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Ro SS, Housey J, Bermudez T, Ferguson E, Sachdeva R, Border W. Comprehensive Assessment of Pediatric Echocardiographic Discrepancy Rates using Real-time Adjudicated Quality Assurance: A Ten-year Experience. J Am Soc Echocardiogr 2024:S0894-7317(24)00167-6. [PMID: 38593890 DOI: 10.1016/j.echo.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Sanghee S Ro
- Emory University School of Medicine, Atlanta, GA, USA;.
| | | | | | - Eric Ferguson
- Emory University School of Medicine, Atlanta, GA, USA
| | - Ritu Sachdeva
- Emory University School of Medicine, Atlanta, GA, USA
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2
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Pongutta S, Ferguson E, Davey C, Tangcharoensathien V, Limwattananon S, Borghi J, Wong CKH, Lin L. The impact of a complex school nutrition intervention on double burden of malnutrition among Thai primary school children: a 2-year quasi-experiment. Public Health 2023; 224:51-57. [PMID: 37734276 DOI: 10.1016/j.puhe.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/22/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE This study assessed the impacts of the Dekthai Kamsai programme on overweight/obesity, underweight and stunting among male and female primary school students. STUDY DESIGN A quasi-experiment was conducted in 16 intervention and 19 control schools across Thailand in 2018 and 2019. In total, 896 treated and 1779 control students from grades 1 to 3 were recruited. In intervention schools, a set of multifaceted intervention components were added into school routine practices. Anthropometric outcomes were measured at baseline and at the beginning and end of every school term. METHODS Propensity score matching with linear and Poisson difference-in-difference analyses were used to adjust for the non-randomisation and to analyse the intervention's effects over time. RESULTS Compared with controls, the increases in mean BMI-for-age Z-score (BAZ) and the incidence rate of overweight/obesity were lower in the intervention schools at the 3rd, 4th and 8th measurements and the 3rd measurement, respectively. The decrease in mean height-for-age Z-score (HAZ) was lower at the 4th measurement. The decrease in the incidence rate of wasting was lower at the 5th, 7th and 8th measurements. The favourable impacts on BAZ and HAZ were found in both sexes, while the favourable impact on overweight/obesity and unfavourable impact on wasting were found in girls. CONCLUSIONS This intervention might be effective in reducing BAZ, overweight/obesity, poor height gain, but not wasting. These findings highlight the benefits of a multifaceted school nutrition intervention and a need to incorporate tailor-made interventions for wasting to comprehensively address the double burden of malnutrition.
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Affiliation(s)
- S Pongutta
- International Health Policy Program, Tiwanon Rd, Muang, Nonthaburi 11000, Thailand; London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E7HT, UK.
| | - E Ferguson
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E7HT, UK
| | - C Davey
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E7HT, UK.
| | - V Tangcharoensathien
- International Health Policy Program, Tiwanon Rd, Muang, Nonthaburi 11000, Thailand.
| | - S Limwattananon
- International Health Policy Program, Tiwanon Rd, Muang, Nonthaburi 11000, Thailand.
| | - J Borghi
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E7HT, UK.
| | - C K H Wong
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Science Park, Hong Kong SAR, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Science Park, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong SAR, China.
| | - L Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E7HT, UK; Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong SAR, China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Abou Zeinab M, Ferguson E, Kaviani A, Tuna Beksac A, Covas Moschovas M, Morgantini L, Hemal S, Josehp J, Kim M, Crivellaro S, Patel V, Nix J, Kaouk J. Single-port extraperitoneal vs. transperitoneal robotic-assisted radical prostatectomy: A multi-institutional matched-pair comparison of perioperative outcomes. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02142-5] [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: 11/07/2022] Open
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4
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Morrison J, Ferguson E, Figueroa J, Karpen SJ. Features of Cirrhotic Cardiomyopathy Early in the Lives of Infants With Biliary Atresia Correlate With Outcomes Following Kasai Portoenterostomy. Hepatol Commun 2022; 6:1413-1424. [PMID: 35060685 PMCID: PMC9134799 DOI: 10.1002/hep4.1890] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/31/2021] [Accepted: 11/21/2021] [Indexed: 11/09/2022] Open
Abstract
Cirrhotic cardiomyopathy (CCM), detected during two-dimensional echocardiography (2DE), is prevalent in patients with biliary atresia (BA) awaiting transplant. Whether CCM occurs early in the lives of infants with BA is unknown. The aim of this study was to explore the incidence and consequence of CCM in patients with BA, focusing on the earliest ages when 2DE was performed. A cohort of 78 patients with BA at a single center underwent 2DE (median age = 132 days) during the first year of life. Left ventricular mass index (LVMI) to upper limit of normal (ULN) ratio ≥ 1.0 was present in 60% of patients who never underwent Kasai portoenterostomy (KPE; n = 15), 49% with nondraining KPE (n = 41), and 21% with draining KPE (n = 19). Patients with a draining KPE (median age at 2DE = 72 days) had a lower LVMI/ULN ratio (0.75 [interquartile range [IQR] 0.70, 0.91]) compared to those with a nondraining KPE (0.99 [IQR 0.78, 1.17] median age of 141 days; P = 0.012). In those whose 2DE was performed within 7 days of KPE (n = 19, median age of 61 days), the LVMI/ULN ratio was lower in those with a future draining KPE (0.73 [IQR 0.66, 0.75]) compared to the group with a future nondraining KPE (1.03 [IQR 0.88, 1.08], P = 0.002). Logistic regression modeling revealed LVMI/ULN ratio ≥ 1.0 as a predictor of KPE outcome, with an odds ratio of 16.7 (95% confidence interval 1.36-204; P = 0.028) for a future nondraining KPE compared to those with a LVMI/ULN ratio < 1.0. Conclusion: 2DE early in the lives of patients with BA revealed features of CCM that correlated with future outcomes. If validated in a multicenter study, this could lead to 2DE as a useful clinical tool in the care of infants with BA.
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Affiliation(s)
- Jhavene Morrison
- Division of Pediatric Critical CareChildren's Healthcare of Atlanta and Emory University School of MedicineAtlantaGAUSA
| | - Eric Ferguson
- Division of CardiologySibley Heart Center and Emory University School of MedicineAtlantaGAUSA
| | - Janet Figueroa
- Pediatric Biostatistics CoreEmory University School of MedicineAtlantaGAUSA
| | - Saul J Karpen
- Division of Pediatric GastroenterologyHepatology and NutritionChildren's Healthcare of Atlanta and Emory University School of MedicineAtlantaGAUSA
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5
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Prosser NS, Green MJ, Ferguson E, Tildesley MJ, Hill EM, Keeling MJ, Kaler J. Cattle farmer psychosocial profiles and their association with control strategies for bovine viral diarrhea. J Dairy Sci 2022; 105:3559-3573. [PMID: 35094853 PMCID: PMC9092459 DOI: 10.3168/jds.2021-21386] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/05/2021] [Indexed: 12/02/2022]
Abstract
Bovine viral diarrhea (BVD) is endemic in the United Kingdom and causes major economic losses. Control is largely voluntary for individual farmers and is likely to be influenced by psychosocial factors, such as altruism, trust, and psychological proximity (feeling close) to relevant “others,” such as farmers, veterinarians, the government, and their cows. These psychosocial factors (factors with both psychological and social aspects) are important determinants of how people make decisions related to their own health, many of which have not been studied in the context of infectious disease control by farmers. Farmer psychosocial profiles were investigated using multiple validated measures in an observational survey of 475 UK cattle farmers using the capability, opportunity, motivation-behavior (COM-B) framework. Farmers were clustered by their BVD control practices using latent class analysis. Farmers were split into 5 BVD control behavior classes, which were tested for associations with the psychosocial and COM-B factors using multinomial logistic regression, with doing nothing as the baseline class. Farmers who were controlling disease both for themselves and others were more likely to do something to control BVD (e.g., test, vaccinate). Farmers who did not trust other farmers, had high psychological capability (knowledge and understanding of how to control disease), and had high physical opportunity (time and money to control disease) were more likely to have a closed, separate herd and test. Farmers who did not trust other farmers were also more likely to undertake many prevention strategies with an open herd. Farmers with high automatic motivation (habits and emotions) and reflective motivation (decisions and goals) were more likely to vaccinate and test, alone or in combination with other controls. Farmers with high psychological proximity (feeling of closeness) to their veterinarian were more likely to undertake many prevention strategies in an open herd. Farmers with high psychological proximity to dairy farmers and low psychological proximity to beef farmers were more likely to keep their herd closed and separate and test or vaccinate and test. Farmers who had a lot of trust in other farmers and invested in them, rather than keeping everything for themselves, were more likely to be careful introducing new stock and test. In conclusion, farmer psychosocial factors were associated with strategies for BVD control in UK cattle farmers. Psychological proximity to veterinarians was a novel factor associated with proactive BVD control and was more important than the more extensively investigated trust. These findings highlight the importance of a close veterinarian-farmer relationship and are important for promoting effective BVD control by farmers, which has implications for successful nationwide BVD control and eradication schemes.
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Affiliation(s)
- N S Prosser
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom.
| | - M J Green
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
| | - E Ferguson
- School of Psychology, University Park, University of Nottingham, Nottingham, NG7 2RD, United Kingdom
| | - M J Tildesley
- Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom; Joint UNIversities Pandemic and Epidemiological Research (JUNIPER; https://maths.org/juniper/)
| | - E M Hill
- Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom; Joint UNIversities Pandemic and Epidemiological Research (JUNIPER; https://maths.org/juniper/)
| | - M J Keeling
- Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom; Joint UNIversities Pandemic and Epidemiological Research (JUNIPER; https://maths.org/juniper/)
| | - J Kaler
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
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Batsis M, Kochilas L, Chin AJ, Kelleman M, Ferguson E, Oster ME. Association of Digoxin With Preserved Echocardiographic Indices in the Interstage Period: A Possible Mechanism to Explain Improved Survival? J Am Heart Assoc 2021; 10:e021443. [PMID: 34854311 PMCID: PMC9075357 DOI: 10.1161/jaha.121.021443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background For patients with hypoplastic left heart syndrome, digoxin has been associated with reduced interstage mortality after the Norwood operation, but the mechanism of this benefit remains unclear. Preservation of right ventricular (RV) echocardiographic indices has been associated with better outcomes in hypoplastic left heart syndrome. Therefore, we sought to determine whether digoxin use is associated with preservation of the RV indices in the interstage period. Methods and Results We conducted a retrospective cohort study of prospectively collected data using the public use data set from the Pediatric Heart Network Single Ventricle Reconstruction trial, conducted in 15 North American centers between 2005 and 2008. We included all patients who survived the interstage period and had echocardiographic data post‐Norwood and pre‐Glenn operations. We used multivariable linear regression to compare changes in RV parameters, adjusting for relevant covariates. Of 289 patients, 94 received digoxin at discharge post‐Norwood. There were no significant differences in baseline clinical characteristics or post‐Norwood echocardiographic RV indices (RV end‐diastolic volume indexed, RV end‐systolic volume indexed, ejection fraction) in the digoxin versus no‐digoxin groups. At the end of the interstage period and after adjustment for relevant covariates, patients on digoxin had better preserved RV indices compared with those not on digoxin for the ΔRV end‐diastolic volume (11 versus 15 mL, P=0.026) and the ΔRV end‐systolic volume (6 versus 9 mL, P=0.009) with the indexed ΔRV end‐systolic volume (11 versus 20 mL/BSA1.3, P=0.034). The change in the RV ejection fraction during the interstage period between the 2 groups did not meet statistical significance (−2 versus −5, P=0.056); however, the trend continued to be favorable for the digoxin group. Conclusions Digoxin use during the interstage period is associated with better preservation of the RV volume and tricuspid valve measurements leading to less adverse remodeling of the single ventricle. These findings suggest a possible mechanism of action explaining digoxin’s survival benefit during the interstage period.
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Affiliation(s)
- Maria Batsis
- Sibley Heart Center Cardiology Children's Healthcare of Atlanta Atlanta GA.,Department of Pediatrics Emory University School of Medicine Atlanta GA
| | - Lazaros Kochilas
- Sibley Heart Center Cardiology Children's Healthcare of Atlanta Atlanta GA.,Department of Pediatrics Emory University School of Medicine Atlanta GA
| | - Alvin J Chin
- Department of Pediatrics Perelman School of Medicine University of Pennsylvania Philadelphia PA
| | - Michael Kelleman
- Department of Pediatrics Emory University School of Medicine Atlanta GA
| | - Eric Ferguson
- Sibley Heart Center Cardiology Children's Healthcare of Atlanta Atlanta GA.,Department of Pediatrics Emory University School of Medicine Atlanta GA
| | - Matthew E Oster
- Sibley Heart Center Cardiology Children's Healthcare of Atlanta Atlanta GA.,Department of Pediatrics Emory University School of Medicine Atlanta GA
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7
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Akin-Akinyosoye K, James RJE, McWilliams DF, Millar B, das Nair R, Ferguson E, Walsh DA. The Central Aspects of Pain in the Knee (CAP-Knee) questionnaire; a mixed-methods study of a self-report instrument for assessing central mechanisms in people with knee pain. Osteoarthritis Cartilage 2021; 29:802-814. [PMID: 33621705 PMCID: PMC8177001 DOI: 10.1016/j.joca.2021.02.562] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 02/01/2021] [Accepted: 02/15/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Pain is the prevailing symptom of knee osteoarthritis. Central sensitisation creates discordance between pain and joint pathology. We previously reported a Central Pain Mechanisms trait derived from eight discrete characteristics: Neuropathic-like pain, Fatigue, Cognitive-impact, Catastrophising, Anxiety, Sleep disturbance, Depression, and Pain distribution. We here validate and show that an 8-item questionnaire, Central Aspects of Pain in the Knee (CAP-Knee) is associated both with sensory- and affective- components of knee pain severity. METHODS Participants with knee pain were recruited from the Investigating Musculoskeletal Health and Wellbeing study in the East Midlands, UK. CAP-Knee items were refined following cognitive interviews. Psychometric properties were assessed in 250 participants using Rasch-, and factor-analysis, and Cronbach's alpha. Intra-class correlation coefficients tested repeatability. Associations between CAP-Knee and McGill Pain questionnaire pain severity scores were assessed using linear regression. RESULTS CAP-Knee targeted the knee pain sample well. Cognitive interviews indicated that participants interpreted CAP-Knee items in diverse ways, which aligned to their intended meanings. Fit to the Rasch model was optimised by rescoring each item, producing a summated score from 0 to 16. Internal consistency was acceptable (Cronbach's alpha = 0.74) and test-retest reliability was excellent (ICC2,1 = 0.91). Each CAP-Knee item contributed uniquely to one discrete 'Central Mechanisms trait' factor. High CAP-Knee scores associated with worse overall knee pain intensity, and with each of sensory- and affective- McGill Pain Questionnaire scores. CONCLUSION CAP-Knee is a simple and valid self-report questionnaire, which measures a single 'Central Mechanisms' trait, and may help identify and target centrally-acting treatments aiming to reduce the burden of knee pain.
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Affiliation(s)
- K Akin-Akinyosoye
- Pain Centre Versus Arthritis, University of Nottingham, UK; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, UK.
| | - R J E James
- Pain Centre Versus Arthritis, University of Nottingham, UK; School of Psychology, University of Nottingham, UK.
| | - D F McWilliams
- Pain Centre Versus Arthritis, University of Nottingham, UK; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, UK.
| | - B Millar
- Pain Centre Versus Arthritis, University of Nottingham, UK; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, UK.
| | - R das Nair
- Pain Centre Versus Arthritis, University of Nottingham, UK; Institute of Mental Health, University of Nottingham, UK; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK.
| | - E Ferguson
- Pain Centre Versus Arthritis, University of Nottingham, UK; School of Psychology, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, UK.
| | - D A Walsh
- Pain Centre Versus Arthritis, University of Nottingham, UK; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, UK; Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, Nottinghamshire, UK.
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8
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Vitanza NA, Biery MC, Myers C, Ferguson E, Zheng Y, Girard EJ, Przystal JM, Park G, Noll A, Pakiam F, Winter CA, Morris SM, Sarthy J, Cole BL, Leary SES, Crane C, Lieberman NAP, Mueller S, Nazarian J, Gottardo R, Brusniak MY, Mhyre AJ, Olson JM. Optimal therapeutic targeting by HDAC inhibition in biopsy-derived treatment-naïve diffuse midline glioma models. Neuro Oncol 2021; 23:376-386. [PMID: 33130903 DOI: 10.1093/neuonc/noaa249] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diffuse midline gliomas (DMGs), including diffuse intrinsic pontine gliomas (DIPGs), have a dismal prognosis, with less than 2% surviving 5 years postdiagnosis. The majority of DIPGs and all DMGs harbor mutations altering the epigenetic regulatory histone tail (H3 K27M). Investigations addressing DMG epigenetics have identified a few promising drugs, including the HDAC inhibitor (HDACi) panobinostat. Here, we use clinically relevant DMG models to identify and validate other effective HDACi and their biomarkers of response. METHODS HDAC inhibitors were tested across biopsy-derived treatment-naïve in vitro and in vivo DMG models with biologically relevant radiation resistance. RNA sequencing was performed to define and compare drug efficacy and to map predictive biomarkers of response. RESULTS Quisinostat and romidepsin showed efficacy with low nanomolar half-maximal inhibitory concentration (IC50) values (~50 and ~5 nM, respectively). Comparative transcriptome analyses across quisinostat, romidepsin, and panobinostat showed a greater degree of shared biological effects between quisinostat and panobinostat, and less overlap with romidepsin. However, some transcriptional changes were consistent across all 3 drugs at similar biologically effective doses, such as overexpression of troponin T1 slow skeletal type (TNNT1) and downregulation of collagen type 20 alpha 1 chain (COL20A1), identifying these as potential vulnerabilities or on-target biomarkers in DMG. Quisinostat and romidepsin significantly (P < 0.0001) inhibited in vivo tumor growth. CONCLUSIONS Our data highlight the utility of treatment-naïve biopsy-derived models; establishes quisinostat and romidepsin as effective in vivo; illuminates potential mechanisms and/or biomarkers of DMG cell lethality due to HDAC inhibition; and emphasizes the need for brain tumor-penetrant versions of potentially efficacious agents.
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Affiliation(s)
- Nicholas A Vitanza
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Matt C Biery
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Carrie Myers
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Eric Ferguson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Ye Zheng
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Emily J Girard
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Giulia Park
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Alyssa Noll
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Molecular and Cellular Biology Graduate Program and Medical Scientist Training Program, University of Washington, Seattle, Washington, USA
| | - Fiona Pakiam
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Conrad A Winter
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Shelli M Morris
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jay Sarthy
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Bonnie L Cole
- Department of Laboratories, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Sarah E S Leary
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Courtney Crane
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Nicole A P Lieberman
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Sabine Mueller
- University Children's Hospital Zurich, Zurich, Switzerland.,University of California San Francisco, San Francisco, California, USA
| | - Javad Nazarian
- University Children's Hospital Zurich, Zurich, Switzerland.,Department of Genetic Medicine Research, Children's National Medical Center, Washington DC, USA
| | - Raphael Gottardo
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Statistics, University of Washington, Seattle, Washington, USA
| | - Mi-Youn Brusniak
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrew J Mhyre
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - James M Olson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
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Vitanza N, Biery M, Myers C, Ferguson E, Park G, Noll A, Pakiam F, Girard E, Morris S, Cole B, Brusniak MY, Mhyre A, Olson J. DIPG-10. OPTIMAL HDAC INHIBITION IN DIFFUSE INTRINSIC PONTINE GLIOMA. Neuro Oncol 2020. [PMCID: PMC7715293 DOI: 10.1093/neuonc/noaa222.060] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
As the majority of diffuse intrinsic pontine glioma (DIPG) have H3K27M mutations, epigenetic-targeting agents have been studied, though evaluations have been limited by their model systems, untranslatable drug concentrations, and/or evasive mechanisms of action. To develop a more translational model, we used biopsy samples from newly diagnosed DIPG patients to create treatment-naïve in vitro and in vivo models (molecular aberrations in parentheses), including PBT-09FH (H3FA3, PI3KCA), PBT-22FH (H3F3A, TP53), PBT-24FH (PMS2), and PBT-27FH (HIST1H3B, TP53, NTRK2). Models demonstrated radiation-resistance similar to the patient from whom the culture was generated, supporting the models’ relevance (e.g. cell viability after 8 Gy was 36%, 81%, 71%, and 61% in PBT-09FH, -22FH, -24FH, and -27FH, respectively, compared to 7% in the medulloblastoma model MED-411FH). We evaluated cell viability and apoptosis following treatment with a panel of HDAC inhibitors, identifying the low nanomolar IC50 of quisinostat (~50 nM) and romidepsin (~5 nM). While RNA expression changes induced by 100 nM panobinostat and quisinostat included shared overexpression of the top 20/25 genes (e.g. FSTL5, ITIH5) and shared downregulation of the top 22/25 (e.g. GPR37L1, HEPACAM), only 9/25 were downregulated by panobinostat, quisinostat, and romidepsin (e.g. C21orf62, IFIT2), identifying these as potential vulnerabilities or biomarkers of lethal HDAC inhibition. Mass-spectrometry (LC-MS) demonstrated panobinostat as the greatest acetylator of cortactin, potentially related to thrombocytopenia. While PBT-09 flank models demonstrated quisinostat’s on-target acetylation and efficacy, orthotopic xenograft models did not, supporting our model’s intact blood-brain barrier and emphasizing the need for CNS penetrant versions of potentially efficacious agents.
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Affiliation(s)
- Nicholas Vitanza
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA
| | - Matt Biery
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Carrie Myers
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Eric Ferguson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Giulia Park
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Alyssa Noll
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Fiona Pakiam
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Emily Girard
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shelli Morris
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Bonnie Cole
- Department of Laboratories, Seattle Children’s Hospital, Seattle, WA, USA
- Department of Anatomic Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Andrew Mhyre
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - James Olson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA
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Batsis M, Kochilas L, Chin A, Kelleman MS, Ferguson E, Oster M. ASSOCIATION OF DIGOXIN WITH PRESERVED ECHOCARDIOGRAPHIC INDICES IN THE INTERSTAGE PERIOD: A POSSIBLE MECHANISM TO EXPLAIN IMPROVED SURVIVAL? J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31206-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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11
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Akin-Akinyosoye K, Sarmanova A, Fernandes GS, Frowd N, Swaithes L, Stocks J, Valdes A, McWilliams DF, Zhang W, Doherty M, Ferguson E, Walsh DA. Baseline self-report 'central mechanisms' trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort. Osteoarthritis Cartilage 2020; 28:173-181. [PMID: 31830591 DOI: 10.1016/j.joca.2019.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/13/2019] [Accepted: 11/18/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES We investigated whether baseline scores for a self-report trait linked to central mechanisms predict 1 year pain outcomes in the Knee Pain in the Community cohort. METHOD 1471 participants reported knee pain at baseline and responded to a 1-year follow-up questionnaire, of whom 204 underwent pressure pain detection thresholds (PPTs) and radiographic assessment at baseline. Logistic and linear regression models estimated the relative risks (RRs) and associations (β) between self-report traits, PPTs and pain outcomes. Discriminative performance for each predictor was compared using receiver-operator characteristics (ROC) curves. RESULTS Baseline Central Mechanisms trait scores predicted pain persistence (Relative Risk, RR = 2.10, P = 0.001) and persistent pain severity (β = 0.47, P < 0.001), even after adjustment for age, sex, BMI, radiographic scores and symptom duration. Baseline joint-line PPTs also associated with pain persistence (RR range = 0.65 to 0.68, P < 0.02), but only in univariate models. Lower baseline medial joint-line PPT was associated with persistent pain severity (β = -0.29, P = 0.013) in a fully adjusted model. The Central Mechanisms trait model showed good discrimination of pain persistence cases from resolved pain cases (Area Under the Curve, AUC = 0.70). The discrimination power of other predictors (PPTs (AUC range = 0.51 to 0.59), radiographic OA (AUC = 0.62), age, sex and BMI (AUC range = 0.51 to 0.64), improved significantly (P < 0.05) when the central mechanisms trait was included in each logistic regression model (AUC range = 0.69 to 0.74). CONCLUSION A simple summary self-report Central Mechanisms trait score may indicate a contribution of central mechanisms to poor knee pain prognosis.
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Affiliation(s)
- K Akin-Akinyosoye
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - A Sarmanova
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - G S Fernandes
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK; Centre for Sports, Exercise, and Osteoarthritis Versus Arthritis, UK.
| | - N Frowd
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - L Swaithes
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - J Stocks
- Pain Centre Versus Arthritis, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - A Valdes
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - D F McWilliams
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - W Zhang
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - M Doherty
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
| | - E Ferguson
- Pain Centre Versus Arthritis, UK; School of Psychology, University of Nottingham, UK.
| | - D A Walsh
- Pain Centre Versus Arthritis, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust, UK; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, UK.
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Rothwell M, Starmer G, Grenfell K, Harrison R, Reeves B, Ferguson E. 706 Rheumatic Heart Disease: Implementation of Innovative Cardiac Care Models under the Auspices of the Queensland Action Plan. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.713] [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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13
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Dasgupta S, Madani R, Figueroa J, Cox D, Ferguson E, Border W, Sachdeva R, Fischbach P, Whitehill R. Myocardial deformation as a predictor of right ventricular pacing‐induced cardiomyopathy in the pediatric population. J Cardiovasc Electrophysiol 2019; 31:337-344. [DOI: 10.1111/jce.14312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/28/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Soham Dasgupta
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - Rohit Madani
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - Janet Figueroa
- Department of BiostatisticsEmory University Atlanta Georgia
| | - David Cox
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - Eric Ferguson
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - William Border
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - Ritu Sachdeva
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - Peter Fischbach
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
| | - Robert Whitehill
- Division of Cardiology, Department of Pediatrics, Children's Healthcare of AtlantaEmory University Atlanta Georgia
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De Beurs D, Fried EI, Wetherall K, Cleare S, O' Connor DB, Ferguson E, O'Carroll RE, O' Connor RC. Exploring the psychology of suicidal ideation: A theory driven network analysis. Behav Res Ther 2019; 120:103419. [PMID: 31238299 DOI: 10.1016/j.brat.2019.103419] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [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: 05/16/2018] [Revised: 05/05/2019] [Accepted: 06/03/2019] [Indexed: 12/24/2022]
Abstract
Two leading theories within the field of suicide prevention are the interpersonal psychological theory of suicidal behaviour (IPT) and the integrated motivational-volitional (IMV) model. The IPT posits that suicidal thoughts emerge from high levels of perceived burdensomeness and thwarted belongingness. The IMV model is a multivariate framework that conceptualizes defeat and entrapment as key drivers of suicide ideation. We applied network analysis to cross-sectional data collected as part of the Scottish Wellbeing Study, in which a nationally representative sample of 3508 young adults (18-34 years) completed a battery of psychological measures. Network analysis can help us to understand how the different theoretical components interact and how they relate to suicide ideation. Within a network that included only the core factors from both models, internal entrapment and perceived burdensomeness were most strongly related to suicide ideation. The core constructs defeat, external entrapment and thwarted belonginess were mainly related to other factors than suicide ideation. Within the network of all available psychological factors, 12 of the 20 factors were uniquely related to suicide ideation, with perceived burdensomeness, internal entrapment, depressive symptoms and history of suicide ideation explaining the most variance. None of the factors was isolated, and we identified four larger clusters: mental wellbeing, interpersonal needs, personality, and suicide-related factors. Overall, the results suggest that relationships between suicide ideation and psychological risk factors are complex, with some factors contributing direct risk, and others having indirect impact.
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Affiliation(s)
- D De Beurs
- Netherlands Institute for Health Services Research, Otterstraat, 118-124, Utrecht, the Netherlands.
| | - E I Fried
- Leiden University, Clinical Psychology, Netherlands
| | - K Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - S Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | | | - E Ferguson
- School of Psychology, University of Nottingham, UK
| | - R E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, UK
| | - R C O' Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
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Dasgupta S, Friedman H, Allen N, Stark M, Ferguson E, Sachdeva R, Border WL. Exercise stress echocardiography: Impact on clinical decision-making in pediatric patients. Echocardiography 2019; 36:938-943. [PMID: 30934142 DOI: 10.1111/echo.14326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/21/2019] [Accepted: 03/06/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The role of exercise stress echocardiography (ESE) in the pediatric population is less well defined as compared to adults. We aimed to determine the utility and impact of ESE on clinical decision-making in pediatric patients. METHODS We identified patients who underwent an ESE at our center from 2011 to 2015. Test indications were categorized into symptoms with exercise; sports/activity clearance; hypertrophic cardiomyopathy (HCM) or suspected HCM; coronary anomalies; or abnormal electrocardiogram (EKG). Change in clinical management was assessed by comparing pre- and post-test activity restrictions, which were categorized into unrestricted from exercise or activity; restricted from exercise or activity; and surgical referral. RESULTS During the study period, 353 ESEs met inclusion criteria. Of all ESEs performed, 263 (75%) were normal. Clinical management changed as a result of ESE in 144 (40%). Of the abnormal ESEs, 44 were restricted from activity, including 25 (56.8%) restricted from competitive or varsity athletics, 14 (31.8%) restricted from recreational sports, and 5 (11.4%) restricted from all activity. Surgical referrals included valve repair/replacement in 7 (50%), ICD placement in 5 (35.8%), coronary re-implantation in 1 (7.1%), and atrial septal defect repair in 1 (7.1%). CONCLUSION Exercise stress echocardiography provides the pediatric cardiologist with useful information that impacts management in a wide variety of cardiac disorders. Clinical management changed in nearly half the patients that were subjected to an ESE at our center. This supports the value of ESE for informing clinical decision-making. Future studies should aim to refine patient selection and examine its impact on patient outcomes.
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Affiliation(s)
- Soham Dasgupta
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia
| | | | - Nicole Allen
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Megan Stark
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Eric Ferguson
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia
| | - Ritu Sachdeva
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia
| | - William L Border
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia
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Moug SJ, Henderson N, Tiernan J, Bisset CN, Ferguson E, Harji D, Maxwell-Armstrong C, MacDermid E, Acheson AG, Steele RJC, Fearnhead NS. The colorectal surgeon's personality may influence the rectal anastomotic decision. Colorectal Dis 2018; 20:970-980. [PMID: 29904991 DOI: 10.1111/codi.14293] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/06/2018] [Indexed: 02/08/2023]
Abstract
AIM Colorectal surgeons regularly make the decision to anastomose, defunction or form an end colostomy when performing rectal surgery. This study aimed to define personality traits of colorectal surgeons and explore any influence of such traits on the decision to perform a rectal anastomosis. METHOD Fifty attendees of The Association of Coloproctology of Great Britain and Ireland 2016 Conference participated. After written consent, all underwent personality testing: alexithymia (inability to understand emotions), type of thinking process (intuitive versus rational) and personality traits (extraversion, agreeableness, openness, emotional stability, conscientiousness). Questions were answered regarding anastomotic decisions in various clinical scenarios and results analysed to reveal any influence of the surgeon's personality on anastomotic decision. RESULTS Participants were: male (86%), consultants (84%) and based in England (68%). Alexithymia was low (4%) with 81% displaying intuitive thinking (reflex, fast). Participants scored higher in emotional stability (ability to remain calm) and conscientiousness (organized, methodical) compared with population norms. Personality traits influenced the next anastomotic decision if: surgeons had recently received criticism at a departmental audit meeting; were operating with an anaesthetist that was not their regular one; or there had been no anastomotic leaks in their patients for over 1 year. CONCLUSION Colorectal surgeons have speciality relevant personalities that potentially influence the important decision to anastomose and could explain the variation in surgical practice across the UK. Future work should explore these findings in other countries and any link of personality traits to patient-related outcomes.
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Affiliation(s)
- S J Moug
- Royal Alexandra Hospital, Paisley, UK.,School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - J Tiernan
- Cleveland Clinic, Cleveland, Ohio, USA
| | | | - E Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
| | - D Harji
- Health Education North East, Newcastle Upon Tyne, UK
| | - C Maxwell-Armstrong
- Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - E MacDermid
- New South Wales Health, North Sydney, Australia
| | - A G Acheson
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | | | - N S Fearnhead
- Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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- Cleveland Clinic, Cleveland, Ohio, USA
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Biery M, Myers C, Girard E, Morris S, Carmack S, Noll A, Sarthy J, Ferguson E, Mhyre A, Strand A, Olson J, Vitanza N. DIPG-35. A NOVEL HDAC INHIBITOR IN NEW PATIENT-DERIVED DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG) MODELS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Matthew Biery
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Carrie Myers
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Emily Girard
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shelli Morris
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Alyssa Noll
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Jay Sarthy
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA
| | - Eric Ferguson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Andrew Mhyre
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Andrew Strand
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - James Olson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA
| | - Nicholas Vitanza
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA
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Ferguson E, Lawrence C. It is only fair: blood donors are more sensitive to violations of fairness norms than nondonors - converging psychometric and ultimatum game evidence. Vox Sang 2018; 113:242-250. [DOI: 10.1111/vox.12636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/09/2017] [Accepted: 01/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- E. Ferguson
- School of Psychology; University of Nottingham; Nottingham UK
| | - C. Lawrence
- School of Psychology; University of Nottingham; Nottingham UK
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Liu NLBH, Kaler J, Ferguson E, O'Kane H, Green LE. Sheep farmers' attitudes to farm inspections and the role of sanctions and rewards as motivation to reduce the prevalence of lameness. Anim Welf 2018. [DOI: 10.7120/09627286.27.1.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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McCabe V, Raleigh R, Pichan A, Lavasseur BI, Swarup R, Fugenschuh D, Ferguson E, Stella PJ, Griggs JJ. Implementation and outcomes of lung cancer screening in a community health care system. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e13035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13035 Background: Lung cancer screening using low dose computed tomography (LDCT) in patients meeting criteria is a covered preventative service under the Affordable Care Act and policies of CMS. The purpose of this study is to describe implementation and results of a lung cancer screening program in a community health care system. Methods: We prospectively collected data on all patients obtaining a baseline LDCT scan who enrolled beginning February 2015. Referring provider, smoking history, demographics, comorbidity, findings, and, in those found to have an abnormality, diagnosis were collected. The study was reviewed by the St Joseph Mercy Health System Institutional Review Board and was considered exempt. Results: Over the course of 18 months, 955 patients were referred for a baseline LDCT. 57% were current smokers, 53% were male, and 38% had no comorbid conditions. The mean number of pack-years was 50 (range 6 to 160). 76% of patients were referred by primary care providers. The number of new patients referred per month increased from 8 to 89, largely due to outreach and education directed at primary care physicians and office staff. Of the 955 patients screened, we identified cancer in 2% overall (small cell cancer in 0.2% patients and non-small cell lung cancer (NSCLC) in 1.6%). Among those with NSCLC, 60% had Stage I disease, 20% had Stage II, 13% had Stage III, and 7% had Stage IV disease. Compared to the stage distribution of lung cancer patients identified before the implementation of the screening program, there was significant down-staging in those with NSCLC. Barriers to implementation have included lack of clear smoking history documentation and billing code release delays which led to reimbursement difficulties. Conclusions: Successful implementation of a LDCT lung cancer screening program in a community setting. Improving patient/provider education and documentation of tobacco use in electronic medical records will streamline the referral process and increase screening among eligible patients. Outreach to practices that serve minority and other medically-underserved populations will require specific efforts to achieve health equity in the area of lung cancer screening.
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Affiliation(s)
- Vita McCabe
- St Joseph Mercy Health System, Ann Arbor, MI
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Raleigh R, McCabe V, Soos A, Pichan A, Lavasseur BI, Stella PJ, Swarup R, Fugenschuh D, Ferguson E, Griggs JJ. Implementing a care model to enhance patient outcomes and limit liability in patients with incidental pulmonary nodules. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e18247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18247 Background: Patients with incidental pulmonary nodules are at risk for loss to follow-up due to fragmented health care delivery systems. The purpose of this study is to describe implementation of a care model to eliminate gaps in care for these patients. Methods: A multifaceted intervention was implemented to improve follow-up of incidental pulmonary nodules in at-risk patients. The intervention included education of all patients with incidental nodules in the emergency room and inpatient setting upon discharge. Other key steps included: (i) engagement of physician leadership, (ii) development of a patient tracking database, (iii) designation of a nurse navigator to ensure timely notification of radiological findings, (iv) ensuring patients received timely follow-up and (v) coordination communication with the primary care physician (PCP) or assistance in establishing a relationship with a PCP. Finally, smoking history was added to all CT body radiology reports to stratify risk and determine follow-up intervals using nationally accepted guidelines. The study was reviewed by the St Joseph Mercy Health System Institutional Review Board and was considered exempt. Results: Over the course of 36 months, 7,962 patients with incidental pulmonary nodules were identified by radiologists and flagged for entry into the follow-up program. 2.6% of patients enrolled were found to have lung neoplasms (68% of which were stage I, II or III non-small cell lung cancer). Conclusions: Integrated care models with a seamless combination of nurse navigation and optimal use of health information technology improves care and outcomes for patients with incidental pulmonary nodules while simultaneously mitigating liability for physicians and health care institutions.
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Affiliation(s)
| | - Vita McCabe
- St Joseph Mercy Health System, Ann Arbor, MI
| | - Alisa Soos
- Saint Joseph Mercy Health System, Ann Arbor, MI
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Abstract
Safety culture is a vital concept in human healthcare because of its influence on staff behaviours in relation to patient safety. Understanding safety culture is essential to ensure the acceptance and sustainability of changes, such as the introduction of safe surgery checklists. While widely studied and assessed in human medicine, there is no tool for its assessment in veterinary medicine. This paper therefore presents initial data on such an assessment: the Nottingham Veterinary Safety Culture Survey (NVSCS). 350 pilot surveys were distributed to practising vets and nurses. The survey was also available online. 229 surveys were returned (65 per cent response rate) and 183 completed online, resulting in 412 surveys for analysis. Four domains were identified: (1) organisational safety systems and behaviours, (2) staff perceptions of management, (3) risk perceptions and (4) teamwork and communication. Initial indications of the reliability and the validity of the final survey are presented. Although early in development, the resulting 29-item NVSCS is presented as a tool for measuring safety culture in veterinary practices with implications for benchmarking, safety culture assessment and teamwork training.
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Affiliation(s)
- C Oxtoby
- School of Veterinary Medicine and Science, Nottingham University, Sutton Bonnington Campus, Leicestershire LE125RD, UK.,36 The Street Shipton Moyne, Tetbury, Gloucestershire GL88PN, UK
| | - L Mossop
- School of Veterinary Medicine and Science, Nottingham University, Nottingham, UK
| | - K White
- School of Veterinary Medicine and Science, Nottingham University, Nottingham, UK
| | - E Ferguson
- Department of Psychology, Nottingham University, University Park Nottingham, Nottingham NG7 2RD, UK
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Wyatt LA, Moreton BJ, Mapp PI, Wilson D, Hill R, Ferguson E, Scammell BE, Walsh DA. Histopathological subgroups in knee osteoarthritis. Osteoarthritis Cartilage 2017; 25:14-22. [PMID: 27720884 DOI: 10.1016/j.joca.2016.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 09/01/2016] [Accepted: 09/28/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is a heterogeneous, multi-tissue disease. We hypothesised that different histopathological features characterise different stages during knee OA progression, and that discrete subgroups can be defined based on validated measures of OA histopathological features. DESIGN Medial tibial plateaux and synovium were from 343 post-mortem (PM) and 143 OA arthroplasty donations. A 'chondropathy/osteophyte' group (n = 217) was classified as PM cases with osteophytes or macroscopic medial tibiofemoral chondropathy lesions ≥grade 3 to represent pre-surgical (early) OA. 'Non-arthritic' controls (n = 48) were identified from the remaining PM cases. Mankin histopathological scores were subjected to Rasch analysis and supplemented with histopathological scores for subchondral bone marrow replacement and synovitis. Item weightings were derived by principle components analysis (PCA). Histopathological subgroups were sought using latent class analysis (LCA). RESULTS Chondropathy, synovitis and osteochondral pathology were each associated with OA at arthroplasty, but each was also identified in some 'non-arthritic' controls. Tidemark breaching in the chondropathy/osteophyte group was greater than in non-arthritic controls. Three histopathological subgroups were identified, characterised as 'mild OA', or 'severe OA' with mild or moderate/severe synovitis. CONCLUSIONS Presence and severity of synovitis helps define distinct histopathological OA subgroups. The absence of a discrete 'normal' subgroup indicates a pathological continuum between normality and OA status. Identifying specific pathological processes and their clinical correlates in OA subgroups has potential to accelerate the development of more effective therapies.
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Affiliation(s)
- L A Wyatt
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.
| | - B J Moreton
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - P I Mapp
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK
| | - D Wilson
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Department of Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Mansfield Road, Sutton in Ashfield, NG17 4JL, UK
| | - R Hill
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Department of Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Mansfield Road, Sutton in Ashfield, NG17 4JL, UK
| | - E Ferguson
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; School of Psychology, University of Nottingham, Nottingham, UK
| | - B E Scammell
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK
| | - D A Walsh
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, UK; Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK; Department of Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Mansfield Road, Sutton in Ashfield, NG17 4JL, UK
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Gibson RS, Hotz C, Temple L, Yeudall F, Mtitimuni B, Ferguson E. Dietary Strategies to Combat Deficiencies of Iron, Zinc, and Vitamin A in Developing Countries: Development, Implementation, Monitoring, and Evaluation. Food Nutr Bull 2016. [DOI: 10.1177/156482650002100218] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In many developing countries, staple diets are plant-based and consumption of animal products is low. As a result, the intake and bioavailability of iron, zinc, and vitamin A are often poor. Deficiencies of these micronutrients can be prevented by using dietary diversification and modification, a strategy involving changes in food production practices, food selection patterns, and traditional household methods for preparing and processing indigenous foods. Strategies at the food production level include the use of fertilizers, plant breeding, and genetic engineering to enhance the content and bioavailability of micronutrients in plant-based staples and increase the yield of indigenous edible wild plants. Household strategies involve small-livestock production, aquaculture, gardening projects, and changes in certain food preparation and processing practices designed to alter the content of absorption modifiers in the diet, such as soaking, germination, fermentation, and enrichment. This review also describes how these household strategies can best be incorporated into existing food consumption patterns, and how their impact on the nutrient adequacy of the diets can be assessed. the steps necessary to test the acceptability of the modified recipes, to identify potential barriers to their adoption, and to implement them in the community are discussed, using an example from rural Malawi. Finally, methods of monitoring the progress and evaluating the impact of the dietary strategies in short- and long-term studies are included.
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Affiliation(s)
- R. S. Gibson
- Department of Human Nutrition, University of Otago, in Dunedin, New Zealand
| | - C. Hotz
- Department of Human Nutrition, University of Otago, in Dunedin, New Zealand
| | - L. Temple
- Department of Human Nutrition, University of Otago, in Dunedin, New Zealand
| | - F. Yeudall
- Department of Human Nutrition, University of Otago, in Dunedin, New Zealand
| | - B. Mtitimuni
- Bunda College of Agriculture, University of Malawi, Malawi
| | - E. Ferguson
- Department of Human Nutrition, University of Otago, in Dunedin, New Zealand
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Zhao K, Ferguson E, Smillie L. Good manners rather than compassion predict fair allocations of wealth to a powerless partner: Personality–situation effects in economic bargaining games. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.05.362] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Villemarette CP, Lyons E, Chung B, Ferguson E, LeMieux FM. 0955 The effect of three levels of unmilled rice on growth performance and digestive tract development in broilers and ducks. J Anim Sci 2016. [DOI: 10.2527/jam2016-0955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dominguez-Salas P, Alarcón P, Häsler B, Dohoo IR, Colverson K, Kimani-Murage EW, Alonso S, Ferguson E, Fèvre EM, Rushton J, Grace D. Nutritional characterisation of low-income households of Nairobi: socioeconomic, livestock and gender considerations and predictors of malnutrition from a cross-sectional survey. BMC Nutr 2016. [DOI: 10.1186/s40795-016-0086-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Affiliation(s)
- E. Ferguson
- Personality, Social Psychology and Health (PSPH) Group; School of Psychology; University of Nottingham; Nottingham UK
| | - C. Lawrence
- Personality, Social Psychology and Health (PSPH) Group; School of Psychology; University of Nottingham; Nottingham UK
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Oxtoby C, Ferguson E, White K, Mossop L. We need to talk about error: causes and types of error in veterinary practice. Vet Rec 2015; 177:438. [DOI: 10.1136/vr.103331] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2015] [Indexed: 11/04/2022]
Affiliation(s)
- C. Oxtoby
- School of Veterinary Medicine and Science, Nottingham University; Sutton Bonnington Campus Leicestershire LE125RD UK
| | - E. Ferguson
- School of Psychology, Nottingham University; University Park Nottingham NG7 2RD UK
| | - K. White
- School of Veterinary Medicine and Science, Nottingham University; Sutton Bonnington Campus Leicestershire LE125RD UK
| | - L. Mossop
- School of Veterinary Medicine and Science, Nottingham University; Sutton Bonnington Campus Leicestershire LE125RD UK
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Ferguson E, Ollivere B, Sahota O. 66DISCHARGE LOCATION AFTER HIP FRACTURE - THE EFFECT OF POSTOPERATIVE COMPLICATIONS. Age Ageing 2015. [DOI: 10.1093/ageing/afv113.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zacharias N, Finch C, Subasavage J, Bredthauer G, Crockett C, Divittorio M, Ferguson E, Harris F, Harris H, Henden A, Kilian C, Munn J, Rafferty T, Rhodes A, Schultheiss M, Tilleman T, Wieder G. THE FIRST U.S. NAVAL OBSERVATORY ROBOTIC ASTROMETRIC TELESCOPE CATALOG. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-6256/150/4/101] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ferguson E. Mechanism of altruism approach to blood donor recruitment and retention: a review and future directions. Transfus Med 2015; 25:211-26. [DOI: 10.1111/tme.12233] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/26/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Affiliation(s)
- E. Ferguson
- Personality, Social Psychology and Health (PSPH) Group, School of Psychology; University of Nottingham; Nottingham UK
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Pearson AB, Ferguson E, Deardon E, Morley WL. 3 * QUALITY OF PRESCRIPTIONS IN ACUTE GERIATRIC / STROKE WARDS WAS IMPROVED BY REGULAR DRUG CHART REVIEWS IN ADDITION TO SERIAL AUDIT FEEDBACK FOR PRESCRIBERS. Age Ageing 2015. [DOI: 10.1093/ageing/afv029.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Walsh M, Verghese G, Ferguson E, Fitzgerald N, Goldberg D, Owens S, Pinto N, Zyblewski S, Quartermain M. 107: Counseling practices for fetal hypoplastic left heart syndrome. Am J Obstet Gynecol 2015. [DOI: 10.1016/j.ajog.2014.10.153] [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: 11/12/2022]
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Abstract
BACKGROUND Approximately a quarter to a half of all people fail to take their medication regimen as prescribed (i.e. non-adherence). Conscientiousness, from the five-factor model of personality, has been positively linked to adherence to medications in several recent studies. PURPOSE This study aimed to systematically estimate the strength and variability of this association across multiple published articles and to identify moderators of this relationship. METHOD A literature search identified 16 studies (N = 3,476) that met the study eligibility criteria. Estimates of effect sizes (r) obtained in these studies were meta-analysed. RESULTS Overall, a higher level of conscientiousness was associated with better medication adherence (r = 0.15; 95 % CI, 0.09, 0.21). Associations were significantly stronger in younger samples (r = 0.26, 95 % CI, 0.17, 0.34; k = 7). CONCLUSION The small association between conscientiousness and medication adherence may have clinical significance in contexts where small differences in adherence result in clinically important effects.
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Affiliation(s)
- G J Molloy
- School of Psychology, National University of Ireland Galway, Galway, Ireland,
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Gallagher SM, Lovell MJ, Jones DA, Ferguson E, Ahktar A, Buckhoree Z, Wragg A, Knight CJ, Mathur A, Smith EJ, Cliffe S, Archbold RA, Rothman MT, Jain AK. Does a 'direct' transfer protocol reduce time to coronary angiography for patients with non-ST-elevation acute coronary syndromes? A prospective observational study. BMJ Open 2014; 4:e005525. [PMID: 25270854 PMCID: PMC4179416 DOI: 10.1136/bmjopen-2014-005525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE National guidelines recommend 'early' coronary angiography within 96 h of presentation for patients with non-ST elevation acute coronary syndromes (NSTE-ACS). Most patients with NSTE-ACS present to their district general hospital (DGH), and await transfer to the regional cardiac centre for angiography. This care model has inherent time delays, and delivery of timely angiography is problematic. The objective of this study was to assess a novel clinical care pathway for the management of NSTE-ACS, known locally as the Heart Attack Centre-Extension or HAC-X, designed to rapidly identify patients with NSTE-ACS while in DGH emergency departments (ED) and facilitate transfer to the regional interventional centre for 'early' coronary angiography. METHODS This was an observational study of 702 patients divided into two groups; 391 patients treated before the instigation of the HAC-X pathway (Pre-HAC-X), and 311 patients treated via the novel pathway (Post-HAC-X). Our primary study end point was time from ED admission to coronary angiography. We also assessed the length of hospital stay. RESULTS Median time from ED admission to coronary angiography was 7.2 (IQR 5.1-10.2) days pre-HAC-X compared to 1.0 (IQR 0.7-2.0) day post-HAC-X (p<0.001). Median length of hospital stay was 3.0 (IQR 2.0-6.0) days post-HAC-X v 9.0 (IQR 6.0-14.0) days pre-HAC-X (p<0.0005). This equates to a reduction of six hospital bed days per NSTE-ACS admission. CONCLUSIONS The introduction of this novel care pathway was associated with significant reductions in time to angiography and in total hospital bed occupancy for patients with NSTE-ACS.
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Affiliation(s)
- S M Gallagher
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK Department of Translational Medicine and Therapeutics, William Harvey Research, Queen Mary College, London, UK
| | - M J Lovell
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - D A Jones
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary College, London, UK
| | - E Ferguson
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - A Ahktar
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - Z Buckhoree
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - A Wragg
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK
| | - C J Knight
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK
| | - A Mathur
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary College, London, UK
| | - E J Smith
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK
| | - S Cliffe
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - R A Archbold
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK
| | - M T Rothman
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - A K Jain
- Department of Cardiology, Barts Health NHS Trust, London, UK NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London, UK
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Moon WJ, Scheller EL, Suneja A, Livermore JA, Malani AN, Moudgal V, Kerr LE, Ferguson E, Vandenberg DM. Plasma fluoride level as a predictor of voriconazole-induced periostitis in patients with skeletal pain. Clin Infect Dis 2014; 59:1237-45. [PMID: 24992954 DOI: 10.1093/cid/ciu513] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Voriconazole is a triazole antifungal medication used for prophylaxis or to treat invasive fungal infections. Inflammation of the periosteum resulting in skeletal pain, known as periostitis, is a reported side effect of long-term voriconazole therapy. The trifluorinated molecular structure of voriconazole suggests a possible link between excess fluoride and periostitis, as elevated blood fluoride has been reported among patients with periostitis who received voriconazole. METHODS Two hundred sixty-four patients from Michigan were impacted by the multistate outbreak of fungal infections as a result of contaminated methylprednisolone injections. A retrospective study was conducted among 195 patients who received voriconazole therapy at St Joseph Mercy Hospital during this outbreak. Twenty-eight patients who received both bone scan and plasma fluoride measurements for skeletal pain were included in the statistical analyses. Increased tracer uptake on bone scan was considered positive for periostitis. The primary outcome measure was the correlation between plasma fluoride and bone scan results. RESULTS Blood fluoride (P < .001), alkaline phosphatase (P = .020), daily voriconazole dose (P < .001), and cumulative voriconazole dose (P = .027) were significantly elevated in patients who had periostitis compared with those who did not. Discontinuation or dose reduction of voriconazole resulted in improvement of pain in 89% of patients. CONCLUSIONS High plasma fluoride levels coupled with skeletal pain among patients who are on long-term voriconazole therapy is highly suggestive of periostitis. Initial measurement of fluoride may be considered when bone scan is not readily available. Early detection should be sought, as discontinuation of voriconazole is effective at reversing the disease.
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Affiliation(s)
- Woo J Moon
- Department of Internal Medicine, St Joseph Mercy Hospital
| | - Erica L Scheller
- Department of Molecular and Integrative Physiology, University of Michigan
| | - Anupam Suneja
- Department of Internal Medicine, St Joseph Mercy Hospital
| | | | - Anurag N Malani
- Department of Internal Medicine, St Joseph Mercy Hospital Section of Infectious Diseases
| | - Varsha Moudgal
- Department of Internal Medicine, St Joseph Mercy Hospital Section of Infectious Diseases
| | - Lisa E Kerr
- Department of Pharmacy, St Joseph Mercy Hospital, Ann Arbor, Michigan
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Evans R, Ferguson E. Defining and measuring blood donor altruism: a theoretical approach from biology, economics and psychology. Vox Sang 2013; 106:118-26. [PMID: 24117697 PMCID: PMC4171832 DOI: 10.1111/vox.12080] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [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: 04/08/2013] [Revised: 07/10/2013] [Accepted: 08/13/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES While blood donation is traditionally described as a behaviour motivated by pure altruism, the assessment of altruism in the blood donation literature has not been theoretically informed. Drawing on theories of altruism from psychology, economics and evolutionary biology, it is argued that a theoretically derived psychometric assessment of altruism is needed. Such a measure is developed in this study that can be used to help inform both our understanding of the altruistic motives of blood donors and recruitment intervention strategies. MATERIALS AND METHODS A cross-sectional survey (N = 414), with a 1-month behavioural follow-up (time 2, N = 77), was designed to assess theoretically derived constructs from psychological, economic and evolutionary biological theories of altruism. Theory of planned behaviour (TPB) variables and co-operation were also assessed at time 1 and a measure of behavioural co-operation at time 2. RESULTS Five theoretical dimensions (impure altruism, kinship, self-regarding motives, reluctant altruism and egalitarian warm glow) of altruism were identified through factor analyses. These five altruistic motives differentiated blood donors from non-donors (donors scored higher on impure altruism and reluctant altruism), showed incremental validity over TPB constructs to predict donor intention and predicted future co-operative behaviour. CONCLUSIONS These findings show that altruism in the context of blood donation is multifaceted and complex and, does not reflect pure altruism. This has implication for recruitment campaigns that focus solely on pure altruism.
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Affiliation(s)
- R Evans
- Personality Social Psychology and Health (PSPH) Group, School of Psychology, University of Nottingham, Nottingham, UK
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Ferguson E, Wright M, Carter T, Van Halderen C, Vaughan R, Otter M. Communication regarding breathing support options for youth with Duchenne muscular dystrophy. Paediatr Child Health 2013; 16:395-8. [PMID: 22851892 DOI: 10.1093/pch/16.7.395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2010] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ventilators for home use, manual and mechanically assisted coughing techniques, and the services of in-home respiratory therapists are options for youth with Duchenne muscular dystrophy (DMD). Evidence supports the use of these modalities, but there seems to be few youth who are receiving these therapies. Is there a knowledge transfer issue? Is there a lack of resources? What is the best way to discuss the issues? What do youth and parents want? OBJECTIVE To determine practices, attitudes and beliefs regarding the timing and content of client/family communication related to ventilatory support decisions for individuals with DMD. METHODS A questionnaire was sent to all 19 children's treatment centres in Ontario. The lead clinician responded on behalf of his or her centre. Another questionnaire was given to 11 families who attended a parent support meeting. RESULTS Respondents from the treatment centres who provide services for youth with DMD indicated that there are resources in terms of personnel and an obligation to provide information about ventilatory support, but provision of information is often late and/or inconsistent. The family respondents wanted more information and they wanted it earlier than they are currently receiving it. CONCLUSIONS Parents and youth dealing with DMD have many resources at their disposal in Ontario. The evidence is clear that there are long-term health benefits to providing ventilatory support as well as instruction in coughing assistance. Due to the classical nature of disease progression in DMD, information should be provided within reasonable timelines.
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Affiliation(s)
- Eric Ferguson
- Children's Developmental Rehabilitation Programme, McMaster Children's Hospital, Hamilton
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Harris J, Felix L, Miners A, Murray E, Michie S, Ferguson E, Free C, Lock K, Landon J, Edwards P. Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis. Health Technol Assess 2011; 15:1-160. [PMID: 22030014 PMCID: PMC4781244 DOI: 10.3310/hta15370] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [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: 11/22/2022] Open
Abstract
BACKGROUND UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is 'e-learning', the use of interactive electronic media to facilitate teaching and learning on a range of issues including health. The high level of accessibility, combined with emerging advances in computer processing power, data transmission and data storage, makes interactive e-learning a potentially powerful and cost-effective medium for improving dietary behaviour. OBJECTIVE This review aims to assess the effectiveness and cost-effectiveness of adaptive e-learning interventions for dietary behaviour change, and also to explore potential psychological mechanisms of action and components of effective interventions. DATA SOURCES Electronic bibliographic databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Dissertation Abstracts, EMBASE, Education Resources Information Center, Global Health, Health Economic Evaluations Database, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science) were searched for the period January 1990 to November 2009. Reference lists of included studies and previous reviews were also screened; authors were contacted and trial registers were searched. REVIEW METHODS Studies were included if they were randomised controlled trials, involving participants aged ≥ 13 years, which evaluated the effectiveness of interactive software programs for improving dietary behaviour. Primary outcomes were measures of dietary behaviours, including estimated intakes or changes in intake of energy, nutrients, dietary fibre, foods or food groups. Secondary outcome measures were clinical outcomes such as anthropometry or blood biochemistry. Psychological mediators of dietary behaviour change were also investigated. Two review authors independently screened results and extracted data from included studies, with any discrepancies settled by a third author. Where studies reported the same outcome, the results were pooled using a random-effects model, with weighted mean differences (WMDs), and 95% confidence intervals (CIs) were calculated. Cost-effectiveness was assessed in two ways: through a systematic literature review and by building a de novo decision model to assess the cost-effectiveness of a 'generic' e-learning device compared with dietary advice delivered by a health-care professional. RESULTS A total of 36,379 titles were initially identified by the electronic searches, of which 43 studies were eligible for inclusion in the review. All e-learning interventions were delivered in high-income countries. The most commonly used behavioural change techniques reported to have been used were goal setting; feedback on performance; information on consequences of behaviour in general; barrier identification/problem solving; prompting self-monitoring of behaviour; and instruction on how to perform the behaviour. There was substantial heterogeneity in the estimates of effect. E-learning interventions were associated with a WMD of +0.24 (95% CI 0.04 to 0.44) servings of fruit and vegetables per day; -0.78 g (95% CI -2.5 g to 0.95 g) total fat consumed per day; -0.24 g (95% CI -1.44 g to 0.96 g) saturated fat intake per day; -1.4% (95% CI -2.5% to -0.3%) of total energy consumed from fat per day; +1.45 g (95% CI -0.02 g to 2.92 g) dietary fibre per day; +4 kcal (95% CI -85 kcal to 93 kcal) daily energy intake; -0.1 kg/m2 (95% CI -0.7 kg/m2 to 0.4 kg/m2) change in body mass index. The base-case results from the E-Learning Economic Evaluation Model suggested that the incremental cost-effectiveness ratio was approximately £102,112 per quality-adjusted life-year (QALY). Expected value of perfect information (EVPI) analysis showed that although the individual-level EVPI was arguably negligible, the population-level value was between £37M and £170M at a willingness to pay of £20,000-30,000 per additional QALY. LIMITATIONS The limitations of this review include potential reporting bias, incomplete retrieval of completed research studies and data extraction errors. CONCLUSION The current clinical and economic evidence base suggests that e-learning devices designed to promote dietary behaviour change will not produce clinically significant changes in dietary behaviour and are at least as expensive as other individual behaviour change interventions. FUTURE WORK RECOMMENDATIONS Despite the relatively high EVPI results from the cost-effectiveness modelling, further clinical trials of individual e-learning interventions should not be undertaken until theoretically informed work that addresses the question of which characteristics of the target population, target behaviour, content and delivery of the intervention are likely to lead to positive results, is completed. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- J Harris
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Cox R, Ferguson E, Sundar S. 7042 POSTER Validation of a Rating Scale to Assess the Effects of Testosterone Deficiency in Prostate Cancer Patients Taking Androgen Deprivation Therapy as an Adjunct to Radical Radiotherapy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71993-1] [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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Wood MJ, Mollison J, Harrild K, Ferguson E, McKay T, Srikantharajah A, Bell L, Bhattacharya S. A pragmatic RCT of conventional versus increased concentration sucrose in freezing and thawing solutions for human embryos. Hum Reprod 2011; 26:1987-96. [PMID: 21586432 PMCID: PMC3137387 DOI: 10.1093/humrep/der147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/28/2011] [Accepted: 04/11/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intact frozen-thawed embryos have a greater potential than damaged embryos to establish successful pregnancies. This study aimed to determine whether elevated concentrations of sucrose during freezing would increase the proportion of patients with ≥ 50% of embryos intact after thawing (primary outcome), and improve clinical outcome. METHODS In a two arm, parallel group, pragmatic trial, IVF/ICSI couples were randomized prospectively to have their supernumerary embryos frozen in a medium containing 0.1 M sucrose (control; n = 99) or 0.3 M sucrose (intervention; n = 102). RESULTS More control (74/99) than intervention (63/102) couples had at least one embryo thawed (P = 0.07). Significantly more (P = 0.005) intervention (53/63) than control (45/74) couples had ≥ 50% of embryos intact. Freezing in a medium containing 0.3 M sucrose increased by 3.4-fold [95% confidence interval (CI) (1.45, 7.82)] the likelihood of a couple having ≥ 50% of their embryos intact. In the fresh cycle, live birth rate per transfer was similar in the control (35/95) and intervention (36/93) groups (P = 0.91). More control (19/63) than intervention (9/59) couples had a live birth after frozen embryo transfer (P = 0.08). When fresh and frozen cycles were combined, fewer intervention (n = 102) than control (n = 99) couples had at least one live birth (42 versus 53%). The difference in cumulative live birth rate was not significant [hazard ratio = 0.75, 95% CI (0.49, 1.13); P = 0.17]. CONCLUSIONS Increasing the concentration of sucrose in the freezing medium improves embryo survival, but this is not reflected by increased cumulative birth rates. CLINICAL TRIALS REGISTRATION NUMBER ISRCTN93314892.
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Affiliation(s)
- M J Wood
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
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Gallagher SM, Lovell MJ, Jones D, Ferguson E, Antoniou S, Mohiddin S, Westwood M, Mathur A, Archbold RA, Knight C, Jain AK. 2 A "direct" transfer protocol for patients with non ST-elevation myocardial infarction reduces time to coronary angiography. Heart 2011. [DOI: 10.1136/heartjnl-2011-300198.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tsim P, Ferguson E, Carty HM, Baxendale B, Dhinsa R, Maxwell-Armstrong CA. Is Laparoscopic Simulator Performance Affected by Training Environment? ACTA ACUST UNITED AC 2011. [DOI: 10.1308/147363511x568488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The use of simulators in laparoscopic surgery complements current training with reduced working hours. Trainees can acquire basic skills quickly and efficiently without compromising patient safety. Competence in skills learnt on a simulator has been shown to translate to operating theatre performance. In addition to this, laparoscopic surgeons require new skills since no transfer has been reported between open surgical skills and new laparoscopic techniques. As a result of their numerous advantages, simulators are routinely used as part of training in laparoscopic surgery.
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Affiliation(s)
- P Tsim
- Medical Student, University of Nottingham
| | - E Ferguson
- Professor of Health Psychology, University of Nottingham
| | - H-M Carty
- Clinical Teaching Fellow, Nottingham University Hospitals NHS Trust
| | - B Baxendale
- Director, Nottingham, University Hospitals NHS Trust
| | - R Dhinsa
- Medical Student, University of Nottingham
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Abstract
Malaria is one of the worst sicknesses to affect humankind. For centuries there was no specific treatment, and it was not until the seventeenth century that Spanish colonisers brought back from Peru tree bark from which quinine was later extracted. In the twentieth century, synthetic alternatives to quinine were developed. Of these, chloroquine was the most successful, but by the 1970s widespread resistance had developed and the world was left without an effective treatment for malaria. During the same decade Chinese scientists extracted from sweet wormwood plant the drug artemisinin, which has proved to be very effective against chloroquine-resistant malarial parasites. The use of a combination therapy including artemisinin has made it possible to contemplate the eradication of malaria. Efforts to produce a stable and inexpensive supply of artemisinin are under way.
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Affiliation(s)
- A R Butler
- Bute Medical School, University of St. Andrews, St. Andrews, UK.
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Tsim P, Carty HM, Baxendale B, Ferguson E, Maxwell-Armstrong CA. Laparoscopic simulator performance: Harrier fighter pilots versus medical and non-medical undergraduates. ACTA ACUST UNITED AC 2010. [DOI: 10.1308/147363510x485841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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]
Abstract
There is increasing use of simulation in medical training, including laparoscopic surgery. This is a situation likely to increase as the number of hours spent in direct surgical training reduces as a result of the European Working Time Directive and the consequently decreased length of training. New skills are required by laparoscopic surgeons, including overcoming altered depth perception, translating 2D images into 3D anatomy, and familiarisation with laparoscopic instruments. These skills must be mastered in addition to those required by open surgeons: no transfer has been found between open surgical and new laparoscopic skills.
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Affiliation(s)
- P Tsim
- Faculty of Medicine and Health Sciences, University of Nottingham
| | - H-M Carty
- Department of Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust
| | - B Baxendale
- Trent Simulation and Clinical Skills Centre, Queens Medical Centre, Nottingham University Hospitals NHS Trust
| | - E Ferguson
- Department of Psychology, University of Nottingham
| | - CA Maxwell-Armstrong
- Department of Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust
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Pal S, Ferguson E, Madill SA, Al-Shahi Salman R. Neurological picture. Double depressor palsy caused by bilateral paramedian thalamic infarcts. J Neurol Neurosurg Psychiatry 2009; 80:1328-9. [PMID: 19917816 DOI: 10.1136/jnnp.2008.167643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S Pal
- Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK
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Lotfipour S, Ferguson E, Leonard G, Perron M, Pike B, Richer L, Séguin JR, Toro R, Veillette S, Pausova Z, Paus T. Orbitofrontal Cortex and Drug Use during Adolescence: Role of Prenatal Exposure to Maternal Smoking and BDNF Genotype. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71358-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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