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Johnson F, Madan I, Pattani S, De Bono A, Boorman S, Goss C, Parsons V. Assessing the profile and utility of diplomates in occupational medicine. Occup Med (Lond) 2024:kqae018. [PMID: 38606796 DOI: 10.1093/occmed/kqae018] [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: 04/13/2024] Open
Abstract
BACKGROUND The utility of the occupational medicine diploma in the UK is yet to be explored. The NHS 'Growing Occupational Health (OH) and Wellbeing' programme provides opportunities for diplomates to increase their OH work. AIMS To assess what proportion of diplomates carry out OH work, the type of work being undertaken, to identify obstacles impeding OH work, to capture their interest in future work opportunities and what additional support they require. METHODS A link to an online questionnaire was sent to diplomates via several professional bodies; we estimate that 2428 diplomates received this. The survey was open from 24 March to 31 May 2022. RESULTS Replies were received from 310/2428 (13%) diplomates. Fifty-two per cent of respondents were males and 35% were female. Respondents were diverse in terms of age and geographical region. Main employment settings: 13% primary care, 43% secondary care, 31% private sector, 24% public sector and 20% self-employed. Seventy-two per cent of diplomates had undertaken OH clinical work since completion of their diploma, and 90% of those were undertaking OH clinical work at the time of the survey. Specific obstacles to accessing OH work highlighted included existing workload constraints, lack of employment opportunities with OH providers and lack of time. CONCLUSIONS Many (126/310; 41%) respondents had considered increasing their OH work in the previous 12 months. Increasing mentorship from senior OH clinicians to diplomates was suggested by 4% of respondents to enhance the utility of diplomates.
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Affiliation(s)
- F Johnson
- Leicester Medical School, University of Leicester, Leicester, UK
| | - I Madan
- Occupational Health, Safety and Wellbeing Service, Guy's and St Thomas NHS Foundation Trust, London, UK
- School of Life Sciences and Medicine, King's College London, London, UK
| | - S Pattani
- Occupational Health Service, London North West University Hospitals NHS Trust, London, UK
| | - A De Bono
- Occupational Health Service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - S Boorman
- Employee Health Empactis, Reading, UK
| | - C Goss
- Occupational Health Service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - V Parsons
- Occupational Health, Safety and Wellbeing Service, Guy's and St Thomas NHS Foundation Trust, London, UK
- School of Life Sciences and Medicine, King's College London, London, UK
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Mohottige D, Davenport CA, Bhavsar N, Schappe T, Lyn MJ, Maxson P, Johnson F, Planey AM, McElroy LM, Wang V, Cabacungan AN, Ephraim P, Lantos P, Peskoe S, Lunyera J, Bentley-Edwards K, Diamantidis CJ, Reich B, Boulware LE. Residential Structural Racism and Prevalence of Chronic Health Conditions. JAMA Netw Open 2023; 6:e2348914. [PMID: 38127347 PMCID: PMC10739116 DOI: 10.1001/jamanetworkopen.2023.48914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/01/2023] [Indexed: 12/23/2023] Open
Abstract
Importance Studies elucidating determinants of residential neighborhood-level health inequities are needed. Objective To quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hypertension. Design, Setting, and Participants This cross-sectional study used public data (2012-2018) and deidentified electronic health records (2017-2018) to describe the burden of structural racism and the prevalence of CKD, diabetes, and hypertension in 150 residential neighborhoods in Durham County, North Carolina, from US census block groups and quantified their associations using bayesian models accounting for spatial correlations and residents' age. Data were analyzed from January 2021 to May 2023. Exposures Global (neighborhood percentage of White residents, economic-racial segregation, and area deprivation) and discrete (neighborhood child care centers, bus stops, tree cover, reported violent crime, impervious areas, evictions, election participation, income, poverty, education, unemployment, health insurance coverage, and police shootings) indicators of structural racism. Main Outcomes and Measures Outcomes of interest were neighborhood prevalence of CKD, diabetes, and hypertension. Results A total of 150 neighborhoods with a median (IQR) of 1708 (1109-2489) residents; median (IQR) of 2% (0%-6%) Asian residents, 30% (16%-56%) Black residents, 10% (4%-20%) Hispanic or Latino residents, 0% (0%-1%) Indigenous residents, and 44% (18%-70%) White residents; and median (IQR) residential income of $54 531 ($37 729.25-$78 895.25) were included in analyses. In models evaluating global indicators, greater burden of structural racism was associated with greater prevalence of CKD, diabetes, and hypertension (eg, per 1-SD decrease in neighborhood White population percentage: CKD prevalence ratio [PR], 1.27; 95% highest density interval [HDI], 1.18-1.35; diabetes PR, 1.43; 95% HDI, 1.37-1.52; hypertension PR, 1.19; 95% HDI, 1.14-1.25). Similarly in models evaluating discrete indicators, greater burden of structural racism was associated with greater neighborhood prevalence of CKD, diabetes, and hypertension (eg, per 1-SD increase in reported violent crime: CKD PR, 1.15; 95% HDI, 1.07-1.23; diabetes PR, 1.20; 95% HDI, 1.13-1.28; hypertension PR, 1.08; 95% HDI, 1.02-1.14). Conclusions and Relevance This cross-sectional study found several global and discrete structural racism indicators associated with increased prevalence of health conditions in residential neighborhoods. Although inferences from this cross-sectional and ecological study warrant caution, they may help guide the development of future community health interventions.
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Affiliation(s)
- Dinushika Mohottige
- Institute for Health Equity Research, Department of Population Health, Icahn School of Medicine at Mount Sinai, New York, New York
- Barbara T. Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Nrupen Bhavsar
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Tyler Schappe
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Michelle J. Lyn
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
| | - Pamela Maxson
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina
| | - Fred Johnson
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
| | - Arrianna M. Planey
- Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, North Carolina
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill
| | - Lisa M. McElroy
- Division of Abdominal Transplant Surgery, Department of Surgery, Duke University, Durham, North Carolina
- Department of Population Health, Duke University, Durham, North Carolina
| | - Virginia Wang
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
- Department of Population Health, Duke University, Durham, North Carolina
| | - Ashley N. Cabacungan
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Patti Ephraim
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Paul Lantos
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Department of Pediatrics, Duke University, Durham, North Carolina
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Sarah Peskoe
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Joseph Lunyera
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Keisha Bentley-Edwards
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
- Samuel DuBois Cook Center on Social Equity, Duke University, Durham, North Carolina
| | - Clarissa J. Diamantidis
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina
| | - Brian Reich
- Department of Statistics, North Carolina State University, Raleigh
| | - L. Ebony Boulware
- Wake Forest University School of Medicine, Winston Salem, North Carolina
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Nohria R, Yu J, Tu K, Feng G, Mcneil S, Johnson F, Lyn M, Scherr K. Community-based organizations' perspectives on piloting health and social care integration in North Carolina. BMC Public Health 2023; 23:1914. [PMID: 37789295 PMCID: PMC10548645 DOI: 10.1186/s12889-023-16722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/08/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Community-based organizations (CBOs) are key players in health and social care integration initiatives, yet little is known about CBO perspectives and experiences in these pilot programs. Understanding CBO perspectives is vital to identifying best practices for successful medical and social care integration. METHODS From February 2021 to March 2021, we conducted surveys with 12 CBOs that participated in the North Carolina COVID-19 Social Support Program, a pre-pilot for North Carolina's Medicaid Sect. 1115 demonstration waiver program that addresses social drivers of health. RESULTS CBO participants preferred communication strategies that involved direct communication and felt clear communication was vital to the program's success. Participants expressed varied experiences regarding their ability to handle a changing volume of referrals. Participants identified their organizations' strengths as: strong organizational operations, past experiences with and understanding of the community, and coordination across organizations. Participants identified challenges as: difficulty communicating with clients, coping with capacity demands for scaling services, and lack of clear processes from external organizations. Almost all CBO participants expressed enthusiasm for participating in similar social care transformation programs in the future. CONCLUSIONS CBO participants in our study had broadly positive experiences in the pilot program and almost all would participate in a similar program in the future. Participants provided perspectives that can inform health and social care integration initiatives, including strengths and challenges in such programs. To build and sustain health and social care integration programs, it is important to: (1) support CBOs through regular, direct communication that builds trust and power-sharing between CBO and health care entities; (2) leverage CBO community expertise; and (3) pursue an individualized assessment of CBO capacity and identify CBO capacity-building strategies that ensure program success and sustainability.
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Affiliation(s)
- Raman Nohria
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA.
| | - Junette Yu
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA
| | - Karissa Tu
- University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Grace Feng
- University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, 92093, CA, San Diego, USA
| | | | - Fred Johnson
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA
| | - Michelle Lyn
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA
| | - Karen Scherr
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA
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Hares MF, Griffiths BE, Johnson F, Nelson C, Haldenby S, Stewart CJ, Duncan JS, Oikonomou G, Coombes JL. Specific pathway abundances in the neonatal calf faecal microbiome are associated with susceptibility to Cryptosporidium parvum infection: a metagenomic analysis. Anim Microbiome 2023; 5:43. [PMID: 37700351 PMCID: PMC10496319 DOI: 10.1186/s42523-023-00265-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/03/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Cryptosporidium parvum is the main cause of calf scour worldwide. With limited therapeutic options and research compared to other Apicomplexa, it is important to understand the parasites' biology and interactions with the host and microbiome in order to develop novel strategies against this infection. The age-dependent nature of symptomatic cryptosporidiosis suggests a link to the undeveloped immune response, the immature intestinal epithelium, and its associated microbiota. This led us to hypothesise that specific features of the early life microbiome could predict calf susceptibility to C. parvum infection. RESULTS In this study, a single faecal swab sample was collected from each calf within the first week of life in a cohort of 346 animals. All 346 calves were subsequently monitored for clinical signs of cryptosporidiosis, and calves that developed diarrhoea were tested for Rotavirus, Coronavirus, E. coli F5 (K99) and C. parvum by lateral flow test (LFT). A retrospective case-control approach was taken whereby a subset of healthy calves (Control group; n = 33) and calves that went on to develop clinical signs of infectious diarrhoea and test positive for C. parvum infection via LFT (Cryptosporidium-positive group; n = 32) were selected from this cohort, five of which were excluded due to low DNA quality. A metagenomic analysis was conducted on the faecal microbiomes of the control group (n = 30) and the Cryptosporidium-positive group (n = 30) prior to infection, to determine features predictive of cryptosporidiosis. Taxonomic analysis showed no significant differences in alpha diversity, beta diversity, and taxa relative abundance between controls and Cryptosporidium-positive groups. Analysis of functional potential showed pathways related to isoprenoid precursor, haem and purine biosynthesis were significantly higher in abundance in calves that later tested positive for C. parvum (q ≤ 0.25). These pathways are either absent or streamlined in the C. parvum parasites. Though the de novo production of isoprenoid precursors, haem and purines are absent, C. parvum has been shown to encode enzymes that catalyse the downstream reactions of these pathway metabolites, indicating that C. parvum may scavenge those products from an external source. CONCLUSIONS The host has previously been put forward as the source of essential metabolites, but our study suggests that C. parvum may also be able to harness specific metabolic pathways of the microbiota in order to survive and replicate. This finding is important as components of these microbial pathways could be exploited as potential therapeutic targets for the prevention or mitigation of cryptosporidiosis in bovine neonates.
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Affiliation(s)
- M F Hares
- Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, iC2 Liverpool Science Park, Liverpool, L3 5RF, UK.
| | - B E Griffiths
- Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Wirral, CH64 7TE, UK
| | - F Johnson
- Centre of Genomic Research, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
| | - C Nelson
- Centre of Genomic Research, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
| | - S Haldenby
- Centre of Genomic Research, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
| | - C J Stewart
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, NE2 4HH, UK
| | - J S Duncan
- Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Wirral, CH64 7TE, UK
| | - G Oikonomou
- Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Wirral, CH64 7TE, UK
| | - J L Coombes
- School of Pharmacy and Life Sciences, Robert Gordon University, Garthdee Road, Aberdeen, AB10 7GJ, UK.
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Liu SM, Ifebi B, Johnson F, Xu A, Ho J, Yang Y, Schwartz G, Jo YH, Chua S. The gut signals to AGRP-expressing cells of the pituitary to control glucose homeostasis. J Clin Invest 2023; 133:e164185. [PMID: 36787185 PMCID: PMC10065075 DOI: 10.1172/jci164185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Glucose homeostasis can be improved after bariatric surgery, which alters bile flow and stimulates gut hormone secretion, particularly FGF15/19. FGFR1 expression in AGRP-expressing cells is required for bile acids' ability to improve glucose control. We show that the mouse Agrp gene has 3 promoter/enhancer regions that direct transcription of each of their own AGRP transcripts. One of these Agrp promoters/enhancers, Agrp-B, is regulated by bile acids. We generated an Agrp-B knockin FLP/knockout allele. AGRP-B-expressing cells are found in endocrine cells of the pars tuberalis and coexpress diacylglycerol lipase B - an endocannabinoid biosynthetic enzyme - distinct from pars tuberalis thyrotropes. AGRP-B expression is also found in the folliculostellate cells of the pituitary's anterior lobe. Mice without AGRP-B were protected from glucose intolerance induced by high-fat feeding but not from excess weight gain. Chemogenetic inhibition of AGRP-B cells improved glucose tolerance by enhancing glucose-stimulated insulin secretion. Inhibition of the AGRP-B cells also caused weight loss. The improved glucose tolerance and reduced body weight persisted up to 6 weeks after cessation of the DREADD-mediated inhibition, suggesting the presence of a biological switch for glucose homeostasis that is regulated by long-term stability of food availability.
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Affiliation(s)
| | | | | | | | | | - Yunlei Yang
- Department of Medicine
- Department of Neuroscience, and
| | - Gary Schwartz
- Department of Medicine
- Department of Neuroscience, and
| | - Young Hwan Jo
- Department of Medicine
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, New York, USA
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Goo K, Silberberg M, Eisenson H, Johnson F, Stinnett S. MEASURING SPECIALTY CARE UTILIZATION AMONG MEDICALLY FRAGILE, LOW-INCOME OLDER OR DISABLED ADULTS. Innov Aging 2022. [PMCID: PMC9767114 DOI: 10.1093/geroni/igac059.2841] [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: 12/24/2022] Open
Abstract
The purpose of this research was to quantify the rates of specialty care referral completion and identify variables associated with successful completion among a population of low-income, elderly and/or disabled homebound patients with barriers to accessing office-based care. This was a cross-sectional study using descriptive and multivariate predictive analysis of specialty care referral completion, operationalized as attending an appointment of the same specialty care type within 6 months of being referred. Independent variables include patient age, sex, race, marital status, health insurance, blood pressure, and body mass index. Patient characteristics, referral information, and appointment information from July 1, 2014 to July 1, 2019 were extracted from electronic health record data of patients enrolled in the Just for Us primary care home visiting program in Durham, NC. Specialty care referrals were restricted to those for office-based consultations for chronic disease co-management originating from an outpatient primary care provider. Of 443 total referrals identified from 162 patients, 36% were successfully completed. Being married and female gender were found to be associated with successful referral completion. Of the 217 total patients in the study sample, 25% were identified as not having any referrals. No included patient characteristics were found to be significantly associated with being referred to specialty care. This study demonstrates that the specialty care needs of a medically and socially vulnerable population of homebound patients are not being adequately met.
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Affiliation(s)
- Kelly Goo
- Duke University Medical Center, Durham, North Carolina, United States
| | - Mina Silberberg
- Duke University Medical Center, Durham, North Carolina, United States
| | - Howard Eisenson
- Duke University Medical Center, Durham, North Carolina, United States
| | - Fred Johnson
- Duke University Medical Center, Durham, North Carolina, United States
| | - Sandra Stinnett
- Duke University Medical Center, Durham, North Carolina, United States
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Liu S, Glamore W, Tamburic B, Morrow A, Johnson F. Remote sensing to detect harmful algal blooms in inland waterbodies. Sci Total Environ 2022; 851:158096. [PMID: 35987216 DOI: 10.1016/j.scitotenv.2022.158096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/25/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Harmful algal blooms (HABs) are an issue of concern for water management worldwide. As such, effective monitoring strategies of HAB spatio-temporal variability in waterbodies are needed. Remote sensing has become an increasingly important tool for HAB detection and monitoring in large lakes. However, accurate HAB detection in small-medium waterbodies via satellite data remains a challenge. Current barriers include the waterbody size, the limited freely available high resolution satellite data, and the lack of field calibration data. To test the applicability of remote sensing for detecting HABs in small-medium waterbodies, three satellites (Planetscope, Sentinel-2 and Landsat-8) were used to understand how spatial resolution, the availability of spectral bands, and the waterbody size itself effect HAB detection skill. Different algorithms and a non-parametric method, Self-Organizing Map (SOM), were tested. Curvature Around Red and NIR minus Red had the best HAB detection skill of the 20 existing algorithms that were tested. Landsat 8 and Sentinel 2 were the best satellites for HAB detection in small to medium waterbodies. The most critical attribute for detecting HABs were the available satellite bands, which determine the detection algorithms that can be used. Importantly, algorithm performance was mostly unrelated to waterbody size. However, there remain some barriers in utilizing satellite data for HAB detection, including algae dynamics, macrophyte cover within the waterbody, weather effects, and the correction models for satellite data. Moreover, it is important to consider the match time between satellite overpass and sampling activities for calibration. Given these challenges, integrating regular sampling activities and remote sensing is recommended for monitoring and managing small-medium waterbodies.
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Affiliation(s)
- S Liu
- Water Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
| | - W Glamore
- Water Research Laboratory, University of New South Wales, Sydney, NSW 2093, Australia
| | - B Tamburic
- Water Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - A Morrow
- Hunter Water Corporation, Newcastle, NSW 2300, Australia
| | - F Johnson
- Water Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
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Udell B, Martin J, Romagosa C, Waddle H, Johnson F, Falk B, Yackel Adams A, Funck S, Ketterlin J, Suarez E, Mazzotti F. Open removal models with temporary emigration and population dynamics to inform invasive animal management. Ecol Evol 2022; 12:e9173. [PMID: 35991280 PMCID: PMC9382647 DOI: 10.1002/ece3.9173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/09/2022] [Accepted: 07/12/2022] [Indexed: 11/07/2022] Open
Abstract
Removal sampling data are the primary source of monitoring information for many populations (e.g., invasive species, fisheries). Population dynamics, temporary emigration, and imperfect detection are common sources of variation in monitoring data and are key parameters for informing management. We developed two open robust-design removal models for simultaneously modeling population dynamics, temporary emigration, and imperfect detection: a random walk linear trend model (estimable without ancillary information), and a 2-age class informed population model (InfoPM, closely related to integrated population models) that incorporated prior information for age-structured vital rates and relative juvenile availability. We applied both models to multiyear, removal trapping time-series of a large invasive lizard (Argentine black and white tegu, Salvator merianae) in three management areas of South Florida to evaluate the effectiveness of management programs. Although estimates of the two models were similar, the InfoPMs generally returned more precise estimates, partitioned dynamics into births, deaths, net migration, and provided a decision support tool to predict population dynamics under different effort scenarios while accounting for uncertainty. Trends in tegu superpopulation abundance estimates were increasing in two management areas despite generally high removal rates. However, tegu abundance appeared to decline in the Core management area, where trapping density was the highest and immigration the lowest. Finally, comparing abundance predictions of no-removal scenarios to those estimated in each management area suggested significant population reductions due to management. These results suggest that local tegu population control via systematic trapping may be feasible with high enough trap density and limited immigration; and highlights the value of these trapping programs. We provided the first estimates of tegu abundance, capture probabilities, and population dynamics, which is critical for effective management. Furthermore, our models are applicable to a wide range of monitoring programs (e.g., carcass recovery or removal point-counts).
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Affiliation(s)
- Bradley Udell
- Wildlife Ecology and Conservation University of Florida Gainesville Florida USA
| | - Julien Martin
- Wetland and Aquatic Research Center U.S. Geological Survey Gainesville Florida USA.,Eastern Ecological Science Center U.S. Geological Survey Laurel Maryland USA
| | - Christina Romagosa
- Wildlife Ecology and Conservation University of Florida Gainesville Florida USA
| | - Hardin Waddle
- Wetland and Aquatic Research Center U.S. Geological Survey Gainesville Florida USA
| | - Fred Johnson
- Department of Bioscience Aarhus University Rønde Denmark
| | - Bryan Falk
- Fort Collins Science Center U.S. Geological Survey Fort Collins Colorado USA.,South Florida Natural Resources Center National Park Service Homestead Florida USA
| | - Amy Yackel Adams
- Fort Collins Science Center U.S. Geological Survey Fort Collins Colorado USA
| | - Sarah Funck
- Florida Fish and Wildlife Conservation Commission West Palm Beach Florida USA
| | - Jennifer Ketterlin
- South Florida Natural Resources Center National Park Service Homestead Florida USA
| | - Eric Suarez
- Florida Fish and Wildlife Conservation Commission West Palm Beach Florida USA
| | - Frank Mazzotti
- Fort Lauderdale Research and Education Center University of Florida Davie Florida USA
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Hofauer B, Johnson F, Zhu Z. AB0469 EVALUATION OF SALIVARY GLAND ALTERATIONS IN SJÖGREN’S SYNDROME WITH MULTISPECTRAL OPTOACOUSTIC TOMOGRAPHY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMore than half of all patients with Sjögren’s syndrome (SjS) show characteristic sonomorphological changes in the salivary glands. The relevance of this alterations for diagnosis and follow-up has been investigated in multiple studies. However, it is still not known which parenchymal changes cause this sonomorphological picture. Multispectral optoacoustic tomography (MSOT) is based on the photoacoustic effect – by exciting different chromophores with lasers of different wavelengths, information on tissue composition can be generated. With the help of MSOT, knowledge about tissue changes in salivary glands in patients with SjS should be gained for the first time.ObjectivesCan MSOT be applied in the area of the salivary glands and provide new information on the parenchymal changes in SjS?MethodsIn patients with SjS, classified according to the ACR/EULAR classification criteria, the ESSPRI and ESSDAI were recorded and tear flow and unstimulated salivary flow were determined. The sonomorphological changes in the salivary glands were evaluated using the OMERACT scoring system. Using MSOT, collagen, lipids and (de)oxygenated hemoglobin of the parotid and submandibular glands on both sides were measured (MSOT Acuity Echo).ResultsTwenty-three patients were included in the study (21 women, age: 62 years). At the time of the study, the ESSPRI averaged 47 points and the ESSDAI 8.5 points. The Schirmer test gave an average value of 6.4 mm/5 min, the unstimulated salivary flow (UWSF) 0.2 ml/5 min. The evaluation of the B-mode sonography showed predominantly hypoechoic lesions and less hyperechoic bands. In the evaluation of the tissue information obtained by means of MSOT, a correlation between increased lipid content and salivary flow measurement was shown as well as a significant difference between collagen proportion between parotid and submandibular glands.ConclusionWith the help of MSOT, statements about the actual tissue changes within the salivary glands in SjS can be made for the first time. This project demonstrated for the first time a correlation between tissue composition and clinical parameter. The evaluation of other wavelengths in order to obtain further information on the tissue composition is planned.Disclosure of InterestsNone declared
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Moore JF, Martin J, Waddle H, Campbell Grant EH, Fleming J, Bohnett E, Akre TSB, Brown DJ, Jones MT, Meck JR, Oxenrider K, Tur A, Willey LL, Johnson F. Evaluating the effect of expert elicitation techniques on population status assessment in the face of large uncertainty. J Environ Manage 2022; 306:114453. [PMID: 35033890 DOI: 10.1016/j.jenvman.2022.114453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/08/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Population projection models are important tools for conservation and management. They are often used for population status assessments, for threat analyses, and to predict the consequences of conservation actions. Although conservation decisions should be informed by science, critical decisions are often made with very little information to support decision-making. Conversely, postponing decisions until better information is available may reduce the benefit of a conservation decision. When empirical data are limited or lacking, expert elicitation can be used to supplement existing data and inform model parameter estimates. The use of rigorous techniques for expert elicitation that account for uncertainty can improve the quality of the expert elicited values and therefore the accuracy of the projection models. One recurring challenge for summarizing expert elicited values is how to aggregate them. Here, we illustrate a process for population status assessment using a combination of expert elicitation and data from the ecological literature. We discuss the importance of considering various aggregation techniques, and illustrate this process using matrix population models for the wood turtle (Glyptemys insculpta) to assist U.S. Fish and Wildlife Service decision-makers with their Species Status Assessment. We compare estimates of population growth using data from the ecological literature and four alternative aggregation techniques for the expert-elicited values. The estimate of population growth rate based on estimates from the literature (λmean = 0.952, 95% CI: 0.87-1.01) could not be used to unequivocally reject the hypotheses of a rapidly declining population nor the hypothesis of a stable, or even slightly growing population, whereas our results for the expert-elicited estimates supported the hypothesis that the wood turtle population will decline over time. Our results showed that the aggregation techniques used had an impact on model estimates, suggesting that the choice of techniques should be carefully considered. We discuss the benefits and limitations associated with each method and their relevance to the population status assessment. We note a difference in the temporal scope or inference between the literature-based estimates that provided insights about historical changes, whereas the expert-based estimates were forward looking. Therefore, conducting an expert-elicitation in addition to using parameter estimates from the literature improved our understanding of our species of interest.
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Affiliation(s)
- Jennifer F Moore
- Moore Ecological Analysis and Management, LLC, Gainesville, FL, USA.
| | - Julien Martin
- U.S. Geological Survey, Wetland and Aquatic Research Center, Gainesville, FL, USA
| | - Hardin Waddle
- U.S. Geological Survey, Wetland and Aquatic Research Center, Gainesville, FL, USA
| | - Evan H Campbell Grant
- U.S. Geological Survey, Eastern Ecological Research Center (formerly the Patuxent Wildlife Research Center), S.O. Conte Anadromous Fish Research Lab, 1 Migratory Way, Turners Falls, MA, 01376, USA
| | - Jill Fleming
- U.S. Geological Survey, Eastern Ecological Research Center (formerly the Patuxent Wildlife Research Center), S.O. Conte Anadromous Fish Research Lab, 1 Migratory Way, Turners Falls, MA, 01376, USA
| | - Eve Bohnett
- University of Florida, Department of Landscape Architecture, Gainesville, FL, USA
| | - Thomas S B Akre
- Conservation Ecology Center, Smithsonian Conservation Biology Institute, 1500 Remount Rd, Front Royal, VA, 22630, USA
| | - Donald J Brown
- School of Natural Resources, West Virginia University, Morgantown, WV, 26506, USA; Northern Research Station, U.S.D.A. Forest Service, Parsons, WV, 26287, USA
| | - Michael T Jones
- Natural Heritage and Endangered Species Program, Massachusetts Division of Fisheries and Wildlife, 1 Rabbit Hill Road, Westborough, MA, 01581, USA
| | - Jessica R Meck
- Conservation Ecology Center, Smithsonian Conservation Biology Institute, 1500 Remount Road, Front Royal, VA, 22630, USA
| | - Kevin Oxenrider
- West Virginia Division of Natural Resources, 1 Depot St, Romney, WV, 26757, USA
| | - Anthony Tur
- U.S. Fish and Wildlife Service, 300 Westgate Center, Hadley, MA, 01035, USA
| | - Lisabeth L Willey
- Antioch University New England, Dept. of Environmental Studies, 40 Avon St, Keene, NH, 03431, USA
| | - Fred Johnson
- University of Florida, Dept of Wildlife Ecology and Conservation, Gainesville, FL, USA
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Hayter E, Rashid M, Johnson F, Erotocritou M, Thomas P. 487 Reducing Intraoperative Fluoroscopic Radiation Exposure in Orthopaedic Theatres at A Trauma Centre. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Intraoperative fluoroscopic imaging in orthopaedic trauma surgery subject’s theatre staff and patients to increasing radiation exposure and its detrimental health effects. This audit cycle uses a target maximum for total number of intraoperative fluoroscopic images taken, as defined by recently published reference values, to reduce intraoperative radiation exposure.
Method
This is a two-phase audit cycle retrospectively reviewing all trauma operations over a 12-month period (456 cases) and a 10-month period (256 cases) after disseminating the target standards through posters and focused training. Audit standards describe target maximum total intraoperative images taken for 5 commonly performed procedures, applicable to 33% of total cases. Operative notes, total intraoperative image count and radiation dose report were reviewed through ORMIS and PACS.
Results
Audit standard compliance improved/remained at 100% in 4/5 of the investigated ‘common procedures’: from 2/5 procedures <80% compliance and 1/5 procedures =100% compliance initially, to 0/5 procedures <80% compliance and 2/5 procedures =100% compliance target upon re-audit. This translated to an improvement in mean radiation risk (DAP Gy.cm^2) in 3/4 common procedures (one exclusion due to dissimilar cohort characteristics).
Conclusions
This study demonstrates employing a target maximum total image count limit reduced radiation exposure in trauma theatres.
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Affiliation(s)
- E Hayter
- Whittington hospital, London, United Kingdom
| | - M Rashid
- Whittington hospital, London, United Kingdom
| | - F Johnson
- Whittington hospital, London, United Kingdom
| | | | - P Thomas
- Whittington hospital, London, United Kingdom
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Yurek S, Eaton MJ, Lavaud R, Laney RW, DeAngelis DL, Pine WE, La Peyre M, Martin J, Frederick P, Wang H, Lowe MR, Johnson F, Camp EV, Mordecai R. Modeling structural mechanics of oyster reef self-organization including environmental constraints and community interactions. Ecol Modell 2021. [DOI: 10.1016/j.ecolmodel.2020.109389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Grobman WA, Sandoval G, Reddy UM, Tita AT, Silver RM, Mallett G, Hill K, Rice MM, El-Sayed YY, Wapner RJ, Rouse DJ, Saade GR, Thorp JM, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA, Peaceman A, Plunkett B, Paycheck K, Dinsmoor M, Harris S, Sheppard J, Biggio J, Harper L, Longo S, Servay C, Varner M, Sowles A, Coleman K, Atkinson D, Stratford J, Dellermann S, Meadows C, Esplin S, Martin C, Peterson K, Stradling S, Willson C, Lyell D, Girsen A, Knapp R, Gyamfi C, Bousleiman S, Perez-Delboy A, Talucci M, Carmona V, Plante L, Tocci C, Leopanto B, Hoffman M, Dill-Grant L, Palomares K, Otarola S, Skupski D, Chan R, Allard D, Gelsomino T, Rousseau J, Beati L, Milano J, Werner E, Salazar A, Costantine M, Chiossi G, Pacheco L, Saad A, Munn M, Jain S, Clark S, Clark K, Boggess K, Timlin S, Eichelberger K, Moore A, Beamon C, Byers H, Ortiz F, Garcia L, Sibai B, Bartholomew A, Buhimschi C, Landon M, Johnson F, Webb L, McKenna D, Fennig K, Snow K, Habli M, McClellan M, Lindeman C, Dalton W, Hackney D, Cozart H, Mayle A, Mercer B, Moseley L, Gerald J, Fay-Randall L, Garcia M, Sias A, Price J, Hale K, Phipers J, Heyborne K, Craig J, Parry S, Sehdev H, Bishop T, Ferrara J, Bickus M, Caritis S, Thom E, Doherty L, de Voest J. Health resource utilization of labor induction versus expectant management. Am J Obstet Gynecol 2020; 222:369.e1-369.e11. [PMID: 31930993 DOI: 10.1016/j.ajog.2020.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization. OBJECTIVE The objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY DESIGN This is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management. We assessed resource utilization after randomization in 3 time periods: antepartum, delivery admission, and discharge through 8 weeks postpartum. RESULTS Of 6096 women with data available, those in the induction of labor group (n = 3059) were significantly less likely in the antepartum period after randomization to have at least 1 ambulatory visit for routine prenatal care (32.4% vs 68.4%), unanticipated care (0.5% vs 2.6%), or urgent care (16.2% vs 44.3%), or at least 1 antepartum hospitalization (0.8% vs 2.2%, P < .001 for all). They also had fewer tests (eg, sonograms, blood tests) and treatments (eg, antibiotics, intravenous hydration) prior to delivery. During the delivery admission, women in the induction of labor group spent a longer time in labor and delivery (median, 0.83 vs 0.57 days), but both women (P = .002) and their neonates (P < .001) had shorter postpartum stays. Women and neonates in both groups had similar frequencies of postpartum urgent care and hospital readmissions (P > .05 for all). CONCLUSION Women randomized to induction of labor had longer durations in labor and delivery but significantly fewer antepartum visits, tests, and treatments and shorter maternal and neonatal hospital durations after delivery. These results demonstrate that the health outcome advantages associated with induction of labor are gained without incurring uniformly greater health care resource use.
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Parr K, Johnson F, Langley N, Richardson P. Improving patient pathways in head and neck cancer at a UK Cancer Centre. Results of a dietetic pre-treatment project (DPP). Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.094] [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: 11/26/2022]
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16
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Feldsine PT, Lienau AH, Roa NH, Green ST, Braut-Taormina J, Braymen C, Chavey C, Cohen A, Deans A, Delancey S, Elems C, Forgey R, Gonzalez E, Hall V, Huang MCJ, Humes L, Johnson F, Kerdaji K, King J, Kipker L, Lau D, Nogle J, Peters C, Pinkston J, Porter M, Potter L, Rogers S, Stephens J, Skorupa G, Taylor R, Tuncan E, Vought K, Vrana D. Enumeration of Total Coliforms and E. coli in Foods by the SimPlate® Coliform and E. coli Color Indicator Method and Conventional Culture Methods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/88.5.1318] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
The relative effectiveness of the SimPlate® Coliform and E. coli Color Indicator (CEc-CI) method was compared to the AOAC 3-tube Most Probable Number (MPN) methods for enumerating and confirming coliforms and Escherichia coli in foods (966.23 and 966.24). In this study, test portions were prepared and analyzed according to the conditions stated in both the AOAC methods and SimPlate directions for use. Six food types were artificially contaminated with coliform bacteria and E. coli: frozen burritos, frozen broccoli, fluid pasteurized milk, whole almond nut meats, cheese, and powdered cake mix. Method comparisons were conducted. Overall, the SimPlate method demonstrated <0.3 log difference for total coliform and E. coli counts compared to the AOAC reference methods for the majority of food types and levels analyzed. In all cases, the repeatability and reproducibility of the SimPlate CEc-CI method were not different from those of the reference methods and in certain cases, were statistically better than those of the AOAC 3-tube MPN methods. These results indicate that the SimPlate CEc-CI method and the reference culture methods are comparable for enumeration of both total coliforms and E. coli in foods.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Nerie H Roa
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Shannon T Green
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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Silbernagel K, Jechorek R, Carver C, Barbour WM, Mrozinski P, Albert A, Andaloro B, Anderson G, Beacorn F, Brooks R, Carson M, Crossfield D, Eliasberg S, Farmer D, Frantzeskakis C, Gasses T, Gatesy T, Hall G, Hanson P, Heddaeus K, Hermann K, Hutchins J, Jenkins J, Johnson F, Johnson J, Kawalek M, Kelly L, Koschmann C, Lannon P, Lester D, Manner K, Martin J, Maselli M, McGovern B, Mohnke F, Moon B, Murray L, Pace R, Richards J, Robeson S, Rodgers D, Rosario G, Saunders C, Shaw C, Dana Shell J, Sloan E, Thompson S, Vialpando M, Voermans R, Watts K, Wieczorek K, Wilson K, Yeh H, Zamora D. Evaluation of the BAX® System for Detection of Salmonella in Selected Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.6.1149] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare the automated BAX® System to the standard cultural methods for detection of Salmonella in selected foods. Five food types—frankfurters, raw ground beef, mozzarella cheese, raw frozen tilapia fish, and orange juice—at 3 inoculation levels, were analyzed by each method. A sixth food type, raw ground chicken, was tested using 3 naturally contaminated lots. A total of 16 laboratories representing government and industry participated. In this study, 1386 samples were analyzed, of which 1188 were paired samples and 198 were unpaired samples. Of the 1188 paired samples, 461 were positive by both methods and 404 were negative by both methods. Thirty-seven samples were positive by the BAX System but negative by the standard reference method, and 11 samples were positive by standard cultural method and negative by the BAX System. Of the 198 unpaired samples, 106 were positive by the BAX System and 60 were positive by the standard cultural method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, the BAX System demonstrated results comparable to those of the standard reference methods based on the Chi square results.
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Affiliation(s)
| | | | - Charles Carver
- rtech laboratories, PO Box 64101, St. Paul, MN 55164-0101
| | - W Mark Barbour
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
| | - Peter Mrozinski
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
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Zullig LL, McCant F, Silberberg M, Johnson F, Granger BB, Bosworth HB. Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention. Transl Behav Med 2018; 8:225-232. [PMID: 29432589 DOI: 10.1093/tbm/ibx030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Relatively few successful medication adherence interventions are translated into real-world clinical settings. The Prevention of Cardiovascular Outcomes in African Americans with Diabetes (CHANGE) intervention was originally conceived as a randomized controlled trial to improve cardiovascular disease-related medication adherence and health outcomes. The purpose of the study was to describe the translation of the CHANGE trial into two community-based clinical programs. CHANGE 2 was available to Medicaid patients with diabetes and hypertension whose primary care homes were part of a care management network in the Northern Piedmont region of North Carolina. CHANGE 3 was available to low-income patients receiving care in three geographical areas with multiple chronic conditions at low or moderate risk for developing cardiovascular disease. Adaptations were made to ensure fit with available organizational resources and the patient population's health needs. Data available for evaluation are presented. For CHANGE 2, we evaluated improvement in A1c control using paired t test. For both studies, we describe feasibility measured by percentage of patients who completed the curriculum. CHANGE 2 involved 125 participants. CHANGE 3 had 127 participants. In CHANGE 2, 69 participants had A1c measurements at baseline and 12-month follow-up; A1c improved from 8.4 to 7.8 (p = .008). In CHANGE 3, interventionists completed 47% (n = 45) of calls to enroll participants at the 4-month encounter, and among those eligible for a 12-month call (n = 52), 21% of 12-month calls were completed with participants. In CHANGE 2, 40% of participants (n = 50) completed all 12 encounters. Thoughtful adaptation is critical to translate clinical trials into community-based clinic settings. Successful implementation of adapted evidence-based interventions may be feasible and can positively affect patients' disease control.
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Affiliation(s)
- Leah L Zullig
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care Center, Durham, NC, USA.,Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Felicia McCant
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care Center, Durham, NC, USA
| | - Mina Silberberg
- Community and Family Medicine, Duke University, Durham, NC, USA
| | - Fred Johnson
- Community and Family Medicine, Duke University, Durham, NC, USA
| | | | - Hayden B Bosworth
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care Center, Durham, NC, USA.,Department of Population Health Sciences, Duke University, Durham, NC, USA.,School of Nursing, Duke University, Durham, NC, USA.,Center for Population Health Sciences, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
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Schoser B, Bratkovic D, Byrne B, Clemens P, Geberhiwot T, Goker-Alpan O, Kishnani P, Ming X, Mozaffar T, Schwenkreis P, Sivakumar K, van der Ploeg A, Wright J, Johnson F, Sitaraman S, Barth J, Sathe S, Roberts M. NEW THERAPEUTIC APPROACHES AND THEIR READOUT. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
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Buchberger AMS, Baumann A, Johnson F, Peters N, Piontek G, Storck K, Pickhard A. The role of oral anticoagulants in epistaxis. Eur Arch Otorhinolaryngol 2018; 275:2035-2043. [PMID: 29936627 PMCID: PMC6060781 DOI: 10.1007/s00405-018-5043-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/16/2018] [Indexed: 01/13/2023]
Abstract
Purpose The purpose of this retrospective study was to identify the impact of oral anticoagulants on epistaxis with the focus on new oral anticoagulants. Methods The study was conducted at the Department for Ear- Nose- and Throat (ENT), Head and Neck Surgery, Technical University Munich, Germany. All patients presenting in 2014 with the diagnosis of epistaxis to a specialized ENT accident and emergency department were identified and analyzed in clinical data and medication. Results 600 adult cases, with a median age of 66.6 years were identified with active bleeding. 66.8% of all cases were anticoagulated. Classic oral anticoagulants (COAC) were three times more common in patients than new-generation oral anticoagulants (NOAC). Recurrent bleeding was significantly associated with oral anticoagulants (OAC) (p = 0.014) and bleeding location was most often anterior (p = 0.006). In contrast, severe cases, which required surgery or embolization were significantly more likely in non-anticoagulated middle-aged patients with posterior bleedings (p < 0.05). In our epistaxis cohort, OAC were highly overrepresented (40%) when compared to the general German population (1%) but COAC as well as NOAC played only a minor role in severe courses of epistaxis. Conclusion Oral anticoagulation, especially with new-generation drugs, is not associated with more complicated and severe courses of epistaxis, but rather with recurrent bleeding. One should keep this information in mind when triaging the patient in the emergency room and when planning further procedures.
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Affiliation(s)
- A M S Buchberger
- Department for Ear- Nose- and Throat, Head and Neck Surgery, University hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - A Baumann
- Department of Otolaryngology Head and Neck Surgery, Helios Amper-Klinikum Dachau, Krankenhausstraße 15, 85221, Dachau, Germany.
| | - F Johnson
- Department for Ear- Nose- and Throat, Head and Neck Surgery, University hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - N Peters
- Department for Ear- Nose- and Throat, Head and Neck Surgery, University hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - G Piontek
- Department for Ear- Nose- and Throat, Head and Neck Surgery, University hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - K Storck
- Department for Ear- Nose- and Throat, Head and Neck Surgery, University hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - A Pickhard
- Department for Ear- Nose- and Throat, Head and Neck Surgery, University hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Daley EAM, Harris CS, Johnson F, Liu R, Wang X, Arnasson JT. A quantitative profile of seasonal variations of alkylamides and phenolics in organically treated Echinacea purpurea (L.) Moench. Am J Transl Res 2018. [DOI: 10.1055/s-0038-1644962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- EAM Daley
- University of Ottawa, Ottawa, Ontario, Canada
| | - CS Harris
- University of Ottawa, Ottawa, Ontario, Canada
| | - F Johnson
- Trout Lake Farms, Trout Lake, Washington, USA
| | - R Liu
- University of Ottawa, Ottawa, Ontario, Canada
| | - X Wang
- University of Ottawa, Ottawa, Ontario, Canada
| | - JT Arnasson
- University of Ottawa, Ottawa, Ontario, Canada
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Cotarlan V, Laxson C, Franzwa J, Chawla R, Johnson F. Low AlloMap Variability Score Within the First 3 Years Post Heart Transplant is Associated with the Combined Endpoint of Death, Malignancy and Coronary Vasculopathy Post Heart Transplant. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.859] [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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Ngo S, Shahsahebi M, Schreiber S, Johnson F, Silberberg M. Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department. J Behav Health Serv Res 2017; 45:651-658. [PMID: 29124454 DOI: 10.1007/s11414-017-9574-7] [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: 10/18/2022]
Abstract
This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p < 0.001) and a decrease of 9.5 h in emergency department length of stay per average visit per patient (p<0.001). There was no significant effect on the number of hospitalizations or hospital length of stay. This intervention demonstrated a correlation with reducing emergency department use in patients with behavioral health issues, but no correlation with reducing hospital utilization. This under-researched approach of integrating medical records at point-of-care could serve as a model for better emergency department management of behavioral health patients.
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Affiliation(s)
- Stephanie Ngo
- Department of Community and Family Medicine, Duke University, Durham, NC, USA
| | - Mohammad Shahsahebi
- Department of Community and Family Medicine, Duke University, Durham, NC, USA. .,Northern Piedmont Community Care, Durham, NC, USA.
| | | | - Fred Johnson
- Department of Community and Family Medicine, Duke University, Durham, NC, USA.,Northern Piedmont Community Care, Durham, NC, USA
| | - Mina Silberberg
- Department of Community and Family Medicine, Duke University, Durham, NC, USA
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Bowlby L, Turner R, Casarett D, Johnson F, Boulware E, Webb J, Bain M. Integration and expansion of palliative care work force. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.31_suppl.126] [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
126 Background: The specialty of Hospice and Palliative Medicine has grown out of the need for care of patients who are living longer with cancer and other serious illness and struggle with symptoms, decisions and care. Cancer patients and others often do not have access to Palliative Care services due to availability or accessibility of PC services. Since 2012, fellowship training is required for board eligibility but available programs do not meet the workforce need. As described by Weissman and Meier, viewing Palliative care services in the context of a primary, secondary or tertiary focus , allows for the expansion of these services outside of the traditional fellowship training. With additional intensive training, it is possible that experienced physicians can fill workforce gaps by providing primary palliative care in the providers practice area such as a clinic. Methods: The faculty member who will participate in a yearlong training program based in the Palliative Care Clinic is the Director of the Outpatient Clinic. This clinic is the center of the Duke resident ambulatory experience for the duration of their training. The complexity of these patients is high and often the DOC is the only place that these patients receive care. The Palliative Care training program will provide the faculty member the opportunity to see patients in the cancer center with board certified palliative care physicians. There will be 3 areas of focus for the trainee: clinical experience, didactic information and mentorship from a board certified palliative care provider around faculty identified cases from her own practice. Results: We have developed a yearlong intensive training program for experienced faculty to gain skills in Palliative Care. Conclusions: 1. It is hoped that this will allow for integration of primary palliative care into patient care areas where there is no formal palliative care program. 2. Integration of Palliative Care principles in the clinic to address symptoms of chronic severe illness as well as difficult conversations with more confidence and skill. 3. Earlier palliative care management–develop a systematic approach to assessing needs in high risk populations ie. Hospital Discharge reviews, now commonly done at the clinic.
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Cotarlan V, Johnson F, Franzwa J, Inampudi C, Emerenini U, Tandon R, Tahir R, Nabeel Y, Goerbig J, Light-McGroary K, Goldsmith G, Giudici M. Biventricular Pacing Has No Acute Hemodynamic Benefit Over Right Ventricular Pacing or Intrinsic Rhythm in LVAD Patients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.975] [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] Open
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Abstract
The acquisition of data about dynamic foot-ground pressures has been possible for some time. The amount of data collected in such studies is large, and a method of data compression is presented which allows rapid comparison between one patient and another, sequential visits, or of left-right asymmetry. Both qualitative and quantitative assessments are provided for and the display is entirely contained within a single A4 size sheet of paper.
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Affiliation(s)
- F Johnson
- Department of Surgery (Orthopaedic and Accident Surgery), Queens Medical Centre, Nottingham
| | - D M C Kong
- Department of Surgery (Orthopaedic and Accident Surgery), Queens Medical Centre, Nottingham
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Affiliation(s)
- E W Jones
- Department of Medicine, Queen's Medical Centre, Nottingham
| | - G R Plant
- Department of Medical Physics, General Hospital, Nottingham
| | - C R Stuart
- Department of Medical Physics, General Hospital, Nottingham
| | | | - F Johnson
- Department of Surgery, Medical School, Queen's Medical Centre, Nottingham
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Cardnell R, Tong P, Giri U, Gudikote J, Banerjee U, Kalu N, Fan Y, Nilsson M, Johnson F, Tran H, Wang J, Heymach J, Byers L. A high-throughput drug screen identifies new therapeutic vulnerabilities in non-small cell lung cancers (NSCLC) with overexpression of the EMT-associated receptor tyrosine kinase AXL. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32840-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kliemann N, Wardle J, Johnson F, Croker H. Reliability and validity of a revised version of the General Nutrition Knowledge Questionnaire. Eur J Clin Nutr 2016; 70:1174-1180. [PMID: 27245211 PMCID: PMC5014128 DOI: 10.1038/ejcn.2016.87] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 04/20/2016] [Accepted: 04/27/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES The General Nutrition Knowledge Questionnaire (GNKQ) was developed in the 1990s and has been widely used. Since then advances in understanding of associations between diet and disease have led to changes in dietary recommendations. This study reports the validity and reliability of an updated version of the GNKQ, bringing it into line with current nutritional advice. METHODS/SUBJECTS Following a review of current recommendations, the revised version of the GNKQ (GNKQ-R) was created, consisting of 88 items and four sections. Reliability and validity of the GNKQ-R were determined in four validation studies: (1) reliability was examined using an online sample (n=266), (2) construct validity was assessed with 96 Dietetics students and 89 english students using the 'known-groups' method, (3) associations between nutrition knowledge and socio-demographic characteristics were examined using the previously described samples and (4) sensitivity to change was tested by measuring GNKQ-R scores pre- and post-exposure to online nutrition information in written (n=65) and video (n=41) formats. RESULTS The reliability was >0.7 in all sections. Dietetics students scored significantly higher than english students. As predicted, GNKQ-R scores were significantly higher among females vs males, people with a degree vs without, and people with very good vs poor or good health status. They were lower in those older than 50 years vs younger adults. GNKQ-R scores were significantly greater after the nutrition interventions in both written and video formats. CONCLUSIONS The GNKQ-R is a valid measure of nutrition knowledge that is consistent, reliable and sensitive to change.
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Affiliation(s)
- N Kliemann
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - J Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - F Johnson
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - H Croker
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
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32
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Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Varner M, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Leveno K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spangler T, Lozitska A, Spong C, Tolivaisa S, VanDorsten J. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016; 215:103.e1-103.e14. [PMID: 26772790 DOI: 10.1016/j.ajog.2016.01.004] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/28/2015] [Accepted: 01/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. OBJECTIVE We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. STUDY DESIGN This was a secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008 through 2011. All liveborn nonanomalous singleton preterm (23.0-36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade I/II, necrotizing enterocolitis stage I, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome for which criteria was met. RESULTS In all, 8334 deliveries met inclusion criteria. There were 119 (1.4%) neonatal deaths. In all, 657 (7.9%) neonates had major morbidity, 3136 (37.6%) had minor morbidity, and 4422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell >32 weeks. After 25 weeks, neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26-32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median postmenstrual age at discharge nadired around 36 weeks' postmenstrual age for babies born at 31-35 weeks of gestation. CONCLUSION Our data show that there is a continuum of outcomes, with each additional week of gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.
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Elburki MS, Moore DD, Terezakis NG, Zhang Y, Lee HM, Johnson F, Golub LM. A novel chemically modified curcumin reduces inflammation-mediated connective tissue breakdown in a rat model of diabetes: periodontal and systemic effects. J Periodontal Res 2016; 52:186-200. [PMID: 27038334 DOI: 10.1111/jre.12381] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontal disease is the most common chronic inflammatory disease known to mankind (and the major cause of tooth loss in the adult population) and has also been linked to various systemic diseases, particularly diabetes mellitus. Based on the literature linking periodontal disease with diabetes in a "bidirectional manner", the objectives of the current study were to determine: (i) the effect of a model of periodontitis, complicated by diabetes, on mechanisms of tissue breakdown including bone loss; and (ii) the response of the combination of this local and systemic phenotype to a novel pleiotropic matrix metalloproteinase inhibitor, chemically modified curcumin (CMC) 2.24. MATERIAL AND METHODS Diabetes was induced in adult male rats by intravenous injection of streptozotocin (nondiabetic rats served as controls), and Escherichia coli endotoxin (lipopolysaccharide) was repeatedly injected into the gingiva to induce periodontitis. CMC 2.24 was administered by oral gavage (30 mg/kg) daily; untreated diabetic rats received vehicle alone. After 3 wk of treatment, the rats were killed, and gingiva, jaws, tibia and skin were collected. The maxillary jaws and tibia were dissected and radiographed. The gingival tissues of each experimental group (n = 6 rats/group) were pooled, extracted, partially purified and, together with individual skin samples, analyzed for matrix metalloproteinase (MMP)-2 and MMP-9 by gelatin zymography; MMP-8 was analyzed in gingival and skin tissue extracts, and in serum, by western blotting. The levels of three bone-resorptive cytokines [interleukin (IL)-1β, IL-6 and tumor necrosis factor-α], were measured in gingival tissue extracts and serum by ELISA. RESULTS Systemic administration of CMC 2.24 to diabetic rats with endotoxin-induced periodontitis significantly inhibited alveolar bone loss and attenuated the severity of local and systemic inflammation. Moreover, this novel tri-ketonic phenylaminocarbonyl curcumin (CMC 2.24) appeared to reduce the pathologically excessive levels of inducible MMPs to near-normal levels, but appeared to have no significant effect on the constitutive MMPs required for physiologic connective tissue turnover. In addition to the beneficial effects on periodontal disease, induced both locally and systemically, CMC 2.24 also favorably affected extra-oral connective tissues, skin and skeletal bone. CONCLUSION This study supports our hypothesis that CMC 2.24 is a potential therapeutic pleiotropic MMP inhibitor, with both intracellular and extracellular effects, which reduces local and systemic inflammation and prevents hyperglycemia- and bacteria-induced connective tissue destruction.
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Affiliation(s)
- M S Elburki
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Department of Periodontics, Faculty of Dentistry, Benghazi University, Benghazi, Libya
| | - D D Moore
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - N G Terezakis
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Y Zhang
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - H-M Lee
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - F Johnson
- Departments of Chemistry and Pharmacological Sciences, Stony Brook University, Stony Brook, NY, USA
| | - L M Golub
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
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Pollak KI, Nagy P, Bigger J, Bilheimer A, Lyna P, Gao X, Lancaster M, Watkins RC, Johnson F, Batish S, Skelton JA, Armstrong S. Effect of teaching motivational interviewing via communication coaching on clinician and patient satisfaction in primary care and pediatric obesity-focused offices. Patient Educ Couns 2016; 99:300-303. [PMID: 26320822 DOI: 10.1016/j.pec.2015.08.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Studies indicate needed improvement in clinician communication and patient satisfaction. Motivational interviewing (MI) helps promote patient behavior change and improves satisfaction. In this pilot study, we tested a coaching intervention to teach MI to all clinic staff to improve clinician and patient satisfaction. METHODS We included four clinics (n=29 staff members). In the intervention clinics (one primary care and one pediatric obesity-focused), we trained all clinic staff in MI through meetings as a group seven times, directly observing clinicians in practice 4-10 times, and providing real-time feedback on MI techniques. In all clinics, we assessed patient satisfaction via anonymous surveys and also assessed clinician burnout and self-rated MI skills. RESULTS Clinicians in the intervention clinics reported improvements in burnout scores, self-rated MI skills, and perceived cohesion whereas clinicians in the control clinic reported worse scores. Patient satisfaction improved in the intervention clinics more than in the control clinics. CONCLUSION This is the first study to find some benefit of training an entire clinic staff in MI via a coaching model. PRACTICE IMPLICATIONS It might help to train staff in MI to improve clinician satisfaction, team cohesion, perceived skills, and patient satisfaction.
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Affiliation(s)
- Kathryn I Pollak
- Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, USA; Department of Community and Family Medicine, Duke School of Medicine, Durham, USA.
| | - Paul Nagy
- Department of Psychiatry, Duke School of Medicine, Durham, USA
| | | | - Alicia Bilheimer
- Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, USA
| | - Pauline Lyna
- Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, USA
| | - Xiaomei Gao
- Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, USA
| | | | | | - Fred Johnson
- Division of Community Health, Department of Community and Family Medicine, Duke School of Medicine, Durham, USA
| | | | - Joseph A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, USA
| | - Sarah Armstrong
- Department of Pediatrics, Duke School of Medicine, Durham, USA
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Rosati G, Ambrosini G, Barni S, Andreoni B, Corradini G, Luchena G, Daniele B, Gaion F, Oliverio G, Duro M, Martignoni G, Pinna N, Sozzi P, Pancera G, Solina G, Pavia G, Pignata S, Johnson F, Labianca R, Apolone G, Zaniboni A, Monteforte M, Negri E, Torri V, Mosconi P, Fossati R. A randomized trial of intensive versus minimal surveillance of patients with resected Dukes B2-C colorectal carcinoma. Ann Oncol 2015; 27:274-80. [PMID: 26578734 DOI: 10.1093/annonc/mdv541] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [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: 07/30/2015] [Accepted: 10/16/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Colorectal cancer is the third most common and the third most lethal cancer in both men and women in developed countries. About 75% of cases are first diagnosed when the disease is classified as localized or regional, undergo potentially curative treatment and enter a post-treatment surveillance program. Although such programs drain significant resources from health systems, empirical evidence of their efficacy is scanty. PATIENTS AND METHODS Dukes B2-C colorectal cancer patients who had no evidence of disease at the end of their front-line treatment (surgery and adjuvant radiochemotherapy, if indicated) were eligible for the trial and randomized to two different surveillance programs. These programs differed greatly in the frequency of diagnostic imaging. They had similar schedules of physical examinations and carcinoembryonic antigen (CEA) assessments. Patients received baseline and yearly health-related quality-of-life (HR-QoL) questionnaires. Primary outcomes were overall survival (OS) and QoL. RESULTS From 1998 to 2006, 1228 assessable patients were randomized, 933 with colon cancer and 295 with rectal cancer. More than 90% of patients had the expected number of diagnostic procedures. Median follow-up duration was 62 months [interquartile range (IQR) 51-86] in the minimal surveillance group and 62 months (IQR 50-85) in the intensive group. At primary analysis, 250 patients had recurred and 218 had died. Intensive surveillance anticipated recurrence, as shown by a significant difference in mean disease-free survival of 5.9 months. Comparison of OS curves of the whole intention-to-treat population showed no statistically significant differences. HR-QoL of life scores did not differ between regimens. CONCLUSION Our findings support the conclusions of other randomized clinical trials, which show that early diagnosis of cancer recurrence is not associated with OS benefit. CLINICALTRIALSGOV NCT02409472.
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Affiliation(s)
- G Rosati
- Department of Oncology, Ospedale San Carlo, Potenza
| | - G Ambrosini
- Department of Oncology, Ospedale Santa Chiara, Trento
| | - S Barni
- Department of Oncology, Az. Osp. Treviglio-Caravaggio, Treviglio
| | - B Andreoni
- Department of Oncology, Istituto Europeo di Oncologia, Milan
| | - G Corradini
- Department of Oncology, Ospedale Civile, Rho
| | - G Luchena
- Department of Oncology, Ospedale Sant'Anna, Como
| | - B Daniele
- Department of Oncology, Az. Osp. G. Rummo, Benevento
| | - F Gaion
- Department of Oncology, Ospedale Civile, Camposampiero
| | - G Oliverio
- Department of Oncology, Ospedale Infermi, Rimini
| | - M Duro
- Department of Oncology, Ospedale Valduce, Como
| | - G Martignoni
- Department of Oncology, Ospedale S. Carlo Borromeo, Milan
| | - N Pinna
- Department of Oncology, Casa di Cura San Carlo, Paderno Dugnano
| | - P Sozzi
- Department of Oncology, Ospedale degli Infermi, Biella
| | - G Pancera
- Department of Oncology, Casa di Cura IGEA, Milan
| | - G Solina
- Department of Oncology, Az. Osp. Ospedali Riuniti Villa Sofia-Cervello, Palermo
| | - G Pavia
- Department of Oncology, Casa di Cura San Carlo, Paderno Dugnano
| | - S Pignata
- Department of Oncology, Istituto Nazionale dei Tumori, Napoli, Italy
| | - F Johnson
- Department of Surgery, St Louis University Hospital, St Louis, USA
| | - R Labianca
- Department of Oncology, Ospedali Riuniti, Bergamo
| | - G Apolone
- Department of Oncology, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia
| | - A Zaniboni
- Department of Oncology, Fondazione Poliambulanza, Brescia
| | - M Monteforte
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - E Negri
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - V Torri
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - P Mosconi
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - R Fossati
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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Deutsch CK, Levy DL, Price SFR, Bodkin JA, Boling L, Coleman MJ, Johnson F, Lerbinger J, Matthysse S, Holzman PS. Quantitative Measures of Craniofacial Dysmorphology in a Family Study of Schizophrenia and Bipolar Illness. Schizophr Bull 2015; 41:1309-16. [PMID: 25795453 PMCID: PMC4601702 DOI: 10.1093/schbul/sbv014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Several laboratories, including ours, have reported an overrepresentation of craniofacial (CF) anomalies in schizophrenia (SZ). How might this dysmorphology arise in a brain-based disorder? Because the brain and face derive from shared embryologic primordia and morphogenetic forces, maldevelopmental processes may result in both CF and brain dysmorphology.Our approach is 2-pronged. First, we have employed, for the first time in the study of psychiatric disorders, objective measures of CF morphology that utilize an extensive normative database, permitting computation of standardized scores for each subject. Second, we have rendered these findings biologically interpretable by adopting principles of embryology in the analysis of dysmorphology.Dependent measures in this investigation focused on derivatives of specific embryonic primordia and were contrasted among probands with psychotic disorders, their first-degree relatives, and normal controls (NC). Subject groups included patients with a diagnosis of SZ (N = 39) or bipolar (BP) disorder with psychotic features (N = 32), their clinically unaffected relatives (N = 82 and N = 41, respectively), and NC (N = 95) subjects.Anomalies involving derivatives of frontonasal and mandibular embryonic primordia showed a clear association with psychotic illness, as well as familial aggregation in relatives in both diagnostic groups. In contrast, one class of CF anomalies emerged only among SZ probands and their first-degree relatives: dysmorphology arising along the junction of the frontonasal and maxillary prominence derivatives, manifested as marked asymmetries. This class was not overrepresented among the BP patients nor among their relatives, indicating that this dysmorphology appears to be specific to SZ and not a generalized feature of psychosis. We discuss these findings in light of embryologic models that relate brain regions to specific CF areas.
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Affiliation(s)
- Curtis K. Deutsch
- Eunice Kennedy Shriver Center, Worcester, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,*To whom correspondence should be addressed; Psychobiology Program, Eunice Kennedy Shriver Center, Psychiatry UMMS, 55 Lake Avenue North, S3-301, Worcester, MA 01655, US; tel: 617-699-7775, fax: 774-455-6565; e-mail:
| | - Deborah L. Levy
- Department of Psychiatry, Harvard Medical School, Boston, MA;,McLean Hospital, Belmont, MA
| | | | - J. Alexander Bodkin
- Department of Psychiatry, Harvard Medical School, Boston, MA;,McLean Hospital, Belmont, MA
| | - Lenore Boling
- Department of Psychiatry, Harvard Medical School, Boston, MA;,McLean Hospital, Belmont, MA
| | | | | | | | - Steven Matthysse
- Department of Psychiatry, Harvard Medical School, Boston, MA;,McLean Hospital, Belmont, MA
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Bailit JL, Grobman W, Zhao Y, Wapner RJ, Reddy UM, Varner MW, Leveno KJ, Caritis SN, Iams JD, Tita AT, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, VanDorsten JP, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Thorp J, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Shubert P, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spong C, Tolivaisa S. Nonmedically indicated induction vs expectant treatment in term nulliparous women. Am J Obstet Gynecol 2015; 212:103.e1-7. [PMID: 24983681 DOI: 10.1016/j.ajog.2014.06.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/27/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected. Maternal and neonatal outcomes for nonmedically indicated induction within each week were compared with women who did not undergo nonmedically indicated induction during that week. Multivariable analysis was used to adjust for hospital, maternal age, race/ethnicity, body mass index, cigarette use, and insurance status. RESULTS We found 31,169 women who met our criteria. Neonatal complications were either less frequent with nonmedically indicated induction or no different between groups. Nonmedically indicated induction was associated with less frequent peripartum infections (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16-0.98) at 38 weeks of gestation and less frequent third- and fourth-degree lacerations (OR, 0.60; 95% CI, 0.42-0.86) and less frequent peripartum infections (OR, 0.66; 95% CI, 0.49-0.90) at 39 weeks of gestation. Nonmedically indicated induction was associated with a longer admission-to-delivery time by approximately 3-4 hours and increased odds of cesarean delivery at 38 (OR, 1.50; 95% CI, 1.08-2.08) and 40 weeks (OR, 1.30; 95% CI, 1.15-1.46) of gestation. CONCLUSION At 39 weeks of gestation, nonmedically indicated induction is associated with lower maternal and neonatal morbidity than women who are expectantly treated.
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Elliott K, Wu W, Bertram R, Johnson F. Disconnection of a basal ganglia circuit in juvenile songbirds attenuates the spectral differentiation of song syllables. Dev Neurobiol 2014. [DOI: 10.1002/dneu.22194] [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: 11/08/2022]
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Bertram R, Daou A, Hyson RL, Johnson F, Wu W. Two neural streams, one voice: pathways for theme and variation in the songbird brain. Neuroscience 2014; 277:806-17. [PMID: 25106128 DOI: 10.1016/j.neuroscience.2014.07.061] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/16/2014] [Accepted: 07/27/2014] [Indexed: 11/25/2022]
Abstract
Birdsong offers a unique model system to understand how a developing brain - once given a set of purely acoustic targets - teaches itself the vocal-tract gestures necessary to imitate those sounds. Like human infants, to juvenile male zebra finches (Taeniopygia guttata) falls the burden of initiating the vocal-motor learning of adult sounds. In both species, adult caregivers provide only a set of sounds to be imitated, with little or no information about the vocal-tract gestures used to produce the sounds. Here, we focus on the central control of birdsong and review the recent discovery that zebra finch song is under dual premotor control. Distinct forebrain pathways for structured (theme) and unstructured (variation) singing not only raise new questions about mechanisms of sensory-motor integration, but also provide a fascinating new research opportunity. A cortical locus for a motor memory of the learned song is now firmly established, meaning that anatomical, physiological, and computational approaches are poised to reveal the neural mechanisms used by the brain to compose the songs of birds.
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Affiliation(s)
- R Bertram
- Department of Mathematics, Program in Neuroscience, Program in Molecular Biophysics, Florida State University, Tallahassee, FL 32306-4510, United States
| | - A Daou
- Department of Mathematics, Program in Neuroscience, Program in Molecular Biophysics, Florida State University, Tallahassee, FL 32306-4510, United States
| | - R L Hyson
- Department of Psychology, Program in Neuroscience, Florida State University, Tallahassee, FL 32306-4301, United States
| | - F Johnson
- Department of Psychology, Program in Neuroscience, Florida State University, Tallahassee, FL 32306-4301, United States.
| | - W Wu
- Department of Statistics, Program in Neuroscience, Florida State University, Tallahassee, FL 32306-4330, United States
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Mavrogianni A, Johnson F, Ucci M, Marmot A, Wardle J, Oreszczyn T, Summerfield A. Historic Variations in Winter Indoor Domestic Temperatures and Potential Implications for Body Weight Gain. Indoor Built Environ 2013; 22:360-375. [PMID: 26321874 PMCID: PMC4456148 DOI: 10.1177/1420326x11425966] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/11/2011] [Indexed: 06/02/2023]
Abstract
It has been argued that the amount of time spent by humans in thermoneutral environments has increased in recent decades. This paper examines evidence of historic changes in winter domestic temperatures in industrialised countries. Future trajectories for indoor thermal comfort are also explored. Whilst methodological differences across studies make it difficult to compare data and accurately estimate the absolute size of historic changes in indoor domestic temperatures, data analysis does suggest an upward trend, particularly in bedrooms. The variations in indoor winter residential temperatures might have been further exacerbated in some countries by a temporary drop in demand temperatures due to the 1970s energy crisis, as well as by recent changes in the building stock. In the United Kingdom, for example, spot measurement data indicate that an increase of up to 1.3°C per decade in mean dwelling winter indoor temperatures may have occurred from 1978 to 1996. The findings of this review paper are also discussed in the context of their significance for human health and well-being. In particular, historic indoor domestic temperature trends are discussed in conjunction with evidence on the links between low ambient temperatures, body energy expenditure and weight gain.
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Affiliation(s)
- A. Mavrogianni
- UCL Energy Institute, University College London, London, UK
| | - F. Johnson
- Department of Epidemiology and Public Health, University College London,
London, UK
| | - M. Ucci
- The Bartlett School of Graduate Studies, University College London, London,
UK
| | - A. Marmot
- The Bartlett School of Graduate Studies, University College London, London,
UK
| | - J. Wardle
- Department of Epidemiology and Public Health, University College London,
London, UK
| | - T. Oreszczyn
- UCL Energy Institute, University College London, London, UK
| | - A. Summerfield
- UCL Energy Institute, University College London, London, UK
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Cotarlan V, Firchau D, Icardi M, Goerbig J, Iqbal O, Light-McGroary K, Johnson F. Heart Transplant: A Mystery in the Myocardium. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Stewart G, Teuteberg J, Kittleson M, Cowger J, Patel C, Johnson F, Mountis M, Patel P, Rame E, Guglin M, Stevenson L. INTERMACS Profiling Identifies Risk of Death or VAD among Medically-Managed Advanced Heart Failure Patients. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kittleson M, Stewart G, Cowger J, Patel C, Rame E, Testani J, Mountis M, Patel P, Johnson F, Guglin M, Teuteberg J, Kobashigawa J, Stevenson L, Hamilton M. Triage for Advanced Heart Failure: Effect of Regional Wait Time Disparity. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cook J, Michener JL, Lyn M, Lobach D, Johnson F. Practice profile. Community collaboration to improve care and reduce health disparities. Health Aff (Millwood) 2013; 29:956-8. [PMID: 20439887 DOI: 10.1377/hlthaff.2010.0094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jennifer Cook
- Department of Community and Family Medicine, Duke University, Durham, NC, USA
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Abstract
Most studies of outcome by race in cancer have shown that blacks have a shorter survival compared to whites, both overall and within each TNM stage. We endeavored to evaluate the difference in survival by race in US military veterans treated for early stage non-small cell lung cancer (NSCLC). This retrospective analysis of overall survival by race, looking at all-cause mortality in a group of consecutively treated veterans with stage I-II NSCLC, was carried out at a 1,000-bed tertiary care Department of Veterans Affairs Medical Center. The study included 143 white and 45 black patients treated with curative intent for stage I-II NSCLC between January 1982 through August 1994. Nineteen patients received radiotherapy alone for their treatment while the remaining 169 underwent a complete surgical resection. There were no significant differences in patient characteristics for important prognostic variables. An overall survival analysis of all-cause mortality found no significant difference between the two groups. With equal access to health care, as is available for eligible patients in Department of Veterans Affairs Medical Centers, racial differences in lung cancer treatment outcome may be diminished or eliminated.
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Affiliation(s)
- M Jahanzeb
- DEPT VET AFFAIRS MED CTR,ST LOUIS,MO 63106. ST LOUIS UNIV,SCH MED,ST LOUIS,MO 63103. WASHINGTON UNIV,SCH MED,ST LOUIS,MO 63130
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Johnson F, Johnson M, Virgo K. Current follow-up strategies after potentially curative resection of upper aerodigestive tract epidermoid carcinoma. Int J Oncol 2012; 10:927-31. [PMID: 21533465 DOI: 10.3892/ijo.10.5.927] [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: 11/05/2022] Open
Abstract
The follow-up of patients after potentially curative resection of squamous cell carcinoma of the upper aerodigestive tract (UADT) mucosa has important clinical and financial implications for patients and society, yet the ideal surveillance strategy is unknown. The aim of this study was to determine the current follow-up practice patterns of a large, diverse group of experts. The 824 members of The Society of Head and Neck Surgeons (SHNS) were asked, via a detailed questionnaire, how often they request 14 discrete follow-up evaluations in their patients treated for cure with TNM stage I, II, and III + (resectable) IV UADT cancer over the first five post-treatment years. The results indicate that SHNS members generally follow their patients personally after performing UADT cancer surgery rather than sending them back to their referral source. Routine office visit is the most frequently performed item for each of the 5 years. The only imaging test commonly used is chest X-ray. There is variation in the pattern of use of most tests. SHNS members from other countries tend to follow their patients more closely than do those living in the USA. Many clinicians use the same surveillance strategy for all TNM stages.
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Affiliation(s)
- F Johnson
- JOHN COCHRAN VET AFFAIRS MED CTR,SURG SERV,ST LOUIS,MO
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Guglin M, Stewart G, Kittleson M, Cowger J, Patel C, Rame J, Mountis M, Patel P, Johnson F, Teuteberg J, Testani J, Miller L. 440 Uric Acid Elevation Is Associated with Severity of Congestion in Advanced Heart Failure. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Stewart G, Kittleson M, Cowger J, Patel C, Johnson F, Mountis M, Patel P, Rame E, Testani J, Guglin M, Teuteberg J, Stevenson L. 5 High Event Rates in Medically Managed Advanced Heart Failure Patients Followed at VAD Centers. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
There is evidence that black women are more satisfied with their body size despite higher rates of overweight. One possible mechanism is differential exposure to ultrathin images. We hypothesized that models in magazines aimed at black women are not as thin as models in materials aimed at the general population. Pictures of women from magazines aimed at black women and magazines aimed at the general population were compared (N=51). Female raters (21 white, 21 black) matched pictures to one of four drawings depicting very thin to normal-weight women. The mean body size of pictures from black magazines was significantly higher than for general magazines (p<0.001, d=0.89); 85% of pictures from general magazines were in the two thinnest size categories compared with 46% of pictures from black magazines. Media aimed at black women are less likely to use extremely slim models, which could contribute to or reflect a greater range of acceptable body sizes.
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Affiliation(s)
- C Shoneye
- Department of Epidemiology and Public Health, University College London, London, UK
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Abstract
BACKGROUND Rates of obesity among black African and black Caribbean women in the UK are consistently higher than among white women. Cultural, attitudinal and behavioural differences may contribute to ethnic variation in weight, and the present study aimed to explore attitudes towards weight and weight control among black and white British women using a qualitative approach. METHODS Ethnically homogeneous focus groups were carried out with 25 white women [mean (SD) body mass index (BMI, kg m(-2)) = 26 (7.2) kg m(-2) ] and 24 black women [mean (SD) BMI = 29 (6.6) kg m(-2) ]. Women were recruited from London boroughs (Lambeth, Southwark and Croydon) and Guildford, Surrey, and focus groups were conducted in London. Focus groups were recorded and transcribed verbatim, and were analysed using thematic analysis. RESULTS All participants had fairly good knowledge of the causes, consequences and treatment of being overweight. However, black women primarily emphasised the health consequences of being overweight, whereas white women were more likely to focus on the perceived social and emotional consequences. White women associated being overweight with negative character traits, whereas black women had a broadly positive attitude towards larger body sizes. CONCLUSIONS Black women were as well-informed about the causes and health risks of obesity as white women in this sample of mainly educated, working women, although they were more accepting of larger body sizes and experienced less social pressure to be slim.
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Affiliation(s)
- C Shoneye
- Epidemiology and Public Health, University College, London, UK
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