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Islam N, Reid D. Inhaled antibiotics: A promising drug delivery strategies for efficient treatment of lower respiratory tract infections (LRTIs) associated with antibiotic resistant biofilm-dwelling and intracellular bacterial pathogens. Respir Med 2024; 227:107661. [PMID: 38729529 DOI: 10.1016/j.rmed.2024.107661] [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: 03/05/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/12/2024]
Abstract
Antibiotic-resistant bacteria associated with LRTIs are frequently associated with inefficient treatment outcomes. Antibiotic-resistant Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus, infections are strongly associated with pulmonary exacerbations and require frequent hospital admissions, usually following failed management in the community. These bacteria are difficult to treat as they demonstrate multiple adaptational mechanisms including biofilm formation to resist antibiotic threats. Currently, many patients with the genetic disease cystic fibrosis (CF), non-CF bronchiectasis (NCFB) and chronic obstructive pulmonary disease (COPD) experience exacerbations of their lung disease and require high doses of systemically administered antibiotics to achieve meaningful clinical effects, but even with high systemic doses penetration of antibiotic into the site of infection within the lung is suboptimal. Pulmonary drug delivery technology that reliably deliver antibacterials directly into the infected cells of the lungs and penetrate bacterial biofilms to provide therapeutic doses with a greatly reduced risk of systemic adverse effects. Inhaled liposomal-packaged antibiotic with biofilm-dissolving drugs offer the opportunity for targeted, and highly effective antibacterial therapeutics in the lungs. Although the challenges with development of some inhaled antibiotics and their clinicals trials have been studied; however, only few inhaled products are available on market. This review addresses the current treatment challenges of antibiotic-resistant bacteria in the lung with some clinical outcomes and provides future directions with innovative ideas on new inhaled formulations and delivery technology that promise enhanced killing of antibiotic-resistant biofilm-dwelling bacteria.
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Affiliation(s)
- Nazrul Islam
- Pharmacy Discipline, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Centre for Immunology and Infection Control (CIIC), Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - David Reid
- Lung Inflammation and Infection, QIMR Berghofer Medical Research Institute, Australia
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Ogaz D, Enayat Q, Brown JRG, Phillips D, Wilkie R, Jayes D, Reid D, Hughes G, Mercer CH, Saunders J, Mohammed H. Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022. Emerg Infect Dis 2024; 30:916-925. [PMID: 38573160 PMCID: PMC11060451 DOI: 10.3201/eid3005.230676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
During the 2022 multicountry mpox outbreak, the United Kingdom identified cases beginning in May. UK cases increased in June, peaked in July, then rapidly declined after September 2022. Public health responses included community-supported messaging and targeted mpox vaccination among eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online survey of GBMSM during November-December 2022, we examined self-reported mpox diagnoses, behavioral risk modification, and mpox vaccination offer and uptake. Among 1,333 participants, only 35 (2.6%) ever tested mpox-positive, but 707 (53%) reported behavior modification to avoid mpox. Among vaccine-eligible GBMSM, uptake was 69% (95% CI 65%-72%; 601/875) and was 92% (95% CI 89%-94%; 601/655) among those offered vaccine. GBMSM self-identifying as bisexual, reporting lower educational qualifications, or identifying as unemployed were less likely to be vaccinated. Equitable offer and provision of mpox vaccine are needed to minimize the risk for future outbreaks and mpox-related health inequalities.
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3
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Lewis R, Bosó Pérez R, Maxwell KJ, Reid D, Macdowall W, Bonell C, Fortenberry JD, Mercer CH, Sonnenberg P, Mitchell KR. Conceptualizing Sexual Wellbeing: A Qualitative Investigation to Inform Development of a Measure (Natsal-SW). J Sex Res 2024:1-19. [PMID: 38517458 DOI: 10.1080/00224499.2024.2326933] [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] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Despite increasing scientific and policy interest in sexual wellbeing, it remains poorly conceptualized. Many studies purporting to measure it instead measure related but distinct concepts, such as sexual satisfaction. This lack of conceptual clarity impedes understanding, measuring, and improving sexual wellbeing. We present qualitative research from multi-stage, mixed-methods work to develop a new measure of sexual wellbeing (Natsal-SW) for the fourth British National Survey of Sexual Attitudes & Lifestyles. Literature review and discussion generated a conceptual framework with seven proposed domains: respect, self-esteem, comfort, self-determination, safety and security, forgiveness, and resilience. Semi-structured interviews with 40 adults aged 18-64 then explored whether and how these domains aligned with participants' own understandings, experiences, and language of sexual wellbeing. Data were analyzed thematically. Participants conceptualized sexual wellbeing as distinct from sexual satisfaction and sexual health and as multidimensional, dynamic, and socially and structurally influenced. All seven proposed domains resonated with accounts of sexual wellbeing as a general construct. The personal salience of different domains and their dimensions varied between individuals (especially by gender and sexual orientation) and fluctuated individually over time. This study clarifies dimensions of domains that participants considered important, providing an empirical basis to inform development of a new measure of sexual wellbeing.
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Affiliation(s)
- R Lewis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - R Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - K J Maxwell
- Research Centre for Health, Glasgow Caledonian University
| | - D Reid
- Institute for Global Health, University College London
| | - W Macdowall
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine
| | - C Bonell
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine
| | - J D Fortenberry
- Department of Pediatrics, Indiana University School of Medicine
| | - C H Mercer
- Institute for Global Health, University College London
| | - P Sonnenberg
- Institute for Global Health, University College London
| | - K R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
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Mitchell KR, Palmer MJ, Lewis R, Bosó Pérez R, Maxwell KJ, Macdowall W, Reid D, Bonell C, Mercer CH, Sonnenberg P, Fortenberry JD. Development and Validation of a Brief Measure of Sexual Wellbeing for Population Surveys: The Natsal Sexual Wellbeing Measure (Natsal-SW). J Sex Res 2023:1-11. [PMID: 38127808 DOI: 10.1080/00224499.2023.2278530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Sexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test-retest reliability. Confirmatory factor analysis indicated that a "general specific model" had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (-0.384), anxiety (-0.340), sexual satisfaction (0.680) and sexual distress (-0.615), and demonstrated good test-retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations.
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Affiliation(s)
| | - Melissa J Palmer
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - Ruth Lewis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | | | - Wendy Macdowall
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - David Reid
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - Chris Bonell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
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Evans IES, Kumar S, France M, Smith D, Masel P, Tay G, Henderson D, Bell SC, Reid D. Paraquat ingestion in an adult with cystic fibrosis (CF): Diagnostic and management dilemmas. Respirol Case Rep 2023; 11:e01235. [PMID: 38028563 PMCID: PMC10655628 DOI: 10.1002/rcr2.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/07/2023] [Indexed: 12/01/2023] Open
Abstract
N,N'-dimethyl-4,4'bipyridinium dichloride (Paraquat) is a potent herbicide used widely in agriculture. We report the effects of an ingestion of paraquat by a 28 year old male with cystic fibrosis and the diagnostic and management challenges this posed in both the acute and longer term setting. We describe the effects of direct paraquat toxicity on the lung tissue secondary to aspiration and review the long-term sequelae of paraquat, namely osteonecrosis. Our case is the first to describe osteonecrosis of the knee in the context of paraquat toxicity. Survival following ingestion remains poor with a high associated mortality. However, timely treatment with NAC and immunosuppression may impact on survival. In those patients who do survive the acute phase post ingestion, follow-up over years may be required to detect the long-term effects of paraquat on bone health.
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Affiliation(s)
- Ieuan E. S. Evans
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
| | - Shanal Kumar
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
| | - Megan France
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
| | - Daniel Smith
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Philip Masel
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - George Tay
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Daniel Henderson
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
| | - Scott C. Bell
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Translational Research InstituteBrisbaneQueenslandAustralia
| | - David Reid
- Adult Cystic Fibrosis CentreThe Prince Charles HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Lung Inflammation & InfectionQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
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6
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Lui S, Dubrofsky L, Khan NA, Tobe SW, Huynh J, Kuyper L, Mathew A, Amin S, Schiffrin EL, Harvey P, Leung AA, Ruzicka M, Mangat B, Reid D, Floras J, Bittman J, Garbutt L, Braam B, Suri R, Hannah-Shmouni F, Prebtani A, Savard S, MacMillan TE, Ruddy TD, Vallee M, Bollu A, Logan A, Padwal R, Ringrose J. Characterizing Hypertension Specialist Care in Canada: A National Survey. CJC Open 2023; 5:907-915. [PMID: 38204853 PMCID: PMC10774075 DOI: 10.1016/j.cjco.2023.08.014] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/29/2023] [Indexed: 01/12/2024] Open
Abstract
Background The hypertension specialist often receives referrals of patients with young-onset, severe, difficult-to-control hypertension, patients with hypertensive emergencies, and patients with secondary causes of hypertension. Specialist hypertension care compliments primary care for these complex patients and contributes to an overall hypertension control strategy. The objective of this study was to characterize hypertension centres and the practice patterns of Canadian hypertension specialists. Methods Adult hypertension specialists across Canada were surveyed to describe hypertension centres and specialist practice in Canada, including the following: the patient population managed by hypertension specialists; details on how care is provided; practice pattern variations; and differences in access to specialized hypertension resources across the country. Results The survey response rate was 73.5% from 25 hypertension centres. Most respondents were nephrologists and general internal medicine specialists. Hypertension centres saw between 50 and 2500 patients yearly. A mean of 17% (± 15%) of patients were referred from the emergency department and a mean of 52% (± 24%) were referred from primary care. Most centres had access to specialized testing (adrenal vein sampling, level 1 sleep studies, autonomic testing) and advanced therapies for resistant hypertension (renal denervation). Considerable heterogeneity was present in the target blood pressure in young people with low cardiovascular risk and in the diagnostic algorithms for investigating secondary causes of hypertension. Conclusions These results summarize the current state of hypertension specialist care and highlight opportunities for further collaboration among hypertension specialists, including standardization of the approach to specialist care for patients with hypertension.
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Affiliation(s)
- Samantha Lui
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Dubrofsky
- Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada, Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nadia A. Khan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheldon W. Tobe
- Division of Nephrology Sunnybrook Health Sciences Centre, University of Toronto, Toronto and Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Jessica Huynh
- Department of General Internal Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Kuyper
- Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna Mathew
- Division of Nephrology, Department of Medicine, St. Joseph Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Syed Amin
- Division of Nephrology, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Ernesto L. Schiffrin
- Department of Medicine, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Paula Harvey
- Division of Cardiology, Department of Medicine and Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alexander A. Leung
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marcel Ruzicka
- Division of Nephrology, University of Ottawa, Ottawa, Ontario, Canada
| | - Birinder Mangat
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Reid
- Dvision of Nephrology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - John Floras
- University Health Network and Sinai Health Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jesse Bittman
- Division of Community Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lauren Garbutt
- Division of Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Branko Braam
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - Rita Suri
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Fady Hannah-Shmouni
- Division of Endocrinology, University of British Columbia, Vancouver, British Columba, Canada, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Ally Prebtani
- Division of Endocrinology & Metabolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sebastien Savard
- Department of Medicine, Universite Laval, Hotel-Dieu de Quebec, Quebec City, Quebec, Canada
| | - Thomas E. MacMillan
- Department of Medicine, Division of General Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Terrence D. Ruddy
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Michel Vallee
- Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Apoorva Bollu
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander Logan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Raj Padwal
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer Ringrose
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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7
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Phillips RA, Wan E, Tuscher JJ, Reid D, Drake OR, Ianov L, Day JJ. Temporally specific gene expression and chromatin remodeling programs regulate a conserved Pdyn enhancer. eLife 2023; 12:RP89993. [PMID: 37938195 PMCID: PMC10631760 DOI: 10.7554/elife.89993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Neuronal and behavioral adaptations to novel stimuli are regulated by temporally dynamic waves of transcriptional activity, which shape neuronal function and guide enduring plasticity. Neuronal activation promotes expression of an immediate early gene (IEG) program comprised primarily of activity-dependent transcription factors, which are thought to regulate a second set of late response genes (LRGs). However, while the mechanisms governing IEG activation have been well studied, the molecular interplay between IEGs and LRGs remain poorly characterized. Here, we used transcriptomic and chromatin accessibility profiling to define activity-driven responses in rat striatal neurons. As expected, neuronal depolarization generated robust changes in gene expression, with early changes (1 hr) enriched for inducible transcription factors and later changes (4 hr) enriched for neuropeptides, synaptic proteins, and ion channels. Remarkably, while depolarization did not induce chromatin remodeling after 1 hr, we found broad increases in chromatin accessibility at thousands of sites in the genome at 4 hr after neuronal stimulation. These putative regulatory elements were found almost exclusively at non-coding regions of the genome, and harbored consensus motifs for numerous activity-dependent transcription factors such as AP-1. Furthermore, blocking protein synthesis prevented activity-dependent chromatin remodeling, suggesting that IEG proteins are required for this process. Targeted analysis of LRG loci identified a putative enhancer upstream of Pdyn (prodynorphin), a gene encoding an opioid neuropeptide implicated in motivated behavior and neuropsychiatric disease states. CRISPR-based functional assays demonstrated that this enhancer is both necessary and sufficient for Pdyn transcription. This regulatory element is also conserved at the human PDYN locus, where its activation is sufficient to drive PDYN transcription in human cells. These results suggest that IEGs participate in chromatin remodeling at enhancers and identify a conserved enhancer that may act as a therapeutic target for brain disorders involving dysregulation of Pdyn.
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Affiliation(s)
- Robert A Phillips
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
| | - Ethan Wan
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
| | - Jennifer J Tuscher
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
| | - David Reid
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
| | - Olivia R Drake
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
| | - Lara Ianov
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
- Civitan International Research Center, University of Alabama at BirminghamBirminghamUnited States
| | - Jeremy J Day
- Department of Neurobiology, University of Alabama at BirminghamBirminghamUnited States
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Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Ogaz D, Hughes G, Mercer CH. Sexual behaviour, STI and HIV testing and testing need among gay, bisexual and other men who have sex with men recruited for online surveys pre/post-COVID-19 restrictions in the UK. Sex Transm Infect 2023; 99:467-473. [PMID: 36858811 DOI: 10.1136/sextrans-2022-055689] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES We examined sexual behaviour, sexually transmitted infection (STI) and HIV testing and testing need, and identified associated factors, among gay, bisexual and other men who have sex with men (GBMSM) in the UK after COVID-19 restrictions ended, and compared these with 'pre-pandemic' estimates. METHODS We analysed survey data from GBMSM (N=1039) recruited via social media and Grindr in November-December 2021. We then compared Grindr-recruited 2021 participants (N=437) with those from an equivalent survey fielded in March-May 2017 (N=1902). Questions on sexual behaviour and service use had lookback periods of 3-4 months in both surveys. Unmet testing need was defined as reporting any new male and/or multiple condomless anal sex (CAS) partners without recent STI/HIV testing. Participants were UK residents, GBMSM, aged ≥16 years who reported sex with men in the last year. Multivariable logistic regression identified associated sociodemographic and health-related factors with unmet STI/HIV testing need in 2021, and then for 2017/2021 comparative analyses, adjusting for demographic differences. RESULTS In 2021, unmet STI and HIV testing need were greater among older GBMSM (aged ≥45 years vs 16-29 years; adjusted OR (aOR): 1.45 and aOR: 1.77, respectively), and lower for pre-exposure prophylaxis (PrEP) users (vs non-PrEP users; aOR: 0.32 and aOR: 0.23, respectively). Less unmet STI testing need was observed among HIV-positive participants (vs HIV-negative/unknown; aOR: 0.63), and trans and non-binary participants (vs cisgender male; aOR: 0.34). Between 2017 (reference) and 2021, reported sexual risk behaviours increased: ≥1 recent new male sex partner (72.1%-81.1%, aOR: 1.71) and ≥2 recent CAS partners (30.2%-48.5%, aOR: 2.22). Reporting recent STI testing was greater in 2021 (37.5%-42.6%, aOR: 1.34) but not recent HIV testing, and there was no significant change over time in unmet STI (39.2% vs 43.7%) and HIV (32.9% vs 39.0%) testing need. DISCUSSION Comparable community surveys suggest that UK resident GBMSM may have engaged in more sexual risk behaviours in late 2021 than pre-pandemic. While there was no evidence of reduced STI/HIV service access during this time, there remained considerable unmet STI/HIV testing need.
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Affiliation(s)
- Jack Rg Brown
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - Alison R Howarth
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - Hamish Mohammed
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - John Saunders
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Caisey V Pulford
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Dana Ogaz
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Gwenda Hughes
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine H Mercer
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
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9
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Black E, Bruno R, Mammen K, Mills L, Siefried KJ, Deacon RM, Shakeshaft A, Dunlop AJ, Ezard N, Montebello M, Childs S, Reid D, Holmes J, Lintzeris N. Substance use, socio-demographic characteristics, and self-rated health of people seeking alcohol and other drug treatment in New South Wales: baseline findings from a cohort study. Med J Aust 2023; 219:218-226. [PMID: 37449648 DOI: 10.5694/mja2.52039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To investigate the demographic characteristics, substance use, and self-rated health of people entering treatment in New South Wales public health services for alcohol, amphetamine-type stimulants, cannabis, cocaine, or opioids use, by principal drug of concern. DESIGN Baseline findings of a cohort study; analysis of data in patient electronic medical records and NSW minimum data set for drug and alcohol treatment services. SETTING, PARTICIPANTS People completing initial Australian Treatment Outcomes Profile (ATOP) assessments on entry to publicly funded alcohol and other drug treatment services in six NSW local health districts/networks, 1 July 2016 - 30 June 2019. MAIN OUTCOME MEASURES Socio-demographic characteristics, and substance use and self-rated health (psychological, physical, quality of life) during preceding 28 days, by principal drug of concern. RESULTS Of 14 087 people included in our analysis, the principal drug of concern was alcohol for 6051 people (43%), opioids for 3158 (22%), amphetamine-type stimulants for 2534 (18%), cannabis for 2098 (15%), and cocaine for 246 (2%). Most people commencing treatment were male (9373, 66.5%), aged 20-39 years (7846, 50.4%), and were born in Australia (10 934, 86.7%). Polysubstance use was frequently reported, particularly by people for whom opioids or amphetamine-type stimulants were the principal drugs of concern. Large proportions used tobacco daily (53-82%, by principal drug of concern group) and reported poor psychological health (47-59%), poor physical health (32-44%), or poor quality of life (43-52%). CONCLUSIONS The prevalence of social disadvantage and poor health is high among people seeking assistance with alcohol, amphetamine-type stimulants, cannabis, cocaine, or opioids use problems. Given the differences in these characteristics by principal drug of concern, health services should collect comprehensive patient information during assessment to facilitate more holistic, tailored, and person-centred care.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- The University of Tasmania, Hobart, TAS
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Krista J Siefried
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, NSW
| | - Rachel M Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- The Poche Centre for Indigenous Health, the University of Queensland, Brisbane, QLD
| | - Adrian J Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW
- The University of Newcastle, Newcastle, NSW
- Hunter Medical Research Institute, Newcastle, NSW
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, NSW
| | - Mark Montebello
- Central Clinical School, the University of Sydney, Sydney, NSW
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, North Sydney Local Health District, Sydney, NSW
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, Central Coast Local Health District, Gosford, NSW
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW
| | - Jennifer Holmes
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
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10
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Phillips RA, Wan E, Tuscher JJ, Reid D, Drake OR, Ianov L, Day JJ. Temporally specific gene expression and chromatin remodeling programs regulate a conserved Pdyn enhancer. bioRxiv 2023:2023.06.02.543489. [PMID: 37333110 PMCID: PMC10274686 DOI: 10.1101/2023.06.02.543489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Neuronal and behavioral adaptations to novel stimuli are regulated by temporally dynamic waves of transcriptional activity, which shape neuronal function and guide enduring plasticity. Neuronal activation promotes expression of an immediate early gene (IEG) program comprised primarily of activity-dependent transcription factors, which are thought to regulate a second set of late response genes (LRGs). However, while the mechanisms governing IEG activation have been well studied, the molecular interplay between IEGs and LRGs remain poorly characterized. Here, we used transcriptomic and chromatin accessibility profiling to define activity-driven responses in rat striatal neurons. As expected, neuronal depolarization generated robust changes in gene expression, with early changes (1 h) enriched for inducible transcription factors and later changes (4 h) enriched for neuropeptides, synaptic proteins, and ion channels. Remarkably, while depolarization did not induce chromatin remodeling after 1 h, we found broad increases in chromatin accessibility at thousands of sites in the genome at 4 h after neuronal stimulation. These putative regulatory elements were found almost exclusively at non-coding regions of the genome, and harbored consensus motifs for numerous activity-dependent transcription factors such as AP-1. Furthermore, blocking protein synthesis prevented activity-dependent chromatin remodeling, suggesting that IEG proteins are required for this process. Targeted analysis of LRG loci identified a putative enhancer upstream of Pdyn (prodynorphin), a gene encoding an opioid neuropeptide implicated in motivated behavior and neuropsychiatric disease states. CRISPR-based functional assays demonstrated that this enhancer is both necessary and sufficient for Pdyn transcription. This regulatory element is also conserved at the human PDYN locus, where its activation is sufficient to drive PDYN transcription in human cells. These results suggest that IEGs participate in chromatin remodeling at enhancers and identify a conserved enhancer that may act as a therapeutic target for brain disorders involving dysregulation of Pdyn.
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Affiliation(s)
- Robert A Phillips
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ethan Wan
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jennifer J Tuscher
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - David Reid
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Olivia R Drake
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Lara Ianov
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Civitan International Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jeremy J Day
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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11
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Guo Z, Arandjelović O, Reid D, Lei Y, Büttner J. A Siamese Transformer Network for Zero-Shot Ancient Coin Classification. J Imaging 2023; 9:107. [PMID: 37367455 PMCID: PMC10299244 DOI: 10.3390/jimaging9060107] [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: 05/02/2023] [Revised: 05/10/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Ancient numismatics, the study of ancient coins, has in recent years become an attractive domain for the application of computer vision and machine learning. Though rich in research problems, the predominant focus in this area to date has been on the task of attributing a coin from an image, that is of identifying its issue. This may be considered the cardinal problem in the field and it continues to challenge automatic methods. In the present paper, we address a number of limitations of previous work. Firstly, the existing methods approach the problem as a classification task. As such, they are unable to deal with classes with no or few exemplars (which would be most, given over 50,000 issues of Roman Imperial coins alone), and require retraining when exemplars of a new class become available. Hence, rather than seeking to learn a representation that distinguishes a particular class from all the others, herein we seek a representation that is overall best at distinguishing classes from one another, thus relinquishing the demand for exemplars of any specific class. This leads to our adoption of the paradigm of pairwise coin matching by issue, rather than the usual classification paradigm, and the specific solution we propose in the form of a Siamese neural network. Furthermore, while adopting deep learning, motivated by its successes in the field and its unchallenged superiority over classical computer vision approaches, we also seek to leverage the advantages that transformers have over the previously employed convolutional neural networks, and in particular their non-local attention mechanisms, which ought to be particularly useful in ancient coin analysis by associating semantically but not visually related distal elements of a coin's design. Evaluated on a large data corpus of 14,820 images and 7605 issues, using transfer learning and only a small training set of 542 images of 24 issues, our Double Siamese ViT model is shown to surpass the state of the art by a large margin, achieving an overall accuracy of 81%. Moreover, our further investigation of the results shows that the majority of the method's errors are unrelated to the intrinsic aspects of the algorithm itself, but are rather a consequence of unclean data, which is a problem that can be easily addressed in practice by simple pre-processing and quality checking.
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Affiliation(s)
- Zhongliang Guo
- School of Computer Science, University of St Andrews, Scotland KY16 9AJ, UK; (D.R.); (Y.L.)
| | - Ognjen Arandjelović
- School of Computer Science, University of St Andrews, Scotland KY16 9AJ, UK; (D.R.); (Y.L.)
| | - David Reid
- School of Computer Science, University of St Andrews, Scotland KY16 9AJ, UK; (D.R.); (Y.L.)
| | - Yaxiong Lei
- School of Computer Science, University of St Andrews, Scotland KY16 9AJ, UK; (D.R.); (Y.L.)
| | - Jochen Büttner
- Max Planck Institute for the History of Science, Boltzmannstraße 22, 14195 Berlin, Germany;
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12
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Mattison G, Canfell OJ, Forrester D, Dobbins C, Smith D, Reid D, Sullivan C. A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care. Med J Aust 2023; 218:384-388. [PMID: 37182214 DOI: 10.5694/mja2.51920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 05/16/2023]
Affiliation(s)
- Graeme Mattison
- Queensland Digital Health Centre, University of Queensland, Brisbane, QLD
- Digital Health Cooperative Research Centre, Sydney, NSW
| | - Oliver J Canfell
- Queensland Digital Health Centre, University of Queensland, Brisbane, QLD
- Digital Health Cooperative Research Centre, Sydney, NSW
| | - Doug Forrester
- The Prince Charles Hospital, Brisbane, QLD
- Curtin University, Perth, WA
| | | | - Daniel Smith
- The Prince Charles Hospital, Brisbane, QLD
- University of Queensland, Brisbane, QLD
| | - David Reid
- The Prince Charles Hospital, Brisbane, QLD
- QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - Clair Sullivan
- Queensland Digital Health Centre, University of Queensland, Brisbane, QLD
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13
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Ogaz D, Allen H, Reid D, Brown JRG, Howarth AR, Pulford CV, Mercer CH, Saunders J, Hughes G, Mohammed H. COVID-19 infection and vaccination uptake in men and gender-diverse people who have sex with men in the UK: analyses of a large, online community cross-sectional survey (RiiSH-COVID) undertaken November-December 2021. BMC Public Health 2023; 23:829. [PMID: 37147609 PMCID: PMC10161154 DOI: 10.1186/s12889-023-15779-5] [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: 01/19/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Men and gender-diverse people who have sex with men are disproportionately affected by health conditions associated with increased risk of severe illness due to COVID-19 infection. METHODS An online cross-sectional survey of men and gender-diverse people who have sex with men in the UK recruited via social networking and dating applications from 22 November-12 December 2021. Eligible participants included self-identifying men, transgender women, or gender-diverse individuals assigned male at birth (AMAB), aged ≥ 16, who were UK residents, and self-reported having had sex with an individual AMAB in the last year. We calculated self-reported COVID-19 test-positivity, proportion reporting long COVID, and COVID-19 vaccination uptake anytime from pandemic start to survey completion (November/December 2021). Logistic regression was used to assess sociodemographic, clinical, and behavioural characteristics associated with SARS-CoV-2 (COVID-19) test positivity and complete vaccination (≥ 2 vaccine doses). RESULTS Among 1,039 participants (88.1% white, median age 41 years [interquartile range: 31-51]), 18.6% (95% CI: 16.3%-21.1%) reported COVID-19 test positivity, 8.3% (95% CI: 6.7%-10.1%) long COVID, and 94.5% (95% CI: 93.3%-96.1%) complete COVID-19 vaccination through late 2021. In multivariable models, COVID-19 test positivity was associated with UK country of residence (aOR: 2.22 [95% CI: 1.26-3.92], England vs outside England) and employment (aOR: 1.55 [95% CI: 1.01-2.38], current employment vs not employed). Complete COVID-19 vaccination was associated with age (aOR: 1.04 [95% CI: 1.01-1.06], per increasing year), gender (aOR: 0.26 [95% CI: 0.09-0.72], gender minority vs cisgender), education (aOR: 2.11 [95% CI: 1.12-3.98], degree-level or higher vs below degree-level), employment (aOR: 2.07 [95% CI: 1.08-3.94], current employment vs not employed), relationship status (aOR: 0.50 [95% CI: 0.25-1.00], single vs in a relationship), COVID-19 infection history (aOR: 0.47 [95% CI: 0.25-0.88], test positivity or self-perceived infection vs no history), known HPV vaccination (aOR: 3.32 [95% CI: 1.43-7.75]), and low self-worth (aOR: 0.29 [95% CI: 0.15-0.54]). CONCLUSIONS In this community sample, COVID-19 vaccine uptake was high overall, though lower among younger age-groups, gender minorities, and those with poorer well-being. Efforts are needed to limit COVID-19 related exacerbation of health inequalities in groups who already experience a greater burden of poor health relative to other men who have sex with men.
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Affiliation(s)
- Dana Ogaz
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK.
| | - Hester Allen
- COVID-19 Vaccines and Epidemiology Division, UK Health Security Agency, London, UK
| | - David Reid
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
- Sigma Research, Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Jack R G Brown
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Alison R Howarth
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Caisey V Pulford
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
| | - Catherine H Mercer
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - John Saunders
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Gwenda Hughes
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
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14
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Maxwell KJ, Bosó Pérez R, Reid D, Freeman L, Menezes D, Sonnenberg P, Field N, Mitchell KR. Balancing risk, intimacy and (non)compliance: a qualitative study of sex across household during COVID-19 social restrictions. Cult Health Sex 2023; 25:582-598. [PMID: 35674048 PMCID: PMC10184729 DOI: 10.1080/13691058.2022.2078507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Government controls over intimate relationships, imposed to limit the spread of Sars-CoV-2, were unprecedented in modern times. This study draws on data from qualitative interviews with 18 participants in Natsal-COVID, a quasi-representative web-panel survey of the British population (n = 6,654 people), reporting that they had sex with someone from outside their household in the preceding four weeks; a period in which contact between households was restricted in the UK. Whilst only 10% of people reported sexual contact outside their household, among single people and those in non-cohabiting relationships, rates were much higher (Natsal-COVID). Our findings show that individuals did not take decisions to meet up with sexual partners lightly. Participants were motivated by needs-for connection, security, intimacy and a sense of normality. People balanced risks-of catching COVID-19, social judgement and punishment for rule-breaking-against other perceived risks, including to their mental health or relationships. We used situated rationality and social action theories of risk to demonstrate that people weighed up risk in socially situated ways and exhibited complex decision-making when deciding not to comply with restrictions. Understanding motivations for non-compliance is crucial to informing future public health messaging which accounts for the needs and circumstances of all population members.
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Affiliation(s)
- Karen J Maxwell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- Institute of Global Health, UCL, London, UK
| | | | - Dee Menezes
- Institute of Health Informatics, UCL, London, UK
| | | | | | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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15
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Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Ogaz D, Hughes G, Mercer CH. Difficulty accessing condoms because of the COVID-19 pandemic reported by gay, bisexual and other men who have sex with men in the UK: findings from a large, cross-sectional, online survey. Int J STD AIDS 2023:9564624231160804. [PMID: 36943893 PMCID: PMC10031272 DOI: 10.1177/09564624231160804] [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: 03/23/2023]
Abstract
BACKGROUND COVID-19 restrictions severely reduced face-to-face sexual health services, an important access point for condoms. We examine whether gay, bisexual and other men who have sex with men (GBMSM) in the UK had difficulty accessing condoms during the first year of the pandemic, and if so, which groups were most affected. METHODS Questions about difficulty accessing condoms were asked as part of a short, online cross-sectional survey of GBMSM undertaken November/December 2021, recruited via social media and Grindr. Eligible participants were UK-resident GBMSM (cis/trans/gender-diverse person assigned male at birth [AMAB]), aged ≥16 years who were sexually active (reported sex with men in the last year). Multivariable logistic regression was used to examine if and how reporting this outcome varied by key sociodemographic, health and behavioural factors independent of the potential confounding effect of numbers of new male sex partners. RESULTS Of all participants (N = 1039), 7.4% (n = 77) reported difficulty accessing condoms due to the pandemic. This was higher among younger GBMSM (aged 16-29 years vs. ≥45; 12.8% vs. 4.9%; aOR: 2.78); trans/gender-diverse AMAB participants (vs. cis gender males; 24.4% vs. 6.6%; aOR = 4.86); bisexually-identifying participants (vs. gay-identifying; 11.1% vs. 6.5%; aOR = 1.78); and those without degree level education (vs. having a degree; 9.8% vs. 5.6%; aOR = 2.01). CONCLUSIONS A minority of sexually active GBMSM reported difficulty accessing condoms because of the pandemic, however, this was more common amongst those who already experience a disproportionate burden of poor sexual health. Interventions are needed to address these inequalities in accessing this important primary STI/HIV prevention measure.
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Affiliation(s)
- Jack Rg Brown
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
| | - David Reid
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
| | - Alison R Howarth
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
| | - Hamish Mohammed
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - John Saunders
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - Caisey V Pulford
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - Dana Ogaz
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - Gwenda Hughes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine H Mercer
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
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16
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Mills B, Hill M, Miles A, Smith E, Afrifa-Yamoah E, Reid D, Rogers S, Sim M. Calling an ambulance for non-emergency medical situations: Results of a cross-sectional online survey from an Australian nationally representative sample. Emerg Med Australas 2023; 35:133-141. [PMID: 36113863 PMCID: PMC10087376 DOI: 10.1111/1742-6723.14086] [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: 04/06/2022] [Revised: 06/10/2022] [Accepted: 08/24/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate the Australian general public's perception of appropriate medical scenarios that warrants a call to an emergency ambulance. METHODS An online survey asked participants to identify the likely medical treatment pathway they would take for 17 hypothetical medical scenarios. The number and type of non-emergency scenarios (n = 8) participants incorrectly suggested were appropriate to place a call for an emergency ambulance were calculated. Participants included Australian residents (aged >18 years) who had never worked as an Australian registered medical doctor, nurse or paramedic. RESULTS From a sample of 5264 participants, 40% suggested calling an emergency ambulance for a woman in routine labour was appropriate. Other medical scenarios which were most suggested by participants to warrant an emergency ambulance call was 'Lego in ear canal' (11%), 'Older person bruising' (8%) and 'Flu' (7%). Women, people aged 56+ years, those without a university qualification, with lower household income and with lower emotional wellbeing were more likely to suggest calling an emergency ambulance was appropriate for non-emergency scenarios. CONCLUSIONS Although emergency healthcare system (EHS) capacity not increasing at the same rate as demand is the biggest contributor to EHS burden, non-urgent medical situations for which other low-acuity healthcare pathways may be appropriate does play a small role in adding to the overburdening of the EHS. This present study outlines a series of complaints and demographic characteristics that would benefit from targeted educational interventions that may aid in alleviating ambulance service attendances to low-acuity callouts.
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Affiliation(s)
- Brennen Mills
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Michella Hill
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Alecka Miles
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Erin Smith
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Eben Afrifa-Yamoah
- School of Science, Edith Cowan University, Perth, Western Australia, Australia
| | - David Reid
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Shane Rogers
- School of Arts and Humanities, Edith Cowan University, Perth, Western Australia, Australia
| | - Moira Sim
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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17
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Black E, Mammen K, Deacon RM, Ezard N, Mills L, Dunlop AJ, Montebello M, Reid D, Childs S, Bruno R, Shakeshaft A, Siefried KJ, Farrell M, Holmes J, Lintzeris N. Health and social characteristics of clients reporting amphetamine type substance use at entry to public alcohol and other drug services in New South Wales, Australia, 2016-2019. Drug Alcohol Rev 2023; 42:389-400. [PMID: 36524444 PMCID: PMC10107800 DOI: 10.1111/dar.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Amphetamine type substances (ATS) are commonly used by Australian alcohol and other drug service entrants. We describe demographic characteristics, patterns of ATS and other substance use, health and social conditions among clients entering New South Wales (NSW) public alcohol and other drug services. METHODS Retrospective cohort of 13,864 records across six health districts (2016-2019) for clients seeking substance use treatment. These districts service approximately 44% of the NSW population aged 15 years and over. Multivariate analysis was conducted on a subsample for whom full data were available (N = 9981). Data included NSW Minimum Data Set for drug and alcohol treatment services and Australian Treatment Outcomes Profile items. RESULTS Over the preceding 4 weeks, 77% (n = 10,610) of clients (N = 13,864) reported no recent ATS use, 15% (n = 2109) reported 'low frequency' (1-12 days) and 8% (n = 1145) 'high frequency' (13-28 days) use. ATS use was most common among people attending for ATS or opioids as primary drug of concern. A multinomial regression (N = 9981) identified that clients reporting recent arrest (aOR 1.74, 95% CI 1.36, 2.24), higher cannabis use frequency (aOR 1.01, 95% CI 1.00, 1.02), lower opioid use frequency (aOR 0.98, 95% CI 0.97, 0.99) and poorer quality of life (aOR 0.91, 95% CI 0.86, 0.97) were more likely to report 'high frequency' rather than 'low frequency' ATS use. DISCUSSION AND CONCLUSIONS People who use ATS experience health and social issues that may require targeted responses. These should be integrated across all services, not only for clients with ATS as principal drug of concern.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
| | - Rachel M. Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Adrian J. Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Clinical Services, Hunter New England Local Health DistrictNewcastleAustralia
- School of Medicine and Public HealthCollege of Health & Wellbeing, University of NewcastleNewcastleAustralia
- HMRI Healthcare Transformation Research ProgramNewcastleAustralia
| | - Mark Montebello
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, North Sydney Local Health DistrictSydneyAustralia
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Central Coast Local Health DistrictGosfordAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | | | - Krista J. Siefried
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Jennifer Holmes
- Centre for Alcohol and other Drugs, NSW Ministry of HealthSydneyAustralia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
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18
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Bosó Pérez R, Reid D, Maxwell KJ, Gibbs J, Dema E, Bonell C, Mercer CH, Sonnenberg P, Field N, Mitchell KR. Access to and quality of sexual and reproductive health services in Britain during the early stages of the COVID-19 pandemic: a qualitative interview study of patient experiences. BMJ Sex Reprod Health 2023; 49:12-20. [PMID: 35444001 PMCID: PMC9062459 DOI: 10.1136/bmjsrh-2021-201413] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/05/2022] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Access to quality sexual and reproductive health (SRH) services remains imperative even during a pandemic. Our objective was to understand experiences of delayed or unsuccessful access to SRH services in Britain during the early stages of the COVID-19 pandemic. METHODS In October and November 2020 we conducted semi-structured telephone interviews with 14 women and six men reporting an unmet need for SRH services in the Natsal-COVID survey, a large-scale quasi-representative web-panel survey of sexual health and behaviour during COVID-19 (n=6654). We purposively sampled eligible participants using sociodemographic quotas. Inductive thematic analysis was used to explore service access and quality and to identify lessons for future SRH service delivery. RESULTS Twenty participants discussed experiences spanning 10 SRH services including contraception and antenatal/maternity care. Participants reported hesitancy and self-censorship of need. Accessing telemedicine and 'socially-distanced' services required tenacity. Challenges included navigating changing information and procedures; perceptions of gatekeepers as obstructing access; and inflexible appointment systems. Concerns about reconfigured services included reduced privacy; decreased quality of interactions with professionals; reduced informal support; and fewer preventive SRH practices. However, some participants also described more streamlined services and staff efforts to compensate for disruptions. Many viewed positively the ongoing blending of telemedicine with in-person care. CONCLUSION The COVID-19 pandemic impacted access and quality of SRH services. Participants' accounts revealed self-censorship of need, difficulty navigating shifting service configurations and perceived quality reductions. Telemedicine offers potential if intelligently combined with in-person care. We offer initial evidence-based recommendations for promoting an equitable restoration and future adaption of services.
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Affiliation(s)
- Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections in partnership with Public Health England, University College London, London, UK
| | - Karen J Maxwell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Christopher Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
| | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Abstract
In 2015, the UK government published the National Strategic Defence and Security Review (SDSR) 2015, which laid out their vision for the future roles and structure of the UK Armed Forces. SDSR 2015 envisaged making broader use of the Armed Forces to support missions other than warfighting. One element of this would be to increase the scale and scope of defence engagement (DE) activities that the UK conducts overseas. DE activities traditionally involve the use of personnel and assets to help prevent conflict, build stability and gain influence with partner nations as part of a short-term training teams. This paper aimed to give an overview of the Specialist Infantry Group and its role in UK DE. It will explore the reasons why the SDSR 2015 recommended their formation as well as an insight into future tasks.
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Affiliation(s)
| | - K M Heil
- Institute of Naval Medicine, Gosport, UK
| | - D Reid
- Specialised Infantry, Army Medical Services, Camberley, Surrey, UK
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20
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Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Hughes G, Mercer CH. Changes in STI and HIV testing and testing need among men who have sex with men during the UK's COVID-19 pandemic response. Sex Transm Infect 2022; 99:sextrans-2022-055429. [PMID: 35863887 PMCID: PMC10313956 DOI: 10.1136/sextrans-2022-055429] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/25/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES We examined the impact of COVID-19-related restrictions on sexual behaviours, STI and HIV testing and testing need among men who have sex with men (MSM) in the UK. METHODS We used social media and dating applications to recruit to three cross-sectional surveys (S1-S3) during the UK's pandemic response (S1: 23 June-14 July 2020; S2: 23 November-12 December 2020; S3: 23 March-14 April 2021). Surveys included lookback periods of around 3-4 months (P1-P3, respectively). Eligible participants were UK resident men (cisgender/transgender) and gender-diverse people assigned male at birth (low numbers of trans and gender-diverse participants meant restricting these analyses to cisgender men), aged ≥16 years who reported sex with men (cisgender/transgender) in the last year (S1: N=1950; S2: N=1463; S3: N=1487). Outcomes were: recent STI/HIV testing and unmet testing need (new male and/or multiple condomless anal sex partners without a recent STI/HIV test). Crude and adjusted associations with each outcome were assessed using logistic regression. RESULTS Participants' sociodemographic characteristics were similar across surveys. The proportion reporting a recent STI and/or HIV test increased between P1 and P2 (25.0% to 37.2% (p<0.001) and 29.7% to 39.4% (p<0.001), respectively), then stabilised in P3 (40.5% reporting HIV testing). Unmet STI testing need increased across P1 and P2 (26.0% to 32.4%; p<0.001), but trends differed between groups, for example, unmet STI testing need was higher in bisexually-identifying (vs gay-identifying) MSM across periods (adjusted OR (aOR): P1=1.64; P2=1.42), but declined in HIV-positive (vs HIV-negative/unknown) MSM (aOR: P1=2.06; P2=0.68). Unmet HIV testing need increased across P1 and P2 (22.9% to 31.0%; p<0.001) and declined in P3 (25.1%; p=0.001). During P3, MSM reporting a low life-satisfaction level (vs medium-very high) had greater unmet need (aOR: 1.44), while from P2 onwards HIV pre-exposure prophylaxis users (vs non-users) had lower unmet need (aOR: P2=0.32; P3=0.50). CONCLUSION Considerable unmet STI/HIV testing need occurred among MSM during COVID-19-related restrictions, especially in bisexually-identifying men and those reporting low life satisfaction. Improving access to STI/HIV testing in MSM is essential to prevent inequalities being exacerbated.
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Affiliation(s)
- Jack Rg Brown
- UCL Institute for Global Health, University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - David Reid
- UCL Institute for Global Health, University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - Alison R Howarth
- UCL Institute for Global Health, University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - Hamish Mohammed
- UCL Institute for Global Health, University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - John Saunders
- UCL Institute for Global Health, University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Caisey V Pulford
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Gwenda Hughes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- UK Public Health Rapid Support Team, London School of Hygiene and Tropical Medicine Department of Infectious Disease Epidemiology, London, UK
| | - Catherine H Mercer
- UCL Institute for Global Health, University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
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Bowman A, Reid D, Bobby Harreveld R, Lawson C. Evaluation of post-simulation sonographer students' professional behaviour in the workplace. Radiography (Lond) 2022; 28:889-896. [PMID: 35780628 DOI: 10.1016/j.radi.2022.06.010] [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: 02/21/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In Australia, sonographer's professional identity is traditionally 'caught' from clinical role models. A four-year undergraduate-postgraduate course introduced professional identity education, with simulated practice, to prepare novice sonographer students prior to clinical practice. Preclinical students learnt sonographer professional behaviour, and humanistic attributes, during simulation designed with volunteer peers as standardised patients, educator role-models, immediate feedback, self-reflection, and longitudinal multi-observer assessment. This paper reports on the transfer of learnt professional behaviour and humanistic attributes to clinical practice. METHODS Professional behaviour evaluations completed by 94 clinical assessors described 174 students' professional behaviour and attributes one month into their initial clinical practice (2015-6). Student performance of each behaviour, and behavioural category, was quantitatively analysed by modelling binomial proportions with logistic regression. RESULTS Students demonstrated substantial learning transfer to clinical practice, achieving an overall mean score of 'consistent' sonographer professional behaviour and humanistic attributes (mean score of equal to or >3/4), one month into clinical practice. Professional behaviours varied in transferability, with 'response to patient's questions' showing least efficacy (P < 0.05). Increased deliberate practice with educator role-models improved transfer efficacy significantly (P < 0.001). CONCLUSION Preclinical application of theory to simulated practice, using standardised patients, educator role-models, immediate feedback, and multi-observer assessment, facilitated substantial transfer of sonographer professional behaviour and attributes to clinical practice. The efficacy of transfer varied but improved with increased deliberate practice and feedback. IMPLICATIONS FOR PRACTICE The incorporation of preclinical professional behaviour education with simulated practice into the core curriculum of sonographer courses is recommended for the formation of sonographer professional identity, improved clinical outcomes and increased patient safety during the early stages of ultrasound education.
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Affiliation(s)
- A Bowman
- School of Graduate Research, Central Queensland University, Cairns, Australia.
| | - D Reid
- Department of Agriculture and Fisheries, Queensland Government, Rockhampton, Australia.
| | - R Bobby Harreveld
- School of Education and the Arts, Central Queensland University, Rockhampton, Australia.
| | - C Lawson
- School of Education and the Arts, Central Queensland University, Rockhampton, Australia.
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22
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Zhang J, Qian S, Su G, Deng C, Reid D, Curtis K, Sinclair B, Yu P. Emergency department presentations of patients with alcohol use disorders in an Australian regional health district. Subst Abus 2022; 43:1126-1138. [DOI: 10.1080/08897077.2022.2060427] [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: 10/18/2022]
Affiliation(s)
- Jingxiang Zhang
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Siyu Qian
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Guoxin Su
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Chao Deng
- School of Medicine and Molecular Horizons, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - David Reid
- Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Kate Curtis
- Illawarra Health and Medical Research Institute, Wollongong, Australia
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Barbara Sinclair
- Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Ping Yu
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
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23
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Purcell R, Pilkington V, Carberry S, Reid D, Gwyther K, Hall K, Deacon A, Manon R, Walton CC, Rice S. An Evidence-Informed Framework to Promote Mental Wellbeing in Elite Sport. Front Psychol 2022; 13:780359. [PMID: 35250720 PMCID: PMC8890033 DOI: 10.3389/fpsyg.2022.780359] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Elite athletes, coaches and high-performance staff are exposed to a range of stressors that have been shown to increase their susceptibility to experiencing mental ill-health. Despite this, athletes may be less inclined than the general population to seek support for their mental health due to stigma, perceptions of limited psychological safety within sport to disclose mental health difficulties (e.g., selection concerns) and/or fears of help-seeking signifying weakness in the context of high performance sport. Guidance on the best ways to promote mental health within sporting environments is increasing, though current frameworks and position statements require greater focus on a whole of system approach, in which the needs of athlete, coaches and high-performance staff are considered within the context of the broader ecological system in which they operate and perform. This paper synthesizes existing research, reviewed for translatability by mental health professionals working in elite sport, to provide an evidence-informed framework with real world utility to promote mentally healthy environments for all stakeholders in elite sporting organizations, from athletes through to administrators. Recommendations are provided to positively impact the mental wellbeing of athletes and support staff, which may in turn influence athletic performance. This framework is intended to provide sporting organizations with evidence-informed or best practice principles on which they can develop or progress their policies to support mental health promotion and prevent the onset of mental health difficulties. It is intended that the framework can be adapted or tailored by elite sporting organizations based upon their unique cultural, contextual and resourcing circumstances.
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Affiliation(s)
- Rosemary Purcell
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Vita Pilkington
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Serena Carberry
- School of Psychology, University College Dublin, Dublin, Ireland
| | - David Reid
- Focus Coaching, Melbourne, VIC, Australia
| | - Kate Gwyther
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Kate Hall
- Australian Football League, Docklands, VIC, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Adam Deacon
- Consultant Psychiatrist, Melbourne, VIC, Australia
| | - Ranjit Manon
- Australian Football League, Docklands, VIC, Australia
- Department of Psychiatry, Monash University, Clayton, VIC, Australia
| | - Courtney C. Walton
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Simon Rice
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Youth Mood Clinic, Orygen Youth Health, Melbourne, VIC, Australia
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24
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Sonnenberg P, Menezes D, Freeman L, Maxwell KJ, Reid D, Clifton S, Tanton C, Copas A, Riddell J, Dema E, Bosó Pérez R, Gibbs J, Ridge MC, Macdowall W, Unemo M, Bonell C, Johnson AM, Mercer CH, Mitchell K, Field N. Intimate physical contact between people from different households during the COVID-19 pandemic: a mixed-methods study from a large, quasi-representative survey (Natsal-COVID). BMJ Open 2022; 12:e055284. [PMID: 35140158 PMCID: PMC8829844 DOI: 10.1136/bmjopen-2021-055284] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/06/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020. METHODS The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH. RESULTS Of 6654 participants aged 18-59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54; 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34; 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks. CONCLUSIONS Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.
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Affiliation(s)
- Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Dee Menezes
- Institute of Health Informatics, University College London, London, UK
| | - Lily Freeman
- Institute for Global Health, University College London, London, UK
| | - Karen J Maxwell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Mary-Clare Ridge
- Institute for Global Health, University College London, London, UK
| | - Wendy Macdowall
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Magnus Unemo
- Institute for Global Health, University College London, London, UK
- Department of Laboratory Medicine, Örebro University, Orebro, Sweden
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne M Johnson
- Institute for Global Health, University College London, London, UK
| | | | - Kirstin Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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25
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Dema E, Gibbs J, Clifton S, Copas AJ, Tanton C, Riddell J, Pérez RB, Reid D, Bonell C, Unemo M, Mercer CH, Mitchell KR, Sonnenberg P, Field N. Initial impacts of the COVID-19 pandemic on sexual and reproductive health service use and unmet need in Britain: findings from a quasi-representative survey (Natsal-COVID). Lancet Public Health 2022; 7:e36-e47. [PMID: 34995541 DOI: 10.2139/ssrn.3862707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/14/2021] [Accepted: 11/01/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND The COVID-19 pandemic has affected sexual and reproductive health (SRH) service use and unmet need, but the impact is unknown. We aimed to determine the proportion of participants reporting sexual risk behaviours, SRH service use and unmet need, and to assess remote sexually transmitted infection (STI) testing service use after the first national lockdown in Britain. METHODS We used data from the National Surveys of Sexual Attitudes and Lifestyles (Natsal)-COVID cross-sectional, quasi-representative web survey (Natsal-COVID Wave 1). Adults aged 18-59 years who resided in England, Scotland, or Wales completed the survey between July 29 and Aug 10, 2020, which included questions about the approximate 4-month period after announcement of the initial lockdown in Britain (March 23, 2020). Quota-based sampling and weighting were used to achieve a quasi-representative population sample. Participants aged 45-59 years were excluded from services analysis due to low rates of SRH service use. Among individuals aged 18-44 years, we estimated reported SRH service use and inability to access, and calculated age-adjusted odds ratios (aORs) among sexually experienced individuals (those reporting any sexual partner in their lifetime) and sexually active individuals (those reporting any sexual partner in the past year). Unweighted denominators and weighted estimates are presented hereafter. FINDINGS 6654 individuals had complete interviews and were included in the analysis. Among 3758 participants aged 18-44 years, 82·0% reported being sexually experienced, and 73·7% reported being sexually active. 20·8% of sexually experienced participants aged 18-44 years reported using SRH services in the 4-month period. Overall, 9·7% of 3108 participants (9·5% of men; 9·9% of women) reported being unable to use a service they needed, although of the participants who reported trying but not being able to use a SRH service at least once, 76·4% of participants also reported an instance of successful use. 5·9% of 1221 sexually active men and 3·6% of 1560 sexually active women reported use of STI-related services and 14·8% of 1728 sexually experienced women reported use of contraceptive services, with SRH service use highest among individuals aged 18-24 years. Sexually active participants reporting condomless sex with new partners since lockdown were much more likely to report using STI-related services than those who did not report condomless sex (aOR 23·8 [95% CI 11·6-48·9]) for men, 10·5 [3·9-28·2] for women) and, among men, were also more likely to have an unsuccessful attempt at STI-service use (aOR 13·3 [5·3-32·9]). Among 106 individuals who reported using STI testing services, 64·4% accessed services remotely (telephone, video, or online). Among 2581 women aged 25-59 years, 2·4% reported cervical screening compared with an estimated 6% in a comparable 4-month period before the pandemic. INTERPRETATION Many people accessed SRH care during the initial lockdown; however, young people and those reporting sexual risk behaviours reported difficulties in accessing services and thus such services might need to address a backlog of need. FUNDING Wellcome Trust, The Economic and Social Research Council, The National Institute for Health Research, Medical Research Council/Chief Scientist Office and Public Health Sciences Unit, and UCL Coronavirus Response Fund.
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Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, London, UK.
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK; NatCen Social Research, London, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University, Örebro, Sweden
| | | | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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Berg J, Sorensen SA, Ting JT, Miller JA, Chartrand T, Buchin A, Bakken TE, Budzillo A, Dee N, Ding SL, Gouwens NW, Hodge RD, Kalmbach B, Lee C, Lee BR, Alfiler L, Baker K, Barkan E, Beller A, Berry K, Bertagnolli D, Bickley K, Bomben J, Braun T, Brouner K, Casper T, Chong P, Crichton K, Dalley R, de Frates R, Desta T, Lee SD, D'Orazi F, Dotson N, Egdorf T, Enstrom R, Farrell C, Feng D, Fong O, Furdan S, Galakhova AA, Gamlin C, Gary A, Glandon A, Goldy J, Gorham M, Goriounova NA, Gratiy S, Graybuck L, Gu H, Hadley K, Hansen N, Heistek TS, Henry AM, Heyer DB, Hill D, Hill C, Hupp M, Jarsky T, Kebede S, Keene L, Kim L, Kim MH, Kroll M, Latimer C, Levi BP, Link KE, Mallory M, Mann R, Marshall D, Maxwell M, McGraw M, McMillen D, Melief E, Mertens EJ, Mezei L, Mihut N, Mok S, Molnar G, Mukora A, Ng L, Ngo K, Nicovich PR, Nyhus J, Olah G, Oldre A, Omstead V, Ozsvar A, Park D, Peng H, Pham T, Pom CA, Potekhina L, Rajanbabu R, Ransford S, Reid D, Rimorin C, Ruiz A, Sandman D, Sulc J, Sunkin SM, Szafer A, Szemenyei V, Thomsen ER, Tieu M, Torkelson A, Trinh J, Tung H, Wakeman W, Waleboer F, Ward K, Wilbers R, Williams G, Yao Z, Yoon JG, Anastassiou C, Arkhipov A, Barzo P, Bernard A, Cobbs C, de Witt Hamer PC, Ellenbogen RG, Esposito L, Ferreira M, Gwinn RP, Hawrylycz MJ, Hof PR, Idema S, Jones AR, Keene CD, Ko AL, Murphy GJ, Ng L, Ojemann JG, Patel AP, Phillips JW, Silbergeld DL, Smith K, Tasic B, Yuste R, Segev I, de Kock CPJ, Mansvelder HD, Tamas G, Zeng H, Koch C, Lein ES. Author Correction: Human neocortical expansion involves glutamatergic neuron diversification. Nature 2022; 601:E12. [PMID: 34992294 PMCID: PMC8770134 DOI: 10.1038/s41586-021-04322-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jim Berg
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Jonathan T Ting
- Allen Institute for Brain Science, Seattle, WA, USA
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | - Nick Dee
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Brian Kalmbach
- Allen Institute for Brain Science, Seattle, WA, USA
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
| | - Changkyu Lee
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Brian R Lee
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Eliza Barkan
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Allison Beller
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Kyla Berry
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Kris Bickley
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | - Peter Chong
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Tsega Desta
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Tom Egdorf
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - David Feng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Olivia Fong
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Szabina Furdan
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Anna A Galakhova
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Clare Gamlin
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Amanda Gary
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Jeff Goldy
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Natalia A Goriounova
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | | | | | - Hong Gu
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Tim S Heistek
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Alex M Henry
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Djai B Heyer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - DiJon Hill
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Chris Hill
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Madie Hupp
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Tim Jarsky
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Sara Kebede
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Lisa Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Lisa Kim
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Caitlin Latimer
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Boaz P Levi
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Rusty Mann
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Desiree Marshall
- Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Medea McGraw
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Erica Melief
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Eline J Mertens
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Leona Mezei
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Norbert Mihut
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | | | - Gabor Molnar
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Alice Mukora
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Lindsay Ng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Kiet Ngo
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Julie Nyhus
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Gaspar Olah
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Aaron Oldre
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Attila Ozsvar
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Daniel Park
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | | | | | - David Reid
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Josef Sulc
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Aaron Szafer
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Viktor Szemenyei
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | | | - Michael Tieu
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Herman Tung
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Femke Waleboer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Katelyn Ward
- Allen Institute for Brain Science, Seattle, WA, USA
| | - René Wilbers
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Zizhen Yao
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Pal Barzo
- Department of Neurosurgery, University of Szeged, Szeged, Hungary
| | - Amy Bernard
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Philip C de Witt Hamer
- Cancer Center Amsterdam, Brain Tumor Center, Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | | | | | - Manuel Ferreira
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | | | - Patrick R Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sander Idema
- Cancer Center Amsterdam, Brain Tumor Center, Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Andrew L Ko
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Gabe J Murphy
- Allen Institute for Brain Science, Seattle, WA, USA
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
| | - Lydia Ng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Jeffrey G Ojemann
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Anoop P Patel
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | - Daniel L Silbergeld
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | | | - Rafael Yuste
- NeuroTechnology Center, Columbia University, New York, NY, USA
| | - Idan Segev
- Edmond and Lily Safra Center for Brain Sciences and Department of Neurobiology, The Hebrew University Jerusalem, Jerusalem, Israel
| | - Christiaan P J de Kock
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Huibert D Mansvelder
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Gabor Tamas
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Hongkui Zeng
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Ed S Lein
- Allen Institute for Brain Science, Seattle, WA, USA.
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
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Dema E, Gibbs J, Clifton S, Copas AJ, Tanton C, Riddell J, Pérez RB, Reid D, Bonell C, Unemo M, Mercer CH, Mitchell KR, Sonnenberg P, Field N. Initial impacts of the COVID-19 pandemic on sexual and reproductive health service use and unmet need in Britain: findings from a quasi-representative survey (Natsal-COVID). Lancet Public Health 2022; 7:e36-e47. [PMID: 34995541 PMCID: PMC8730819 DOI: 10.1016/s2468-2667(21)00253-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/14/2021] [Accepted: 11/01/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic has affected sexual and reproductive health (SRH) service use and unmet need, but the impact is unknown. We aimed to determine the proportion of participants reporting sexual risk behaviours, SRH service use and unmet need, and to assess remote sexually transmitted infection (STI) testing service use after the first national lockdown in Britain. METHODS We used data from the National Surveys of Sexual Attitudes and Lifestyles (Natsal)-COVID cross-sectional, quasi-representative web survey (Natsal-COVID Wave 1). Adults aged 18-59 years who resided in England, Scotland, or Wales completed the survey between July 29 and Aug 10, 2020, which included questions about the approximate 4-month period after announcement of the initial lockdown in Britain (March 23, 2020). Quota-based sampling and weighting were used to achieve a quasi-representative population sample. Participants aged 45-59 years were excluded from services analysis due to low rates of SRH service use. Among individuals aged 18-44 years, we estimated reported SRH service use and inability to access, and calculated age-adjusted odds ratios (aORs) among sexually experienced individuals (those reporting any sexual partner in their lifetime) and sexually active individuals (those reporting any sexual partner in the past year). Unweighted denominators and weighted estimates are presented hereafter. FINDINGS 6654 individuals had complete interviews and were included in the analysis. Among 3758 participants aged 18-44 years, 82·0% reported being sexually experienced, and 73·7% reported being sexually active. 20·8% of sexually experienced participants aged 18-44 years reported using SRH services in the 4-month period. Overall, 9·7% of 3108 participants (9·5% of men; 9·9% of women) reported being unable to use a service they needed, although of the participants who reported trying but not being able to use a SRH service at least once, 76·4% of participants also reported an instance of successful use. 5·9% of 1221 sexually active men and 3·6% of 1560 sexually active women reported use of STI-related services and 14·8% of 1728 sexually experienced women reported use of contraceptive services, with SRH service use highest among individuals aged 18-24 years. Sexually active participants reporting condomless sex with new partners since lockdown were much more likely to report using STI-related services than those who did not report condomless sex (aOR 23·8 [95% CI 11·6-48·9]) for men, 10·5 [3·9-28·2] for women) and, among men, were also more likely to have an unsuccessful attempt at STI-service use (aOR 13·3 [5·3-32·9]). Among 106 individuals who reported using STI testing services, 64·4% accessed services remotely (telephone, video, or online). Among 2581 women aged 25-59 years, 2·4% reported cervical screening compared with an estimated 6% in a comparable 4-month period before the pandemic. INTERPRETATION Many people accessed SRH care during the initial lockdown; however, young people and those reporting sexual risk behaviours reported difficulties in accessing services and thus such services might need to address a backlog of need. FUNDING Wellcome Trust, The Economic and Social Research Council, The National Institute for Health Research, Medical Research Council/Chief Scientist Office and Public Health Sciences Unit, and UCL Coronavirus Response Fund.
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Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, London, UK.
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK; NatCen Social Research, London, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University, Örebro, Sweden
| | | | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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28
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Gomez HM, Pillar AL, Brown AC, Kim RY, Ali MK, Essilfie AT, Vanders RL, Frazer DM, Anderson GJ, Hansbro PM, Collison AM, Jensen ME, Murphy VE, Johnstone DM, Reid D, Milward EA, Donovan C, Horvat JC. Investigating the Links between Lower Iron Status in Pregnancy and Respiratory Disease in Offspring Using Murine Models. Nutrients 2021; 13:nu13124461. [PMID: 34960012 PMCID: PMC8708709 DOI: 10.3390/nu13124461] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
Maternal iron deficiency occurs in 40-50% of all pregnancies and is associated with an increased risk of respiratory disease and asthma in children. We used murine models to examine the effects of lower iron status during pregnancy on lung function, inflammation and structure, as well as its contribution to increased severity of asthma in the offspring. A low iron diet during pregnancy impairs lung function, increases airway inflammation, and alters lung structure in the absence and presence of experimental asthma. A low iron diet during pregnancy further increases these major disease features in offspring with experimental asthma. Importantly, a low iron diet increases neutrophilic inflammation, which is indicative of more severe disease, in asthma. Together, our data demonstrate that lower dietary iron and systemic deficiency during pregnancy can lead to physiological, immunological and anatomical changes in the lungs and airways of offspring that predispose to greater susceptibility to respiratory disease. These findings suggest that correcting iron deficiency in pregnancy using iron supplements may play an important role in preventing or reducing the severity of respiratory disease in offspring. They also highlight the utility of experimental models for understanding how iron status in pregnancy affects disease outcomes in offspring and provide a means for testing the efficacy of different iron supplements for preventing disease.
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Affiliation(s)
- Henry M. Gomez
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Amber L. Pillar
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Alexandra C. Brown
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Richard Y. Kim
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Md Khadem Ali
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Ama-Tawiah Essilfie
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
| | - Rebecca L. Vanders
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - David M. Frazer
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Gregory J. Anderson
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
- School of Chemistry and Molecular Bioscience, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Philip M. Hansbro
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Centre for Inflammation, School of Life Sciences, Faculty of Science, Centenary Institute and University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Adam M. Collison
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
| | - Megan E. Jensen
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
| | - Vanessa E. Murphy
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, and Priority Research Centre for GrowUpWell, The University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (A.M.C.); (M.E.J.); (V.E.M.)
| | - Daniel M. Johnstone
- School of Medical Sciences, University of Sydney, Camperdown, NSW 2050, Australia;
| | - David Reid
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (A.-T.E.); (D.M.F.); (G.J.A.); (D.R.)
| | - Elizabeth A. Milward
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
| | - Chantal Donovan
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Jay C. Horvat
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, and Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW 2308, Australia; (H.M.G.); (A.L.P.); (A.C.B.); (R.Y.K.); (M.K.A.); (R.L.V.); (P.M.H.); (E.A.M.); (C.D.)
- Correspondence: ; Tel.: +612-4042-0220
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Kumar K, Pasachnik SA, Reid D, Harmer AMT. Spatial Ecology of Invasive Predatory Species Informs Predator Control Program for the Jamaican Rock Iguana (Cyclura collei). CARIBB J SCI 2021. [DOI: 10.18475/cjos.v51i2.a11] [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: 11/06/2022]
Affiliation(s)
- Kirtana Kumar
- International Iguana Foundation, Fort Worth, Texas, U. S. A
| | | | - David Reid
- National Environment and Planning Agency, Kingston, Jamaica
| | - Aaron M. T. Harmer
- School of Natural and Computational Sciences, Massey University, Auckland, New Zealand
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30
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Kohli M, Reid D, Pulford CV, Howarth A, Brown J, Mohammed H, Hughes G, Mercer CH, Saunders J. Choice of antibiotics for prophylaxis of bacterial STIs among individuals currently self-sourcing. Sex Transm Infect 2021; 98:158. [PMID: 34873029 DOI: 10.1136/sextrans-2021-055310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Manik Kohli
- Institute for Global Health, University College London, London, UK .,Department of Sexual Health and HIV, Central and North West London NHS Foundation Trust, London, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK
| | - Caisey V Pulford
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK.,Blood Safety, Hepatitis, STIs and HIV Division, National Infection Service, UK Health Security Agency, London, UK
| | - Alison Howarth
- Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK
| | - Jack Brown
- Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK
| | - Hamish Mohammed
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK.,Blood Safety, Hepatitis, STIs and HIV Division, National Infection Service, UK Health Security Agency, London, UK
| | - Gwenda Hughes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK.,Blood Safety, Hepatitis, STIs and HIV Division, National Infection Service, UK Health Security Agency, London, UK
| | - Catherine H Mercer
- Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UK Health Security Agency, London, UK
| | - John Saunders
- Institute for Global Health, University College London, London, UK.,Blood Safety, Hepatitis, STIs and HIV Division, National Infection Service, UK Health Security Agency, London, UK
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31
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Telford C, Reid D, Philp F, McCluskey M. Normative performance values of modified Star Excursion Balance Test and Limb Symmetry in female adolescent footballers. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Taylor R, Reid D. EP.TU.972Torsion of the gallbladder: a rare disease. Br J Surg 2021. [DOI: 10.1093/bjs/znab311.116] [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
Gallbladder torsion was first described as early as in the 19th century but there are only about five hundred cases reported in literature. This rare disease predominantly affects elderly women with a median age of 77 years.The female to male ratio is 4:1. Though the exact etiology is unknown, certain anatomical variants of the gallbladder are thought to increase one's predisposition to the condition. Gallbladder torsion is very difficult to diagnose preoperatively and even with all the advancements in imaging techniques, only about a quarter of cases are diagnosed preoperatively. Most cases like the index case are diagnosed during surgery
Aim
To review the diagnosis and management of gallbladder torsion in 78 year old female patient who presented acutely to our unit.
Method
Discussion on the presentation, assessment, imaging and preoperative findings to as well as the management plan adopted.
Results
A review of intraoperative findings, postoperative recovery of the patient and literature on gallbladder torsion.
Conclusion
Since the first case of laparoscopic cholecystectomy for torsion in 1994, 105 further cases have been reported. Of this, 28% were managed by laparoscopic surgery whilst 8% resulted in a laparoscopy converted to open procedure. one case of ERCP detorsion has been reported. A high index of suspicion together with improved imaging techniques can help to significantly improve the preoperative diagnosis of gallbladder torsion. Early operative management usually results in a good prognosis. Innovations imaging techniques to help improve preoperative diagnosis will be discussed.
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Berg J, Sorensen SA, Ting JT, Miller JA, Chartrand T, Buchin A, Bakken TE, Budzillo A, Dee N, Ding SL, Gouwens NW, Hodge RD, Kalmbach B, Lee C, Lee BR, Alfiler L, Baker K, Barkan E, Beller A, Berry K, Bertagnolli D, Bickley K, Bomben J, Braun T, Brouner K, Casper T, Chong P, Crichton K, Dalley R, de Frates R, Desta T, Lee SD, D'Orazi F, Dotson N, Egdorf T, Enstrom R, Farrell C, Feng D, Fong O, Furdan S, Galakhova AA, Gamlin C, Gary A, Glandon A, Goldy J, Gorham M, Goriounova NA, Gratiy S, Graybuck L, Gu H, Hadley K, Hansen N, Heistek TS, Henry AM, Heyer DB, Hill D, Hill C, Hupp M, Jarsky T, Kebede S, Keene L, Kim L, Kim MH, Kroll M, Latimer C, Levi BP, Link KE, Mallory M, Mann R, Marshall D, Maxwell M, McGraw M, McMillen D, Melief E, Mertens EJ, Mezei L, Mihut N, Mok S, Molnar G, Mukora A, Ng L, Ngo K, Nicovich PR, Nyhus J, Olah G, Oldre A, Omstead V, Ozsvar A, Park D, Peng H, Pham T, Pom CA, Potekhina L, Rajanbabu R, Ransford S, Reid D, Rimorin C, Ruiz A, Sandman D, Sulc J, Sunkin SM, Szafer A, Szemenyei V, Thomsen ER, Tieu M, Torkelson A, Trinh J, Tung H, Wakeman W, Waleboer F, Ward K, Wilbers R, Williams G, Yao Z, Yoon JG, Anastassiou C, Arkhipov A, Barzo P, Bernard A, Cobbs C, de Witt Hamer PC, Ellenbogen RG, Esposito L, Ferreira M, Gwinn RP, Hawrylycz MJ, Hof PR, Idema S, Jones AR, Keene CD, Ko AL, Murphy GJ, Ng L, Ojemann JG, Patel AP, Phillips JW, Silbergeld DL, Smith K, Tasic B, Yuste R, Segev I, de Kock CPJ, Mansvelder HD, Tamas G, Zeng H, Koch C, Lein ES. Human neocortical expansion involves glutamatergic neuron diversification. Nature 2021; 598:151-158. [PMID: 34616067 PMCID: PMC8494638 DOI: 10.1038/s41586-021-03813-8] [Citation(s) in RCA: 111] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/07/2021] [Indexed: 11/09/2022]
Abstract
The neocortex is disproportionately expanded in human compared with mouse1,2, both in its total volume relative to subcortical structures and in the proportion occupied by supragranular layers composed of neurons that selectively make connections within the neocortex and with other telencephalic structures. Single-cell transcriptomic analyses of human and mouse neocortex show an increased diversity of glutamatergic neuron types in supragranular layers in human neocortex and pronounced gradients as a function of cortical depth3. Here, to probe the functional and anatomical correlates of this transcriptomic diversity, we developed a robust platform combining patch clamp recording, biocytin staining and single-cell RNA-sequencing (Patch-seq) to examine neurosurgically resected human tissues. We demonstrate a strong correspondence between morphological, physiological and transcriptomic phenotypes of five human glutamatergic supragranular neuron types. These were enriched in but not restricted to layers, with one type varying continuously in all phenotypes across layers 2 and 3. The deep portion of layer 3 contained highly distinctive cell types, two of which express a neurofilament protein that labels long-range projection neurons in primates that are selectively depleted in Alzheimer's disease4,5. Together, these results demonstrate the explanatory power of transcriptomic cell-type classification, provide a structural underpinning for increased complexity of cortical function in humans, and implicate discrete transcriptomic neuron types as selectively vulnerable in disease.
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Affiliation(s)
- Jim Berg
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Jonathan T Ting
- Allen Institute for Brain Science, Seattle, WA, USA
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | - Nick Dee
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Brian Kalmbach
- Allen Institute for Brain Science, Seattle, WA, USA
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
| | - Changkyu Lee
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Brian R Lee
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Eliza Barkan
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Allison Beller
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Kyla Berry
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Kris Bickley
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | - Peter Chong
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Tsega Desta
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Tom Egdorf
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - David Feng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Olivia Fong
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Szabina Furdan
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Anna A Galakhova
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Clare Gamlin
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Amanda Gary
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Jeff Goldy
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Natalia A Goriounova
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | | | | | - Hong Gu
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Tim S Heistek
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Alex M Henry
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Djai B Heyer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - DiJon Hill
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Chris Hill
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Madie Hupp
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Tim Jarsky
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Sara Kebede
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Lisa Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Lisa Kim
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Caitlin Latimer
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Boaz P Levi
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Rusty Mann
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Desiree Marshall
- Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Medea McGraw
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Erica Melief
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Eline J Mertens
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Leona Mezei
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Norbert Mihut
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | | | - Gabor Molnar
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Alice Mukora
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Lindsay Ng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Kiet Ngo
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Julie Nyhus
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Gaspar Olah
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Aaron Oldre
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Attila Ozsvar
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Daniel Park
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | | | | | - David Reid
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Josef Sulc
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Aaron Szafer
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Viktor Szemenyei
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | | | - Michael Tieu
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Herman Tung
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Femke Waleboer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Katelyn Ward
- Allen Institute for Brain Science, Seattle, WA, USA
| | - René Wilbers
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Zizhen Yao
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Pal Barzo
- Department of Neurosurgery, University of Szeged, Szeged, Hungary
| | - Amy Bernard
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Philip C de Witt Hamer
- Cancer Center Amsterdam, Brain Tumor Center, Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | | | | | - Manuel Ferreira
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | | | - Patrick R Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sander Idema
- Cancer Center Amsterdam, Brain Tumor Center, Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Andrew L Ko
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Gabe J Murphy
- Allen Institute for Brain Science, Seattle, WA, USA
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
| | - Lydia Ng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Jeffrey G Ojemann
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Anoop P Patel
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | - Daniel L Silbergeld
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | | | - Rafael Yuste
- NeuroTechnology Center, Columbia University, New York, NY, USA
| | - Idan Segev
- Edmond and Lily Safra Center for Brain Sciences and Department of Neurobiology, The Hebrew University Jerusalem, Jerusalem, Israel
| | - Christiaan P J de Kock
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Huibert D Mansvelder
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit, Amsterdam, The Netherlands
| | - Gabor Tamas
- MTA-SZTE Research Group for Cortical Microcircuits, Department of Physiology, Anatomy, and Neuroscience, University of Szeged, Szeged, Hungary
| | - Hongkui Zeng
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Ed S Lein
- Allen Institute for Brain Science, Seattle, WA, USA.
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
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Semasinghe Bandaralage SP, Tay G, Hay K, Megram E, Smith D, Gadowski T, Wright E, France M, Bell S, Reid D. Outcomes of artery embolisation for cystic fibrosis patients with haemoptysis: a 20-year experience at a major Australian tertiary centre. Intern Med J 2021; 51:1526-1529. [PMID: 34541776 DOI: 10.1111/imj.15483] [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: 10/09/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Abstract
There are no published data on Australian adult cystic fibrosis (CF) patient outcomes post bronchial arterial embolisation (BAE). We report 20 years of experience of BAE at a major Australian tertiary adult CF centre, where 46 patients underwent 100 BAE during this period. Mortality rate was comparable to previous studies (4% per year) and most who died had repeat BAE requirements. A higher proportion (9 out of 45) of patients were transplanted compared to previous publications. Repeat BAE was common and significantly higher in patients already on tranexamic acid.
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Affiliation(s)
- Sahan P Semasinghe Bandaralage
- Respiratory Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - George Tay
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Karen Hay
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Emma Megram
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Daniel Smith
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Tahlia Gadowski
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Eimear Wright
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Megan France
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Scott Bell
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia.,Lung Bacteria Group, Child Health Research Centre - University of Queensland, Brisbane, Queensland, Australia
| | - David Reid
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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35
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Howarth AR, Saunders J, Reid D, Kelly I, Wayal S, Weatherburn P, Hughes G, Mercer CH. 'Stay at home …': exploring the impact of the COVID-19 public health response on sexual behaviour and health service use among men who have sex with men: findings from a large online survey in the UK. Sex Transm Infect 2021; 98:346-352. [PMID: 34544888 PMCID: PMC8457994 DOI: 10.1136/sextrans-2021-055039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 02/25/2021] [Accepted: 08/20/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The first UK national lockdown began on 23 March 2020, in response to the COVID-19 pandemic, and led to reduced STI/HIV service provision in the UK. We investigated sexual behaviour, use and need for sexual healthcare during the pandemic. METHODS Participants (N=2018), including men (cis/transgender), transwomen and gender-diverse people reporting sex with another man (cis/transgender) or non-binary person assigned male at birth, completed an online cross-sectional survey (23 June 2020-14 July 2020), in response to adverts on social media and dating apps.Sexual behaviour, service use and unmet need for STI testing (any new male and/or multiple condomless anal sex (CAS) partners without STI testing) in the 3 months since lockdown began were examined and compared using multivariable analyses with an equivalent 3-month period in a 2017 survey (N=1918), conducted by the same research team. RESULTS Since lockdown began, 36.7% of participants reported one or more new partners, 17.3% reported CAS with multiple partners, 29.7% HIV testing (among 1815 of unknown/negative status), 24.9% STI testing and 15.4% using pre-exposure prophylaxis (PrEP).Since lockdown began, 25.3% of participants had unmet need for STI testing. This was more likely among Asian versus white participants (adjusted OR (aOR)=1.76, (1.14 to 2.72), p=0.01); for participants living in Scotland (aOR=2.02, (1.40 to 2.91), p<0.001) or Northern Ireland (aOR=1.93, (1.02-3.63), p=0.04) versus England; and for those living with HIV (aOR=1.83, (1.32 to 2.53), p<0.001).Compared to 2017, the equivalent 2020 subsample were less likely to report new male partners (46.8% vs 71.1%, p<0.001), multiple CAS partners (20.3% vs 30.8%, p<0.001) and have unmet need for STI testing (32.8% vs 42.5%, p<0.001) in the past 3 months. CONCLUSIONS We found potential for ongoing STI/HIV transmission among men who have sex with men during the initial UK lockdown, despite reduced sexual activity, and inequalities in service access. These findings will support public health planning to mitigate health risks during and after the COVID-19 response.
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Affiliation(s)
- Alison R Howarth
- UCL Institute for Global Health, University College London, London, UK .,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK
| | - John Saunders
- UCL Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK.,Blood Safety, Hepatitis, STIs and HIV Division, National Infection Service, Public Health England, London, UK
| | - David Reid
- UCL Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK.,Sigma Research, Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Isabelle Kelly
- UCL Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK
| | - Sonali Wayal
- UCL Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK
| | - Peter Weatherburn
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK.,Sigma Research, Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Gwenda Hughes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK.,Blood Safety, Hepatitis, STIs and HIV Division, National Infection Service, Public Health England, London, UK
| | - Catherine H Mercer
- UCL Institute for Global Health, University College London, London, UK.,The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England, London, UK
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36
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Conway A, Valerio H, Peacock A, Degenhardt L, Hayllar J, Harrod ME, Henderson C, Read P, Gilliver R, Christmass M, Dunlop A, Montebello M, Whitton G, Reid D, Lam T, Alavi M, Silk D, Marshall AD, Treloar C, Dore GJ, Grebely J. Non-fatal opioid overdose, naloxone access, and naloxone training among people who recently used opioids or received opioid agonist treatment in Australia: The ETHOS Engage study. Int J Drug Policy 2021; 96:103421. [PMID: 34452808 DOI: 10.1016/j.drugpo.2021.103421] [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: 03/08/2021] [Revised: 07/07/2021] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Overdose is a major cause of morbidity and mortality among people who use opioids. Naloxone can reverse opioid overdoses and can be distributed and administered with minimal training. People with experience of overdose are a key population to target for overdose prevention strategies. This study aims to understand if factors associated with recent non-fatal opioid overdose are the same as factors associated with naloxone access and naloxone training in people who recently used opioids or received opioid agonist treatment (OAT). METHODS ETHOS Engage is an observational study of people who inject drugs in Australia. Logistic regression models were used to estimate odds ratios for non-fatal opioid overdose, naloxone access and naloxone training. RESULTS Between May 2018-September 2019, 1280 participants who recently used opioids or received OAT were enrolled (62% aged >40 years; 35% female, 80% receiving OAT, 62% injected drugs in the preceding month). Recent opioid overdose (preceding 12 months) was reported by 7% of participants, lifetime naloxone access by 17%, and lifetime naloxone training by 14%. Compared to people receiving OAT with no additional opioid use, recent opioid, benzodiazepine (preceding six months), and hazardous alcohol use was associated with recent opioid overdose (aOR 3.91; 95%CI: 1.68-9.10) and lifetime naloxone access (aOR 2.12; 95%CI 1.29-3.48). Among 91 people who reported recent overdose, 65% had never received take-home naloxone or naloxone training. CONCLUSIONS Among people recently using opioids or receiving OAT, benzodiazepine and hazardous alcohol use is associated with non-fatal opioid overdose. Not all factors associated with non-fatal overdose correspond to factors associated with naloxone access. Naloxone access and training is low across all groups. Additional interventions are needed to scale up naloxone provision.
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Affiliation(s)
- A Conway
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia.
| | - H Valerio
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - A Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; School of Psychology, University of Tasmania, Hobart, Tasmania, Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - J Hayllar
- Alcohol and Drug Service, Metro North Mental Health, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - M E Harrod
- NSW Users and AIDS Association, NSW, Australia
| | - C Henderson
- NSW Users and AIDS Association, NSW, Australia
| | - P Read
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Kirketon Road Centre, Sydney, NSW, Australia
| | - R Gilliver
- Kirketon Road Centre, Sydney, NSW, Australia
| | - M Christmass
- Next Step Drug and Alcohol Services, Mental Health Commission, WA, Australia; National Drug Research Institute, Curtin University, WA, Australia
| | - A Dunlop
- Centre for Translational Neuroscience and Mental Health, Hunter Medical Research Institute & University of Newcastle, Newcastle, NSW, Australia; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - M Montebello
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; Drug and Alcohol Services, Northern Sydney Local Health District, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia
| | - G Whitton
- Drug Health Service, South West Sydney LHD, NSW, Australia
| | - D Reid
- Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - T Lam
- Drug Health, Western Sydney Local Health District, Sydney, NSW, Australia
| | - M Alavi
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - D Silk
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - A D Marshall
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - C Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - G J Dore
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - J Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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37
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McKetin R, Dean OM, Turner A, Kelly PJ, Quinn B, Lubman DI, Dietze P, Carter G, Higgs P, Sinclair B, Reid D, Baker AL, Manning V, Pas NT, Thomas T, Bathish R, Raftery DK, Wrobel A, Saunders L, Arunogiri S, Cordaro F, Hill H, Hall S, Clare PJ, Mohebbi M, Berk M. N-acetylcysteine (NAC) for methamphetamine dependence: A randomised controlled trial. EClinicalMedicine 2021; 38:101005. [PMID: 34308314 PMCID: PMC8283342 DOI: 10.1016/j.eclinm.2021.101005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Methamphetamine dependence is a significant global health concern for which there are no approved medications. The cysteine prodrug, N-acetylcysteine (NAC), has been found to ameliorate glutamate dysregulation in addiction, and to reduce craving for methamphetamine and other drugs. We evaluated the efficacy and safety of NAC as a pharmacotherapy for methamphetamine dependence. METHODS A parallel double-blind randomised placebo-controlled trial of people dependent on methamphetamine recruited from Geelong, Melbourne and Wollongong, Australia, between July 2018 and December 2019. Participants were randomised to receive either 12 weeks of oral NAC (2400 mg/day) or matched placebo, delivered as a take-home medication. The primary outcome was methamphetamine use, measured in two ways: (a) change in days of use in the past 4 weeks from baseline to weeks 4, 8 and 12, assessed using the Timeline Followback; and (b) methamphetamine-positive oral fluid samples taken weekly. Analyses were intention-to-treat and based on imputed data. Secondary outcomes were craving, severity of dependence, withdrawal severity and psychiatric symptoms (depression, suicidality, hostility and psychotic symptoms). Significance levels were p < 0.025 for primary outcomes and p < 0.01 for secondary outcomes. Adverse events were compared between groups by system organ class. The study was prospectively registered, ACTRN12618000366257. RESULTS Participants (N = 153; 59% male, mean [SD] age 38 [8]) were randomised to placebo (n = 77) or NAC (n = 76). Both groups had a median (IQR) of 24 (15-28) days of methamphetamine use in the 4 weeks prior to baseline. Both groups significantly reduced methamphetamine use (mean [SE] reduction of 7.3 [1.2]) days for placebo, 6.8 [1.2] for NAC) but NAC did not reduce days of methamphetamine use more than placebo (group difference of 0.5 days, 97.5% CI -3.4-4.3). There was no significant effect of NAC on methamphetamine-positive oral fluid samples (placebo 79%, NAC 76%; mean difference -2.6, 97.5% CI -12.6-7.4). NAC did not significantly reduce craving, severity of dependence, withdrawal, suicidality, depression, hostility or psychotic symptoms relative to placebo. Adverse events did not differ significantly between placebo and NAC groups. INTERPRETATION These findings suggest that take-home oral NAC has no significant effect on methamphetamine use or most clinically related outcomes amongst people who are dependent on the drug.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Corresponding author.
| | - Olivia M. Dean
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Alyna Turner
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Peter J. Kelly
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Brendan Quinn
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Dan I. Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Richmond, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Australia
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Peter Higgs
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Barbara Sinclair
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - David Reid
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Richmond, Australia
| | - Nina te Pas
- National Drug Research Institute, Curtin University, Australia
| | - Tamsin Thomas
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Ramez Bathish
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Richmond, Australia
| | - Dayle K. Raftery
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Anna Wrobel
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Lucy Saunders
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Frank Cordaro
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Harry Hill
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Scott Hall
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Philip J. Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Prevention Research Collaboration, School of Public Health, University of Sydney, Australia
| | - Mohammadreza Mohebbi
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Australia
- Health Drug and Alcohol Services, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
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McNair ED, Bezaire J, Moser M, Mondal P, Conacher J, Franczak A, Sawicki G, Reid D, Khani-Hanjani A. The Association of Matrix Metalloproteinases With Acute Kidney Injury Following CPB-Supported Cardiac Surgery. Can J Kidney Health Dis 2021; 8:20543581211019640. [PMID: 34350005 PMCID: PMC8287351 DOI: 10.1177/20543581211019640] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/19/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cardiac surgery-associated acute kidney injury (AKI) is an adverse outcome that increases morbidity and mortality in patients undergoing cardiac surgical procedures. To date, the use of serum creatinine levels as an early indicator of AKI has limitations because of its slow rise and poor predictive accuracy for renal injury. This delay in diagnosis may lead to prolonged initiation in treatment and increased risk for adverse outcomes. OBJECTIVE This pilot study explores serum and urine matrix metalloproteinases (MMPs)-2 and MMP-9 and their association, and potentially earlier detection of AKI in patients following cardiopulmonary bypass (CPB)-supported cardiac surgery. We hypothesize that increased activity of serum and urine levels MMP-2 and/ or MMP-9 are associated with AKI. Furthermore, MMP-2 and/ or MMP-9 may provide earlier identification of AKI as compared with serum levels of creatinine. METHODS During the study period, there were 150 CPB-supported surgeries, 21 of which developed AKI according to the Kidney Disease Improving Global Outcomes criteria. We then selected a sample of 21 matched cases from those patients who went through the surgery without developing AKI. Primary outcomes were the measurement via gel zymography of the serum and urine activity of MMP-2 and MMP-9 drawn at the following intervals: pre-CPB; 10-minute post-CPB; and 4-hour post-CPB time points. Secondary variables were the measurement of serum creatinine, intensive care unit (ICU) fluid balance, and length of ICU stay. RESULTS At the 10-minute and 4-hour post-CPB time points, the serum MMP-2 activity of AKI patients were significantly higher as compared with non-AKI patients (P < .001 and P = .004), respectively. Similarly, at the 10-minute and 4-hour post-CPB time points, the serum MMP-9 activity of AKI patients was significantly higher as compared with non-AKI patients (P = .001 and P = .014), respectively. The activity of urine MMP-2 and MMP-9 of AKI patients was significantly higher as compared with non-AKI patients at all 3 time points (P = .004, P < .001, P < .001), respectively. CONCLUSION Although the pilot study may have limitations, it has demonstrated that the serum and urine levels of activity of MMP-2 and MMP-9 are associated with the clinical endpoint of AKI and appear to have earlier rising levels as compared with those of serum creatinine. Furthermore, in depth, exploration is underway with a larger sample size to attempt validation of the analytical performance and reproducibility of the assay for MMP-2 and MMP-9 to aid in earlier diagnosis of AKI following CPB-supported cardiac surgery.
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Affiliation(s)
- Erick D. McNair
- Department of Pathology and Laboratory
Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
- Department of Surgery/Division of
Cardiac Surgery, College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Jennifer Bezaire
- Department of Pathology and Laboratory
Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Michael Moser
- Department of Medicine, College of
Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Prosanta Mondal
- Department of Community Health and
Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Josie Conacher
- Department of Pathology and Laboratory
Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Aleksandra Franczak
- Department of Medicine, College of
Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Greg Sawicki
- Department of Pharmacology, College of
Medicine, University of Saskatchewan, Saskatoon, Canada
| | - David Reid
- Department of Medicine, College of
Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Abass Khani-Hanjani
- Department of Surgery/Division of
Cardiac Surgery, College of Medicine, University of Saskatchewan, Saskatoon,
Canada
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Valerio H, Alavi M, Silk D, Treloar C, Martinello M, Milat A, Dunlop A, Holden J, Henderson C, Amin J, Read P, Marks P, Degenhardt L, Hayllar J, Reid D, Gorton C, Lam T, Dore GJ, Grebely J. Progress Towards Elimination of Hepatitis C Infection Among People Who Inject Drugs in Australia: The ETHOS Engage Study. Clin Infect Dis 2021; 73:e69-e78. [PMID: 32421194 DOI: 10.1093/cid/ciaa571] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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: 01/15/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Evaluating progress towards hepatitis C virus (HCV) elimination is critical. This study estimated prevalence of current HCV infection and HCV treatment uptake among people who inject drugs (PWID) in Australia. METHODS The Enhancing Treatment of Hepatitis C in Opioid Substitution Settings Engage is an observational study of PWID attending drug treatment clinics and needle and syringe programs (NSPs). Participants completed a questionnaire including self-reported treatment history and underwent point-of-care HCV RNA testing (Xpert HCV Viral Load Fingerstick; Cepheid). RESULTS Between May 2018 and September 2019, 1443 participants were enrolled (64% injected drugs in the last month, 74% receiving opioid agonist therapy [OAT]). HCV infection status was uninfected (28%), spontaneous clearance (16%), treatment-induced clearance (32%), and current infection (24%). Current HCV was more likely among people who were homeless (adjusted odds ratio, 1.47; 95% confidence interval, 1.00-2.16), incarcerated in the previous year (2.04; 1.38-3.02), and those injecting drugs daily or more (2.26; 1.43-2.42). Among those with previous chronic or current HCV, 66% (n = 520/788) reported HCV treatment. In adjusted analysis, HCV treatment was lower among females (.68; .48-.95), participants who were homeless (.59; .38-.96), and those injecting daily or more (.51; .31-.89). People aged ≥45 years (1.46; 1.06-2.01) and people receiving OAT (2.62; 1.52-4.51) were more likely to report HCV treatment. CONCLUSIONS Unrestricted direct-acting antiviral therapy access in Australia has yielded high treatment uptake among PWID attending drug treatment and NSPs, with a marked decline in HCV prevalence. To achieve elimination, PWID with greater marginalization may require additional support and tailored strategies to enhance treatment.
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Affiliation(s)
- Heather Valerio
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Maryam Alavi
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - David Silk
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | | | - Andrew Milat
- Centre for Epidemiology and Evidence, NSW Health, Sydney, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Adrian Dunlop
- Centre for Translational Neuroscience and Mental Health, Hunter Medical Research Institute and University of Newcastle, Newcastle, New South Wales, Australia.,Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Jo Holden
- Population Health Strategy and Performance, NSW Health, Sydney, New South Wales, Australia
| | | | - Janaki Amin
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.,Macquarie University, Sydney, New South Wales, Australia
| | - Phillip Read
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.,Kirketon Road Centre, Sydney, New South Wales, Australia
| | - Philippa Marks
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jeremy Hayllar
- Alcohol and Drug Service, Metro North Mental Health, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - David Reid
- The Orana Centre, Illawarra Shoalhaven LHD, Wollongong, New South Wales, Australia
| | - Carla Gorton
- Cairns Sexual Health Service, Cairns, Queensland, Australia
| | - Thao Lam
- Drug Health, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
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40
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Topcu-Uzer C, Randall AK, Vedes AM, Reid D, Bodenmann G. We-ness Questionnaire: Development and Validation. Journal of Couple & Relationship Therapy 2021. [DOI: 10.1080/15332691.2020.1805082] [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] [Indexed: 10/23/2022]
Affiliation(s)
- Cigdem Topcu-Uzer
- Disability and Psychoeducational Studies, University of Arizona, Tucson, Arizona, USA
| | - Ashley K. Randall
- Counseling and Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - Ana M. Vedes
- Department of Psychology, University of Lisbon, Lisbon, Portugal
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - David Reid
- Department of Psychology, York University, Toronto, Canada
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, Zurich, Switzerland
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41
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Gosling J, Mays N, Erens B, Reid D, Exley J. Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers. BMJ Open Qual 2021; 10:bmjoq-2020-001309. [PMID: 34049868 PMCID: PMC8166611 DOI: 10.1136/bmjoq-2020-001309] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/11/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND This paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities. METHODS This was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017. RESULTS Responses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included 'good clinical leadership'. The two main barriers were 'too many demands from external stakeholders' and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools. CONCLUSION GPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time.
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Affiliation(s)
- Jennifer Gosling
- Health Services Research & Policy, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Nicholas Mays
- Health Services Research & Policy, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Bob Erens
- Health Services Research & Policy, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - David Reid
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Josephine Exley
- Health Services Research & Policy, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
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Siegle JH, Jia X, Durand S, Gale S, Bennett C, Graddis N, Heller G, Ramirez TK, Choi H, Luviano JA, Groblewski PA, Ahmed R, Arkhipov A, Bernard A, Billeh YN, Brown D, Buice MA, Cain N, Caldejon S, Casal L, Cho A, Chvilicek M, Cox TC, Dai K, Denman DJ, de Vries SEJ, Dietzman R, Esposito L, Farrell C, Feng D, Galbraith J, Garrett M, Gelfand EC, Hancock N, Harris JA, Howard R, Hu B, Hytnen R, Iyer R, Jessett E, Johnson K, Kato I, Kiggins J, Lambert S, Lecoq J, Ledochowitsch P, Lee JH, Leon A, Li Y, Liang E, Long F, Mace K, Melchior J, Millman D, Mollenkopf T, Nayan C, Ng L, Ngo K, Nguyen T, Nicovich PR, North K, Ocker GK, Ollerenshaw D, Oliver M, Pachitariu M, Perkins J, Reding M, Reid D, Robertson M, Ronellenfitch K, Seid S, Slaughterbeck C, Stoecklin M, Sullivan D, Sutton B, Swapp J, Thompson C, Turner K, Wakeman W, Whitesell JD, Williams D, Williford A, Young R, Zeng H, Naylor S, Phillips JW, Reid RC, Mihalas S, Olsen SR, Koch C. Survey of spiking in the mouse visual system reveals functional hierarchy. Nature 2021; 592:86-92. [PMID: 33473216 PMCID: PMC10399640 DOI: 10.1038/s41586-020-03171-x] [Citation(s) in RCA: 148] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 12/09/2020] [Indexed: 12/14/2022]
Abstract
The anatomy of the mammalian visual system, from the retina to the neocortex, is organized hierarchically1. However, direct observation of cellular-level functional interactions across this hierarchy is lacking due to the challenge of simultaneously recording activity across numerous regions. Here we describe a large, open dataset-part of the Allen Brain Observatory2-that surveys spiking from tens of thousands of units in six cortical and two thalamic regions in the brains of mice responding to a battery of visual stimuli. Using cross-correlation analysis, we reveal that the organization of inter-area functional connectivity during visual stimulation mirrors the anatomical hierarchy from the Allen Mouse Brain Connectivity Atlas3. We find that four classical hierarchical measures-response latency, receptive-field size, phase-locking to drifting gratings and response decay timescale-are all correlated with the hierarchy. Moreover, recordings obtained during a visual task reveal that the correlation between neural activity and behavioural choice also increases along the hierarchy. Our study provides a foundation for understanding coding and signal propagation across hierarchically organized cortical and thalamic visual areas.
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Affiliation(s)
| | - Xiaoxuan Jia
- Allen Institute for Brain Science, Seattle, WA, USA.
| | | | - Sam Gale
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Nile Graddis
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Hannah Choi
- Allen Institute for Brain Science, Seattle, WA, USA.,Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | | | | | | | | | - Amy Bernard
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Dillan Brown
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Nicolas Cain
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Linzy Casal
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Andrew Cho
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Timothy C Cox
- University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA
| | - Kael Dai
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Daniel J Denman
- Allen Institute for Brain Science, Seattle, WA, USA.,The University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | | | - David Feng
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | | | | | - Brian Hu
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Ross Hytnen
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - India Kato
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Jerome Lecoq
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Arielle Leon
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Yang Li
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Fuhui Long
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Kyla Mace
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | - Lydia Ng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Kiet Ngo
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Kat North
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | - Jed Perkins
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - David Reid
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | - Sam Seid
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | - Ben Sutton
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Jackie Swapp
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | | | | | | | | | | | - Rob Young
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Hongkui Zeng
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Sarah Naylor
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - R Clay Reid
- Allen Institute for Brain Science, Seattle, WA, USA
| | | | - Shawn R Olsen
- Allen Institute for Brain Science, Seattle, WA, USA.
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Nguyen J, Baradi A, Reid D, Jin D, Navani R, Huang K, Ellis Z, Santamaria J, Newcomb A, Darby J, Wilson A. Characteristics, Outcomes and Prognostic Factors of Infective Endocarditis in the Intensive Care Unit. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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44
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Witzel TC, Eshun-Wilson I, Jamil MS, Tilouche N, Figueroa C, Johnson CC, Reid D, Baggaley R, Siegfried N, Burns FM, Rodger AJ, Weatherburn P. Comparing the effects of HIV self-testing to standard HIV testing for key populations: a systematic review and meta-analysis. BMC Med 2020; 18:381. [PMID: 33267890 PMCID: PMC7713313 DOI: 10.1186/s12916-020-01835-z] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We update a previous systematic review to inform new World Health Organization HIV self-testing (HIVST) recommendations. We compared the effects of HIVST to standard HIV testing services to understand which service delivery models are effective for key populations. METHODS We did a systematic review of randomised controlled trials (RCTs) which compared HIVST to standard HIV testing in key populations, published from 1 January 2006 to 4 June 2019 in PubMed, Embase, Global Index Medicus, Social Policy and Practice, PsycINFO, Health Management Information Consortium, EBSCO CINAHL Plus, Cochrane Library and Web of Science. We extracted study characteristic and outcome data and conducted risk of bias assessments using the Cochrane ROB tool version 1. Random effects meta-analyses were conducted, and pooled effect estimates were assessed along with other evidence characteristics to determine the overall strength of the evidence using GRADE methodology. RESULTS After screening 5909 titles and abstracts, we identified 10 RCTs which reported on testing outcomes. These included 9679 participants, of whom 5486 were men who have sex with men (MSM), 72 were trans people and 4121 were female sex workers. Service delivery models included facility-based, online/mail and peer distribution. Support components were highly diverse and ranged from helplines to training and supervision. HIVST increased testing uptake by 1.45 times (RR=1.45 95% CI 1.20, 1.75). For MSM and small numbers of trans people, HIVST increased the mean number of HIV tests by 2.56 over follow-up (mean difference = 2.56; 95% CI 1.24, 3.88). There was no difference between HIVST and SoC in regard to positivity among tested overall (RR = 0.91; 95% CI 0.73, 1.15); in sensitivity analysis of positivity among randomised HIVST identified significantly more HIV infections among MSM and trans people (RR = 2.21; 95% CI 1.20, 4.08) and in online/mail distribution systems (RR = 2.21; 95% CI 1.14, 4.32). Yield of positive results in FSW was not significantly different between HIVST and SoC. HIVST reduced linkage to care by 17% compared to SoC overall (RR = 0.83; 95% CI 0.74, 0.92). Impacts on STI testing were mixed; two RCTs showed no decreases in STI testing while one showed significantly lower STI testing in the intervention arm. There were no negative impacts on condom use (RR = 0.95; 95% CI 0.83, 1.08), and social harm was very rare. CONCLUSIONS HIVST is safe and increases testing uptake and frequency as well as yield of positive results for MSM and trans people without negative effects on linkage to HIV care, STI testing, condom use or social harm. Testing uptake was increased for FSW, yield of positive results were not and linkage to HIV care was worse. Strategies to improve linkage to care outcomes for both groups are crucial for effective roll-out.
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Affiliation(s)
- T Charles Witzel
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | | | - Muhammad S Jamil
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Nerissa Tilouche
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Carmen Figueroa
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Cheryl C Johnson
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - David Reid
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Rachel Baggaley
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Nandi Siegfried
- Independent Clinical Epidemiologist, Cape Town, Republic of South Africa
| | - Fiona M Burns
- Institute for Global Health, University College London, London, UK
| | - Alison J Rodger
- Institute for Global Health, University College London, London, UK
| | - Peter Weatherburn
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Qian S, Munyisia E, Reid D, Hailey D, Pados J, Yu P. Trend in data errors after the implementation of an electronic medical record system: A longitudinal study in an Australian regional Drug and Alcohol Service. Int J Med Inform 2020; 144:104292. [DOI: 10.1016/j.ijmedinf.2020.104292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
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Gouwens NW, Sorensen SA, Baftizadeh F, Budzillo A, Lee BR, Jarsky T, Alfiler L, Baker K, Barkan E, Berry K, Bertagnolli D, Bickley K, Bomben J, Braun T, Brouner K, Casper T, Crichton K, Daigle TL, Dalley R, de Frates RA, Dee N, Desta T, Lee SD, Dotson N, Egdorf T, Ellingwood L, Enstrom R, Esposito L, Farrell C, Feng D, Fong O, Gala R, Gamlin C, Gary A, Glandon A, Goldy J, Gorham M, Graybuck L, Gu H, Hadley K, Hawrylycz MJ, Henry AM, Hill D, Hupp M, Kebede S, Kim TK, Kim L, Kroll M, Lee C, Link KE, Mallory M, Mann R, Maxwell M, McGraw M, McMillen D, Mukora A, Ng L, Ng L, Ngo K, Nicovich PR, Oldre A, Park D, Peng H, Penn O, Pham T, Pom A, Popović Z, Potekhina L, Rajanbabu R, Ransford S, Reid D, Rimorin C, Robertson M, Ronellenfitch K, Ruiz A, Sandman D, Smith K, Sulc J, Sunkin SM, Szafer A, Tieu M, Torkelson A, Trinh J, Tung H, Wakeman W, Ward K, Williams G, Zhou Z, Ting JT, Arkhipov A, Sümbül U, Lein ES, Koch C, Yao Z, Tasic B, Berg J, Murphy GJ, Zeng H. Integrated Morphoelectric and Transcriptomic Classification of Cortical GABAergic Cells. Cell 2020; 183:935-953.e19. [PMID: 33186530 PMCID: PMC7781065 DOI: 10.1016/j.cell.2020.09.057] [Citation(s) in RCA: 227] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 07/06/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022]
Abstract
Neurons are frequently classified into distinct types on the basis of structural, physiological, or genetic attributes. To better constrain the definition of neuronal cell types, we characterized the transcriptomes and intrinsic physiological properties of over 4,200 mouse visual cortical GABAergic interneurons and reconstructed the local morphologies of 517 of those neurons. We find that most transcriptomic types (t-types) occupy specific laminar positions within visual cortex, and, for most types, the cells mapping to a t-type exhibit consistent electrophysiological and morphological properties. These properties display both discrete and continuous variation among t-types. Through multimodal integrated analysis, we define 28 met-types that have congruent morphological, electrophysiological, and transcriptomic properties and robust mutual predictability. We identify layer-specific axon innervation pattern as a defining feature distinguishing different met-types. These met-types represent a unified definition of cortical GABAergic interneuron types, providing a systematic framework to capture existing knowledge and bridge future analyses across different modalities.
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Affiliation(s)
| | | | | | - Agata Budzillo
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Brian R Lee
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Tim Jarsky
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Lauren Alfiler
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Eliza Barkan
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Kyla Berry
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Kris Bickley
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Jasmine Bomben
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Thomas Braun
- Byte Physics, Schwarzastraße 9, Berlin 12055, Germany
| | - Krissy Brouner
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Tamara Casper
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Tanya L Daigle
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Rachel Dalley
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Nick Dee
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Tsega Desta
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | | | - Tom Egdorf
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Rachel Enstrom
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Luke Esposito
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Colin Farrell
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - David Feng
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Olivia Fong
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Rohan Gala
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Clare Gamlin
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Amanda Gary
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Jeff Goldy
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Melissa Gorham
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Lucas Graybuck
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Hong Gu
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Kristen Hadley
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Alex M Henry
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - DiJon Hill
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Madie Hupp
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Sara Kebede
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Tae Kyung Kim
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Lisa Kim
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Matthew Kroll
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Changkyu Lee
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | | | - Rusty Mann
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Medea McGraw
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Alice Mukora
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Lindsay Ng
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Lydia Ng
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Kiet Ngo
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Aaron Oldre
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Daniel Park
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Hanchuan Peng
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Osnat Penn
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Thanh Pham
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Alice Pom
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Zoran Popović
- Center for Game Science, Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA 98195, USA
| | | | | | - Shea Ransford
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - David Reid
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | | | | | - Augustin Ruiz
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - David Sandman
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Kimberly Smith
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Josef Sulc
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Susan M Sunkin
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Aaron Szafer
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Michael Tieu
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Amy Torkelson
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Jessica Trinh
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Herman Tung
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Wayne Wakeman
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Katelyn Ward
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Grace Williams
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Zhi Zhou
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Anton Arkhipov
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Uygar Sümbül
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Ed S Lein
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Christof Koch
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Zizhen Yao
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Bosiljka Tasic
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Jim Berg
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Gabe J Murphy
- Allen Institute for Brain Science, Seattle, WA 98109, USA.
| | - Hongkui Zeng
- Allen Institute for Brain Science, Seattle, WA 98109, USA
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Doran J, Weatherburn P, Hickson F, Marcus U, Reid D, Schmidt AJ. An update on the performance of STI services for gay and bisexual men across European cities: results from the 2017 European MSM Internet Survey. Sex Transm Infect 2020; 97:201-208. [PMID: 33144345 DOI: 10.1136/sextrans-2020-054681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/26/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Rectal STIs compromise health and are common in men who have sex with men (MSM). However, the European-MSM-Internet-Survey (EMIS-2010) showed that in 2010, the prevalence of anal swabbing during STI screening by MSM varied widely across 40 European cities. In this paper, we replicate a variety of measures of STI testing performance using 2017-18 data and extending the geographic spread of the analysis. METHODS Data were analysed from the EMIS-2017, a 33-language online sexual health survey accessible from 18 October 2017 to 31 January 2018. We focus on a subsample of 38 439 respondents living in the same 40 European cities we reported on in 2010. For a broader perspective, we also included an additional 65 cities in the analysis (combined n=56 661). We compared the prevalence of STI screening in MSM and disclosure of same-sex sexual contacts to the healthcare provider. We applied multivariable logistic regression models to compare the odds of MSM receiving each of four diagnostic procedures, including anal swabbing in the previous 12 months, controlling for age, HIV diagnosis, pre-exposure prophylaxis use and number of sexual partners. RESULTS In 2017, across 40 European cities, the proportion of respondents screened for STIs ranged from under 19% in Belgrade to over 59% in London. At an individual level, in comparison to London, the adjusted OR (AOR) of having received anal swabbing ranged from 0.03 in Belgrade, Bucharest and Istanbul to 0.80 in Oslo, with little evidence for a difference in Amsterdam and Dublin. Since 2010, most cities in West and South-west Europe have substantially narrowed their performance gap with London, but some in East and South-east Europe have seen the gap increase. CONCLUSIONS Although comprehensive STI screening in MSM has expanded across many European cities, the low prevalence of anal swabbing indicates that rectal STIs continue to be underdiagnosed, particularly in East/South-east Europe.
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Affiliation(s)
- Jason Doran
- Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Peter Weatherburn
- Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Ford Hickson
- Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Ulrich Marcus
- Department of Infectious Diseases Epidemiology, Robert Koch Institut, Berlin, Germany
| | - David Reid
- Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Axel Jeremias Schmidt
- Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
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Bowman A, Reid D, Bobby Harreveld R, Lawson C. Evaluation of students' clinical performance post-simulation training. Radiography (Lond) 2020; 27:404-413. [PMID: 33876732 DOI: 10.1016/j.radi.2020.10.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/18/2020] [Accepted: 10/03/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Traditionally in Australia, sonographer skills are learnt on patients in clinical practice. A four-year undergraduate-postgraduate course introduced ultrasound simulation to prepare novice sonographer students for interaction with patients. Second-year students learnt psychomotor and patient-sonographer communication skills during simulation using commercial ultrasound machines and volunteer year-group peers as standardised patients. This paper reports on the transfer of the ultrasound skills learnt in simulation to clinical practice. METHODS Clinical performance evaluations were completed by 94 supervisors involved in the initial clinical practice of 174 post-simulation second-year students over a two-year period (2015-2016). Student performance of each component skill, and skill category, was analysed by modelling binomial proportions with logistic regression. RESULTS Students demonstrated substantial transfer of learnt ultrasound skills to achieve a mean of advanced beginner competence (mean score of equal to or >3/5) in complex psychomotor and patient-sonographer communication skills, as measured one month into clinical practice. Knowledge and skill components, or sub-tasks, varied significantly (P < 0.001) in transferability. Scanning tasks in general, particularly the skill of 'extending the examination', transferred with significantly (P < 0.001) less efficacy than pre-exam, instrumentation, post-exam, and additional tasks. Skill transfer improved significantly (P < 0.001) following increased deliberate practice with tutor feedback. CONCLUSION Preclinical simulation, using standardised patients, clearly stated objectives to manage cognitive load and immediate tutor feedback, facilitated substantial transfer of ultrasound skills to clinical practice. The efficacy of skill transfer varied but improved with increased deliberate practice and feedback quality. IMPLICATIONS FOR PRACTICE The incorporation of preclinical simulation into the core curriculum of sonographer courses is recommended to improve student performance, reduce the burden on clinical staff and increase patient safety during the early stages of ultrasound education.
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Affiliation(s)
- A Bowman
- School of Graduate Research, Central Queensland University, Cairns, Australia.
| | - D Reid
- Department of Agriculture and Fisheries, Queensland Government, Rockhampton, Australia.
| | - R Bobby Harreveld
- School of Education and the Arts, Central Queensland University, Rockhampton, Australia.
| | - C Lawson
- School of Education and the Arts, Central Queensland University, Rockhampton, Australia.
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Hickson F, Appenroth M, Koppe U, Schmidt AJ, Reid D, Weatherburn P. Sexual and Mental Health Inequalities across Gender Identity and Sex-Assigned-at-Birth among Men-Who-Have-Sex-with-Men in Europe: Findings from EMIS-2017. Int J Environ Res Public Health 2020; 17:ijerph17207379. [PMID: 33050370 PMCID: PMC7601462 DOI: 10.3390/ijerph17207379] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/28/2022]
Abstract
Some men who have sex with men (MSM) were assigned female at birth (AFB) and/or identify as trans men. Little is known about how these men differ from other MSM. We compared sexual and mental health indicators from the European MSM Internet Survey (EMIS-2017), comparing men AFB and/or currently identifying as trans men with those assigned male at birth (AMB) who identified as men. EMIS-2017 was an opportunistic 33-language online sexual health survey for MSM recruiting throughout Europe. We used regression models adjusting for age, country of residence and employment status to examine differences across groups. An analytic sample of 125,720 men living in 45 countries was used, of which 674 (0.5%) were AFB and 871 (0.7%) identified as trans men. The two sub-groups were not coterminous, forming three minority groups: AFB men, AFB trans men and AMB trans men. Minority groups were younger and more likely unemployed. Anxiety, depression, alcohol dependence and sexual unhappiness were more prevalent in sex/gender minority men. Conversely HIV and STI diagnoses were less common. AMB trans men were most likely to have sexual risk behavior with steady partners and to have unmet health promotion needs, and were least likely to be reached by interventions. Sex assigned at birth and trans identification were associated with different sexual and mental health needs. To facilitate service planning and to foster inclusion, sex-assigned-at-birth and current gender identity should be routinely collected in health surveys.
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Affiliation(s)
- Ford Hickson
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK; (A.J.S.); (D.R.); (P.W.)
- Correspondence: ; Tel.: +44-0207-927-2791
| | - Max Appenroth
- Institute of Public Health, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Uwe Koppe
- Department of Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany;
| | - Axel J. Schmidt
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK; (A.J.S.); (D.R.); (P.W.)
| | - David Reid
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK; (A.J.S.); (D.R.); (P.W.)
| | - Peter Weatherburn
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK; (A.J.S.); (D.R.); (P.W.)
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50
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McKETIN R, Quinn B, Higgs P, Berk M, Dean OM, Turner A, Kelly PJ, Lubman DI, Carter G, Baker AL, Manning V, Thomas T, Bathish R, Raftery D, Saunders L, Wrobel A, Meehan A, Sinclair B, Reid D, Arunogiri S, Hill H, Cordaro F, Dietze PM. Clinical and demographic characteristics of people who smoke versus inject crystalline methamphetamine in Australia: Findings from a pharmacotherapy trial. Drug Alcohol Rev 2020; 40:1249-1255. [PMID: 33022140 DOI: 10.1111/dar.13183] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS There has been a rapid increase in smoking crystalline methamphetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use methamphetamine. DESIGN AND METHODS Participants (N = 151) were dependent on methamphetamine, aged 18-60 years, enrolled in a pharmacotherapy trial for methamphetamine dependence, and reported either injecting (n = 54) or smoking (n = 97) methamphetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking methamphetamine and to compare the clinical characteristics of participants who smoked versus injected. RESULTS Compared to participants who injected methamphetamine, those who smoked methamphetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked methamphetamine used methamphetamine on more days in the past 4 weeks than participants who injected methamphetamine (26 vs. 19 days, P = 0.001); they did not differ significantly in their severity of methamphetamine dependence, withdrawal, craving or psychiatric symptoms (P > 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = -1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = -1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = -1.1 (0.5), P = 0.022]. DISCUSSION AND CONCLUSIONS Smoking crystalline methamphetamine is associated with a younger less marginalised demographic profile than injecting methamphetamine, but a similarly severe clinical profile.
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Affiliation(s)
- Rebecca McKETIN
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Brendan Quinn
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Michael Berk
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.,Mental Health and Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Olivia M Dean
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Alyna Turner
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Gregory Carter
- Centre for Brain and Mental Health Priority Research Centre, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Amanda L Baker
- Centre for Brain and Mental Health Priority Research Centre, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Tamsin Thomas
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Ramez Bathish
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Dayle Raftery
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Lucy Saunders
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Anna Wrobel
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Alcyone Meehan
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Barbara Sinclair
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - David Reid
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Harry Hill
- Mental Health and Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Frank Cordaro
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
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