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Bailey S, Newton N, Perry Y, Davies C, Lin A, Marino JL, Skinner RS, Grummitt L, Barrett E. Minority stressors, traumatic events, and associations with mental health and school climate among gender and sexuality diverse young people in Australia: Findings from a nationally representative cohort study. J Adolesc 2024; 96:275-290. [PMID: 38018791 DOI: 10.1002/jad.12274] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/19/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION Population-level, nationally representative data on the prevalence of minority stressors and traumatic events, mental ill-health effects, and the preventative utility of school climate, among gender and sexuality diverse young people in Australia, is significantly lacking. In this study, we estimated the prevalence and distribution of minority stressors and traumatic events among young people by sexuality identity (gay/lesbian, bisexual, other sexuality, heterosexual), sexuality diversity (sexuality diverse, not sexuality diverse), and gender identity (transgender, cisgender) and assessed associations with mental ill-health and the moderating role of school climate factors. METHODS Using Wave 8 (2018) follow-up data from a population-level, nationally representative longitudinal cohort study, the sample comprised 3037 young people aged 17-19 years in Australia. Prevalence ratios for minority stressors and traumatic events were calculated for gender and sexuality diverse categories using logistic regression models. Linear regression models were used to test associations between traumatic events and minority stressors, and mental ill-health. Multivariate linear regression tested school climate factors as effect modifier between minority stressors and mental ill-health among sexuality diverse young people. RESULTS Rates of traumatic events and minority stressors were highest among bisexual and gay/lesbian young people and were significantly associated with mental ill-health among all gender and sexuality diverse young people. Highest mental ill-health effects were observed among trans young people. Among sexuality diverse young people, positive and negative feelings toward school climate were associated with decreased and increased mental ill-health, respectively. After accounting for sexuality diversity, positive overall school climate appeared protective of mental ill-health effects of sexuality-based discrimination. DISCUSSION Minority stressors, traumatic events, and associated mental ill-health are prevalent among gender and sexuality diverse young people in Australia, especially trans, bisexual, and gay/lesbian young people. Promotion of affirmative, safe, and inclusive school climate demonstrates significant promise for the prevention and early intervention of mental ill-health among gender and sexuality diverse young people.
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Affiliation(s)
- Sasha Bailey
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Cristyn Davies
- School of Medicine, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ashleigh Lin
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Parkville, Australia
- School of Population Health, University of Western Australia, Perth, Australia
| | - Jennifer L Marino
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Rachel S Skinner
- School of Medicine, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Marino JL, Lin A, Davies C, Kang M, Bista S, Skinner SR. Childhood and Adolescence Gender Role Nonconformity and Gender and Sexuality Diversity in Young Adulthood. JAMA Pediatr 2023; 177:1176-1186. [PMID: 37747725 PMCID: PMC10520839 DOI: 10.1001/jamapediatrics.2023.3873] [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] [Received: 03/01/2023] [Accepted: 08/02/2023] [Indexed: 09/26/2023]
Abstract
Importance Sexuality- and gender-diverse youth experience disproportionate health and social adversity. Accurate early-life indicators are important for development of supportive approaches. Objective To examine whether commonly used items measuring childhood conformity to gender roles are associated with sexual orientation in young adulthood. Design, Setting, and Participants This single-center, prospective cohort study (the Raine Study) assessed 2868 children of 2900 women who were recruited during pregnancy from August 1, 1989, to April 30, 1992, with follow-up ongoing. The Achenbach System of Empirically Based Assessment (ASEBA) Child Behavior Checklist, Teacher Report Form, and Youth Self-Report tools were used to survey parents, teachers, and youths to examine gender diversity among the participating youths. Parents were followed up at years 5, 8, 10, 14, and 17, adolescents at years 14, 17, and 27, and teachers at years 10 and 14. Data were analyzed from August 1, 2020, to July 31, 2023. Exposures Parent and teacher report that a child "behaves like the opposite sex" (gender role behavior), and parent and self-report that a child "wishes to be the opposite sex" (gender role wish), in response to assessment items. Main Outcome Measures Year 27 self-reported sexual identity, attraction, and behavior. Results Of the 2868 children in the original birth cohort, 1154 (40.2%) participated in the year 27 follow-up, of whom 608 (52.7%) were recorded female at birth and 546 (47.3%) were recorded male at birth. Of these, 582 who were recorded female at birth continued to identify as female (cisgender) (95.7%), and 515 recorded male at birth continued to identify as male (cisgender) (94.3%); 47 (4.1%) did not complete the questionnaire. Of cisgender participants, 76 of 605 women (12.6%) and 52 of 540 men (9.6%) had a diverse sexual identity, 204 of 605 women (33.8%) and 77 of 540 men (14.3%) were same-gender attracted, and 100 of 605 women (18.6%) and 39 of 540 men (7.2%) had ever engaged in same-gender sexual behavior. Across all follow-ups, after adjusting for gender, nonconforming gender role behavior was consistently associated with diverse sexual identity and behavior (adjusted odds ratio [aOR] for identity, 2.8; 95% CI, 1.9-4.2; behavior aOR, 2.4; 95% CI, 1.6-3.5). Self-reported gender role wish was consistently associated with diverse sexual orientation (identity aOR, 2.3; 95% CI, 1.4-3.8; attraction aOR, 1.7; 95% CI, 1.1-2.5; behavior aOR, 1.9; 95% CI, 1.2-2.9). Conclusions and Relevance In this cohort study, ASEBA gender role nonconformity was associated with diverse sexual orientation, beginning in early childhood. Findings suggest that the ASEBA measures should not be used to infer sexual orientation or gender diversity in clinical or research settings; asking direct questions may provide more accurate data.
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Affiliation(s)
- Jennifer L. Marino
- Department of Obstetrics and Gynaecology, Royal Women’s Hospital and University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Melissa Kang
- Specialty of General Practice, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Sarita Bista
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
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Berger MN, Mowbray ES, Farag MWA, Mathieu E, Davies C, Thomas C, Booy R, Forster AH, Skinner SR. Immunogenicity, safety, usability and acceptability of microarray patches for vaccination: a systematic review and meta-analysis. BMJ Glob Health 2023; 8:e012247. [PMID: 37827725 PMCID: PMC10583062 DOI: 10.1136/bmjgh-2023-012247] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/10/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Microarray patches (MAPs) deliver vaccines to the epidermis and the upper dermis, where abundant immune cells reside. There are several potential benefits to using MAPs, including reduced sharps risk, thermostability, no need for reconstitution, tolerability and self-administration. We aimed to explore and evaluate the immunogenicity, safety, usability and acceptability of MAPs for vaccination. METHODS We searched CINAHL, Cochrane Library, Ovid Embase, Ovid MEDLINE and Web of Science from inception to January 2023. Eligibility criteria included all research studies in any language, which examined microarrays or microneedles intended or used for vaccination and explored immunogenicity, safety, usability or acceptability in their findings. Two reviewers conducted title and abstract screening, full-text reviewing and data extraction. RESULTS Twenty-two studies were included (quantitative=15, qualitative=2 and mixed methods=5). The risk of bias was mostly low, with two studies at high risk of bias. Four clinical trials were included, three using influenza antigens and one with Japanese encephalitis delivered by MAP. A meta-analysis indicated similar or higher immunogenicity in influenza MAPs compared with needle and syringe (N&S) (standardised mean difference=10.80, 95% CI: 3.51 to 18.08, p<0.00001). There were no significant differences in immune cell function between MAPs and N&S. No serious adverse events were reported in MAPs. Erythema was more common after MAP application than N&S but was brief and well tolerated. Lower pain scores were usually reported after MAP application than N&S. Most studies found MAPs easy to use and highly acceptable among healthcare professionals, laypeople and parents. CONCLUSION MAPs for vaccination were safe and well tolerated and evoked similar or enhanced immunogenicity than N&S, but further research is needed. Vaccine uptake may be increased using MAPs due to less pain, enhanced thermostability, layperson and self-administration. MAPs could benefit at-risk groups and low and middle-income countries. PROSPERO REGISTRATION NUMBER CRD42022323026.
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Affiliation(s)
- Matthew N Berger
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, New South Wales, Australia
- Sydney Infectious Diseases Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ellen S Mowbray
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Marian W A Farag
- Hillarys Plaza Medical Centre, Perth, Western Australia, Australia
| | - Erin Mathieu
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- Sydney Infectious Diseases Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Claire Thomas
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, New South Wales, Australia
| | - Robert Booy
- Sydney Infectious Diseases Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | | | - S Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- Sydney Infectious Diseases Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kids Research, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
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Hacker E, Baker B, Lake T, Ross C, Cox M, Davies C, Skinner SR, Booy R, Forster A. Vaccine microarray patch self-administration: An innovative approach to improve pandemic and routine vaccination rates. Vaccine 2023; 41:5925-5930. [PMID: 37643926 DOI: 10.1016/j.vaccine.2023.08.027] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/20/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023]
Abstract
The high-density microprojection array patch (HD-MAP) is a novel vaccine delivery system with potential for self-administered vaccination. HD-MAPs provide an alternative to needle and syringe (N&S) vaccination. Additional advantages could include reduced cold-chain requirements, reduced vaccine dose, reduced vaccine wastage, an alternative for needle phobic patients and elimination of needlestick injuries. The drivers and potential benefits of vaccination by self-administering HD-MAPs are high patient acceptance and preference, higher vaccination rates, speed of roll-out, cost-savings, and reduced sharps and environmental waste. The HD-MAP presents a unique approach in pandemic preparedness and routine vaccination of adults. It could alleviate strain on the healthcare workforce and allows vaccine administration by minimally-trained workers, guardian or subjects themselves. Self-vaccination using HD-MAPs could occur in vaccination hubs with supervision, at home after purchasing at the pharmacy, or direct distribution to in-home settings. As a result, it has the potential to increase vaccine coverage and expand the reach of vaccines, while also reducing labor costs associated with vaccination. Key challenges remain around shifting the paradigm from medical professionals administrating vaccines using N&S to a future of self-administration using HD-MAPs. Greater awareness of HD-MAP technology and improving our understanding of the implementation processes required for adopting this technology, are critical factors underpinning HD-MAP uptake by the public.
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Affiliation(s)
- E Hacker
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, QLD 4222, Australia
| | - B Baker
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia
| | - T Lake
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia
| | - C Ross
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia
| | - M Cox
- NextWaveBio, East Haven, CT, United States
| | - C Davies
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - S R Skinner
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - R Booy
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - A Forster
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia.
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Netfa F, King C, Davies C, Rashid H, Tashani M, Booy R, Rachel Skinner S. Perceived facilitators and barriers to the uptake of the human papillomavirus (HPV) vaccine among adolescents of Arabic-speaking mothers in NSW, Australia: A qualitative study. Vaccine X 2023; 14:100335. [PMID: 37409191 PMCID: PMC10318426 DOI: 10.1016/j.jvacx.2023.100335] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/16/2023] [Indexed: 07/07/2023] Open
Abstract
Background Australia has a large immigrant population but there is little data regarding whether human papillomavirus (HPV) vaccination coverage in adolescents varies according to parents' cultural or ethnic background. This work aims to identify facilitators and barriers to HPV vaccination of adolescents as perceived by Arabic-speaking mothers in Western Sydney, South Western Sydney and Wollongong, NSW, Australia. Methods A purposive sampling approach was applied to recruit mothers of adolescents from Arabic speaking backgrounds who had at least one child eligible for the HPV school-based vaccination program. Face-to-face semi-structured well as online interviews were conducted in Arabic between April 2021 and July 2021. The interviews were audio-recorded, transcribed, and translated into English and examined using thematic analysis. Results Sixteen mothers of adolescents from Arabic backgrounds described facilitators and barriers to HPV vaccination. A) Facilitators of HPV vaccination included: knowledge of HPV disease, trust in the school vaccination program, opportunistic recommendations from healthcare workers, information from friends. B) Barriers to accessing HPV vaccination included communication gaps: breakdown in school-parent information flow, lack of access to the Arabic language version of the information sheet, mother - GP communication barriers, mother-child communication gap; and health system gaps: missed opportunities for vaccination. C) Mothers' suggestions to improve HPV vaccination acceptance: to involve religious and cultural leadership, encourage engagement with GPs, and provide school-based education for parents and students. Conclusion Parents could benefit from assistance with HPV vaccination decision making. Interventions via schools, health professionals and religious and cultural organisations could play important roles in HPV vaccination acceptance for Arabic speaking immigrant families and in introducing their adolescent children to this vaccine.
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Affiliation(s)
- Faeza Netfa
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Catherine King
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Harunor Rashid
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Mohamed Tashani
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya
| | - Robert Booy
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
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Davies C, Marshall HS, Brotherton JML, McCaffery K, Kang M, Macartney K, Garland S, Kaldor J, Zimet G, Skinner SR. Complex intervention to promote human papillomavirus (HPV) vaccine uptake in school settings: A cluster-randomized trial. Prev Med 2023; 172:107542. [PMID: 37172767 DOI: 10.1016/j.ypmed.2023.107542] [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: 12/19/2022] [Revised: 04/14/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
Using a cluster-randomized trial design, we aimed to evaluate a complex intervention to increase uptake of human papillomavirus (HPV) vaccination in schools. The study was undertaken in high schools in Western Australia and South Australia between 2013 and 2015 with adolescents aged 12-13 years. Interventions included education, shared decision-making, and logistical strategies. The main outcome was school vaccine uptake. Secondary outcomes included consent forms returned and mean time to vaccinate 50 students. We hypothesised that a complex intervention would increase 3-dose HPV vaccine uptake. We recruited 40 schools (21 intervention, 19 control) with 6, 967 adolescents. There was no difference between intervention and control (3-dose mean 75.7% and 78.9%, respectively). Following adjustment for baseline covariates, absolute differences in coverage in favour of the intervention group were: dose 1, 0.8% (95% CI, -1.4,3.0); dose 2, 0.2% (95% CI, -2.7, 3.1); dose 3, 0.5% (95% CI, -2.6, 3.7). The percentage of returned consent forms in intervention schools (91.4%) was higher than in control schools (difference: 6%, 95% CI, 1.4, 10.7). There was a shorter mean time to vaccinate 50 students at dose 3. The difference for dose 3 was 110 min (95% CI, 42, 177); for dose 2, 90 min (95% CI, -15, 196); and dose 1, 28 min (95% CI, -71, 127). Logs revealed the inconsistent implementation of logistical strategies. The intervention had no impact on uptake. Inadequate resourcing for logistical strategies and advisory board reluctance toward strategies with potential financial implications impacted the implementation of logistical components. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12614000404628, 14.04.2014. The study protocol was published in 2015 before data collection was finalised (Skinner et al., 2015). THE HPV.EDU STUDY GROUP: We would like to acknowledge the contributions to this study by members of the HPV.edu Study Group, including: Professor Annette Braunack-Mayer: Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia; Dr. Joanne Collins: Women's and Children's Health Network and School of Medicine and Robinson Research Institute, University of Adelaide, SA, Australia; Associate Professor Spring Cooper: School of Public Health, City University of New York (CUNY), New York, NY, USA; Heidi Hutton: Telethon Kids Institute, University of Western Australia, WA, Australia; Jane Jones: Telethon Kids Institute, University of Western Australia, WA, Australia; Dr. Adriana Parrella: Women's and Children's Health Network and School of Medicine and Robinson Research Institute, University of Adelaide, SA, Australia; and South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; Associate Professor David G. Regan: The Kirby Institute for Infection and Immunity in Society, Faculty of Medicine, UNSW Sydney, NSW, Australia; Professor Peter Richmond: Perth Children's Hospital, Child and Adolescent Health Service, Western Australia, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, WA, Australia, and School of Medicine, University of Western Australia, Perth, WA, Australia; Dr. Tanya Stoney: Telethon Kids Institute, University of Western Australia, WA, Australia. Contact for the HPV.edu study group: Cristyn.Davies@sydney.edu.au or Rachel.Skinner@sydney.edu.au.
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Affiliation(s)
- Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Sydney Infectious Diseases Institute, The University of Sydney, NSW, Australia; Wellbeing, Health and Youth National Health and Medical Research Council Centre for Research Excellence in Adolescent Health, Sydney, Australia.
| | - Helen S Marshall
- Women's and Children's Hospital and School of Medicine and Robinson Research Institute, The University of Adelaide, SA, Australia
| | - Julia M L Brotherton
- Australian Centre for the Prevention of Cervical Cancer, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia; National Centre for Immunisation Research and Surveillance, NSW, Australia
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Melissa Kang
- General Practice Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Kristine Macartney
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance, NSW, Australia
| | - Suzanne Garland
- Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Melbourne, Victoria, Australia; Reproductive and Neonatal Infectious Diseases, Department of Obstetrics and Gynaecology, University of Melbourne, Murdoch Children's Research Institute, Victoria, Australia
| | - John Kaldor
- The Kirby Institute for Infection and Immunity in Society, Faculty of Medicine, UNSW Sydney, NSW, Australia
| | - Gregory Zimet
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University, Indianapolis, USA
| | - S Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Wellbeing, Health and Youth National Health and Medical Research Council Centre for Research Excellence in Adolescent Health, Sydney, Australia
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Perry EN, Davies C, McCarthy P. Topical hypertonic saline as a treatment for ocular and nasal hirudiniasis in a dog. Aust Vet J 2023. [PMID: 37127402 DOI: 10.1111/avj.13245] [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: 01/07/2023] [Revised: 03/13/2023] [Accepted: 04/09/2023] [Indexed: 05/03/2023]
Abstract
This case report describes ocular and nasal leech infestation (hirudiniasis) in a dog. The patient presented for a suspected ocular foreign body. The patient was sedated to allow proper examination, which revealed a leech foreign body attached to the bulbar conjunctiva adjacent to the inferotemporal limbus of the left eye. A 3.5% hypertonic saline solution was applied topically to the eye in four sequential drops, until the leech detached itself and was removed with a cotton bud. The affected eye was found to have a small corneal ulcer, a small area of scleral haemorrhage, and prominent lymphoid follicles within the third eyelid. Approximately 5 min after the leech was removed, another leech emerged from the left nostril. The patient was sent home on chloramphenicol ointment for treatment of the corneal ulcer, was rechecked 4 days later by an American Board of Veterinary Ophthalmology resident (PM) and found to have a normal ocular exam. This case report highlights that topical hypertonic saline solution (3.5%) can be an effective and easily prepared treatment for ocular and nasal hirudiniasis in veterinary patients.
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Affiliation(s)
- E N Perry
- Northside Emergency Veterinary Service, Terrey Hills, New South Wales, Australia
| | - C Davies
- Northside Emergency Veterinary Service, Terrey Hills, New South Wales, Australia
| | - Pmg McCarthy
- Eye Clinic for Animals, Artarmon, New South Wales, Australia
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Ussher JM, Power R, Allison K, Sperring S, Parton C, Perz J, Davies C, Cook T, Hawkey AJ, Robinson KH, Hickey M, Anazodo A, Ellis C. Reinforcing or Disrupting Gender Affirmation: The Impact of Cancer on Transgender Embodiment and Identity. Arch Sex Behav 2023; 52:901-920. [PMID: 36689129 PMCID: PMC10101894 DOI: 10.1007/s10508-023-02530-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/14/2022] [Accepted: 01/02/2023] [Indexed: 05/11/2023]
Abstract
There is a pressing need for greater understanding and focus on cancer survivorship and informal cancer caring of trans people (binary and non-binary), across tumor types, to inform culturally safe trans inclusive cancer information and care. This qualitative study, part of the mixed methods Out with Cancer project, examined experiences of trans embodiment and identity after cancer diagnosis and treatment. We drew on open-ended survey responses from 63 trans cancer survivors and 23 trans cancer carers, as well as interviews and a photo-elicitation activity with a subset of 22 participants (15 cancer survivors, 7 cancer carers). Reflexive thematic analysis identified three themes: Cancer enhances trans embodiment, through experiences of gender euphoria following cancer treatment, and acceleration of decisions about gender affirmation; cancer erases or inhibits gender affirmation; trans embodiment is invisible or pathologized in cancer care. These findings demonstrate that trans embodiment and identity, as well as the process of gender affirmation, may be disrupted by cancer or informal cancer caring. Conversely, cancer and cancer treatment can positively impact the embodied identity and lives of trans people, despite the anxiety and strain of negotiating medical procedures. However, if healthcare professionals operate within a cis-heteronormative framework and do not understand the meaning of embodied change following cancer treatment for trans individuals, these positive benefits may not be realized.
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Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia.
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia
| | - Kimberley Allison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia
| | - Samantha Sperring
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia
| | - Chloe Parton
- School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia
- School of Social Sciences, Western Sydney University, Penrith, Sydney, Australia
| | - Teddy Cook
- TransHub, ACON, Surry Hills, Sydney, Australia
| | - Alexandra J Hawkey
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia
| | - Kerry H Robinson
- School of Social Sciences and Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Melbourne, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital and School of Women's and Children's, University of New South Wales, Sydney, Australia
| | - Colin Ellis
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW, 2752, Australia
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Swist T, Collin P, Lewis J, Medlow S, Williams I, Davies C, Steinbeck K. A digital innovation typology: Navigating the complexity of emerging technologies to negotiate health systems research with young people. Digit Health 2023; 9:20552076231212286. [PMID: 38025097 PMCID: PMC10631344 DOI: 10.1177/20552076231212286] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objective This study aims to explore young people's perspectives of emerging technologies and health systems research in an adolescent health community of practice. Methods The context of this integrated knowledge translation study is the Wellbeing Health & Youth Centre of Research Excellence in Adolescent Health. A theory-building, non-systematic review was conducted to examine the concepts and interrelationships of emerging technologies associated with digital innovation and health systems. This typology informed the design of an online workshop with young people to explore their views, concerns, and ideas about health systems research. Results A digital innovation typology was identified to differentiate and explain emerging technology concepts and interrelationships that can be applied to the health systems context. Aligned with this typology, youth perspectives about digital health challenges and opportunities were identified to support future research, policy, and practice. Conclusion The integrated findings from this study can assist the navigation of complex emerging technologies, and the negotiation of equitable health systems research, between youth and adult stakeholders. Further, with these typology-related resources, mutual learning and the public involvement of young people in health systems research and priority setting agendas can be supported.
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Affiliation(s)
- Teresa Swist
- Institute for Culture and Society, Young and Resilient Research Centre, Western Sydney University, Penrith, NSW, Australia
- Education Futures Studio, Sydney School of Education and Social Work, University of Sydney, Camperdown, NSW, Australia
| | - Philippa Collin
- Institute for Culture and Society, Young and Resilient Research Centre, Western Sydney University, Penrith, NSW, Australia
| | - John Lewis
- Wellbeing Health & Youth Commission, Sydney, NSW, Australia
| | - Sharon Medlow
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, Australia
| | - Ian Williams
- Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Children's Hospital Westmead Clinical School, Westmead, NSW, Australia
| | - Katharine Steinbeck
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, Australia
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando 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Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, 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L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton 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Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [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] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Thornton A, Peterson E, Thomas A, Regouski M, Liu Y, White K, Davies C, Polejaeva I, Rutigliano H. 86 The role of extracellular vesicles in immunomodulation during bovine pregnancy. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab86] [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: 12/12/2022] Open
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Swist T, Collin P, Nguyen B, Davies C, Cullen P, Medlow S, Skinner SR, Third A, Steinbeck K. Guiding, sustaining and growing the public involvement of young people in an adolescent health research community of practice. Health Expect 2022; 25:3085-3095. [DOI: 10.1111/hex.13616] [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] [Received: 10/17/2021] [Revised: 09/01/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Teresa Swist
- Institute for Culture and Society Western Sydney University Penrith New South Wales Australia
- Education Futures Studio, Sydney School of Education and Social Work University of Sydney Camperdown New South Wales Australia
| | - Philippa Collin
- Institute for Culture and Society Western Sydney University Penrith New South Wales Australia
| | - Betty Nguyen
- Young and Resilient Research Centre Western Sydney University Penrith New South Wales Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health University of Sydney Westmead New South Wales Australia
| | - Patricia Cullen
- School of Population Health UNSW Sydney Kensington New South Wales Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute University of Wollongong Wollongong New South Wales Australia
- The George Institute for Global Health UNSW Sydney Newtown New South Wales Australia
| | - Sharon Medlow
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia
- Academic Department of Adolescent Medicine The Children's Hospital Westmead Westmead New South Wales Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health University of Sydney Westmead New South Wales Australia
| | - Amanda Third
- Institute for Culture and Society Western Sydney University Penrith New South Wales Australia
| | - Katharine Steinbeck
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia
- Academic Department of Adolescent Medicine The Children's Hospital Westmead Westmead New South Wales Australia
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, 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Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Vujovich-Dunn C, Wand H, Brotherton JML, Gidding H, Sisnowski J, Lorch R, Veitch M, Sheppeard V, Effler P, Skinner SR, Venn A, Davies C, Hocking J, Whop L, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson C, Lane N, Kaldor J, Guy R. Measuring school level attributable risk to support school-based HPV vaccination programs. BMC Public Health 2022; 22:822. [PMID: 35468743 PMCID: PMC9036743 DOI: 10.1186/s12889-022-13088-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/24/2022] [Indexed: 12/27/2022] Open
Abstract
Background In Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation. Methods A population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence). Results The factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1–14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7–8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9–3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7–3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6–4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3–2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76–82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31–44) and lower attendance rate (PAR = 37%, 95%CI: 29–46). Conclusion This analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13088-x.
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Affiliation(s)
- C Vujovich-Dunn
- University of New South Wales, Kirby Institute, Kensington, Australia.
| | - H Wand
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - J M L Brotherton
- Australian Centre for the Prevention of Cervical Cancer, Population Health, East Melbourne, Victoria, Australia.,University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia
| | - H Gidding
- University of Sydney, Northern Clinical School, Sydney, Australia.,Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, Sydney, Australia.,School of Population Health, University of New South Wales, Kensington, Australia.,National Centre for Immunisation Research and Surveillance, Sydney, Australia
| | - J Sisnowski
- University of New South Wales, Kirby Institute, Kensington, Australia.,Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia
| | - R Lorch
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - M Veitch
- Department of Health and Human Services, Tasmanian Government, Hobart, Australia
| | - V Sheppeard
- Communicable Diseases Branch, NSW Health, St Leonards, New South Wales, Australia.,University of Sydney, Sydney School of Public Health, Camperdown, NSW, Australia
| | - P Effler
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia
| | - S R Skinner
- University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.,Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia
| | - C Davies
- University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.,Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia
| | - J Hocking
- University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia
| | - L Whop
- Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.,Menzies School of Health Research, Charles Darwin University, Cairns, QLD, Australia
| | - J Leask
- National Centre for Immunisation Research and Surveillance, Sydney, Australia.,University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, NSW, Australia
| | - K Canfell
- The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - L Sanci
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - M Smith
- The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - M Kang
- University of Sydney, Westmead Clinical School, Sydney, New South Wales, Australia
| | - M Temple-Smith
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - M Kidd
- Flinders University, Southgate Institute for Health, Society and Equity, Bedford Park, South Australia, Australia
| | - S Burns
- Curtin University, School of Population Health, Bentley, WA, Australia
| | - L Selvey
- University of Queensland, School of Public Health, St Lucia, QLD, Australia
| | - D Meijer
- Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia
| | - S Ennis
- Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia
| | - C Thomson
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia
| | - N Lane
- Department of Health and Human Services, Tasmanian Government, Hobart, Australia
| | - J Kaldor
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - R Guy
- University of New South Wales, Kirby Institute, Kensington, Australia
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Madlmeir S, Forgber T, Trogrlic M, Jajcevic D, Kape A, Contreras L, Carmody A, Liu P, Davies C, Sarkar A, Khinast J. Quantifying the Coating Yield by Modeling Heat and Mass Transfer in a Wurster Fluidized Bed Coater. Chem Eng Sci 2022. [DOI: 10.1016/j.ces.2022.117505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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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16
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Fadel MG, Walters U, Smith A, Bedi N, Davies C, Brock C, Dinneen M. Splenogonadal fusion: aiding detection and avoiding radical orchidectomy. Ann R Coll Surg Engl 2022; 104:32-34. [PMID: 35100848 DOI: 10.1308/rcsann.2021.1170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Splenogonadal fusion is a rare benign congenital anomaly in which there is an abnormal connection between the gonad and the spleen. It was first described over 100 years ago with limited reports in the literature since then. Its similarity in presentation to testicular neoplasia poses a significant challenge in diagnosis and management, often resulting in radical orchidectomy. We present the case of a 31-year-old man who presented with a rapidly growing left-sided testicular mass and suspicious ultrasound findings; histology from the subsequent radical inguinal orchidectomy showed findings consistent with splenogonadal fusion. We describe points for consideration in the clinical history, examination and imaging that could suggest splenogonadal fusion, including preoperative technetium-99m-sulfur colloid imaging and intraoperative frozen section evaluation, which may confirm the diagnosis and prevent unnecessary orchidectomy.
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Affiliation(s)
- M G Fadel
- Chelsea and Westminster Hospital, London, UK
| | - U Walters
- Chelsea and Westminster Hospital, London, UK
| | - A Smith
- Imperial College London, London, UK
| | - N Bedi
- Chelsea and Westminster Hospital, London, UK
| | - C Davies
- Chelsea and Westminster Hospital, London, UK
| | - C Brock
- Chelsea and Westminster Hospital, London, UK
| | - M Dinneen
- Chelsea and Westminster Hospital, London, UK
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17
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Hewawasam E, Davies C, Li Z, Clayton P, Sullivan E, McDonald S, Jesudason S. POS-161 Trends in labour and delivery outcomes among mothers receiving kidney replacement therapy: analysis of linked ANZDATA Registry and Perinatal datasets over 22 years. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.175] [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: 10/19/2022] Open
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18
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Davies C, Taba M, Deng L, Karatas C, Bag S, Ross C, Forster A, Booy R, Skinner SR. Usability, acceptability, and feasibility of a High-Density Microarray Patch (HD-MAP) applicator as a delivery method for vaccination in clinical settings. Hum Vaccin Immunother 2022; 18:2018863. [PMID: 35100525 PMCID: PMC9196792 DOI: 10.1080/21645515.2021.2018863] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background High-density microarray patch (HD-MAP) vaccines may increase vaccine acceptance and use. We aimed to ascertain whether professional immunizers (PIs) and other healthcare workers (HCWs) in Australia, a High-Income Country (HIC), found the HD-MAP applicator usable and acceptable for vaccine delivery. Methods This feasibility study recruited PIs and HCWs to administer/receive simulated HD-MAP administration, including via self-administration. We assessed usability against essential and desirable criteria. Participants completed a survey, rating their agreement to statements about HD-MAP administration. A subset also participated in an interview or focus group. Survey data were analyzed using descriptive statistics, and interviews were transcribed and subject to thematic analysis. Results We recruited 61 participants: 23 PIs and 38 HCWs. Findings indicated high usability and acceptability of HD-MAP use across both groups by a healthcare professional or trained user and for self-administration with safety measures in place. Most administrations met essential criteria, but PIs, on average, applied the HD-MAP for slightly less time than the required 10-seconds, which the HCWs achieved. PIs perceived safety concerns about home administration but found layperson self-administration acceptable in an emergency, pandemic, and rural or remote settings. Conclusions Participants found HD-MAP administration usable and acceptable. Usability and acceptability are likely to be improved through end-user education and training. Professional immunizers and healthcare workers found high-density microarray patch devices highly usable and acceptable to administer vaccines. HD-MAPs may have advantages over intramuscular injections in clinical settings and in pandemics.
Vaccination with HD-MAP may improve acceptance for those with needle-related anxiety.
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Affiliation(s)
- Cristyn Davies
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - Melody Taba
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - Lucy Deng
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia
| | - Ceylan Karatas
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,Graduate School of Medicine, The University of Wollongong, Keiraville, Australia
| | - Shopna Bag
- Centre for Population Health, Western Sydney Public Health Unit, North Parramatta, Australia.,Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Westmead, Australia
| | - Charles Ross
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia
| | - Angus Forster
- Vaxxas Pty Ltd, Translational Research Institute, Woolloongabba, Australia
| | - Robert Booy
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - S Rachel Skinner
- Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,Sydney Institute of Infectious Diseases, University of Sydney, Sydney, Australia
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19
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Wood CH, Underwood J, Davies C, Taylor PN. Patient Characteristics and Variables Influencing Acute Medical Flow. Acute Med 2022; 21:168-175. [PMID: 36809447 DOI: 10.52964/amja.0920] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Waiting times are the most widely used indicator of patient flow. This project aims to analyse 24-hour variation in referrals and waiting times for patients referred to the Acute Medical Service (AMS). A retrospective cohort study was conducted at the AMS of Wales' largest hospital. Collected data included patient characteristics, referral times, waiting times and adherence to Clinical Quality Indicators (CQIs). Peak referral times were found between 11:00-19:00. Peak waiting times occurred between 17:00-01:00, which was longer on weekdays in comparison to weekends. Referrals between 17:00-21:00 had the longest waiting times with > 40% of patients failing both junior and senior CQIs. Mean and median age and NEWS were higher between 17:00-09:00. Weekday evening and nights are problematic for acute medical patient flow. Interventions, including workforce, should be targeted towards these findings.
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Affiliation(s)
- C H Wood
- School of Medicine, Cardiff University, UK, CF14 4YS
| | - J Underwood
- Department of Infectious Diseases, Cardiff and Vale University Health Board
| | - C Davies
- Acute Medicine Service Manager, Cardiff and Vale University Healthy Board
| | - P N Taylor
- Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, CF14 4YS
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20
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Davies C, Marshall HS, Zimet G, McCaffery K, Brotherton JML, Kang M, Garland S, Kaldor J, McGeechan K, Skinner SR. Effect of a School-Based Educational Intervention About the Human Papillomavirus Vaccine on Psychosocial Outcomes Among Adolescents: Analysis of Secondary Outcomes of a Cluster Randomized Trial. JAMA Netw Open 2021; 4:e2129057. [PMID: 34726749 PMCID: PMC8564580 DOI: 10.1001/jamanetworkopen.2021.29057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Delivery of vaccination to adolescents via a school-based program provides an opportunity to promote their involvement in health decision-making, service provision, and self-efficacy (belief in one's ability to perform a certain behavior). OBJECTIVE To examine the effect of a human papillomavirus (HPV) vaccination education and logistical intervention on adolescent psychosocial outcomes. DESIGN, SETTING, AND PARTICIPANTS In this cluster randomized trial and process and qualitative evaluation, adolescents aged 12 to 13 years (first year of high school) were recruited at high schools in Western Australia (WA) and South Australia (SA) in 2013 and 2014. Statistical analysis was performed from January 2016 to December 2020. INTERVENTIONS The complex intervention consisted of an adolescent intervention to promote knowledge and psychosocial outcomes, shared decisional support tool, and logistical strategies. MAIN OUTCOMES AND MEASURES Prespecified secondary outcomes were assessed. The HPV Adolescent Vaccination Intervention Questionnaire (HAVIQ) was used to measure changes in adolescent knowledge (6-item subscale), fear and anxiety (6-item subscale), self-efficacy (5-item subscale), and decision-making (8-item subscale). The hypothesis was that the intervention would improve adolescent involvement in vaccine decision-making (measured before dose 1 only), improve vaccine-related self-efficacy, and reduce vaccine-related fear and anxiety (measured before doses 1, 2, and 3). Mean (SD) scores for each subscale were compared between intervention and control students. In the process evaluation, focus groups were conducted. Analyses of the HAVIQ data were conducted from 2016 to 2020. Qualitative analyses of the focus groups were undertaken from 2017 to 2020. RESULTS The trial included 40 schools (21 intervention and 19 control) across sectors with 6967 adolescents (mean [SD] age, 13.70 [0.45] years). There were 3805 students (1689 girls and 2116 boys) in the intervention group and 3162 students (1471 girls and 1691 boys) in the control group. The overall response rate for the HAVIQ was 55%. In WA, where parental consent was required, the response rate was 35% (1676 of 4751 students); in SA, where parental consent was not required, it was 97% (2166 of 2216 students). The mean (SD) score for decision-making in the intervention group before dose 1 was 3.50 (0.42) of 5 points and 3.40 (0.40) in the control group, a small but significant difference of 0.11 point (95% CI, 0.06 to 0.16 point; P < .001). There was a small difference in favor of the intervention group in reduced vaccination-related anxiety (pre-dose 1 difference, -0.11 point [95% CI, -0.19 to -0.02 point]; pre-dose 2 difference, -0.18 point [95% CI, -0.26 to -0.10 point]; pre-dose 3 difference, -0.18 [95% CI, -0.24 to -0.11]) and increased vaccination self-efficacy (pre-dose 1 difference, 4.0 points; [95% CI, 1.0 to 7.0 points]; pre-dose 2 difference, 4.0 points [95% CI, 2.0 to 6.0 points]; pre-dose 3 difference, 3.0 points [95% CI, 1.0 to 5.0 points]). Focus group data from 111 adolescents in 6 intervention and 5 control schools revealed more confidence and less anxiety with each vaccine dose. CONCLUSIONS AND RELEVANCE In this cluster randomized trial, there was a small difference in adolescent decisional involvement and vaccine-related confidence and reduced vaccination-related fear and anxiety that was maintained throughout the vaccine course in the intervention vs control groups. Guidelines for vaccination at school should incorporate advice regarding how this outcome can be achieved. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry: ACTRN12614000404628.
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Affiliation(s)
- Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Helen S. Marshall
- Women’s and Children’s Hospital and School of Medicine and Robinson Research Institute, The University of Adelaide, South Australia, Australia
| | - Gregory Zimet
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Julia M. L. Brotherton
- VCS Population Health, VCS Foundation, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melissa Kang
- Specialty of General Practice, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Health, School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Suzanne Garland
- Centre for Women’s Infectious Diseases Research, The Royal Women’s Hospital, Melbourne, Victoria, Australia
- Reproductive and Neonatal Infectious Diseases, Department of Obstetrics and Gynaecology, University of Melbourne, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - John Kaldor
- The Kirby Institute for Infection and Immunity in Society, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kevin McGeechan
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Vujovich-Dunn C, Skinner SR, Brotherton J, Wand H, Sisnowski J, Lorch R, Veitch M, Sheppeard V, Effler P, Gidding H, Venn A, Davies C, Hocking J, Whop LJ, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson CA, Lane N, Kaldor J, Guy R. School-Level Variation in Coverage of Co-Administered dTpa and HPV Dose 1 in Three Australian States. Vaccines (Basel) 2021; 9:vaccines9101202. [PMID: 34696310 PMCID: PMC8537995 DOI: 10.3390/vaccines9101202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/25/2021] [Revised: 09/14/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Australian adolescents are routinely offered HPV and dTpa (diphtheria, tetanus, pertussis) vaccines simultaneously in the secondary school vaccination program. We identified schools where HPV initiation was lower than dTpa coverage and associated school-level factors across three states. METHODS HPV vaccination initiation rates and dTpa vaccination coverage in 2016 were calculated using vaccine databases and school enrolment data. A multivariate analysis assessed sociodemographic and school-level factors associated with HPV initiation being >5% absolute lower than dTpa coverage. RESULTS Of 1280 schools included, the median school-level HPV initiation rate was 85% (interquartile range (IQR):75-90%) and the median dTpa coverage was 86% (IQR:75-92%). Nearly a quarter (24%) of all schools had HPV vaccination initiation >5% lower than dTpa coverage and 11 % had >10% difference. School-level factors independently associated with >5% difference were remote schools (aOR:3.5, 95% CI = 1.7-7.2) and schools in major cities (aOR:1.8, 95% CI = 1.0-3.0), small schools (aOR:3.3, 95% CI = 2.3-5.7), higher socioeconomic advantage (aOR:1.7, 95% CI = 1.1-2.6), and lower proportions of Language-background-other-than-English (aOR:1.9, 95% CI = 1.2-3.0). CONCLUSION The results identified a quarter of schools had lower HPV than dTpa initiation coverage, which may indicate HPV vaccine hesitancy, and the difference was more likely in socioeconomically advantaged schools. As hesitancy is context specific, it is important to understand the potential drivers of hesitancy and future research needs to understand the reasons driving differential uptake.
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Affiliation(s)
- Cassandra Vujovich-Dunn
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
- Correspondence: ; Tel.: +61-2-9348-0033
| | - Susan Rachel Skinner
- Children’s Hospital Westmead, Sydney Children’s Hospitals Network, Sydney 2145, Australia; (S.R.S.); (C.D.)
- Faculty of Medicine and Health, University of Sydney, Specialty of Child and Adolescent Health, Sydney 2006, Australia
| | - Julia Brotherton
- Population Health, VCS Foundation Ltd., East Melbourne, Melbourne 3053, Australia;
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne 3010, Australia;
| | - Handan Wand
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| | - Jana Sisnowski
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
- National Centre for Epidemiology & Population Health, Australian National University, Canberra 0200, Australia;
| | - Rebecca Lorch
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| | - Mark Veitch
- Department of Health and Human Services, Tasmanian Government, Hobart 7001, Australia; (M.V.); (N.L.)
| | - Vicky Sheppeard
- Communicable Diseases Branch, Health Protection NSW, St Leonards, Sydney 2065, Australia;
- School of Public Health, University of Sydney, Camperdown, Sydney 2006, Australia;
| | - Paul Effler
- Department of Health, Communicable Disease Control Directorate, East Perth 6000, Australia; (P.E.); (C.A.T.)
| | - Heather Gidding
- School of Population Health, University of New Souh Wales, Sydney 2052, Australia;
- Norther Clinical School of Sydney, University of Sydney, Camperdown, Sydney 2006, Australia
- Women and Babies Research, Kollin Intstitye, Northern Sydney Local Health District, St Leaonards, Sydney 2064, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, Sydney 2145, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian 7000, Australia;
| | - Cristyn Davies
- Children’s Hospital Westmead, Sydney Children’s Hospitals Network, Sydney 2145, Australia; (S.R.S.); (C.D.)
- Faculty of Medicine and Health, University of Sydney, Specialty of Child and Adolescent Health, Sydney 2006, Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne 3010, Australia;
| | - Lisa J. Whop
- National Centre for Epidemiology & Population Health, Australian National University, Canberra 0200, Australia;
- Menzies School of Health Research, Charles Darwin University, Brisbane 4000, Australia
| | - Julie Leask
- Faculty of Medicine and Health, Sydney Nursing School, University of Sydney, Camperdown, Sydney 2006, Australia;
| | - Karen Canfell
- Cancer Research Division, Cancer Council, Brisbane 2011, Australia;
| | - Lena Sanci
- Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Melbourne 3010, Australia; (L.S.); (M.T.-S.)
| | - Megan Smith
- School of Public Health, University of Sydney, Camperdown, Sydney 2006, Australia;
- Cancer Research Division, Cancer Council, Brisbane 2011, Australia;
| | - Melissa Kang
- Westmead Clinical School, University of Sydney, Sydney 2006, Australia;
| | - Meredith Temple-Smith
- Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Melbourne 3010, Australia; (L.S.); (M.T.-S.)
| | - Michael Kidd
- Southgate Institute for Health, Flinders University, Adelaide 5042, Australia;
| | - Sharyn Burns
- School of Population Health, Curtin University, Perth 6102, Australia;
| | - Linda Selvey
- School of Public Health, University of Queensland, Brisbane 4072, Australia;
| | - Dennis Meijer
- Immunisation Unit, Health Protection NSW, St Leonards, Sydney 2065, Australia; (D.M.); (S.E.)
| | - Sonya Ennis
- Immunisation Unit, Health Protection NSW, St Leonards, Sydney 2065, Australia; (D.M.); (S.E.)
| | - Chloe A. Thomson
- Department of Health, Communicable Disease Control Directorate, East Perth 6000, Australia; (P.E.); (C.A.T.)
| | - Nikole Lane
- Department of Health and Human Services, Tasmanian Government, Hobart 7001, Australia; (M.V.); (N.L.)
| | - John Kaldor
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| | - Rebecca Guy
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
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22
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Wallace J, Faiz J, Lowry D, Williams A, Davies C. 923 How Did the Initial Wave Of COVID-19 Affect CEPOD Waiting Times for Vascular Surgery? A Comparative Audit. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1125] [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: 11/14/2022]
Abstract
Abstract
Aim
Many vascular patients present acutely, relying on emergency theatre availability when surgical intervention is required. The prioritisation of the CEPOD operating list is a challenge, and the additional pressures of the COVID-19 pandemic have necessitated changes to established practice. The purpose of this audit was to review the effects of the pandemic on the CEPOD waiting times for vascular patients at the main centre for the South West Wales Vascular Network.
Method
The CEPOD waiting times for vascular patients during the initial wave of the COVID-19 pandemic were compared with the same period the previous year. Data was analysed according to booking category and procedure type.
Results
98 emergency vascular procedures were performed during the initial wave of the COVID pandemic, compared to 133 in 2019. In 2019, amputations (major and minor) accounted for 47% of cases, which rose to 53% during the pandemic. Median waiting times for category 1 and 2a operations were significantly shorter in 2020, whilst category 3 waiting times rose. There was no significant difference overall in the proportion of patients operated on within the target timescale, regardless of CEPOD booking category.
Conclusions
Managing the impact of COVID-19 required change to established practice. Although fewer procedures were performed, significant logistical challenges were faced. By adjusting the organisation of CEPOD, the most urgent vascular cases were performed quicker during this time. It is important to identify and promote the positive organisational changes that have arisen as a result of COVID-19, and to continue to review procedures as the pandemic progresses.
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Affiliation(s)
- J Wallace
- Morriston Hospital, Swansea, United Kingdom
| | - J Faiz
- Morriston Hospital, Swansea, United Kingdom
| | - D Lowry
- Morriston Hospital, Swansea, United Kingdom
- University Hospital Wales, Cardiff, United Kingdom
| | - A Williams
- University Hospital Wales, Cardiff, United Kingdom
| | - C Davies
- Morriston Hospital, Swansea, United Kingdom
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23
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Sisnowski J, Vujovich-Dunn C, Gidding H, Brotherton J, Wand H, Lorch R, Veitch M, Sheppeard V, Effler P, Skinner SR, Venn A, Davies C, Hocking J, Whop L, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson C, Lane N, Kaldor J, Guy R. Differences in school factors associated with adolescent HPV vaccination initiation and completion coverage in three Australian states. Vaccine 2021; 39:6117-6126. [PMID: 34493408 DOI: 10.1016/j.vaccine.2021.08.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/14/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. METHODS Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. RESULTS Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. CONCLUSION This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.
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Affiliation(s)
- J Sisnowski
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia; Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.
| | - C Vujovich-Dunn
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - H Gidding
- University of New South Wales, School of Public Health and Community Medicine, Kensington, Australia; National Centre for Immunisation Research and Surveillance, Westmead, Australia; The University of Sydney Northern Clinical School, St Leonards, Australia.
| | - J Brotherton
- Population Health, VCS Foundation, East Melbourne, Victoria, Australia; University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - H Wand
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - R Lorch
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - M Veitch
- Tasmanian Government, Department of Health and Human Services, Hobart, Australia.
| | - V Sheppeard
- Communicable Diseases Branch, Health Protection NSW, St Leonards, New South Wales, Australia; University of Sydney, Sydney School of Public Health, Camperdown, New South Wales, Australia.
| | - P Effler
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.
| | - S R Skinner
- Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia.
| | - C Davies
- Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - J Hocking
- University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - L Whop
- Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia; Menzies School of Health Research, Charles Darwin University, Cairns, Queensland, Australia.
| | - J Leask
- National Centre for Immunisation Research and Surveillance, Westmead, Australia; University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - K Canfell
- Cancer Research Division, Cancer Council, New South Wales, Australia.
| | - L Sanci
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia.
| | - M Smith
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia; Cancer Research Division, Cancer Council, New South Wales, Australia.
| | - M Kang
- University of Sydney, Westmead Clinical School, New South Wales, Australia.
| | - M Temple-Smith
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia.
| | - M Kidd
- Flinders University, Southgate Institute for Health, Society and Equity, South Australia, Australia.
| | - S Burns
- Curtin University, School of Population Health, Western Australia, Australia.
| | - L Selvey
- University of Queensland, School of Public Health, Queensland, Australia.
| | - D Meijer
- Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia.
| | - S Ennis
- Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia.
| | - C Thomson
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.
| | - N Lane
- Tasmanian Government, Department of Health and Human Services, Hobart, Australia.
| | - J Kaldor
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - R Guy
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
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24
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Wood RM, Pratt AC, Murch BJ, Powell AL, Booton RD, Thomas DG, Twigger J, Diakou E, Coleborn S, Manning T, Davies C, Turner KM. Establishing an SEIR-based framework for local modelling of COVID-19 infections, hospitalisations and deaths. Health Syst (Basingstoke) 2021; 10:337-347. [PMID: 34745593 PMCID: PMC8567954 DOI: 10.1080/20476965.2021.1973348] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/19/2021] [Indexed: 12/13/2022] Open
Abstract
Without timely assessments of the number of COVID-19 cases requiring hospitalisation, healthcare providers will struggle to ensure an appropriate number of beds are made available. Too few could cause excess deaths while too many could result in additional waits for elective treatment. As well as supporting capacity considerations, reliably projecting future "waves" is important to inform the nature, timing and magnitude of any localised restrictions to reduce transmission. In making the case for locally owned and locally configurable models, this paper details the approach taken by one major healthcare system in founding a multi-disciplinary "Scenario Review Working Group", comprising commissioners, public health officials and academic epidemiologists. The role of this group, which met weekly during the pandemic, was to define and maintain an evolving library of plausible scenarios to underpin projections obtained through an SEIR-based compartmental model. Outputs have informed decision-making at the system's major incident Bronze, Silver and Gold Commands. This paper presents illustrated examples of use and offers practical considerations for other healthcare systems that may benefit from such a framework.
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Affiliation(s)
- R. M. Wood
- Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK
- School of Management, University of Bath, Bath, UK
| | - A. C. Pratt
- Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK
| | - B. J. Murch
- Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK
| | - A. L. Powell
- Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK
| | - R. D. Booton
- Bristol Medical School, University of Bristol, Bristol, UK
| | - D. G. Thomas
- Public Health, Bristol City Council, Bristol, UK
| | - J. Twigger
- Public Health, Bristol City Council, Bristol, UK
| | - E. Diakou
- Business Intelligence, North Somerset Council, Weston-Super-Mare, UK
| | - S. Coleborn
- Public Health, South Gloucestershire Council, Yate, UK
| | - T. Manning
- Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK
| | - C. Davies
- Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK
| | - K. M. Turner
- Bristol Medical School, University of Bristol, Bristol, UK
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25
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Netfa F, King C, Davies C, Rashid H, Tashani M, Booy R, Skinner SR. Knowledge, Attitudes, and Perceptions of the Arabic-Speaking Community in Sydney, Australia, toward the Human Papillomavirus (HPV) Vaccination Program: A Qualitative Study. Vaccines (Basel) 2021; 9:vaccines9090940. [PMID: 34579177 PMCID: PMC8473026 DOI: 10.3390/vaccines9090940] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Little is known about acceptability of the human papillomavirus (HPV) vaccine among parents of adolescents from culturally and linguistically diverse backgrounds in Australia. This study aimed to explore the knowledge and attitudes of parents from Arabic backgrounds towards HPV vaccination offered to their children in the national school-based vaccination program. Methods: Qualitative interviews were conducted in Western Sydney, with parents of adolescents from Arabic backgrounds. Recruitment was via informal personal contacts and passive snowballing. Face-to-face semi-structured interviews were conducted in Arabic. These were audio-recorded, transcribed, and translated into English. Thematic analysis was used to identify emerging themes. Results: Commonly identified themes across fifteen interviews included: (1) lack of awareness and knowledge of HPV and its vaccination, (2) awareness and understanding of the government vaccination information sheet, (3) parents’ preferences for information provision, (4) the role of parents’ religious beliefs in forming attitudes about HPV vaccination, and (5) lost opportunities to educate parents about HPV vaccination during general practitioner (GP) visits. Conclusion: The findings point to the need to address cultural, language, and communication barriers to improve awareness and acceptability of HPV vaccination in the Arabic community. Educational strategies should be tailored to this community based on their specific information needs and preferences.
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Affiliation(s)
- Faeza Netfa
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Correspondence: or ; Tel.: +61-2-9351-2222; Fax: +61-29845-1418
| | - Catherine King
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Harunor Rashid
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Mohamed Tashani
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya
| | - Robert Booy
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - S. Rachel Skinner
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
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26
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Davies C, Elder CV, Riggs DW, Robinson KH. The importance of informed fertility counselling for trans young people. Lancet Child Adolesc Health 2021; 5:e36-e37. [PMID: 34418375 DOI: 10.1016/s2352-4642(21)00234-0] [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] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Cristyn Davies
- Speciality of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, NSW 2145, Australia; Wellbeing, Health & Youth National Health and Medical Research Council Centre for Research Excellence in Adolescent Health, Sydney, NSW, Australia.
| | - Charlotte V Elder
- Austin Health, Heidelberg, VIC, Australia; The Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Mercy Hospital for Women, Heidelberg, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Damien W Riggs
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia; School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Kerry H Robinson
- School of Social Sciences, Western Sydney University, NSW, Australia
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27
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Madlmeir S, Forgber T, Trogrlic M, Jajcevic D, Kape A, Contreras L, Carmody A, Liu P, Davies C, Sarkar A, Khinast JG. Modeling the coating layer thickness in a pharmaceutical coating process. Eur J Pharm Sci 2021; 161:105770. [PMID: 33610738 DOI: 10.1016/j.ejps.2021.105770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/13/2020] [Revised: 01/25/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022]
Abstract
Although mechanistic numerical simulations can offer great insights into a process, they are limited with respect to resolved process time. While statistical models provide long-term predictability, determining the underlying probability distributions is often challenging. In this work, detailed CFD-DEM simulations of a pharmaceutical Wurster coating process for microspheres are used to evaluate the input parameters for a novel Monte-Carlo simulation approach. The combined strengths of both modeling approaches make it possible to predict the coating mass and thickness distributions over the entire process time. It was observed that smaller beads receive a thicker coating layer since they pass the spray zone closer to the nozzle. Moreover, it was established that, in contrast to the airflow rate, the spray rate has a great impact on the inter-particle coating variability. A stochastic model was developed to investigate the relative contribution of coating layer variability and fill weight variability to the product non-uniformity in a capsule filling process of Multiple Unit Pellet Systems (MUPS).
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Affiliation(s)
- S Madlmeir
- Research Center Pharmaceutical Engineering, Graz, Austria
| | - T Forgber
- Research Center Pharmaceutical Engineering, Graz, Austria
| | - M Trogrlic
- Research Center Pharmaceutical Engineering, Graz, Austria
| | - D Jajcevic
- Research Center Pharmaceutical Engineering, Graz, Austria
| | - A Kape
- Glatt, Integrated Process Solution, Binzen, Germany
| | - L Contreras
- Worldwide Research, Development and Medical, Pfizer Inc., Sandwich, UK
| | - A Carmody
- Worldwide Research, Development and Medical, Pfizer Inc., Sandwich, UK
| | - P Liu
- Worldwide Research, Development and Medical, Pfizer Inc., Groton CT, USA
| | - C Davies
- Worldwide Research, Development and Medical, Pfizer Inc., Groton CT, USA
| | - A Sarkar
- Worldwide Research, Development and Medical, Pfizer Inc., Groton CT, USA
| | - J G Khinast
- Research Center Pharmaceutical Engineering, Graz, Austria; Institute of Process and Particle Engineering, Technical University of Graz, Austria.
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28
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Lai TC, Davies C, Robinson K, Feldman D, Elder CV, Cooper C, Pang KC, McDougall R. Effective fertility counselling for transgender adolescents: a qualitative study of clinician attitudes and practices. BMJ Open 2021; 11:e043237. [PMID: 34011585 PMCID: PMC8137211 DOI: 10.1136/bmjopen-2020-043237] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Fertility counselling for trans and gender diverse (TGD) adolescents has many complexities, but there is currently little guidance for clinicians working in this area. This study aimed to identify effective strategies for-and qualities of-fertility counselling for TGD adolescents based on clinicians' experiences. DESIGN We conducted qualitative semi-structured individual interviews in 2019 which explored clinician experiences and fertility counselling practices, perspectives of the young person's experience and barriers and facilitators to fertility preservation access. Data were analysed using thematic analysis. SETTING This qualitative study examined experiences of clinicians at the Royal Children's Hospital-a tertiary, hospital-based, referral centre and the main provider of paediatric TGD healthcare in Victoria, Australia. PARTICIPANTS We interviewed 12 clinicians from a range of disciplines (paediatrics, psychology, psychiatry and gynaecology), all of whom were involved with fertility counselling for TGD adolescents. RESULTS Based on clinician experiences, we identified five elements that can contribute to an effective approach for fertility counselling for TGD adolescents: a multidisciplinary team approach; shared decision-making between adolescents, their parents and clinicians; specific efforts to facilitate patient engagement; flexible personalised care; and reflective practice. CONCLUSIONS Identification of these different elements can inform and hopefully improve future fertility counselling practices for TGD adolescents, but further studies examining TGD adolescents' experiences of fertility counselling are also required.
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Affiliation(s)
- Timothy Chwan Lai
- Austin Health, Heidelberg, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kerry Robinson
- School of Social Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - Debi Feldman
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Charlotte Victoria Elder
- Austin Health, Heidelberg, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Charlie Cooper
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ken C Pang
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rosalind McDougall
- The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
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HEWAWASAM E, Davies C, Gulyani A, Li Z, Clayton P, Sullivan E, McDonald S, Jesudason S. POS-184 Maternal characteristics and birth outcomes for mothers receiving kidney replacement therapy: An analysis of linked ANZDATA Registry and Perinatal datasets over 22 years. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.196] [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: 10/21/2022] Open
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Fadel MG, Walters U, Smith A, Bedi N, Davies C, Brock C, Dinneen M. Splenogonadal fusion: aiding detection and avoiding radical orchidectomy. Ann R Coll Surg Engl 2021; 104:e32-e34. [PMID: 33739169 DOI: 10.1308/rcsann.2021.0080] [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] [Indexed: 11/22/2022] Open
Abstract
Splenogonadal fusion is a rare benign congenital anomaly in which there is an abnormal connection between the gonad and the spleen. It was first described over 100 years ago with limited reports in the literature since then. Its similarity in presentation to testicular neoplasia poses a significant challenge in diagnosis and management, often resulting in radical orchidectomy. We present the case of a 31-year-old man who presented with a rapidly growing left-sided testicular mass and suspicious ultrasound findings; histology from the subsequent radical inguinal orchidectomy showed findings consistent with splenogonadal fusion. We describe points for consideration in the clinical history, examination and imaging that could suggest splenogonadal fusion, including preoperative technetium-99m-sulfur colloid imaging and intraoperative frozen section evaluation, which may confirm the diagnosis and prevent unnecessary orchidectomy.
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Affiliation(s)
- M G Fadel
- Chelsea and Westminster Hospital, London, UK
| | - U Walters
- Chelsea and Westminster Hospital, London, UK
| | - A Smith
- Imperial College London, London, UK
| | - N Bedi
- Chelsea and Westminster Hospital, London, UK
| | - C Davies
- Chelsea and Westminster Hospital, London, UK
| | - C Brock
- Chelsea and Westminster Hospital, London, UK
| | - M Dinneen
- Chelsea and Westminster Hospital, London, UK
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Newman CE, Smith AKJ, Duck-Chong E, Vivienne S, Davies C, Robinson KH, Aggleton P. Waiting to be seen: social perspectives on trans health. Health Sociol Rev 2021; 30:1-8. [PMID: 33622203 DOI: 10.1080/14461242.2020.1868900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Anthony K J Smith
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Son Vivienne
- Thorne Harbour Health, Melbourne, Australia
- Transgender Victoria, Melbourne, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kerry H Robinson
- School of Social Sciences, Western Sydney University, Sydney, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
- School of Sociology, The Australian National University, Canberra, Australia
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Sayan A, Plant R, Eccles B, Davies C, Ilankovan V. Recent advances in the management of cutaneous malignant melanoma: our case cohort. Br J Oral Maxillofac Surg 2020; 59:534-545. [PMID: 33766481 DOI: 10.1016/j.bjoms.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/10/2020] [Indexed: 11/18/2022]
Abstract
Decades of research into the management of cutaneous malignant melanoma have proven it to be a 'tough nut to crack', and its incidence has continued to increase over the last 30 years. Surgery remains a gold standard for early-stage melanoma with five-year survival of 98% for stage I disease, and 90% for stage II. Nonetheless, patients with stage III disease are at a higher risk, resulting in local recurrence as well as distant metastasis. Research regarding the control of metastatic malignant melanoma of the head and neck has evolved. Currently the search is on to understand metastatic malignant melanoma as a heterogeneous disease both at the molecular and clinical level. This paper focuses on the latest systemic therapy for metastatic disease of the head and neck, including cytotoxic chemotherapy, immunotherapy, and target therapy. The new eighth edition of tumour staging, and the sequelae for malignant melanoma, sentinel lymph node biopsy (SLNB), surgical intervention, and its benefits and shortfalls, are discussed. Also, the outcome of our cohort series of patients with metastatic cutaneous malignant melanoma who were treated with systemic combination therapy in Dorset is presented.
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Affiliation(s)
- A Sayan
- Poole Hospital NHS Foundation Trust.
| | - R Plant
- Poole Hospital NHS Foundation Trust
| | - B Eccles
- Poole Hospital NHS Foundation Trust
| | - C Davies
- Poole Hospital NHS Foundation Trust
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Livesey LC, Yorke E, Parra A, Gray Q, Davies C, Weldon D, Schumacher J, Kimura S, Howard C, Sierra‐Rodriguez T, Mora‐Pereira M. Use of a carbonated beverage to disintegrate a phytobezoar obstructing the intrathoracic portion of the oesophagus of a horse. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L. C. Livesey
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - E. Yorke
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - A. Parra
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - Q. Gray
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - C. Davies
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - D. Weldon
- Southeast Equine Veterinary Services Phenix City AlabamaUSA
| | - J. Schumacher
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - S. Kimura
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - C. Howard
- Bluegrass Animal Clinic Grayson Kentucky USA
| | - T. Sierra‐Rodriguez
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - M. Mora‐Pereira
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
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Davies C, El Khaleq YA, Punwani R. EBUS audit Poole Hospital: how to improve patient experience. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30051-9] [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: 10/25/2022]
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McDonald S, Ullah S, Duncanson E, Dansie K, Gulyani A, Davies C, Jesudason S. SAT-032 WASTED TIME: HOW LONG DO AUSTRALIANS SPEND TRAVELLING TO HAEMODIALYSIS TREATMENTS? Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.054] [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] Open
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37
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Dansie K, Davies C, Hawley C, Johnson D, Craig J, Chapman J, Cooper B, Pollock C, Harris D, McDonald S. SAT-022 ASSOCIATION BETWEEN PUBLICATION OF THE INITIATING DIALYSIS EARLY AND LATE (IDEAL) STUDY AND CHANGE IN DIALYSIS INITIATION PRACTICE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.044] [Citation(s) in RCA: 1] [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: 11/16/2022] Open
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Akhtar AMA, Patel K, Chahal A, Akhtar M, Nay A, Fung K, Sekhri N, Treibel T, Westwood M, Davies C, Khanji M, Manisty C, Lorenzini M, Moon J, Petersen SE. P593Hypereosinophilic carditis (HEC): a cmr-based case series from a quaternary cardiology centre. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez116] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A M A Akhtar
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - K Patel
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - A Chahal
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Akhtar
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - A Nay
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - N Sekhri
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - T Treibel
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Westwood
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - C Davies
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Khanji
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - C Manisty
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Lorenzini
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - J Moon
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
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Asher A, Ghelani R, Singhal A, Thornton G, Davies C, Wragg A. P113Current utility and provision of FFRCT. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Asher
- Barts Health Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - R Ghelani
- Barts Health Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - A Singhal
- Barts Health Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - G Thornton
- Barts Health Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - C Davies
- Barts Health Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - A Wragg
- Barts Health Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
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Tzioras M, Davies C, Newman A, Jackson R, Spires‐Jones T. Invited Review: APOE at the interface of inflammation, neurodegeneration and pathological protein spread in Alzheimer's disease. Neuropathol Appl Neurobiol 2019; 45:327-346. [PMID: 30394574 PMCID: PMC6563457 DOI: 10.1111/nan.12529] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 10/27/2018] [Indexed: 12/13/2022]
Abstract
Despite more than a century of research, the aetiology of sporadic Alzheimer's disease (AD) remains unclear and finding disease modifying treatments for AD presents one of the biggest medical challenges of our time. AD pathology is characterized by deposits of aggregated amyloid beta (Aβ) in amyloid plaques and aggregated tau in neurofibrillary tangles. These aggregates begin in distinct brain regions and spread throughout the brain in stereotypical patterns. Neurodegeneration, comprising loss of synapses and neurons, occurs in brain regions with high tangle pathology, and an inflammatory response of glial cells appears in brain regions with pathological aggregates. Inheriting an apolipoprotein E ε4 (APOE4) allele strongly increases the risk of developing AD for reasons that are not yet entirely clear. Substantial amounts of evidence support a role for APOE in modulating the aggregation and clearance of Aβ, and data have been accumulating recently implicating APOE4 in exacerbating neurodegeneration, tau pathology and inflammation. We hypothesize that APOE4 influences all the pathological hallmarks of AD and may sit at the interface between neurodegeneration, inflammation and the spread of pathologies through the brain. Here, we conducted a systematic search of the literature and review evidence supporting a role for APOE4 in neurodegeneration and inflammation. While there is no direct evidence yet for APOE4 influencing the spread of pathology, we postulate that this may be found in future based on the literature reviewed here. In conclusion, this review highlights the importance of understanding the role of APOE in multiple important pathological mechanisms in AD.
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Affiliation(s)
- M. Tzioras
- UK Dementia Research Institute and Centre for Discovery Brain SciencesThe University of EdinburghEdinburghUK
| | - C. Davies
- UK Dementia Research Institute and Centre for Discovery Brain SciencesThe University of EdinburghEdinburghUK
| | - A. Newman
- UK Dementia Research Institute and Centre for Discovery Brain SciencesThe University of EdinburghEdinburghUK
| | - R. Jackson
- UK Dementia Research Institute and Centre for Discovery Brain SciencesThe University of EdinburghEdinburghUK
- Massachusetts General Hospital and Harvard Medical SchoolCharlestownMAUSA
| | - T. Spires‐Jones
- UK Dementia Research Institute and Centre for Discovery Brain SciencesThe University of EdinburghEdinburghUK
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Pugh G, Hough R, Gravestock H, Davies C, Horder R, Fisher A. The development and user evaluation of health behaviour change resources for teenage and young adult Cancer survivors. Res Involv Engagem 2019; 5:9. [PMID: 30815279 PMCID: PMC6377718 DOI: 10.1186/s40900-019-0142-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
PLAIN ENGLISH SUMMARY This paper describes the methods that were used to develop a health behaviour intervention specifically for teenage and young adult cancer survivors (TYACS). The program of work, carried out in partnership with CLIC Sargent (a UK based cancer charity for children and young people) was guided by The Behaviour Change Intervention Design Process. A systematic review of existing intervention studies was carried out and TYACS were surveyed on their interest in receiving health behaviour information and their preference regarding the format, delivery and timing of such information. Health professionals were also surveyed to gather their views on how health behaviour information would be best delivered to young people with cancer. The results of these studies informed the development of a collection of health behaviour change intervention resources containing comprehensive lifestyle information and behaviour change support tools. TYACS and TYA health professionals were invited to review and provide feedback on the relevance, appeal and usability of the resources. It is hoped that by involving TYACS and TYA representatives at every stage of intervention development the problem of low uptake and adherence commonly encountered during intervention piloting will be prevented. ABSTRACT Background Teenage and Young Adult Cancer Survivors (TYACS) are advised to adopt a healthy lifestyle in order to reduce the impact of cancer and its treatments upon their long-term health. However, at present there are no interventions available in the UK to support TYACS to lead a healthy lifestyle. To inform the development of a lifestyle intervention for TYACS a partnership was set up between academic behavioural scientists and CLIC Sargent, a cancer charity which supports children and young people. Methods A series of studies to understand patient and professionals needs and perspectives regarding health behaviour change were carried out. TYACS were surveyed to gather data on their current health behaviour status; interest in, and experience of receiving, lifestyle advice; and preference regarding the type, format, and delivery of a lifestyle intervention. Health care professionals were surveyed simultaneously to gather their views on how best to promote health behaviour change to TYACS. In this paper we summarise key findings from the development work, the resulting lifestyle intervention, and new data from a preliminary evaluation study exploring TYACS and TYA health professionals' views on the relevance, appeal and usability of the intervention resources. Results A collection of health behaviour change intervention resources containing lifestyle information and behaviour change support tools were developed. These intervention resources were well received by TYACS and health professionals with the majority rating the information as high quality, helpful and relevant. Over 80% of TYACS reported they would find the support tools 'very appealing' or 'quite appealing'. TYACS and health professionals provided feedback on how the resources could be improved including commenting that more personalized or tailored health behaviour information would be beneficial. Discussion and conclusion It is hoped that by involving TYACS and TYA representatives at every stage of intervention development,and carrying out a preliminary evaluation of the intervention resources, the problem of low uptake and adherence commonly encountered during formal intervention piloting and evaluation will be prevented.
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Affiliation(s)
- Gemma Pugh
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
- Centre for Sports & Exercise Medicine, Queen Mary University of London, London, UK
| | - R. Hough
- Department of Haematology, University College London Hospital, London, UK
| | - H. Gravestock
- CLIC Sargent, No. 1 Farriers Yard, Assembly London, 77-85 Fulham Palace Road, London, UK
| | - C. Davies
- CLIC Sargent, No. 1 Farriers Yard, Assembly London, 77-85 Fulham Palace Road, London, UK
| | - R. Horder
- CLIC Sargent, No. 1 Farriers Yard, Assembly London, 77-85 Fulham Palace Road, London, UK
| | - A. Fisher
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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Nalajala N, Davies C. Leader's behaviors for promoting innovation in a multidisciplinary musculoskeletal service. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.140] [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: 10/27/2022]
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Brodbelt A, Williams M, Thorpe A, Mills S, Price S, Lekka E, Watts C, Davies C, Jenkinson M. P01.100 Tumour treating fields: Acceptable, tolerable, and can we reduce cost? Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.142] [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 Brodbelt
- The Walton Centre NHS Foundation trust, Liverpool, United Kingdom
| | - M Williams
- Imperial College Healthcare NHS Foundation Trust, London, United Kingdom
| | - A Thorpe
- The Walton Centre NHS Foundation trust, Liverpool, United Kingdom
| | - S Mills
- The Walton Centre NHS Foundation trust, Liverpool, United Kingdom
| | - S Price
- Cambridge University Hospitals NHS Foundation trust, Cambridge, United Kingdom
| | - E Lekka
- Lancashire teaching hospitals NHS Foundation trust, Preston, United Kingdom
| | - C Watts
- University hospitals Birmingham NHS Foundation trust, Birmingham, United Kingdom
| | - C Davies
- Lancashire teaching hospitals NHS Foundation trust, Preston, United Kingdom
| | - M Jenkinson
- Liverpool University, Liverpool, United Kingdom
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Castle EV, Rathod K, Treibel T, Davies C, Guttmann O, Curtis M, Knight C, Moon J, Smith E, Weerackody R, Bourantas C, Wragg A, Mathur A, Pugliese F, Jones D. P1781An observational study assessing the value of computed tomography cardiac angiography (CTCA) in planning invasive angiographic procedures in patients with previous coronary artery bypass grafts (CABG). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1781] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E V Castle
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - K Rathod
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - T Treibel
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - C Davies
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - O Guttmann
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - M Curtis
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - C Knight
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - J Moon
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - E Smith
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - R Weerackody
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - C Bourantas
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - A Wragg
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - A Mathur
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - F Pugliese
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - D Jones
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
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Dewi M, Hopkins L, Davies C. Do vascular surgery interventions increase frailty? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.665] [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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Fernando GJP, Hickling J, Jayashi Flores CM, Griffin P, Anderson CD, Skinner SR, Davies C, Witham K, Pryor M, Bodle J, Rockman S, Frazer IH, Forster AH. Safety, tolerability, acceptability and immunogenicity of an influenza vaccine delivered to human skin by a novel high-density microprojection array patch (Nanopatch™). Vaccine 2018; 36:3779-3788. [PMID: 29779922 DOI: 10.1016/j.vaccine.2018.05.053] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Injection using needle and syringe (N&S) is the most widely used method for vaccination, but requires trained healthcare workers. Fear of needles, risk of needle-stick injury, and the need to reconstitute lyophilised vaccines, are also drawbacks. The Nanopatch (NP) is a microarray skin patch comprised of a high-density array of microprojections dry-coated with vaccine that is being developed to address these shortcomings. Here we report a randomised, partly-blinded, placebo-controlled trial that represents the first use in humans of the NP to deliver a vaccine. METHODS Healthy volunteers were vaccinated once with one of the following: (1) NPs coated with split inactivated influenza virus (A/California/07/2009 [H1N1], 15 µg haemagglutinin (HA) per dose), applied to the volar forearm (NP-HA/FA), n = 15; (2) NPs coated with split inactivated influenza virus (A/California/07/2009 [H1N1], 15 µg HA per dose), applied to the upper arm (NP-HA/UA), n = 15; (3) Fluvax® 2016 containing 15 µg of the same H1N1 HA antigen injected intramuscularly (IM) into the deltoid (IM-HA/D), n = 15; (4) NPs coated with excipients only, applied to the volar forearm (NP-placebo/FA), n = 5; (5) NPs coated with excipients only applied to the upper arm (NP-placebo/UA), n = 5; or (6) Saline injected IM into the deltoid (IM-placebo/D), n = 5. Antibody responses at days 0, 7, and 21 were measured by haemagglutination inhibition (HAI) and microneutralisation (MN) assays. FINDINGS NP vaccination was safe and acceptable; all adverse events were mild or moderate. Most subjects (55%) receiving patch vaccinations (HA or placebo) preferred the NP compared with their past experience of IM injection with N&S (preferred by 24%). The antigen-vaccinated groups had statistically higher HAI titres at day 7 and 21 compared with baseline (p < 0.0001), with no statistical differences between the treatment groups (p > 0.05), although the group sizes were small. The geometric mean HAI titres at day 21 for the NP-HA/FA, NP-HA/UA and IM-HA/D groups were: 335 (189-593 95% CI), 160 (74-345 95% CI), and 221 (129-380 95% CI) respectively. A similar pattern of responses was seen with the MN assays. Application site reactions were mild or moderate, and more marked with the influenza vaccine NPs than with the placebo or IM injection. INTERPRETATION Influenza vaccination using the NP appeared to be safe, and acceptable in this first time in humans study, and induced similar immune responses to vaccination by IM injection.
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Affiliation(s)
- Germain J P Fernando
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Brisbane, QLD 4102, Australia
| | | | - Cesar M Jayashi Flores
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Brisbane, QLD 4102, Australia
| | - Paul Griffin
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Q-Pharm Pty Ltd, Brisbane, QLD, Australia; Department of Medicine and Infectious Dieases, Mater Hospital and Mater Research Institute, Brisbane, QLD, Australia; The University of Queensland, Brisbane, QLD, Australia
| | - Christopher D Anderson
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linkӧping University, Linkӧping, Sweden; Department of Dermatology and Venereology, Heart and Medicine Centre, Region Ӧstergötland, Sweden
| | - S Rachel Skinner
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Katey Witham
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Brisbane, QLD 4102, Australia
| | - Melinda Pryor
- 360biolabs Pty Ltd, Burnet Institute, Melbourne, VIC, Australia
| | | | - Steve Rockman
- Seqirus Pty Ltd, Melbourne, VIC, Australia; University of Melbourne, Melbourne, VIC, Australia
| | - Ian H Frazer
- The University of Queensland, Brisbane, QLD, Australia
| | - Angus H Forster
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Brisbane, QLD 4102, Australia.
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Gahkani A, Piotrowski C, Haberl B, Wilcock P, Davies C. 115 Rapid Determination of Proximates and Amino Acids in Corn Distillers Grains Using Near Infrared Spectroscopy. J Anim Sci 2018. [DOI: 10.1093/jas/sky073.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
| | | | - B Haberl
- Iowa Select Farms, Iowa Falls, IA
| | - P Wilcock
- AB Vista, Marlborough, United Kingdom
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Bailey J, Davies C, McCrossin T, Kiernan M, Skinner R, Steinbeck K, Mendis K. Fit4YAMs: Structuring a Lifestyle Intervention for Rural Overweight and Obese Young Adult Males Using Participatory Design. J Adolesc Health 2018; 62:S65-S71. [PMID: 29455721 DOI: 10.1016/j.jadohealth.2017.06.019] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/15/2017] [Accepted: 06/21/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Young adult males (YAMs) are understudied with respect to lifestyle interventions to address overweight and obesity in this group. This study reports on the participatory design of the structure and delivery of the Fit4YAMs text message-based lifestyle intervention for 18- to 25-year-old rural YAMs in Australia. METHODS Two semi-structured focus group discussions were held with six overweight or obese YAMs. Sessions explored their preferences for the structure and delivery of a weight loss intervention. Focus groups were recorded, and the contents transcribed verbatim for thematic analysis. RESULTS The YAMs were unanimous in their preference for a highly personalized intervention program, complete with personalized goal setting, personalized motivation and engagement strategies, and personalized text message content. A text message frequency of three-four messages per week was deemed optimal for this group. Minimal direct contact by the intervention team was requested, but with clear guidelines and reminders of key contacts whom they could contact should they require help and guidance. The YAMs also agreed that a comprehensive goal setting session and personalization session prior to commencement of the intervention would be best. CONCLUSIONS To engage rural YAMs in lifestyle interventions, a high degree of personalization of the program appears important. Although initially more time and resource intensive than a less personalized approach, it is essential to identify strategies to prevent and reverse weight gain in this hard to engage group. Maximizing their engagement using a more personalized approach could be the key to promoting long-term health outcomes in this group.
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Affiliation(s)
- Jannine Bailey
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, New South Wales, Australia.
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, University of Sydney, The Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Timothy McCrossin
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, New South Wales, Australia
| | - Michael Kiernan
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Rachel Skinner
- Discipline of Child and Adolescent Health, University of Sydney, The Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Katharine Steinbeck
- Discipline of Child and Adolescent Health, University of Sydney, The Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Kumara Mendis
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, New South Wales, Australia
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Fusar-Poli P, Palombini E, Davies C, Oliver D, Bonoldi I, Ramella-Cravaro V, McGuire P. Why transition risk to psychosis is not declining at the OASIS ultra high risk service: The hidden role of stable pretest risk enrichment. Schizophr Res 2018; 192:385-390. [PMID: 28734908 DOI: 10.1016/j.schres.2017.06.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 10/28/2016] [Revised: 06/07/2017] [Accepted: 06/10/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The reason for declining risk to psychosis across individuals assessed and meeting Ultra High Risk (UHR) criteria is still unclear. No studies have investigated the potential substantial role of the underlying risk enrichment across all the individuals undergoing an UHR assessment. METHODS Cohort study including all non-psychotic subjects who were assessed on suspicion of psychosis risk by the OASIS UHR service in the period 2001 to 2015. Posttest (after UHR assessment) and pretest risk (before UHR assessment) of psychosis were stratified and compared across three time periods (2001-2005, 2006-2010, 2011-2015) with Cox analysis and modulating factors were investigated. RESULTS The posttest risk of psychosis at the OASIS service has increased from the initial pilot years of the service (2001-2005) and then stabilised and not declined over the following decade (2006-2010 and 2011-2015). This was paralleled by a similar course of pretest risk for psychosis. Stability of pretest risk for psychosis over the past decade was associated with a lack of change in ethnicity and to counterweighting changes in the type of referral sources over different time periods. CONCLUSIONS The time course of transition risk to psychosis in UHR services is strictly associated with the time course of pretest risk enrichment. If the latter remains stable over time, as for the OASIS service, no declining transition risk is observed over the most recent years. Pretest risk enrichment is determined by recruitment and sampling strategies. This study confirms the need to control these factors in the UHR field.
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Affiliation(s)
- P Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, United Kingdom.
| | - E Palombini
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - C Davies
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - D Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - I Bonoldi
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
| | - V Ramella-Cravaro
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - P McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
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50
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Griffin P, Elliott S, Krauer K, Davies C, Rachel Skinner S, Anderson CD, Forster A. Safety, acceptability and tolerability of uncoated and excipient-coated high density silicon micro-projection array patches in human subjects. Vaccine 2017; 35:6676-6684. [DOI: 10.1016/j.vaccine.2017.10.021] [Citation(s) in RCA: 28] [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: 05/08/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 11/16/2022]
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