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Howren A, Sayre EC, Avina-Zubieta JA, Puyat JH, Da Costa D, Xie H, Davidson E, De Vera MA. "What Came First?" Population-Based Evaluation of Health Care Encounters for Depression and Anxiety Before and After Inflammatory Arthritis Diagnosis: Disentangling the Relationship Between Mental Health and Arthritis. Arthritis Care Res (Hoboken) 2024; 76:743-752. [PMID: 38191988 DOI: 10.1002/acr.25294] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/04/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVE The study objective was to describe patterns of depression and anxiety health care use before and after diagnosis among patients with inflammatory arthritis (IA), namely, ankylosing spondylitis, psoriatic arthritis, and rheumatoid arthritis. METHODS We used population-based linked administrative health data from British Columbia, Canada, to build a cohort of individuals (≥18 years) with incident IA and individuals without IA ("IA-free controls") matched on age and sex. We computed the proportion of individuals with IA and controls who had one or more depression or one or more anxiety health care encounters and the use of one or more antidepressants or one or more anxiolytics in each yearly interval five years before and after IA diagnosis. We used multivariable logistic regression models to evaluate the association between IA status and aforementioned depression and anxiety health care use outcomes in each yearly interval. RESULTS A total of 80,238 individuals with IA (62.9% female; mean ± SD age 56.2 ± 16.7 years) and 80,238 IA-free controls (62.9% female; mean ± SD age 56.2 ± 16.6 years) were identified between January 1, 2001, and March 31, 2018. Individuals with IA had significantly increased odds of depression and anxiety health care encounters and dispensation of antidepressants and anxiolytics for each yearly interval before and after diagnosis. Adjusted odds ratios (ORs) were highest in the year immediately before (one or more depression visits: adjusted OR 1.61, 95% confidence interval [CI] 1.55-1.66; one or more anxiolytics: adjusted OR 1.71, 95% CI 1.66-1.77) or after (one or more antidepressants: adjusted OR 1.95, 95% CI 1.89-2.00) IA diagnosis. CONCLUSION Findings suggest a role for depression and anxiety in characterizing the IA prodrome period and generate hypotheses regarding overlapping biopsychosocial processes that link IA and mental health comorbidities.
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Affiliation(s)
- Alyssa Howren
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Eric C Sayre
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - J Antonio Avina-Zubieta
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph H Puyat
- Centre for Health Evaluation & Outcome Science and University of British Columbia, Vancouver, British Columbia, Canada
| | - Deborah Da Costa
- Arthritis Research Canada, Vancouver, British Columbia, Canada, and McGill University, Montreal, Quebec, Canada
| | - Hui Xie
- Arthritis Research Canada and Simon Frasier University, Vancouver, British Columbia, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Mary A De Vera
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, Arthritis Research Canada, and Centre for Health Evaluation & Outcome Science, Vancouver, British Columbia, Canada
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2
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Gavin JP, Rossiter L, Fenerty V, Leese J, Adams J, Hammond A, Davidson E, Backman CL. The Impact of Occupational Therapy on the Self-Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review. ACR Open Rheumatol 2024; 6:214-249. [PMID: 38332322 PMCID: PMC11016568 DOI: 10.1002/acr2.11650] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE To determine the impact of occupational therapy (OT) on the self-management of function, pain, fatigue, and lived experience for people living with rheumatoid arthritis (RA). METHODS Five databases and gray literature were searched up to June 30, 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE- Confidence in Evidence from Reviews of Qualitative research (qualitative) were used to assess the quality of evidence for each intervention type. RESULTS Of 39 eligible papers, 29 were quantitative (n = 2,029), 4 qualitative (n = 50), and 6 mixed methods (n = 896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long-term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self-management for fatigue. CONCLUSION Although patient education is promising for self-managing RA, no strong evidence was found to support OT programs for self-managing fatigue or patient experience and long-term effectiveness. More research is required on lived experience, and the long-term efficacy of self-management approaches incorporating OT, particularly timing programs to meet the individual's conditional needs (i.e., early or established RA) to build on the few studies to date.
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Affiliation(s)
| | | | | | - Jenny Leese
- Arthritis Research Canada, Vancouver, British Columbia, University of OttawaOttawaOntarioCanada
| | - Jo Adams
- University of SouthamptonSouthamptonUnited Kingdom
| | | | | | - Catherine L. Backman
- Arthritis Research Canada and University of British ColumbiaVancouverBritish ColumbiaCanada
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3
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Subdar S, Hoens AM, White K, Hartfeld NMS, Dhiman K, Duffey K, Heath CE, Lamoureux G, Graveline C, Davidson E, Hazlewood G, Lacaille D, Lopatina E, Barber MRW, Then KL, Crump T, Zafar S, Manske SL, Charlton A, Osinski K, Fifi-Mah A, Mosher D, Barber CEH. An Environmental Scan and Appraisal of Patient Online Resources for Managing Rheumatoid Arthritis Flares. J Rheumatol 2024:jrheum.2023-1025. [PMID: 38490667 DOI: 10.3899/jrheum.2023-1025] [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: 03/17/2024]
Abstract
OBJECTIVE To conduct an environmental scan and appraisal of online patient resources to support rheumatoid arthritis (RA) flare self-management. METHODS We used the Google search engine (last search March 2023) using the terms "rheumatoid arthritis" and "flare management." Additional searches targeted major arthritis organizations, as well as regional, national, and international resources. Appraisal of the resources was conducted by 2 research team members and 1 patient partner to assess the understandability and actionability of the resource using the Patient Education Materials Assessment Tool (PEMAT). Resources rating ≥ 60% in both domains by either the research team or the patient partner were further considered for content review. During content review, resources were excluded if they contained product advertisements, inaccurate information, or use of noninclusive language. If content review criteria were met, resources were designated as "highly recommended" if both patient partners and researchers' PEMAT ratings were ≥ 60%. If PEMAT ratings were divergent and had a rating ≥ 60% from only 1 group of reviewers, the resource was designated "acceptable." RESULTS We identified 44 resources; 12 were excluded as they did not pass the PEMAT assessment. Fourteen resources received ratings ≥ 60% on understandability and actionability from both researchers and patient partners; 10 of these were retained following content review as "highly recommended" flare resources. Of the 18 divergent PEMAT ratings, 8 resources were retained as "acceptable" following content review. CONCLUSION There is high variability in the actionability and understandability of online RA flare materials; only 23% of resources were highly recommended by researchers and patient partners.
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Affiliation(s)
- Shakeel Subdar
- S. Subdar, HBSc, University of Toronto, Toronto, Ontario
| | - Alison M Hoens
- A.M. Hoens, PT, MSc, Arthritis Research Canada, and Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia
| | - Krista White
- K. White, MA, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Nicole M S Hartfeld
- N.M.S. Hartfeld, MSc, MC, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Kiran Dhiman
- K. Dhiman, MPH, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Keeva Duffey
- K. Duffey, MPH, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia
| | - Claire E Heath
- C.E. Heath, MN, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia
| | - Gisele Lamoureux
- G. Lamoureux, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia
| | - Christine Graveline
- C. Graveline, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia
| | - Eileen Davidson
- E. Davidson, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia
| | - Glen Hazlewood
- G. Hazlewood, MD, PhD, Arthritis Research Canada, Vancouver, British Columbia, and Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Diane Lacaille
- D. Lacaille, MDCM, MHSc, Arthritis Research Canada, and Department of Medicine, University of British Columbia, Vancouver, British Columbia
| | - Elena Lopatina
- E. Lopatina, MD, PhD, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta
| | - Megan R W Barber
- M.R.W. Barber, MD, PhD, Arthritis Research Canada, Vancouver, British Columbia, and Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Karen L Then
- K.L. Then, ACNP, PhD, Faculty of Nursing, University of Calgary, Calgary, Alberta
| | - Trafford Crump
- T. Crump, PhD, Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec
| | - Saania Zafar
- S. Zafar, BCR, MSc, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Sarah L Manske
- S.L. Manske, PhD, Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Alexandra Charlton
- A. Charlton, BScPharm, PharmD, Alberta Health Services, Calgary, Alberta
| | - Kelly Osinski
- K. Osinski, RN, BN, Alberta Health Services, Calgary, Alberta
| | - Aurore Fifi-Mah
- A. Fifi-Mah, MD, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Dianne Mosher
- D. Mosher, MD, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Claire E H Barber
- C.E.H. Barber, MD, PhD, Arthritis Research Canada, Vancouver, British Columbia, and Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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4
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Leese J, Therrien S, Ramachandran S, Backman CL, Ma JK, Koehn CL, Hoens AM, English K, Davidson E, McQuitty S, Gavin J, Adams J, Li LC. Decision-Making Around COVID-19 Public Health Measures and Implications for Self-Care Activities: Experiences of Persons With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2024; 76:140-152. [PMID: 37870115 DOI: 10.1002/acr.25262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE We aimed to advance understanding of how persons with rheumatoid arthritis (RA) experience decision-making about adopting public health measures during the COVID-19 pandemic. METHODS Persons living with RA partnered throughout this nested qualitative study. One-to-one semistructured telephone interviews were conducted with participants with RA between December 2020 and December 2021. They were strategically sampled from a randomized controlled trial that was underway to test a physical activity counseling intervention. Analysis was guided by reflexive thematic analysis. RESULTS Thirty-nine participants (aged 26-86 years; 36 women) in British Columbia, Canada were interviewed. We developed three themes. Participants described how their decision-making about public health measures related to 1) "upholding moral values of togetherness" because decisions were intertwined with moral values of neighborliness and reciprocity. Some adapted their self-care routines to uphold these moral values; 2) "relational autonomy-supports and challenges," because they sometimes felt supported and undermined in different relational settings (eg, by family, local community, or provincial government); and 3) "differing trust in information sources," in which decisions were shaped by the degree of faith they had in various information sources, including their rheumatologists. CONCLUSION Across themes, experiences of decision-making about public health measures during the pandemic were embedded with moral concepts of solidarity, autonomy, and trust, with implications for how persons with RA chose and sustained their self-care activities. Insights gained help sensitize researchers and clinicians to moral issues experienced by persons with RA, which may inform support for self-care activities during and after the pandemic.
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Affiliation(s)
- Jenny Leese
- Arthritis Research Canada, Vancouver, British Columbia, and University of Ottawa, Ottawa, Ontario, Canada
| | | | - Smruthi Ramachandran
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmin K Ma
- Arthritis Research Canada and University of British Columbia and International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
| | - Cheryl L Koehn
- Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | - Alison M Hoens
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly English
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Shanon McQuitty
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Jo Adams
- University of Southampton, Southampton, UK
| | - Linda C Li
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
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5
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Li LC, Xie H, Feehan LM, Shaw C, Lu N, Ramachandran S, Wang E, Therrien S, Mucha J, Hoens AM, English K, Davidson E, Liu-Ambrose T, Backman CL, Esdaile JM, Miller KJ, Lacaille D. Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial. Rheumatology (Oxford) 2023:kead709. [PMID: 38152927 DOI: 10.1093/rheumatology/kead709] [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: 10/09/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES To assess a remote physiotherapist (PT) counselling intervention using self-monitoring tools for improving self-management ability, physical activity participation, and health outcomes in people with rheumatoid arthritis (RA). METHODS Eligible participants were randomly assigned to receive group education, a Fitbit®, a self-monitoring app, and PT counselling phone calls (Immediate Group). The Delayed Group received a monthly e-newsletter until week 26, and then the intervention. The primary outcome was Patient Activation Measure (PAM-13). Participants were assessed at baseline, 27 weeks (the primary end point) and 53 weeks. Secondary outcomes included disease activity, pain, fatigue, depression, sitting/walking habits, daily physical activity time, and daily awake sedentary time. Generalized Linear Mixed-effect Models (GLMMs) were used to assess the effect of the intervention on the change of each outcome measure from the initiation to 27 weeks after the intervention. RESULTS Analysis included 131 participants (91.6% women; 80.2% completed during the COVID-19 pandemic). The mean change of PAM-13 at 27 weeks was 4.6 (SD = 14.7) in the Immediate Group vs -1.6 (SD = 12.5) in the Delayed Group. The mean change in Delayed Group at 53 weeks (after the 26-week intervention) was 3.6 (SD = 14.6). Overall, the intervention improved PAM-13 at 27 weeks post-intervention from the GLMM analysis (adjusted coefficient: 5.3; 95% CI: 2.0, 8.7; p = <0.001). Favourable intervention effects were also found in disease activity, fatigue, depression, and self-reported walking habit. CONCLUSION Remote counselling paired with self-monitoring tools improved self-management ability in people with RA. Findings of secondary outcomes indicate that the intervention had a positive effect on symptom management.
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive Burnaby, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Chris Shaw
- School of Interactive Arts and Technology, Simon Fraser University, 102 Avenue Surrey BC, 250-13450, Canada
| | - Na Lu
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Smruthi Ramachandran
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Ellen Wang
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Stephanie Therrien
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Julia Mucha
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Kelly English
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Catherine L Backman
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Wesbrook Mall, Vancouver, BC, 325-2211, Canada
| | - John M Esdaile
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Kimberly J Miller
- New Knowledge and Innovation, BC Children's Hospital and BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC, Canada
| | - Diane Lacaille
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
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6
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England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Constien D, Chan KK, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips L“R, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR. 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Rheumatol 2023; 75:1299-1311. [PMID: 37227071 PMCID: PMC10947582 DOI: 10.1002/art.42507] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop initial American College of Rheumatology (ACR) guidelines on the use of exercise, rehabilitation, diet, and additional interventions in conjunction with disease-modifying antirheumatic drugs (DMARDs) as part of an integrative management approach for people with rheumatoid arthritis (RA). METHODS An interprofessional guideline development group constructed clinically relevant Population, Intervention, Comparator, and Outcome (PICO) questions. A literature review team then completed a systematic literature review and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the certainty of evidence. An interprofessional Voting Panel (n = 20 participants) that included 3 individuals with RA achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS The Voting Panel achieved consensus on 28 recommendations for the use of integrative interventions in conjunction with DMARDs for the management of RA. Consistent engagement in exercise received a strong recommendation. Of 27 conditional recommendations, 4 pertained to exercise, 13 to rehabilitation, 3 to diet, and 7 to additional integrative interventions. These recommendations are specific to RA management, recognizing that other medical indications and general health benefits may exist for many of these interventions. CONCLUSION This guideline provides initial ACR recommendations on integrative interventions for the management of RA to accompany DMARD treatments. The broad range of interventions included in these recommendations illustrates the importance of an interprofessional, team-based approach to RA management. The conditional nature of most recommendations requires clinicians to engage persons with RA in shared decision-making when applying these recommendations.
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Affiliation(s)
- Bryant R. England
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE
| | | | | | - Jennifer L. Barton
- VA Portland Health Care System and Oregon Health & Science University, Portland, OR
| | | | | | | | | | | | | | | | - Carole V. Dodge
- University of Michigan Hospital and Health System, Ann Arbor, MI
| | | | - Sotiria Everett
- Department of Family, Population, Preventive Medicine, Stony Brook Renaissance School of Medicine, Stony Brook, NY
| | | | | | | | | | | | | | | | - Sarah Patterson
- UCSF Osher Center for Integrative Medicine, San Francisco, CA
| | | | | | | | | | | | | | | | | | | | - Tate Johnson
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE
| | | | - Chris Y. Lane
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Linda C. Li
- University of British Columbia and Arthritis Research Canada, Vancouver, BC, Canada
| | - Hiral Master
- Vanderbilt University Medical Center, VICTR, Nashville, TN
| | | | | | | | | | - Louise Thoma
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Chan KK, Constien D, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips LR, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR. 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2023. [PMID: 37227116 DOI: 10.1002/acr.25117] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop initial American College of Rheumatology (ACR) guidelines on the use of exercise, rehabilitation, diet, and additional interventions in conjunction with disease-modifying antirheumatic drugs (DMARDs) as part of an integrative management approach for people with rheumatoid arthritis (RA). METHODS An interprofessional guideline development group constructed clinically relevant Population, Intervention, Comparator, and Outcome (PICO) questions. A literature review team then completed a systematic literature review and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the certainty of evidence. An interprofessional Voting Panel (n = 20 participants) that included 3 individuals with RA achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS The Voting Panel achieved consensus on 28 recommendations for the use of integrative interventions in conjunction with DMARDs for the management of RA. Consistent engagement in exercise received a strong recommendation. Of 27 conditional recommendations, 4 pertained to exercise, 13 to rehabilitation, 3 to diet, and 7 to additional integrative interventions. These recommendations are specific to RA management, recognizing that other medical indications and general health benefits may exist for many of these interventions. CONCLUSION This guideline provides initial ACR recommendations on integrative interventions for the management of RA to accompany DMARD treatments. The broad range of interventions included in these recommendations illustrates the importance of an interprofessional, team-based approach to RA management. The conditional nature of most recommendations requires clinicians to engage persons with RA in shared decision-making when applying these recommendations.
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Affiliation(s)
- Bryant R England
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha
| | | | | | - Jennifer L Barton
- VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon
| | | | | | | | | | | | | | | | - Carole V Dodge
- University of Michigan Hospital and Health System, Ann Arbor
| | | | - Sotiria Everett
- Department of Family, Population, Preventive Medicine, Stony Brook Renaissance School of Medicine, Stony Brook, New York
| | | | | | | | - Janet Lewis
- University of Virginia, Charlottesville, Virginia
| | | | | | | | - Sarah Patterson
- UCSF Osher Center for Integrative Medicine, San Francisco, California
| | | | - Neha Shah
- Stanford Health Care, Palo Alto, California
| | | | | | - Rawan AlHeresh
- MGH Institute of Health Professions, Boston, Massachusetts
| | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Tate Johnson
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha
| | | | | | - Linda C Li
- University of British Columbia and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Hiral Master
- Vanderbilt University Medical Center, VICTR, Nashville, Tennesee
| | | | | | | | | | | | | | | | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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Constien D, Davidson E, Phillips LR. Patient Perspectives on the 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2023. [PMID: 37227060 DOI: 10.1002/acr.25124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Deb Constien
- Arthritis and Arthritis Foundation, Patient Panel Member, Sun Prairie, Wisconsin
| | - Eileen Davidson
- Patient Panel Member, Rheumatoid arthritis patient advocate, writer and partner in arthritis research, Vancouver, British Columbia, Canada
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9
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Howren A, Avina-Zubieta JA, Puyat JH, Da Costa D, Xie H, Davidson E, Rebić N, Gastonguay L, Dau H, De Vera MA. Impact of Loneliness and Social Isolation on Mental Health Outcomes Among Individuals With Rheumatic Diseases During the COVID-19 Pandemic. ACR Open Rheumatol 2023; 5:243-250. [PMID: 36964954 PMCID: PMC10184014 DOI: 10.1002/acr2.11539] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/05/2023] [Accepted: 02/12/2023] [Indexed: 03/27/2023] Open
Abstract
OBJECTIVE The study objective was to assess mental and social health outcomes for individuals with rheumatic disease during the COVID-19 pandemic and evaluate the relationship of loneliness and social isolation with depression and anxiety. METHODS We administered an international cross-sectional online survey to individuals with rheumatic disease(s) (≥18 years) between April 2020 and September 2020, with a follow-up survey from December 2020 to February 2021. We used questionnaires to evaluate loneliness (3-item UCLA Loneliness Scale [UCLA-3]), social isolation (Lubben Social Network Scale [LSNS-6]), depression (Patient Health Questionnaire [PHQ-9]), and anxiety (Generalized Anxiety Disorder 7-item [GAD-7] Scale). We used multivariable linear regression models to evaluate the cross-sectional associations of loneliness and social isolation with depression and anxiety at baseline. RESULTS Seven hundred eighteen individuals (91.4% women, mean age: 45.4 ± 14.2 years) participated in the baseline survey, and 344 completed the follow-up survey. Overall, 51.1% of participants experienced loneliness (UCLA-3 score ≥6) and 30.3% experienced social isolation (LSNS-6 score <12) at baseline. Depression (PHQ-9 score ≥10) and anxiety (GAD-7 score ≥10) were experienced by 42.8% and 34.0% of participants at baseline, respectively. Multivariable models showed that experiencing both loneliness and social isolation, in comparison to experiencing neither, was significantly associated with an average 7.27 higher depression score (ß = 7.27; 95% confidence interval [CI]: 6.08-8.47) and 5.14 higher anxiety score (ß = 5.14; 95% CI: 4.00-6.28). CONCLUSION Aside from showing substantial experience of loneliness and social isolation during the COVID-19 pandemic, our survey showed significant associations with depression and anxiety. Patient supports to address social health have potential implications for also supporting mental health.
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Affiliation(s)
- Alyssa Howren
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, and Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - J Antonio Avina-Zubieta
- University of British Columbia and Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - Joseph H Puyat
- University of British Columbia and Centre for Health Evaluation & Outcome Sciences, British Columbia, Vancouver, Canada
| | | | - Hui Xie
- Arthritis Research Canada, Vancouver, and Simon Fraser University, British Columbia, Burnaby, Canada
| | - Eileen Davidson
- Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - Nevena Rebić
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, and Arthritis Research Canada, British Columbia, Vancouver, Canada
| | - Louise Gastonguay
- University of British Columbia and Collaboration for Outcomes Research and Evaluation, British Columbia, Vancouver, Canada
| | - Hallie Dau
- University of British Columbia and Collaboration for Outcomes Research and Evaluation, British Columbia, Vancouver, Canada
| | - Mary A De Vera
- University of British Columbia, Collaboration for Outcomes Research and Evaluation, Arthritis Research Canada, and Centre for Health Evaluation & Outcome Sciences, British Columbia, Vancouver, Canada
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10
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Gavin JP, Rossiter L, Fenerty V, Leese J, Hammond A, Davidson E, Backman CL. The role of occupational therapy for the self-management of rheumatoid arthritis: A protocol for a mixed methods systematic review. Musculoskeletal Care 2023; 21:56-62. [PMID: 35719049 DOI: 10.1002/msc.1665] [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: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Occupational therapists can support people with rheumatoid arthritis to self-manage their disease symptoms and engage in daily activities. This protocol reports a review to broaden understanding of what is known about the role of occupational therapy in the self-management of rheumatoid arthritis. METHODS Studies involving adults with rheumatoid arthritis, having participated in self-management involving occupational therapy, will be included. Patient involvement will help develop the search strategy by identifying patient-centred interventions and outcomes to complement those identified by researchers. An electronic search will be performed using several bibliographic databases, including grey literature from subject-specific, health-related, and social care databases. Searches will run from the database inception until the date that the search is conducted (December 2021-May 2022). Retrieved studies will be de-duplicated, and the remaining titles and abstracts will be screened by three reviewers. Full texts of all eligible studies will be independently reviewed by the reviewers to select papers for data extraction and quality assessment. Outcomes are function, pain, fatigue and lived experience. For quantitative studies, data will be synthesised using descriptive statistics in text and tables, whereas for qualitative studies, data will be synthesised using thematic synthesis. DISCUSSION This review will synthesise current evidence on how occupational therapy can help the self-management of rheumatoid arthritis. It will include evidence of best practice, including advice, education and training provided by occupational therapists. These findings can inform future research and the selection of strategies to promote quality of life for people with rheumatoid arthritis. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022302205.
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Affiliation(s)
- James P Gavin
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Laura Rossiter
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Vicky Fenerty
- Library Services, University of Southampton, Southampton, UK
| | - Jenny Leese
- Department of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Alison Hammond
- School of Health and Society, University of Salford, Salford, UK
| | - Eileen Davidson
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Richmond, British Columbia, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Columbia, British Columbia, Canada
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11
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Rebić N, Park JY, Garg R, Ellis U, Kelly A, Davidson E, De Vera MA. Rapid Review of Medication Taking (Adherence) Among Patients With Rheumatic Diseases During the COVID-19 Pandemic. Arthritis Care Res (Hoboken) 2022; 74:1961-1969. [PMID: 34219400 PMCID: PMC8426729 DOI: 10.1002/acr.24744] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/15/2021] [Accepted: 07/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We aimed to identify, appraise, synthesize, and contextualize rapidly emerging reports on medication taking (adherence) among patients with rheumatic diseases during the COVID-19 pandemic. METHODS We searched MEDLINE, EMBASE, and CINAHL for peer-reviewed communications, letters, and articles published during the COVID-19 pandemic evaluating medication taking among individuals with rheumatic diseases. We appraised assessment and reporting of medication adherence according to established definitions of 3 distinct problems of medication taking (i.e., noninitiation, poor implementation, and discontinuation) and pooled findings using random-effects models. RESULTS We included 31 peer-reviewed studies in our synthesis from various jurisdictions, of which 25 described medication taking among rheumatology patients and 6 described medication prescribing among rheumatology providers. The pooled prevalence of overall medication nonadherence was 14.8% (95% confidence interval [95% CI] 12.3-17.2) and that of medication discontinuation (i.e., stopping of prescriptions) and poor implementation (i.e., not taking medication at the dose/frequency prescribed) as 9.5% (95% CI 5.1-14.0) and 9.6% (95% CI 6.2-13.0), respectively. Noninitiation (i.e., not starting/not filling new prescriptions) was not addressed. CONCLUSION Medication taking among individuals with rheumatic diseases during the COVID-19 pandemic varies globally. Unclear reporting and extensive variation in research methods between studies create barriers to research replication, comparison, and generalization to specific patient populations. Future research in this area should use consistent and transparent approaches to defining and measuring medication taking problems to ensure that findings appropriately describe the epidemiology of medication adherence and have the potential to identify modifiable targets for improving patient care.
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Affiliation(s)
- Nevena Rebić
- University of British Columbia and Collaboration for Outcomes Research and Evaluation, Vancouver, and Arthritis Research CanadaRichmondBritish ColumbiaCanada
| | - Jamie Y. Park
- University of British Columbia and Collaboration for Outcomes Research and EvaluationVancouverBritish ColumbiaCanada
| | - Ria Garg
- University of British Columbia and Collaboration for Outcomes Research and EvaluationVancouverBritish ColumbiaCanada
| | - Ursula Ellis
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Ayano Kelly
- Australian National University and Canberra Rheumatology, Canberra, ACT, and The Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | | | - Mary A. De Vera
- University of British Columbia and Collaboration for Outcomes Research and Evaluation, Vancouver, and Arthritis Research CanadaRichmondBritish ColumbiaCanada
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12
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13
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Leese J, Backman CL, Ma JK, Koehn C, Hoens AM, English K, Davidson E, McQuitty S, Gavin J, Adams J, Therrien S, Li LC. Experiences of self-care during the COVID-19 pandemic among individuals with rheumatoid arthritis: A qualitative study. Health Expect 2021; 25:482-498. [PMID: 34403189 PMCID: PMC8444741 DOI: 10.1111/hex.13341] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/06/2021] [Accepted: 07/21/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives This study aimed to explore the impact of the coronavirus disease 2019 (COVID‐19) pandemic on self‐care of individuals living with rheumatoid arthritis (RA). Methods Guided by a constructivist, qualitative design, we conducted one‐to‐one in‐depth telephone interviews between March and October 2020 with participants with RA purposively sampled for maximum variation in age, sex and education, who were participating in one of two ongoing randomized‐controlled trials. An inductive, reflexive thematic analysis approach was used. Results Twenty‐six participants (aged 27–73 years; 23 females) in British Columbia, Canada were interviewed. We identified three themes: (1) Adapting to maintain self‐care describes how participants took measures to continue self‐care activities while preventing virus transmissions. While spending more time at home, some participants reported improved self‐care. (2) Managing emotions describes resilience‐building strategies such as keeping perspective, positive reframing and avoiding negative thoughts. Participants described both letting go and maintaining a sense of control to accommodate difficulties and emotional responses. (3) Changing communication with health professionals outlined positive experiences of remote consultations with health professionals, particularly if good relationships had been established prepandemic. Conclusion The insights gained may inform clinicians and researchers on ways to support the self‐care strategies of individuals with RA and other chronic illnesses during and after the COVID‐19 pandemic. The findings reveal opportunities to further examine remote consultations to optimize patient engagement and care. Patient or Public Contribution This project is jointly designed and conducted with patient partners in British Columbia, Canada. Patient partners across the United Kingdom also played in a key role in providing interpretations of themes during data analysis.
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Affiliation(s)
- Jenny Leese
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmin K Ma
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Kelly English
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Shanon McQuitty
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - James Gavin
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Jo Adams
- School of Health Sciences, University of Southampton, Southampton, UK
| | | | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
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14
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Park JYE, Howren AM, Davidson E, De Vera MA. Insights on mental health when living with rheumatoid arthritis: a descriptive qualitative study of threads on the Reddit website. BMC Rheumatol 2020; 4:62. [PMID: 33292866 PMCID: PMC7690206 DOI: 10.1186/s41927-020-00163-2] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Reddit is a highly visited social news and discussion website where individuals anonymously ask questions, post opinions and share experiences, which provide a valuable pool of publicly available data. Our objective was to systematically search and analyze threads on the social news website, Reddit, to understand experiences of individuals with rheumatoid arthritis (RA) regarding their mental health. METHODS We conducted a patient-oriented descriptive qualitative study. We identified threads from two subreddits, "r/Thritis" and "r/Rheumatoid", using keywords such as "mood", "mental health", "stressed", "depressed", "anxious" over a 1-year period between June 2018 and June 2019. For included threads, we extracted the title, original post, and corresponding comments and responses. We applied thematic analysis using an inductive approach. RESULTS Of 81 threads identified, we included 27. We identified four themes: 1) Navigating the management of RA explores how the physical impacts of the disease, lack of health resources/support and the complexity of medications affect mental health; 2) Experiencing impact on relationships and social isolation includes experiencing misconceptions of RA, feeling misunderstood and feeling guilt; 3) Experiencing loss, touches on the helplessness brought by challenges with performing self-defining activities such as self-care, work, and childbearing/parenting; and finally, 4) Experiencing emotional struggles captures how tension between fighting through and despair has led some to suicide ideation and thoughts of death. CONCLUSIONS Online forums and communities such as Reddit have created opportunities for individuals with RA to share experiences on mental health matters, which they may not necessarily be able to share with others.
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Affiliation(s)
- Jamie Y E Park
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Alyssa M Howren
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | | | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada.
- Arthritis Research Canada, Vancouver, BC, Canada.
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15
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Dixon B, Hoffman E, Feng B, Davidson E, Hays R, Worrall A, Hansen J, Fei T, Hiruta H, Peterson-Droogh J, Ganda F, Betzler B, Kim T, Taiwo T. Reassessing methods to close the nuclear fuel cycle. ANN NUCL ENERGY 2020. [DOI: 10.1016/j.anucene.2020.107652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Howren A, Aviña-Zubieta JA, Rebić N, Dau H, Gastonguay L, Shojania K, Davidson E, De Vera MA. Virtual rheumatology appointments during the COVID-19 pandemic: an international survey of perspectives of patients with rheumatic diseases. Clin Rheumatol 2020; 39:3191-3193. [PMID: 32803570 PMCID: PMC7429087 DOI: 10.1007/s10067-020-05338-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/29/2020] [Accepted: 08/08/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Alyssa Howren
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | - J Antonio Aviña-Zubieta
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Medicine, Division of Rheumatology, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | - Nevena Rebić
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | - Hallie Dau
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
| | - Louise Gastonguay
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
| | - Kam Shojania
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Medicine, Division of Rheumatology, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | | | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada. .,Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada. .,Arthritis Research Canada, Richmond, BC, Canada.
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18
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Brown K, Stefanovski D, Davidson E. Prevalence of adverse events and their effect on completion of high speed treadmill exercise tests at a single institution (2000-2015). Equine Vet J 2019; 52:232-237. [PMID: 31228868 DOI: 10.1111/evj.13143] [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: 11/10/2018] [Accepted: 06/13/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Decline in high speed treadmill (HSTM) exercise testing may be attributed to the rise of over-ground endoscopy and telemetric electrocardiography, in addition to concerns of adverse events during treadmill exercise resulting in injury or inadequate testing. OBJECTIVES To describe adverse events occurring during HSTM exercise tests at a single institution and determine their effect on likelihood of completing diagnostic HSTM exercise testing. STUDY DESIGN Retrospective cohort study. METHODS Pearson's chi-square test was used to determine if a significant difference in frequencies of adverse events existed between complete and incomplete HSTM exercise tests. Two Firth logistic regression models were used to determine likelihood of exercise test completion given the presence of any adverse event, and the likelihood of exercise test completion for each type of adverse event. RESULTS The majority of horses presenting for HSTM evaluation underwent exercise testing (900/1003; 90%). Eight-hundred and seven (90%) exercise tests were completed. Adverse events occurred in 136 (15%) HSTM exercise tests of which 97 (71%) did not impact ability to complete HSTM testing. Adverse events significantly but variably decreased the likelihood of HSTM exercise test completion. Sixty-six percent of incomplete exercise tests were prematurely terminated due to poor performance abnormalities during which diagnosis of poor performance cause(s) was still achieved. MAIN LIMITATIONS Variable personnel recorded data over the study period. Per-test rather than per-horse evaluation does not account for the effect of multiple training and testing episodes performed in the same horse. CONCLUSIONS This study supports the continued usage of HSTM exercise testing for examination of horses with poor performance, with adverse events occurring infrequently. Adverse events reduced the likelihood of completing HSTM exercise testing although not all adverse events affected likelihood of completion similarly. In many cases, a performance limiting problem was identified for horses in which an exercise test was considered incomplete. The Summary is available in Spanish - see Supporting information.
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Affiliation(s)
- K Brown
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - D Stefanovski
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - E Davidson
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
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19
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Ohlhausen A, Dozier M, Davidson E, Ayers C. A COMPARISON OF HOARDING DISORDER WITH AND WITHOUT COMORBID MAJOR DEPRESSIVE DISORDER. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M Dozier
- San Diego State University/University of California at San Diego Joint Doctoral Program in Clinical Psychology
| | - E Davidson
- San Diego State University/University of California at San Diego Joint Doctoral Program in Clinical Psychology
| | - C Ayers
- VA San Diego Healthcare System/University of California San Diego, Department of Psychiatry
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20
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Chichura A, Davidson E, Kho R. Vaginal Hysterectomy for a Large Fibroid Uterus: Contemporary Techniques and Tips for Success. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Abstract
SummaryIn the post-operative period the levels of factor I, VII—X, VIII, IX and X as well as the platelets are increased. In the immediate post-operative period there is a decrease in the levels of factors II and XI. The significance of these changes in relation to venous thrombosis is discussed.
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22
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Abstract
SummaryA simplified method of preparing platelet suspensions is described. The efficiency and reproducibility of results using these suspensions compares favourably with those of standard platelet suspensions and brain extract. In comparing the thromboplastin generation and the thromboplastin screening tests no important practical differences are noted. The use of simplified platelet suspensions is recommended for routine use in the thromboplastin screening test.
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23
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Terragni L, Beune E, Stronks K, Davidson E, Qureshi S, Kumar B, Diaz E. Developing culturally adapted lifestyle interventions for South Asian migrant populations: a qualitative study of the key success factors and main challenges. Public Health 2018; 161:50-58. [PMID: 29902781 DOI: 10.1016/j.puhe.2018.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 03/15/2018] [Accepted: 04/13/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES South Asian migrant populations have a high risk of non-communicable diseases, such as type 2 diabetes (T2D). The aim of this study is to provide in-depth insight into key success factors and challenges in developing culturally adapted lifestyle interventions to prevent T2D within South Asian migrant populations. STUDY DESIGN The study has a qualitative research design. METHODS In-depth interviews, using a semi-structured interview guide, were conducted with eight researchers and project leaders from five studies of culturally adapted lifestyle interventions for South Asian migrant populations. Data were analysed using a grounded theory approach. RESULTS Four main themes emerged as key factors for success: 'approaching the community in the right way', 'the intervention as a space for social relations', 'support from public authorities' and 'being reflexive and flexible'. Two themes emerged as challenges: 'struggling with time' and 'overemphasising cultural differences'. CONCLUSIONS Our findings augment existing research by establishing the importance of cooperation at the organisational and institutional levels, of fostering the creation of social networks through interventions and of acknowledging the multiplicity of identities and resources among individuals of the same ethnic origin.
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Affiliation(s)
- L Terragni
- Norwegian Centre for Migration and Minority Health-The Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway; Institute of Nursing and Health Promotion, Department of Health, OsloMet - Oslo Metropolitan University, Oslo, Norway.
| | - E Beune
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - K Stronks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - E Davidson
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom.
| | - S Qureshi
- Norwegian Centre for Migration and Minority Health-The Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway.
| | - B Kumar
- Norwegian Centre for Migration and Minority Health-The Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway; Department of Community Medicine, Institute of Health and Society, University of Oslo, Postboks 4959 Nydalen, 0424, Oslo, Norway.
| | - E Diaz
- Norwegian Centre for Migration and Minority Health-The Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway; Department of Global Public Health and Primary Care, University of Bergen, PO. Box 7804 N-5020, Bergen, Norway.
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24
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Davidson E, Villarroel-Williams N, Pereyra-Zamora P, Krasnik A, Bhopal R. 5.4-O2The influence of contextual factors on granular ethnic classifications in Europe: results from the Heterogeneity/Granularity in Ethnic Classifications (HGEC) project. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.178] [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: 11/15/2022] Open
Affiliation(s)
- E Davidson
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
| | | | - P Pereyra-Zamora
- Research Unit for the Analysis of Mortality and Health Statistics, University of Alicante, Spain
| | - A Krasnik
- Department of Public Health, University of Copenhagen, Denmark
| | - R Bhopal
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
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25
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Beune E, van Valkengoed I, Muilwijk M, Kumar B, Diaz E, Gill J, Palaniappan L, Davidson E. 5.10-P15Development of an intervention for the prevention of type 2 diabetes addressing the specific needs of South Asian-origin population living in the Netherlands: a pilot study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Beune
- Academic Medical Centre - University of Amsterdam, The Netherlands
| | - I van Valkengoed
- Academic Medical Centre - University of Amsterdam, The Netherlands
| | - M Muilwijk
- Academic Medical Centre - University of Amsterdam, The Netherlands
| | - B Kumar
- The Norwegian Centre for Migration and Minority Health (NAKMI), Norway
| | - E Diaz
- The Norwegian Centre for Migration and Minority Health (NAKMI), Norway
| | - J Gill
- BHF Glasgow Cardiovascular Research Centre-University of Glasgow, United Kingdom
| | - L Palaniappan
- The Stanford University Medical Center, United States
| | - E Davidson
- Usher Institute of Population Health Sciences and Informatics, United Kingdom
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26
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Chatterji R, Naylor JM, Harris IA, Armstrong E, Davidson E, Ekmejian R, Descallar J. An equivalence study: Are patient-completed and telephone interview equivalent modes of administration for the EuroQol survey? Health Qual Life Outcomes 2017; 15:18. [PMID: 28114993 PMCID: PMC5259885 DOI: 10.1186/s12955-017-0596-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 01/22/2016] [Accepted: 01/17/2017] [Indexed: 11/13/2022] Open
Abstract
Background To determine if the EuroQol Health Related Quality of Life survey produces equivalent results when administered by phone interview or patient-completed forms. Methods People awaiting hip or knee arthroplasty at a major metropolitan hospital participated. They were randomly assigned to receive the EuroQol Health Related Quality of Life survey via telephone, followed by a patient completed form 1 week later, or vice versa. Equivalence was determined using two one-sided tests (TOST) based on minimal clinically-important differences for the visual analogue scale (VAS) and the summary Utility Index. Cohen’s Kappa scores were computed to determine agreement for the individual EuroQoL Likert scale items. Results Seventy-six from 90 (84%) participants completed the survey twice. Based on limits set at ±7 and ±0.11 for the VAS and Utility Index, respectively, equivalence was established between the two methods of administration for both the VAS (mean difference 0.05 [90% CI −3.76–3.67]) and the Utility Index (mean difference 0.06 [90% CI 0.02–0.11]). Varying levels of agreement, ranging from slight to substantial (κ = 0.17–0.67), were demonstrated for the individual health domains. The order of telephone and patient-completed survey administration had no significant effect on results. Conclusions Equivalent results are obtained between telephone and patient-completed administration for the VAS and Utility Index of the EuroQol Survey in people with advanced hip or knee osteoarthritis. The limits of agreement for the individual health domains vary which prevents the accurate interpretation of real change in these items across modes.
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Affiliation(s)
- R Chatterji
- South Western Sydney Clinical School, UNSW Australia, Liverpool, NSW, Australia. .,Orthopaedic Department, Liverpool Hospital, Locked Bag 7103, Liverpool, BC, 1871, Australia.
| | - J M Naylor
- South Western Sydney Clinical School, UNSW Australia, Liverpool, NSW, Australia.,Liverpool Hospital Orthopaedic Department, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - I A Harris
- South Western Sydney Clinical School, UNSW Australia, Liverpool, NSW, Australia.,Liverpool Hospital Orthopaedic Department, South Western Sydney Local Health District, Liverpool, NSW, Australia.,Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW, Australia
| | - E Armstrong
- South Western Sydney Clinical School, UNSW Australia, Liverpool, NSW, Australia.,Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW, Australia
| | - E Davidson
- Nepean Hospital Physiotherapy Department, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - R Ekmejian
- South Western Sydney Clinical School, UNSW Australia, Liverpool, NSW, Australia
| | - J Descallar
- South Western Sydney Clinical School, UNSW Australia, Liverpool, NSW, Australia.,Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW, Australia
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Abstract
Radiological evidence of post-traumatic osteoarthritis (PTOA) after fracture of the tibial plateau is common but end-stage arthritis which requires total knee arthroplasty is much rarer. The aim of this study was to examine the indications for, and outcomes of, total knee arthroplasty after fracture of the tibial plateau and to compare this with an age and gender-matched cohort of TKAs carried out for primary osteoarthritis. Between 1997 and 2011, 31 consecutive patients (23 women, eight men) with a mean age of 65 years (40 to 89) underwent TKA at a mean of 24 months (2 to 124) after a fracture of the tibial plateau. Of these, 24 had undergone ORIF and seven had been treated non-operatively. Patients were assessed pre-operatively and at 6, 12 and > 60 months using the Short Form-12, Oxford Knee Score and a patient satisfaction score. Patients with instability or nonunion needed total knee arthroplasty earlier (14 and 13.3 months post-injury) than those with intra-articular malunion (50 months, p < 0.001). Primary cruciate-retaining implants were used in 27 (87%) patients. Complication rates were higher in the PTOA cohort and included wound complications (13% vs 1% p = 0.014) and persistent stiffness (10% vs 0%, p = 0.014). Two (6%) PTOA patients required revision total knee arthroplasty at 57 and 114 months. The mean Oxford knee score was worse pre-operatively in the cohort with primary osteoarthritis (18 vs 30, p < 0.001) but there were no significant differences in post-operative Oxford knee score or patient satisfaction (primary osteoarthritis 86%, PTOA 78%, p = 0.437). Total knee arthroplasty undertaken after fracture of the tibial plateau has a higher rate of complications than that undertaken for primary osteoarthritis, but patient-reported outcomes and satisfaction are comparable. Cite this article: Bone Joint J 2015;97-B:532-8.
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Affiliation(s)
- C E H Scott
- Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK
| | - E Davidson
- Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK
| | - D J MacDonald
- Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK
| | - T O White
- Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK
| | - J F Keating
- Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK
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Haroutiunian S, Kagan L, Yifrach-Damari I, Davidson E, Ratz Y, Hoffman A. Enhanced antinociceptive efficacy of epidural compared with i.v. methadone in a rat model of thermal nociception. Br J Anaesth 2014; 112:150-8. [DOI: 10.1093/bja/aet234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Liu J, Davidson E, Bhopal R, White M, Johnson M, Netto G, Deverill M, Sheikh A. Adapting health promotion interventions to meet the needs of ethnic minority groups: mixed-methods evidence synthesis. Health Technol Assess 2013; 16:1-469. [PMID: 23158845 DOI: 10.3310/hta16440] [Citation(s) in RCA: 137] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is now a considerable body of evidence revealing that a number of ethnic minority groups in the UK and other economically developed countries experience disproportionate levels of morbidity and mortality compared with the majority white European-origin population. Across these countries, health-promoting approaches are increasingly viewed as the long-term strategies most likely to prove clinically effective and cost-effective for preventing disease and improving health outcomes in those with established disease. OBJECTIVES To identify, appraise and interpret research on the approaches employed to maximise the cross-cultural appropriateness and effectiveness of health promotion interventions for smoking cessation, increasing physical activity and improving healthy eating for African-, Chinese- and South Asian-origin populations. DATA SOURCES Two national conferences; seven databases of UK guidelines and international systematic reviews of health promotion interventions aimed at the general population, including the Clinical Evidence, National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines Network databases (1950-2009); 11 databases of research on adapted health promotion interventions for ethnic minority populations, including BIOSIS, EMBASE and MEDLINE (1950-2009); and in-depth qualitative interviews with a purposive sample of researchers and health promoters. REVIEW METHODS Theoretically based, mixed-methods, phased programme of research that involved user engagement, systematic reviews and qualitative interviews, which were integrated through a realist synthesis. Following a launch conference, two reviewers independently identified and extracted data from guidelines and systematic reviews on the effectiveness of interventions for the general population and any guidance offered in relation to how to interpret this evidence for ethnic minority populations. Data were thematically analysed. Reviewers then independently identified and critically appraised studies of adapted interventions and summarised data to assess feasibility, acceptability, equity, clinical effectiveness and cost-effectiveness. Interviews were transcribed, coded and thematically analysed. The quantitative and qualitative data were then synthesised using a realist framework to understand better how adapted interventions work and to assess implementation considerations and prioritise future research. Our preliminary findings were refined through discussion and debate at an end-of-study national user engagement conference. RESULTS Initial user engagement emphasised the importance of extending this work beyond individual-centred behavioural interventions to also include examination of community- and ecological-level interventions; however, individual-centred behavioural approaches dominated the 15 relevant guidelines and 111 systematic reviews we identified. The most consistent evidence of effectiveness was for pharmacological interventions for smoking cessation. This body of work, however, provided scant evidence on the effectiveness of these interventions for ethnic minority groups. We identified 173 reports of adapted health promotion interventions, the majority of which focused on US-based African Americans. This body of evidence was used to develop a 46-item Typology of Adaptation and a Programme Theory of Adapted Health Promotion Interventions. Only nine empirical studies directly compared the effectiveness of culturally adapted interventions with standard health promotion interventions, these failing to yield any consistent evidence; no studies reported on cost-effectiveness. The 26 qualitative interviews highlighted the need to extend thinking on ethnicity from conventional dimensions to more contextual considerations. The realist synthesis enabled the production of a decision-making tool (RESET) to support future research. LIMITATIONS The lack of robust evidence of effectiveness for physical activity and healthy-eating interventions in the general population identified at the outset limited the comparative synthesis work we could undertake in the latter phases. Furthermore, the majority of studies undertaking an adapted intervention were conducted within African American populations; this raises important questions about the generalisability of findings to, for example, a UK context and other ethnic minority groups. Lastly, given our focus on three health areas and three populations, we have inevitably excluded many studies of adapted interventions for other health topics and other ethnic minority populations. CONCLUSIONS There is currently a lack of evidence on how best to deliver smoking cessation, physical activity and healthy eating-related health promotion interventions to ethnic minority populations. Although culturally adapting interventions can increase salience, acceptability and uptake, there is as yet insufficient evidence on the clinical effectiveness or cost-effectiveness of these adapted approaches. More head-to-head comparisons of adapted compared with standard interventions are warranted. The Typology of Adaptation, Programme Theory of Adapted Health Promotion Interventions and RESET tool should help researchers to develop more considered approaches to adapting interventions than has hitherto been the case. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Jj Liu
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Abstract
Septic arthritis of the native knee joint and total knee arthroplasty both cause diagnostic and treatment issues. There is no gold standard test to diagnose a joint infection and the use of joint aspiration is commonly relied on. It is widely accepted by orthopaedic surgeons that antibiotics should be withheld until aspiration has been performed to increase the odds of identifying an organism. Patients often present to other specialties that may not be as familiar with these principles. Our study found that 25 (51%) of the 49 patients treated for septic arthritis of the native or prosthetic knee in our unit over a 3-year period had received antibiotics prior to discussion or review by the on-call orthopaedic service. Patients were significantly less likely to demonstrate an organism on initial microscopy (entire cohort: p=0.001, native knees: p=0.006, prosthetic knees: p=0.033) or on subsequent culture (entire cohort: p=0.001, native knees: p=0.017, prosthetic knees: p=0.012) of their aspirate if they had received antibiotics. The sensitivity of microscopy in all patients dropped from 58% to 12% when patients had received antibiotics (native knees: 46% to 0%, prosthetic knees: 72% to 27%). The sensitivity of the culture dropped from 79% to 28% in all patients when the patient had received antibiotics (native knees: 69% to 21%, prosthetic knees: 91% to 36%). This study demonstrated how the management of patients with suspected cases of septic arthritis of the knee may be compromised by empirical administration of antibiotics. These patients were significantly less likely to demonstrate an organism on microscopy and culture of their initial aspirate. There is a significant high false negative rate associated with knee aspiration with prior administration of antibiotic therapy.
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Affiliation(s)
- K.Y. Mumcuoglu
- Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, Hadassah Medical School, The Hebrew University, Jerusalem, Israel
| | - E. Davidson
- Department of Anesthesia and CCM, Hadassah University Hospital, Jerusalem, Israel
| | - A. Avidan
- Department of Anesthesia and CCM, Hadassah University Hospital, Jerusalem, Israel
| | - L. Gilead
- Department of Dermatology and Venereology, Hadassah University Hospital, Jerusalem, Israel
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Haroutiunian S, Ratz Y, Rosen G, Ezra Y, Livay R, Davidson E. S627 EVALUATION OF PAIN AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) OUTCOMES IN CHRONIC PAIN PATIENTS TREATED WITH CANNABIS. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s1754-3207(11)70957-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zaslansky R, Chapman C, Rothaug J, Bäckström R, Brill S, Davidson E, Elessi K, Fletcher D, Fodor L, Karanja E, Konrad C, Kopf A, Leykin Y, Lipman A, Puig M, Rawal N, Schug S, Ullrich K, Volk T, Meissner W. Feasibility of international data collection and feedback on post-operative pain data: Proof of concept. Eur J Pain 2011; 16:430-8. [DOI: 10.1002/j.1532-2149.2011.00024.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2011] [Indexed: 11/05/2022]
Affiliation(s)
- R. Zaslansky
- Department of Anesthesiology and Intensive Care; Friedrich-Schiller University Hospital; Jena; Germany
| | - C.R. Chapman
- Pain Research Center; Department of Anesthesiology; University of Utah; Salt Lake City; UT; USA
| | - J. Rothaug
- Department of Anesthesiology and Intensive Care; Friedrich-Schiller University Hospital; Jena; Germany
| | - R. Bäckström
- Department of Anesthesiology and Intensive Care; University Hospital Örebro; Örebro; Sweden
| | - S. Brill
- Department of Anesthesiology and Intensive Care; Sourasky Medical Center; Tel-Aviv; Israel
| | - E. Davidson
- Department of Anesthesiology and Intensive Care; Hadassah Medical Center; Jerusalem; Israel
| | - K. Elessi
- El-Wafa Medical Rehabilitation Hospital; Gaza Strip
| | - D. Fletcher
- Department of Anesthesiology and Intensive Care; Raymond Poincaré Hospital; Garches; France
| | - L. Fodor
- Plastic and Reconstructive Surgery; Cluj University Hospital; Cluj; Romania
| | - E. Karanja
- Doctor's Service; Avenue Hospital; Nairobi; Kenya
| | - C. Konrad
- Department of Anesthesiology and Intensive Care; Kantonsspital; Lucerne; Switzerland
| | - A. Kopf
- Department of Anesthesiology and Intensive Care; Charite Medical Center; Berlin; Germany
| | - Y. Leykin
- Department of Anesthesiology and Intensive Care; Santa Maria Degli Angeli; University of Trieste and Udine; Udine; Italy
| | - A. Lipman
- Department of Pharmacotherapy; College of Pharmacy; University of Utah; Salt Lake City; UT; USA
| | - M. Puig
- Department of Anesthesiology and Intensive Care; IMIM-Hospital del Mar-UAB; Barcelona; Spain
| | - N. Rawal
- Department of Anesthesiology and Intensive Care; University Hospital Örebro; Örebro; Sweden
| | - S. Schug
- Department of Anesthesiology and Intensive Care; University of Western Australia and Royal Perth Hospital; Perth; Australia
| | - K. Ullrich
- Department of Anesthesiology and Intensive Care; Queen Mary and Westfield College; University of London; London; UK
| | - T. Volk
- Department of Anesthesiology and Intensive Care; Saarland University Hospital; Homburg; Germany
| | - W. Meissner
- Department of Anesthesiology and Intensive Care; Friedrich-Schiller University Hospital; Jena; Germany
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Davidson E, Liu JJ, Yousuf U, Bhopal R, Johnson M, White M, Netto G, Deverill M, Sheikh A. P48 Modifying health promotion interventions for ethnic minority groups: systematic overview of guidelines and reviews. J Epidemiol Community Health 2010. [DOI: 10.1136/jech.2010.120477.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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Liu JJ, Davidson E, Bhopal R, Johnson M, White M, Deverill M, Netto G, Sheikh A. P49 Modifying health promotion interventions for ethnic minority groups: systematic review of empirical evidence. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120477.49] [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: 11/04/2022]
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Daldal F, Cheng S, Applebaum J, Davidson E, Prince RC. Cytochrome c(2) is not essential for photosynthetic growth of Rhodopseudomonas capsulata. Proc Natl Acad Sci U S A 2010; 83:2012-6. [PMID: 16593675 PMCID: PMC323220 DOI: 10.1073/pnas.83.7.2012] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The structural gene for cytochrome c(2) (cycA) of the photosynthetic bacterium Rhodopseudomonas capsulata has been cloned, and the nucleotide and deduced polypeptide sequences have been determined. Compared with the known amino acid sequence of the purified cytochrome c(2), the nucleotide sequence corresponding to the N-terminal part of the cycA gene product indicates the presence of a putative 21 amino acid signal sequence. Thus, cytochrome c(2) may be synthesized as a precursor which is processed during its secretion to the periplasm. Insertion and insertion-deletion mutations were constructed in vitro and the chromosomal cycA(+) allele of a wild-type strain was replaced with these mutations by homologous recombination to yield c(2) (-) mutants of R. capsulata. The c(2) (-) mutants are stable, and they can grow by photosynthesis and by respiration. Since cytochrome c(2) is the primary electron donor to the reaction center during photosynthesis, the ability of these mutants to grow photosynthetically indicates that an alternative way(s) of reducing the oxidized reaction center must exist in R. capsulata. One candidate for this role may be the membrane-bound cytochrome c(1).
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Affiliation(s)
- F Daldal
- Cold Spring Harbor Laboratory, P.O. Box 100, Cold Spring Harbor, NY 11724
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37
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Ginosar Y, Nitzan M, Davidson E. Reply. Acta Anaesthesiol Scand 2010. [DOI: 10.1111/j.1399-6576.2010.02256.x] [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: 11/29/2022]
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Bobbink R, Hicks K, Galloway J, Spranger T, Alkemade R, Ashmore M, Bustamante M, Cinderby S, Davidson E, Dentener F, Emmett B, Erisman JW, Fenn M, Gilliam F, Nordin A, Pardo L, De Vries W. Global assessment of nitrogen deposition effects on terrestrial plant diversity: a synthesis. Ecol Appl 2010; 20:30-59. [PMID: 20349829 DOI: 10.1890/08-1140.1] [Citation(s) in RCA: 901] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Atmospheric nitrogen (N) deposition is a recognized threat to plant diversity in temperate and northern parts of Europe and North America. This paper assesses evidence from field experiments for N deposition effects and thresholds for terrestrial plant diversity protection across a latitudinal range of main categories of ecosystems, from arctic and boreal systems to tropical forests. Current thinking on the mechanisms of N deposition effects on plant diversity, the global distribution of G200 ecoregions, and current and future (2030) estimates of atmospheric N-deposition rates are then used to identify the risks to plant diversity in all major ecosystem types now and in the future. This synthesis paper clearly shows that N accumulation is the main driver of changes to species composition across the whole range of different ecosystem types by driving the competitive interactions that lead to composition change and/or making conditions unfavorable for some species. Other effects such as direct toxicity of nitrogen gases and aerosols, long-term negative effects of increased ammonium and ammonia availability, soil-mediated effects of acidification, and secondary stress and disturbance are more ecosystem- and site-specific and often play a supporting role. N deposition effects in mediterranean ecosystems have now been identified, leading to a first estimate of an effect threshold. Importantly, ecosystems thought of as not N limited, such as tropical and subtropical systems, may be more vulnerable in the regeneration phase, in situations where heterogeneity in N availability is reduced by atmospheric N deposition, on sandy soils, or in montane areas. Critical loads are effect thresholds for N deposition, and the critical load concept has helped European governments make progress toward reducing N loads on sensitive ecosystems. More needs to be done in Europe and North America, especially for the more sensitive ecosystem types, including several ecosystems of high conservation importance. The results of this assessment show that the vulnerable regions outside Europe and North America which have not received enough attention are ecoregions in eastern and southern Asia (China, India), an important part of the mediterranean ecoregion (California, southern Europe), and in the coming decades several subtropical and tropical parts of Latin America and Africa. Reductions in plant diversity by increased atmospheric N deposition may be more widespread than first thought, and more targeted studies are required in low background areas, especially in the G200 ecoregions.
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Affiliation(s)
- R Bobbink
- B-WARE Research Centre, Radboud University Nijmegen, P.O. Box 9010, 6500 GL Nijmegen, The Netherlands.
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Meir P, Brando PM, Nepstad D, Vasconcelos S, Costa ACL, Davidson E, Almeida S, Fisher RA, Sotta ED, Zarin D, Cardinot G. The effects of drought on Amazonian rain forests. Amazonia and Global Change 2009. [DOI: 10.1029/2009gm000882] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Wallace S, Maki-Petaja K, Cheriyan J, Davidson E, McEniery C, Wilkinson I, Kharbanda R. 02.01 SIMVASTATIN PREVENTS ACUTE INFLAMMATION-INDUCED AORTIC STIFFENING IN HEALTHY VOLUNTEERS. Artery Res 2007. [DOI: 10.1016/s1872-9312(07)70004-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lewis MC, Nevo I, Paniagua MA, Ben-Ari A, Pretto E, Eisdorfer S, Davidson E, Matot I, Eisdorfer C. Uncomplicated general anesthesia in the elderly results in cognitive decline: does cognitive decline predict morbidity and mortality? Med Hypotheses 2006; 68:484-92. [PMID: 17141964 DOI: 10.1016/j.mehy.2006.08.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2006] [Accepted: 08/16/2006] [Indexed: 11/22/2022]
Abstract
Elderly surgical patients constitute a unique surgical group. They require special consideration in order to preempt the long term adverse effects of anesthesia. This paper examines the proposition that general anesthesia causes harm to elderly patients with its impact being felt long after the anesthetic agents are cleared from the body. One complication, Postoperative Cognitive Decline (POCD), is associated with the administration of anesthesia and deep sedation. Its' occurrence may herald an increase in morbidity and mortality. Based on both human and animal data, this paper outlines a unitary theoretical framework to explain these phenomena. If this hypothesis proves to be correct, anesthesiologist should consider regional rather than general anesthesia for equivalent surgical procedures to reduce POCD and consequently achieving superior patient outcome.
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Affiliation(s)
- M C Lewis
- Miller School of Medicine, University of Miami, Miami, FL 33101, USA.
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Grosset A, Moskowitz K, Nelsen C, Pan T, Davidson E, Orser CS. Rapid presymptomatic detection of PrPSc via conformationally responsive palindromic PrP peptides. Peptides 2005; 26:2193-200. [PMID: 16269350 DOI: 10.1016/j.peptides.2005.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Revised: 03/09/2005] [Accepted: 03/09/2005] [Indexed: 11/27/2022]
Abstract
Structurally unique, synthetic prion peptides provide the basis of a simple assay to serve as both a detection and signal amplification system that distinguishes the normal prion protein, PrPC, from the misfolded prion protein, PrPSc, that is associated with the occurrence of transmissible spongiform encephalopathies (TSE). Proof-of-principle has been shown on brain samples from an experimental scrapie hamster model. The assay demonstrates very sensitive detection of PrPSc in animal brain tissue with potential application for early presymptomatic detection in animal screening. Furthermore, the sensitivity of the assay could enable blood tests for this TSE disease as well as other amyloid and/or misfolded protein diseases.
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Affiliation(s)
- A Grosset
- Department of Biochemistry and Molecular Biology, Georgetown University, Washington, DC 20006, USA
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McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'Neill D, Petitjean S, Rumble B, Shan JJ. Erratum. J Am Geriatr Soc 2004. [DOI: 10.1111/j.1532-5415.2004.52247.x] [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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Reilly S, Graham-Jones S, Gaulton E, Davidson E. Can a health advocate for homeless families reduce workload for the primary healthcare team? A controlled trial. Health Soc Care Community 2004; 12:63-74. [PMID: 14675366 DOI: 10.1111/j.1365-2524.2004.00469.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The objective of the present study was to determine whether provision of health advocacy for homeless patients would reduce the burden of care for a primary healthcare team. The impact of a health advocacy intervention was assessed in a quasi-experimental, three-armed controlled trial. Homeless patients registering at an inner-city health centre were allocated in alternating periods to health advocacy (with or without outreach registration) or 'usual care' over a total intake period of 3 years. The client group were homeless people in hostels or other temporary accommodation in the Liverpool 8 area of the UK. The majority of participants (n = 400) were women (76%) in their twenties (mean age = 26.6 years). Most (63%) were temporarily housed at either one of the women's refuges or Liverpool City Council family hostels, and all were registered with an inner-city health centre. Data on health service utilisation over a 3-month period was collected for all clients recruited to the study and direct health service costs were measured. Homeless adults who were proactively registered by the health advocate on outreach visits to hostels made significantly less use of health centre resources whilst having more contact with the health advocate than patients who registered at the health centre at a time of need. There was no reduction in health centre workload when the offer of health advocacy was made after registration at the health centre. The additional costs of providing health advocacy were offset by a reduction in demand for health-centre-based care. The results demonstrate that health advocacy can alter the pattern of help-seeking by temporarily homeless adults. The intervention was cost-neutral. The short-term health service workload associated with symptomatic homeless patients requiring medication was not reduced, but outreach health advocacy was used successfully to address psycho-social issues and reduce the workload for primary care staff.
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Affiliation(s)
- S Reilly
- Personal Social Services Research Unit, Faculty of Medicine, Dentistry and Nursing, University of Manchester, Manchester, UK.
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Walker C, Davidson E, Kingerlee W, Savage K. Incubation conditions of forest soil yielding maximum dissolved organic nitrogen concentrations and minimal residual nitrate. Biol Bull 2003; 205:256-257. [PMID: 14583559 DOI: 10.2307/1543282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- C Walker
- Woods Hole Research Center, Woods Hole, MA, USA
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Davidson E. Maternal serum activin, inhibin, human chorionic gonadotrophin and α-fetoprotein as second trimester predictors of pre-eclampsia. BJOG 2003. [DOI: 10.1016/s1470-0328(02)02937-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gaudinski J, Trumbore S, Davidson E, Cook A, Markewitz D, Richter D. The age of fine-root carbon in three forests of the eastern United States measured by radiocarbon. Oecologia 2001; 129:420-429. [DOI: 10.1007/s004420100746] [Citation(s) in RCA: 205] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2000] [Accepted: 05/10/2001] [Indexed: 11/30/2022]
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Straubinger RK, Dharma Rao T, Davidson E, Summers BA, Jacobson RH, Frey AB. Protection against tick-transmitted Lyme disease in dogs vaccinated with a multiantigenic vaccine. Vaccine 2001; 20:181-93. [PMID: 11567763 DOI: 10.1016/s0264-410x(01)00251-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In an effort to develop a safe and effective vaccine for the prevention of Lyme borreliosis that addresses concerns raised over currently available vaccines, dogs were vaccinated twice with a multiantigenic preparation of Borrelia burgdorferi, strain N40, on days 0 and 20 of the experiment. About 70 and 154 days after the first immunization, dogs were challenged by exposing them to field-collected Ixodes scapularis ticks harboring B. burgdorferi. Vaccinated dogs were completely protected from infection by all criteria utilized to assess infection, developed high-titer anti-B. burgdorferi serum antibodies and growth inhibitory activity which persisted for over 200 days, and did not demonstrate any untoward consequence of vaccination. Serum absorption experiments revealed that borreliacidal and most likely protective antibodies in dogs receiving the multiantigenic preparation were not only elicited against the OspA antigen, but were also produced against additional yet to be determined targets on B. burgdorferi organisms. These data demonstrate that a multiantigenic vaccine is effective in preventing Lyme disease transmitted via the natural vector.
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Affiliation(s)
- R K Straubinger
- Universität Leipzig, Veterinärmedizinische Fakultät, Institut für Immunologie, An den Tierkliniken 11, 04103, Leipzig, Germany.
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Babchenko A, Davidson E, Ginosar Y, Kurz V, Faib I, Adler D, Nitzan M. Photoplethysmographic measurement of changes in total and pulsatile tissue blood volume, following sympathetic blockade. Physiol Meas 2001; 22:389-96. [PMID: 11411248 DOI: 10.1088/0967-3334/22/2/310] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Epidural anaesthesia, used for pain relief, is based on blocking the sensory and the sympathetic nerves in the lower part of the body. Since the sympathetic nervous system regulates blood vessel diameter, the sympathetic block is also associated with several haemodynamic changes. In the current study photoplethysmography (PPG) was measured on toes and fingers of patients undergoing epidural anaesthesia. Three parameters, which are related to the change in total and pulsatile tissue blood volume, were derived from the PPG baseline and amplitude. All parameters showed statistically significant increase in the toes after the sympathetic block, indicating higher arterial and venous blood volume and higher pulsatile increase in the arterial blood volume (higher arterial compliance) in the toe. These haemodynamic changes originate from the lower tonus of the arterial and venous wall muscles after the sympathetic block. In the fingers the PPG parameters based on the change in PPG amplitude decreased after the sympathetic block, indicating lower compliance. The measurement of the haemodynamic changes by PPG enables the assessment of the depth of anaesthesia, and can help control the adverse effects of the blockade on the vascular system.
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Affiliation(s)
- A Babchenko
- Department of Physics/Electro-Optics, Jerusalem College of Technology, Israel
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Pérez-Martínez X, Antaramian A, Vazquez-Acevedo M, Funes S, Tolkunova E, d'Alayer J, Claros MG, Davidson E, King MP, González-Halphen D. Subunit II of cytochrome c oxidase in Chlamydomonad algae is a heterodimer encoded by two independent nuclear genes. J Biol Chem 2001; 276:11302-9. [PMID: 11094061 DOI: 10.1074/jbc.m010244200] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The mitochondrial genomes of Chlamydomonad algae lack the cox2 gene that encodes the essential subunit COX II of cytochrome c oxidase. COX II is normally a single polypeptide encoded by a single mitochondrial gene. In this work we cloned two nuclear genes encoding COX II from both Chlamydomonas reinhardtii and Polytomella sp. The cox2a gene encodes a protein, COX IIA, corresponding to the N-terminal portion of subunit II of cytochrome c oxidase, and the cox2b gene encodes COX IIB, corresponding to the C-terminal region. The cox2a and cox2b genes are located in the nucleus and are independently transcribed into mRNAs that are translated into separate polypeptides. These two proteins assemble with other cytochrome c oxidase subunits in the inner mitochondrial membrane to form the mature multi-subunit complex. We propose that during the evolution of the Chlorophyte algae, the cox2 gene was divided into two mitochondrial genes that were subsequently transferred to the nucleus. This event was evolutionarily distinct from the transfer of an intact cox2 gene to the nucleus in some members the Leguminosae plant family.
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Affiliation(s)
- X Pérez-Martínez
- Departamento de Genética Molecular, Instituto de Fisiologia Celular, Universidad Nacional Autónoma de México, Apartado Postal 70-243, México 04510, D.F. Mexico
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