.22 to 0.86; p=0.016).
Multivariate logistic regression assessing 1-year outcome by gender for all-cause mortality, MACE, and unplanned admissions Outcome Male (vs female) Odds ratio 95% CI P-value Death (143) 0.58 0.31 to 1.07 0.08 MACE (334) 0.84 0.55 to 1.28 0.42 Unplanned readmission (888) 0.79 0.63 to 0.98 0.04
Conclusion
Women have significant differences in baseline characteristics and increased all-cause mortality at 1 year compared to men, although overall MACE rates are similar. This study increases awareness of women at high risk, highlighting the need to improve the care of women undergoing PCI.
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Cranney L, Wen LM, Xu H, Tam N, Whelan A, Hua M, Ahmed N. Formative research to promote the Get Healthy Information and Coaching Service (GHS) in the Australian-Chinese community. Aust J Prim Health 2019; 24:248-255. [PMID: 29739491 DOI: 10.1071/py17133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/22/2018] [Indexed: 01/23/2023]
Abstract
The free, telephone-based Get Healthy Information and Coaching Service (GHS) has made sustained improvements in healthy behaviours and weight change in the Australian population, but there is poor uptake of the GHS by culturally and linguistically diverse communities. This formative research study explored the Australian-Chinese community's awareness, perceptions and experiences of the GHS and their knowledge and cultural beliefs about healthy lifestyles. Conducted in Sydney, Australia, the research included 16 Chinese community-stakeholder interviews, a cross-sectional survey of 253 Chinese community members; and a review of Chinese participant GHS data. The study revealed poor uptake (<1%) and awareness (16%) of the GHS, but good intent (86%) to use it. The need for culturally appropriate and relevant information on healthy eating and physical activity was identified. Employment of a bilingual, bicultural coach, redesign and translation of written resources and targeted promotion in partnership with community organisations were recommended.
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Affiliation(s)
- Leonie Cranney
- Health Promotion Service, Directorate Planning, Population Health & Equity, South Eastern Sydney Local Health District, 301 Forbes Street, Darlinghurst, NSW 2010, Australia
| | - Li Ming Wen
- Prevention Research Collaboration, School of Public Health, Level 6, The Hub, The University of Sydney, NSW 2006, Australia
| | - Huilan Xu
- Health Promotion Unit, Sydney Local Health District, Level 9 North, KGV Building, Missenden Road, Camperdown, NSW 2050, Australia
| | - Nancy Tam
- Health Promotion Service, Directorate Planning, Population Health & Equity, South Eastern Sydney Local Health District, 301 Forbes Street, Darlinghurst, NSW 2010, Australia
| | - Anna Whelan
- Charles Perkins Centre, D17, The University of Sydney, NSW 2006, Australia
| | - Myna Hua
- Health Promotion Service, Directorate Planning, Population Health & Equity, South Eastern Sydney Local Health District, 301 Forbes Street, Darlinghurst, NSW 2010, Australia
| | - Nageen Ahmed
- NSW Office of Preventive Health, Level 1, Don Everett Building, Liverpool Hospital, Liverpool, NSW 2170, Australia
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Eccleston D, Rafter T, Whelan A, Chowdhury E, Worthley S, Chandrasekhar J. Effect of Long-term Compliance with Statin Therapy on All-cause Mortality After Percutaneous Coronary Intervention in Australia; the GenesisCare Cardiovascular Outcomes Registry (GCOR) Observational Cohort Study. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.610] [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: 11/30/2022]
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30
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Eccleston D, Chandrasekhar J, Chowdhury E, Rafter T, Conradie A, Whelan A, Worthley S. Does Sex Affect Outcomes After Percutaneous Coronary Intervention in Patients with Insulin-treated Diabetes Mellitus? Cohort Analysis from the Multi-centre GenesisCare Outcomes Registry (GCOR). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.609] [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: 10/26/2022]
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31
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Whelan A, Ghelani S, Majewski E, Wagner-Schuman M, Summers S, Class Q. 826: Inpatient psychiatric admissions and obstetric outcomes. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2018.11.849] [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: 11/27/2022]
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32
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Whelan A, Burks C, Stephenson M. Successful Pregnancy Outcomes after Septum or no Septum Resection in Patients with Recurrent Pregnancy Loss [4B]. Obstet Gynecol 2018. [DOI: 10.1097/01.aog.0000532906.57204.94] [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: 11/25/2022]
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Beek K, Dawson A, Whelan A. A review of factors affecting the transfer of sexual and reproductive health training into practice in low and lower-middle income country humanitarian settings. Confl Health 2017; 11:16. [PMID: 28883889 PMCID: PMC5580288 DOI: 10.1186/s13031-017-0118-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 07/04/2017] [Indexed: 11/20/2022] Open
Abstract
Background A lack of access to sexual and reproductive health (SRH) care is the leading cause of morbidity and mortality among displaced women and girls of reproductive age. Efforts to address this public health emergency in humanitarian settings have included the widespread delivery of training programmes to address gaps in health worker capacity for SRH. There remains a lack of data on the factors which may affect the ability of health workers to apply SRH knowledge and skills gained through training programmes in humanitarian contexts. Methods We searched four electronic databases and ten key organizations’ websites to locate literature on SRH training for humanitarian settings in low and lower-middle income countries. Papers were examined using content analysis to identify factors which contribute to health workers’ capacity to transfer SRH knowledge, skills and attitudes learned in training into practice in humanitarian settings. Results Seven studies were included in this review. Six research papers focused on the response stage of humanitarian crises and five papers featured the disaster context of conflict. A range of SRH components were addressed including maternal, newborn health and sexual violence. The review identified factors, including appropriate resourcing, organisational support and confidence in health care workers that were found to facilitate the transfer of learning. The findings suggest the presence of factors that moderate the transfer of training at the individual, training, organisational, socio-cultural, political and health system levels. Conclusion Supportive strategies are necessary to best assist trainees to apply newly acquired knowledge and skills in their work settings. These interventions must address factors that moderate the success of learning transfer. Findings from this review suggest that these are related to the individual trainee, the training program itself and the workplace as well as the broader environmental context. Organisations which provide SRH training for humanitarian emergencies should work to identify the system of moderating factors that affect training transfer in their setting and employ evidence-based strategies to ameliorate these.
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Affiliation(s)
- Kristen Beek
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, Level 7, 235 Jones St, PO Box 123, Ultimo, NSW 2007 Australia
| | - Angela Dawson
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, Level 7, 235 Jones St, PO Box 123, Ultimo, NSW 2007 Australia
| | - Anna Whelan
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, Level 7, 235 Jones St, PO Box 123, Ultimo, NSW 2007 Australia
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Roberts DA, Cole AJ, Whelan A, de Nys R, Paul NA. Slow pyrolysis enhances the recovery and reuse of phosphorus and reduces metal leaching from biosolids. Waste Manag 2017; 64:133-139. [PMID: 28318964 DOI: 10.1016/j.wasman.2017.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/13/2017] [Accepted: 03/07/2017] [Indexed: 06/06/2023]
Abstract
In this study, biochar is produced from biosolids with and without alum at a range of temperatures and simulated oxidative aging of the biochars is conducted to quantify the long-term leaching of P and metals. While biosolids containing alum had negligible amounts of plant-available P, after pyrolysis >90% of the P became immediately available for plant growth. When biosolids with no alum were converted into biochar there was a small increase in the availability of P but a larger pool was available after oxidation. Both of the biosolids leached significant amounts of metals after oxidation. In contrast, the biochars had a very low available metal content and this did not increase with oxidation, demonstrating a stable metal content. Pyrolysis is an effective waste management strategy for biosolids that can simultaneously reduce the leaching of metals and increase the efficiency of recycling of P for beneficial re-use.
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Affiliation(s)
- David A Roberts
- MACRO - the Centre for Macroalgal Resources and Biotechnology, College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia.
| | - Andrew J Cole
- MACRO - the Centre for Macroalgal Resources and Biotechnology, College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Anna Whelan
- Wastewater Operations, Townsville Water and Waste, QLD 4811, Australia
| | - Rocky de Nys
- MACRO - the Centre for Macroalgal Resources and Biotechnology, College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - Nicholas A Paul
- MACRO - the Centre for Macroalgal Resources and Biotechnology, College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia; Present address: Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia
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Wen LM, Rissel C, Baur LA, Hayes AJ, Xu H, Whelan A, Hua M, Shaw M, Phongsavan P. A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants to prevent childhood obesity. BMC Public Health 2017; 17:79. [PMID: 28088203 PMCID: PMC5237545 DOI: 10.1186/s12889-016-4005-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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: 12/06/2016] [Accepted: 12/26/2016] [Indexed: 11/16/2022] Open
Abstract
Background With an increasing prevalence of obesity in young children globally, there is an urgent need for the development of effective early interventions. A previous Healthy Beginnings Trial using a nurse-led home visiting program has demonstrated that providing mothers with evidence-based advice can improve maternal practice regarding obesity prevention, and can reduce Body Mass Index (BMI) in the first few years of life. However, the costs for scale-up of home visiting limit its population reach. This trial aims to determine the efficacy of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants in improving infant feeding practices and preventing the early onset of childhood overweight and obesity. Methods/Design We propose a 3-arm randomised controlled trial (RCT) with a consecutive sample of 1056 mothers with their newborn children in New South Wales (NSW) Australia. Pregnant women who are between weeks 28 and 34 of their pregnancy will be invited to participate in the CHAT trial. Informed consent will be obtained, and after baseline data collection, participants will be randomly allocated to the telephone intervention, text messaging intervention, or the control group. The intervention comprises telephone consultations or text messages, together with 6 intervention packages being mailed at specific times from the third trimester of pregnancy until 12 months post birth. The main trial outcome measures include a) duration of breastfeeding, b) timing of introduction of solids, c) nutrition behaviours, physical activity and television viewing, and d) weight and BMI z-score at 12 and 24 months, e) cost-effectiveness, as well as f) feasibility and acceptability of the interventions. Discussion The results will ascertain whether early intervention using telephone consultation or text messaging together with staged mailed intervention resources can be feasible and effective in improving infant feeding practices, physical activity and reducing children’s BMI in the early years of life. If proven to be feasible, effective as well as cost-effective, the trial results will inform a series of recommendations for policy and practice related to promoting healthy infant feeding and physical activity in young children in the first years of life. Trial registration The CHAT Trial is registered with the Australian Clinical Trial Registry (ACTRN12616001470482p). It was registered on October 21, 2016.
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Affiliation(s)
- Li Ming Wen
- Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia. .,Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia. .,Charles Perkins Centre, University of Sydney, Camperdown, Australia.
| | - Chris Rissel
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia.,Office of Preventive Health, Ministry of Health, Camperdown, NSW, Australia
| | - Louise A Baur
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia.,Discipline of Child & Adolescent Health, University of Sydney, Camperdown, Australia
| | - Alison J Hayes
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia
| | - Huilan Xu
- Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Anna Whelan
- Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia
| | - Myna Hua
- Health Promotion Unit, South Eastern Sydney Local Health District, Camperdown, NSW, Australia
| | - Miranda Shaw
- Community Health Services, Sydney Local Health District, Camperdown, NSW, Australia
| | - Philayrath Phongsavan
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia
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Swanson K, Whelan A, Grobman WA, Miller ES. 682: Can venous cord gas predict fetal acidemia? Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.11.416] [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: 10/20/2022]
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Beker MP, Boari P, Burachik M, Cuadrado V, Junco M, Lede S, Lema MA, Lewi D, Maggi A, Meoniz I, Noé G, Roca C, Robredo C, Rubinstein C, Vicien C, Whelan A. Development of a construct-based risk assessment framework for genetic engineered crops. Transgenic Res 2016; 25:597-607. [PMID: 27339146 PMCID: PMC5023744 DOI: 10.1007/s11248-016-9955-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 12/14/2015] [Accepted: 04/05/2016] [Indexed: 01/07/2023]
Abstract
Experience gained in the risk assessment (RA) of genetically engineered (GE) crops since their first experimental introductions in the early nineties, has increased the level of familiarity with these breeding methodologies and has motivated several agencies and expert groups worldwide to revisit the scientific criteria underlying the RA process. Along these lines, the need to engage in a scientific discussion for the case of GE crops transformed with similar constructs was recently identified in Argentina. In response to this need, the Argentine branch of the International Life Sciences Institute (ILSI Argentina) convened a tripartite working group to discuss a science-based evaluation approach for transformation events developed with genetic constructs which are identical or similar to those used in previously evaluated or approved GE crops. This discussion considered new transformation events within the same or different species and covered both environmental and food safety aspects. A construct similarity concept was defined, considering the biological function of the introduced genes. Factors like environmental and dietary exposure, familiarity with both the crop and the trait as well as the crop biology, were identified as key to inform a construct-based RA process.
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Affiliation(s)
- M P Beker
- Bayer SA, Ricardo Gutierrez 3652, CP 1605, Munro, Buenos Aires, Argentina
| | - P Boari
- Biotechnology Directorate, Secretariat of Value Adding, Av. Paseo Colón 922, 2nd, Of. 247, CP 1063, Ciudad Autonoma de Buenos Aires, Argentina
| | - M Burachik
- Indear, Ocampo 210 bis Predio CCT Rosario (2000), Rosario, Santa Fe, Argentina
| | - V Cuadrado
- Monsanto Argentina, Maipu 1210, CP 1006, Ciudad Autonoma de Buenos Aires, Argentina
| | - M Junco
- National Agri Food Health and Quality Service, SENASA, Azopardo 1020, 1st, CP 1107, Ciudad Autonoma de Buenos Aires, Argentina
| | - S Lede
- BASF Argentina, Tucuman 1, 18th, CP 1049, Ciudad Autonoma de Buenos Aires, Argentina.,National Scientific and Technical Research Council, CONICET, Av. Rivadavia 1917, C1033AAJ, Ciudad Autonoma de Buenos Aires, Argentina
| | - M A Lema
- Biotechnology Directorate, Secretariat of Value Adding, Av. Paseo Colón 922, 2nd, Of. 247, CP 1063, Ciudad Autonoma de Buenos Aires, Argentina.,National University of Quilmes, Roque Sáenz Peña 352, CP 1876, Bernal, Buenos Aires, Argentina
| | - D Lewi
- National Agricultural Research Institute, INTA, Nicolas Repetto y de los Reseros s/n, CP 1686, Hurlingham, Buenos Aires, Argentina
| | - A Maggi
- National Agri Food Health and Quality Service, SENASA, Azopardo 1020, 1st, CP 1107, Ciudad Autonoma de Buenos Aires, Argentina
| | - I Meoniz
- National Agri Food Health and Quality Service, SENASA, Azopardo 1020, 1st, CP 1107, Ciudad Autonoma de Buenos Aires, Argentina
| | - G Noé
- Syngenta Agro, Av. Libertador 1855, CP 1638, Vicente Lopez, Buenos Aires, Argentina
| | - C Roca
- Dow Agroscience SA, Cecilia Grierson 355, CP 1107, Ciudad Autonoma de Buenos Aires, Argentina
| | - C Robredo
- Chacra Experimental Agricola Santa Rosa, Camino Vecinal Nº 8, Km 6, CP 4531, Colonia Santa Rosa, Salta, Argentina
| | - C Rubinstein
- Monsanto Argentina, Maipu 1210, CP 1006, Ciudad Autonoma de Buenos Aires, Argentina. .,ILSI Argentina, Ave Santa Fe 1145, 4th, C1059ABF, Ciudad Autonoma de Buenos Aires, Argentina.
| | - C Vicien
- University of Buenos Aires and CERA, Sr Consultant, Av. San Martín 4453, CP 1417, Ciudad Autonoma de Buenos Aires, Argentina
| | - A Whelan
- Biotechnology Directorate, Secretariat of Value Adding, Av. Paseo Colón 922, 2nd, Of. 247, CP 1063, Ciudad Autonoma de Buenos Aires, Argentina.,National University of Quilmes, Roque Sáenz Peña 352, CP 1876, Bernal, Buenos Aires, Argentina
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38
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Neveux N, Magnusson M, Mata L, Whelan A, de Nys R, Paul N. The treatment of municipal wastewater by the macroalga Oedogonium sp. and its potential for the production of biocrude. ALGAL RES 2016. [DOI: 10.1016/j.algal.2015.12.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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39
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Dawson AJ, Nkowane AM, Whelan A. Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: a systematic review. Hum Resour Health 2015; 13:97. [PMID: 26684471 PMCID: PMC4683743 DOI: 10.1186/s12960-015-0096-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/08/2015] [Indexed: 05/07/2023]
Abstract
BACKGROUND Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations. METHODS We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework. RESULTS Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse's and midwives' roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between nurses and midwives and other health providers and organizations, across sectors, and with communities and individuals that resulted in improved health care and outcomes. CONCLUSIONS The findings of this review confirm the importance of a conceptual framework for understanding and planning leadership and governance approaches, management strategies and collaboration and education and training efforts to scale up and support nurses and midwives in existing or expanded roles to improve access to PHC for vulnerable populations.
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Affiliation(s)
- A J Dawson
- Faculty of Health, University of Technology Sydney (UTS) World Health Organization Collaborating Centre for Nursing, Midwifery and Health Development, Jones Street, Sydney, NSW, Australia.
| | - A M Nkowane
- Health Workforce Department, World Health Organization, Geneva, Switzerland.
| | - A Whelan
- Faculty of Health, University of Technology Sydney (UTS) World Health Organization Collaborating Centre for Nursing, Midwifery and Health Development, Jones Street, Sydney, NSW, Australia.
- University of New South Wales (UNSW), Sydney, Australia.
- Sydney Local Health District, Sydney, NSW, Australia.
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Rehmani A, Judkins C, Atique S, Nunn T, Rodrigues F, Nguyen M, Whelan A. Fremantle experience of patients undergoing bioresorbable vascular scaffold implantation. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.386] [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: 10/23/2022]
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41
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Dean G, Whelan A, Clifford D, Salguero F, Xing Z, Gilbert S, McShane H, Hewinson R, Vordermeier M, Villarreal-Ramos B. Comparison of the immunogenicity and protection against bovine tuberculosis following immunization by BCG-priming and boosting with adenovirus or protein based vaccines. Vaccine 2014; 32:1304-10. [DOI: 10.1016/j.vaccine.2013.11.045] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/05/2013] [Accepted: 11/11/2013] [Indexed: 10/26/2022]
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42
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Casal C, Bezos J, Díez-Guerrier A, Álvarez J, Romero B, de Juan L, Rodriguez-Campos S, Vordermeier M, Whelan A, Hewinson RG, Mateos A, Domínguez L, Aranaz A. Evaluation of two cocktails containing ESAT-6, CFP-10 and Rv-3615c in the intradermal test and the interferon-γ assay for diagnosis of bovine tuberculosis. Prev Vet Med 2012; 105:149-54. [PMID: 22391021 DOI: 10.1016/j.prevetmed.2012.02.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 02/02/2012] [Accepted: 02/07/2012] [Indexed: 12/01/2022]
Abstract
The intradermal tuberculin tests and the interferon-gamma (IFN-γ) assay are the principal tests used worldwide for the ante-mortem diagnosis of bovine tuberculosis. The conventional reagent currently in use in these tests is purified protein derivative (PPD) tuberculin obtained from Mycobacterium bovis culture. The components of PPD are poorly characterized and difficult to standardize. To overcome this issue, antigens specific to the Mycobacterium tuberculosis complex are being studied. Here we have assessed the biological potency of ESAT-6, CFP-10 and Rv-3615c presented as peptide or recombinant protein cocktails in comparison with the standard bovine PPD used routinely in Spanish eradication campaigns. The study was performed in cattle (n=23) from a herd with natural M. bovis infection. Animals were simultaneously injected with PPD and the peptide and protein cocktails. The percentages of cattle reacting positively to single intradermal test were 60.9% (bovine PPD), 47.8% (peptide cocktail) and 60.9% (protein cocktail), with no significant difference between the actual skin fold thickness increases (p>0.05). The IFN-γ assay detected 60.9% of animals when stimulation was performed with bovine PPD, but decreased to 52.2% when stimulation was performed with the peptide cocktail and to 47.8% when stimulation was performed with the protein cocktail. However, no significant differences were found between IFN-γ responder frequencies (p>0.05). These results show a potential use of these defined reagents for in vivo tuberculosis diagnosis.
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Affiliation(s)
- C Casal
- Centro VISAVET, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
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Eccleston D, Sage P, Rafter T, Holt G, Whelan A, Horrigan M. Does STEMI Management in Australia Meet 2012 Performance Targets? Results from a National Multi-centre Registry. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.381] [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: 10/28/2022]
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44
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Baldry C, Jack B, Groves K, Gaunt K, Sephton J, Whelan A. 'Made to fit': filling critical gaps with a hospice at home service. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000105.95] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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45
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Schiller I, Vordermeier HM, Waters WR, Kyburz A, Cagiola M, Whelan A, Palmer MV, Thacker TC, Meijlis J, Carter C, Gordon S, Egnuni T, Hardegger R, Marg-Haufe B, Raeber A, Oesch B. Comparison of tuberculin activity using the interferon-gamma assay for the diagnosis of bovine tuberculosis. Vet Rec 2010; 167:322-6. [PMID: 20802185 DOI: 10.1136/vr.c3403] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In this study, interferon-gamma (IFN-gamma) responses in whole blood cultures stimulated with tuberculins from different sources were compared with regard to their diagnostic reliability in cattle experimentally and naturally infected with Mycobacterium bovis. The IFN-gamma responses to different concentrations of purified protein derivatives (PPDs) from M bovis and Mycobacterium avium were quantified. Significant differences (P<0.05) between sources and concentrations of PPDs used for stimulation were detected, indicating a need for standardisation of PPDs used in the IFN-gamma assay. Additionally, a tool named'relative potency 30' that allows rapid comparison of batches and sources of PPDs was defined.
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Affiliation(s)
- I Schiller
- Prionics, Wagistrasse 27a, 8952 Schlieren-Zurich, Switzerland
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Vale C, Nightingale A, Spera N, Whelan A, Hanley B, Tierney JF. Late complications from chemoradiotherapy for cervical cancer: reflections from cervical cancer survivors 10 years after the national cancer institute alert. Clin Oncol (R Coll Radiol) 2010; 22:588-9. [PMID: 20554439 DOI: 10.1016/j.clon.2010.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 04/22/2010] [Accepted: 05/12/2010] [Indexed: 11/17/2022]
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47
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Newman L, Lightfoot T, Singleton G, Aroche J, Yong CS, Eagar S, Gordon A, Kotala P, Whelan A, Whittaker M. Mental illness in Australian immigration detention centres. Lancet 2010; 375:1344-5. [PMID: 20399975 DOI: 10.1016/s0140-6736(10)60571-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/20/2022]
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Pourfarzi F, Whelan A, Kaldor J, Malekzadeh R. The role of diet and other environmental factors in the causation of gastric cancer in Iran--a population based study. Int J Cancer 2009; 125:1953-60. [PMID: 19569234 DOI: 10.1002/ijc.24499] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Despite a declining trend in the incidence of gastric cancer (GC), it is still a major global public health concern of the 21st century. The rates of GC reported from Ardabil Province, Iran, are among the highest in the world. To investigate risk factors for GC in Ardabil, we undertook a population-based case-control study. The study aimed to recruit all Ardabil residents newly diagnosed with GC in the time period of 2004-2005, and 2 controls per case. Participants were interviewed using a structured questionnaire. Ten milliliters of blood was collected for blood grouping and investigating the presence of IgG antibodies against Helicobacter pylori. During the study period, 217 people with GC and 394 controls were recruited. In multivariate analysis, diet and Helicobacter pylori infection (OR = 2.41; 95% CI: 1.35-4.32) were found to be the factors that were most strongly related to GC. High intake of Allium vegetables (OR = 0.35) and fruit, especially citrus fruit (OR = 0.31) and consumption of fresh fish (OR = 0.37) were significantly protective. On the other hand, consumption of red meat (OR = 3.40) and dairy products (OR = 2.28) were positively associated with the risk of GC. People who had a preference for higher salt intake (OR = 3.10) and drinking strong and hot tea (OR = 2.64 and 2.85, respectively) were at higher risk. In conclusion, Helicobacter pylori infection as measured by serum IgG as well as the consumption of red meat and dairy products increases the risk of GC in Ardabil, while the intake of fresh fruit and fresh fish decrease the risk.
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Affiliation(s)
- Farhad Pourfarzi
- Division of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran.
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49
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Pourfarzi F, Whelan A, Kaldor J, Malekzadeh R. The role of diet and other environmental factors in the causation of gastric cancer in Iran--a population based study. Int J Cancer 2009. [PMID: 19569234 DOI: 10.1002/ijc24499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Despite a declining trend in the incidence of gastric cancer (GC), it is still a major global public health concern of the 21st century. The rates of GC reported from Ardabil Province, Iran, are among the highest in the world. To investigate risk factors for GC in Ardabil, we undertook a population-based case-control study. The study aimed to recruit all Ardabil residents newly diagnosed with GC in the time period of 2004-2005, and 2 controls per case. Participants were interviewed using a structured questionnaire. Ten milliliters of blood was collected for blood grouping and investigating the presence of IgG antibodies against Helicobacter pylori. During the study period, 217 people with GC and 394 controls were recruited. In multivariate analysis, diet and Helicobacter pylori infection (OR = 2.41; 95% CI: 1.35-4.32) were found to be the factors that were most strongly related to GC. High intake of Allium vegetables (OR = 0.35) and fruit, especially citrus fruit (OR = 0.31) and consumption of fresh fish (OR = 0.37) were significantly protective. On the other hand, consumption of red meat (OR = 3.40) and dairy products (OR = 2.28) were positively associated with the risk of GC. People who had a preference for higher salt intake (OR = 3.10) and drinking strong and hot tea (OR = 2.64 and 2.85, respectively) were at higher risk. In conclusion, Helicobacter pylori infection as measured by serum IgG as well as the consumption of red meat and dairy products increases the risk of GC in Ardabil, while the intake of fresh fruit and fresh fish decrease the risk.
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Affiliation(s)
- Farhad Pourfarzi
- Division of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran.
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50
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Lydard P, Whelan A, Fanger MW. Book Review. Autoimmunity 2009. [DOI: 10.3109/08916930008994094] [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: 11/13/2022]
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