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Ghanem AI, Gilbert M, Keller C, Gardner G, Mayerhoff R, Siddiqui F. Definitive and Salvage Radiotherapy Compared to Other Modalities for Laryngeal Carcinoma in Situ. Int J Radiat Oncol Biol Phys 2023; 117:e583. [PMID: 37785769 DOI: 10.1016/j.ijrobp.2023.06.2519] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We sought to analyze survival endpoints for laryngeal carcinoma in situ (CIS) undergoing definitive radiotherapy (RT) compared to other modalities. MATERIALS/METHODS Usingour prospectively maintained head and neck cancer database, we identified laryngeal CIS patients treated between 6/2001 and 12/2021. We excluded low-grade dysplasia, CIS with any synchronous invasive squamous cell carcinoma (SCC) within 3 months of the initial CIS biopsy and cases with inadequate follow up. Patients were offered either definitive RT, CO2/KTP laser ablation, photodynamic therapy (PDT) or any sort of therapeutic excision. After first line treatment, follow-up includes visits every 3-6 months with laryngoscopy and biopsies as appropriate. For recurrent CIS beyond 6 months of first line treatment, we reported salvage therapies received and long-term outcomes were reported. Using Kaplan-Meier curves and log-rank test we investigated recurrence free (RFS), progression to invasive SCC free (IFS) and overall (OS) survival across treatment groups. Patients managed with salvage RT were compared to first line RT recipients. RESULTS Atotal of 85 CIS cases were included: median age 65 years (IQR: 55-74), 73 males (85%) and 70 white (82.4%). 86% had a history of smoking with median pack year of 38 (IQR: 20-55) and 66% had a history of alcohol use. CIS was glottic in most of the cases (90.6%: 66% unilateral, 21% bilateral & 13% involved commissure); with only 9.4% in the supraglottic region. RT was used in 49.4% (n = 42) after biopsy (55%) or surgery (45%) with median dose of 63 Gy/28 fractions, mainly by 3D conformal RT (76%). The remaining 50.6% (n = 43) got therapeutic excision alone (commonly microflap excision) (46.5%), CO2/KTP laser (32.6%) or PDT (20.9%). Demographics and clinicopathological details were non-different between RT and non-RT patients except for Charlson comorbidity index: median 2 (IQR 1-3) in non-RT vs 1 (IQR 0-2) in 1ry RT; p = 0.007. After a median follow-up of 4.8 years (IQR 3.5), 51.8% had recurrent disease, 21.2% progressed to invasive SCC and 9.4% had laryngectomies mainly for invasive SCC after RT. First line RT had improved 2-(83% vs 39%) and 5-(74% vs 22%) year RFS vs non-RT therapies (p<0.001). Nevertheless, 2- and 5-year IFS (89% vs 98% and 80% vs 79%) and OS (92% vs 93% and 81% vs 77%) were non-significant among both (p>0.05 for all). Among non-RT cases with CIS recurrences, 12/35 (34%) had salvage RT. Following RT, salvage RT patients had similar 2- and 5-year RFS (81% vs 83% and 81% vs 74%) and IFS (81% vs 89% and 81% vs 80%) compared to first line RT (p>0.05 for all). All cases with CIS recurrences were salvaged successfully with 100% living with no CIS at latest follow-up. CONCLUSION Laryngeal CIS can be treated with a wide range of modalities including 1ry RT which has better recurrence free survival. Nevertheless, non-RT recurrent CIS can be salvaged successfully with many options including RT with equivalent long-term results.
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Affiliation(s)
- A I Ghanem
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI; Alexandria Clinical Oncology Department, Alexandria University, Alexandria, Egypt
| | - M Gilbert
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - C Keller
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI
| | - G Gardner
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - R Mayerhoff
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - F Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
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Bachtel HA, Hussaini SH, Austin PF, Janzen NK, Chau A, Pezeshkmehr A, Nguyen Galvan NT, Brewer ED, Swartz S, Hernandez JA, Gardner G, Cotton RT, O'Mahony CA, Koh CJ, Kukreja KU. Ureteral stricture after pediatric kidney transplantation: Is there a role for percutaneous antegrade ureteroplasty? J Pediatr Urol 2023:S1477-5131(23)00018-9. [PMID: 36750396 DOI: 10.1016/j.jpurol.2023.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Ureteral obstruction following pediatric kidney transplantation occurs in 5-8% of cases. We describe our experience with percutaneous antegrade ureteroplasty for the treatment of ureteral stricture in pediatric kidney transplant patients. METHODS We retrospectively reviewed all pediatric kidney transplantation patients who presented with ureteral stricture and underwent percutaneous antegrade ureteroplasty at our institution from July 2009 to July 2021. Variables included patient demographics, timing of presentation, location and extent of stricture, ureteroplasty technique and clinical outcomes. Our primary outcome was persistent obstruction of the kidney transplant. RESULTS Twelve patients met inclusion criteria (4.2% of all transplants). Median age at time of ureteroplasty was 11.5 years (range: 3-17.5 years). Median time from kidney transplantation to ureteroplasty was 3 months. Patency was maintained in 50% of patients. Seven patients (58.3%) required additional surgery. Four patients developed vesicoureteral reflux. Patients with persistent obstruction had a longer time from transplant to ureteroplasty compared to those who achieved patency (19.3 vs 1.3 months, p = 0.0163). Of those treated within 6 months after transplantation, two patients (25%) required surgery for persistent obstruction (p = 0.06). All patients treated >1 year after transplantation had persistent obstruction following ureteroplasty (p = 0.06). CONCLUSION Percutaneous antegrade ureteroplasty can be considered a viable minimally invasive treatment option for pediatric patients who develop early ureteral obstruction (<6 months) following kidney transplantation. In patients who are successfully treated with ureteroplasty, 67% can develop vesicoureteral reflux into the transplant kidney. Patients who fail early percutaneous ureteroplasty or develop obstruction >1 year after transplantation are best managed with surgical intervention.
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Affiliation(s)
- Hannah Agard Bachtel
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital and Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
| | - S Hamza Hussaini
- Division of Interventional Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Paul F Austin
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital and Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Nicolette K Janzen
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital and Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Alex Chau
- Division of Interventional Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Amir Pezeshkmehr
- Division of Interventional Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - N Thao Nguyen Galvan
- Division of Abdominal Transplantation, Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Eileen D Brewer
- Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Sarah Swartz
- Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J Alberto Hernandez
- Division of Interventional Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Greg Gardner
- Division of Interventional Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Ronald T Cotton
- Division of Abdominal Transplantation, Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Christine A O'Mahony
- Division of Abdominal Transplantation, Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Chester J Koh
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital and Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Kamlesh U Kukreja
- Division of Interventional Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
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Nosyk B, Min JE, Pearce LA, Zhou H, Homayra F, Wang L, Piske M, McCarty D, Gardner G, O'Briain W, Wood E, Daly P, Walsh T, Henry B. Development and validation of health system performance measures for opioid use disorder in British Columbia, Canada. Drug Alcohol Depend 2022; 233:109375. [PMID: 35231716 DOI: 10.1016/j.drugalcdep.2022.109375] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Performance measurement provides an evidence-based means to inform development of interventions to improve the quality of care for people who use opioids. We aimed to develop and assess the predictive validity of health system performance measures for opioid use disorder (OUD) in British Columbia (BC), Canada. METHODS Performance measures were generated using retrospective population-level administrative datasets (both provincial and regional) and publicly-reported retrospective data according to four domains (care engagement, clinical guideline compliance, integration, and healthcare utilization). The adjusted odds ratio was estimated via generalized linear mixed models to determine predictive validity for all-cause hospitalization or mortality within 6 months of measurement. FINDINGS A total of 102 performance measures were constructed. We identified 55,470 diagnosed PWOUD, and 39,456 ever engaged in opioid agonist treatment (OAT). We found divergent rates of treatment for concurrent conditions (7.4% for alcohol use disorder to 80.1% for HIV/AIDS), low levels of linkage to OAT and other outpatient care following acute care, and increasing levels of service provision, including increases in OAT prescribers and pharmacies, naloxone kit distribution and overdose prevention site visitation. Our analyses on the predictive validity measures largely supported a priori hypotheses on the direction of effect on the outcome. CONCLUSIONS We identified a range of priorities to improve the quality of care for PWOUD, with critical gaps in linkage to care through acute care settings and long-term engagement in OAT. The proposed measures can be derived for geographic and clinical subgroups and updated over time, providing a basis to monitor and evaluate efforts to address the public health burden of OUD.
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Affiliation(s)
- B Nosyk
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St Paul's Hospital, 588-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada; Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Rm 11300 8888 University Drive, Burnaby, British Columbia V5A 1S6, Canada.
| | - J E Min
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St Paul's Hospital, 588-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - L A Pearce
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - H Zhou
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St Paul's Hospital, 588-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - F Homayra
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St Paul's Hospital, 588-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - L Wang
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - M Piske
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St Paul's Hospital, 588-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - D McCarty
- Oregon Health & Science University, 1810 SW 5th Ave, Flrs 2 5 and 6, Portland, OR 97201, USA
| | - G Gardner
- British Columbia Ministry of Mental Health and Addictions, PO Box 9672 Stn Prov Govt, Victoria, British Columbia V8W 9P6, Canada
| | - W O'Briain
- British Columbia Centre on Substance Use, 1045 Howe St Suite 400, Vancouver, British Columbia V6Z 2A9, Canada
| | - E Wood
- British Columbia Centre on Substance Use, 1045 Howe St Suite 400, Vancouver, British Columbia V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 317 -2194 Health Sciences Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - P Daly
- Vancouver Coastal Health Authority, 601 West Broadway, Vancouver, British Columbia V5Z 4C2, Canada
| | - T Walsh
- British Columbia Ministry of Mental Health and Addictions, PO Box 9672 Stn Prov Govt, Victoria, British Columbia V8W 9P6, Canada
| | - B Henry
- Office of the Provincial Health Officer, PO Box 9648, Stn Prov Govt, Victoria, British Columbia V8W 9P4, Canada
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Singh N, Huang I, Singleton M, Bays A, Sabo J, Chung S, Gardner G, Schaeffer J, Wysham K, Andrews J, Patel R, Simard J, Liew J. POS1422 CORRELATES OF TESTING POSITIVE FOR SARS-COV-2 IN PATIENTS WITH RHEUMATIC AD MUSCULOSKELETAL DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.858] [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
Background:Many studies on COVID-19 outcomes in patients with RMD have either restricted to COVID positive RMD patients or compared them to the general clinic population as a comparator. Given heterogeneity in behaviors and risks, clinical characteristics associated with a positive diagnosis among patients with RMD seeking testing for Sars-CoV-2 remain less well studied.Objectives:Among patients with RMD receiving a Sars-CoV-2 PCR test, we aimed to identify RMD-related factors associated with a positive test result.Methods:Among patients seen at least once in the University of Washington (UW) rheumatology clinics between March 2018 to March 2020, we reviewed electronic medical records to identify patients undergoing Sars-CoV-2 PCR testing from March 1 through October 31, 2020. Patients with RMD were categorized into two groups: those who tested positive for Sars-CoV-2 and those who tested negative. We randomly selected patients from the negative group in a 2:1 ratio for further data abstraction. Student’s t-test and Chi-squared tests were used to compare continuous and categorical variables, respectively, between the groups. To determine the correlates of testing positive for Sars-CoV-2, specifically RMD medication use and disease activity, we constructed different multivariable logistic regression models adjusted for age, sex, race/ethnicity, presence of comorbidities, body mass index, and smoking.Results:A total of 2768 RMD patients underwent SARS-CoV-2 PCR testing within the UW system, of whom 43 (1.5%) were positive at least once. Three patients with incomplete information were excluded. Patients who tested positive had higher prevalence of end stage renal disease (ESRD)/chronic kidney disease (CKD) (24% versus 11%), had higher rates of active disease (24% versus 20%), were older (>55 years) (mean age 57.3 versus 54.8 years), male (63% versus 55%), non-white race/ethnicity (32% versus 26%), and higher prevalence of multiple comorbidities (42% versus 31%) (Table 1). In the multivariable models, neither RMD medication use (versus no use, Table 1) nor high disease activity (vs low disease activity/remission) were statistically significantly associated with COVID-19 positivity. Among the 41 COVID-19 positive patients, a majority recovered without specific treatments, although approximately one third of the positive patients were hospitalized and three deaths were observed.Conclusion:In this study, patients who tested positive did not differ in many ways from those who tested negative.Table 1.Baseline characteristics of the patients prior to COVID testingVariablesAll(N=126)COVID Positive (N=41)COVID Negative(N=85)P valueAge in years – mean (SD)55.6 (15.3)57.3 (16.3)54.8 (14.9)0.40Sex0.39 Male73 (57.9)26 (63.4)47 (55.3) Female53 (42.1)15 (36.6)38 (44.7)Race0.39 White89 (71.2)26 (63.4)63 (74.1) Other race35 (28.2)13 (31.7)22 (25.9) Missing2 (1.6)2 (4.9)0 (0.0)Rheumatic disease0.64 OA/Crystal/Fibromyalgia37 (29.4)11 (26.8)26 (30.6) RA/SpA32 (25.4)9 (22.0)23 (27.1) All others57 (45.2)21 (51.2)36 (42.3)Rheumatic disease activity0.57 Active27 (21.4)10 (24.4)17 (20.0) Not active99 (78.6)31 (75.6)68 (80.0)Co-morbidities Diabetes mellitus (%)25 (19.8)9 (22.0)16 (18.8)0.68 Hypertension48 (38.1)20 (48.8)28 (32.9)0.09 Cardiovascular disease23 (18.3)9 (22.0)14 (16.5)0.46 Lung disease25 (19.8)10 (24.4)15 (17.7)0.37 Cancer10 (7.9)3 (7.3)7 (8.2)0.86 ESRD/CKD19 (15.1)10 (24.4)9 (10.6)0.04*BMI: Body mass index; SD: Standard deviation; OA: Osteoarthritis; Crystal: Crystalline diseases; RA: Rheumatoid arthritis; SpA: SpondyloarthritisAcknowledgements:The work in this study was supported by grant UL1 TR002319 to Dr Singh from the Institute of Translational Health Sciences of the University of Washington.Disclosure of Interests:None declared
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Carter J, Abu-Rustum N, Saban S, Chen L, Vickers A, Billanti G, Connors N, Broach V, Brown C, Chi D, Gardner G, Goldfrank D, Jewell E, Leitao M, Long Roche K, Mueller J, Sonoda Y, Zivanovic O. 013 The Development and Implementation of a Gynecologic Cancer Survivorship Tool. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.249] [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: 11/27/2022]
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Carter J, Goldfarb S, Baser R, Goldfrank D, Seidel B, Milli L, Saban S, Kollmeier M, Stabile C, Canty J, Gardner G, Jewell E, Sonoda Y, Alektiar K. A Single-Arm Clinical Trial Investigating the Effectiveness of a Non-Hormonal Vaginal Moisturizer in Endometrial Cancer Survivors. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ortiz C, Kukreja K, Hayatghaibi S, Moturu A, Gardner G, Pezeshkmehr A, Desai S. 03:27 PM Abstract No. 36 Process map for interventional radiology at a large tertiary children’s hospital: understanding the workflow and identifying areas for improvement. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Gardner G, Ziauddeen N, Alwan N. Investigating maternal risk factors for stillbirth in a population-based cohort in the South of England. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.097] [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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Johnson M, Villani T, Bachelor M, Oldach J, Gardner G. 696 Three dimensional IHC characterization of aging in 3D skin models. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.705] [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: 11/15/2022]
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Affiliation(s)
- J. Carryer
- School of Nursing College of Health Massey University Palmerston North New Zealand
| | - J. Wilkinson
- School of Public Health College of Health Massey University Palmerston North New Zealand
| | - A. Towers
- School of Nursing College of Health Massey University Wellington New Zealand
| | - G. Gardner
- Faculty of Health School of Nursing Queensland University of Technology Brisbane QLD Australia
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Abstract
AIM To identify the practice patterns of the Australian registered nurse workforce according to position title and to map these disparate titles across all jurisdictions of the country. INTRODUCTION Effective nursing workforce planning can contribute to improved patient care and increased effectiveness and efficiency of healthcare systems. BACKGROUND The prevailing approach to nursing workforce planning focuses on number of nursing staff needed in relation to the number of patients. The level of expertise and skill mix of registered nurses as a variable in workforce planning is rarely considered. METHODS A national cross-sectional electronic survey of registered nurses in Australia was conducted using the validated Advanced Practice Role Delineation tool developed from the Strong Model of Advanced Practice. The study involved a sample of 5599 registered nurses. RESULTS Sixty-six nursing position titles nationally were mapped using cluster analysis technique and gave rise to seven clusters of equivalent Australian jurisdictional nursing position titles and practice profiles. DISCUSSION Effective workforce policy and planning is reliant upon access to reliable evidence. This research is an international first in that it has provided comprehensive knowledge of the clinical level and practice profiles of a national nursing workforce. IMPLICATIONS FOR NURSING POLICY Effective, patient-centred workforce planning must consider both the numerical and expertise mix of a nursing workforce. This research provides Australian health service and policy planners with evidence-base knowledge of the nursing workforce. Internationally, this research establishes a platform from which to develop validated tools and established processes to support replication of this research.
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Affiliation(s)
- G Gardner
- School of Nursing, Institute for Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - C Duffield
- Nursing and Health Services Management, Centre for Health Services Management, University of Technology Sydney, Sydney, NSW, Australia
| | - A Doubrovsky
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - U T Bui
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - M Adams
- School of Nursing, Institute for Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Cleveland H, Pimpalwar S, Hernandez J, Ashton D, Gardner G, Kukreja K. Percutaneous ultrasound-guided liver biopsy in infants: Is it safe? J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Cleveland H, Ashton D, Pimpalwar S, Hernandez J, Gardner G, Kukreja K. Percutaneous ultrasound-guided renal biopsy in pediatrics: Does pre-procedure hypertension matter? J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yang R, Ryan U, Gardner G, Carmichael I, Campbell AJD, Jacobson C. Prevalence, faecal shedding and genetic characterisation ofYersiniaspp. in sheep across four states of Australia. Aust Vet J 2016; 94:129-37. [DOI: 10.1111/avj.12428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 07/01/2015] [Accepted: 08/16/2015] [Indexed: 11/30/2022]
Affiliation(s)
- R Yang
- School of Veterinary and Life Sciences; Murdoch University; Murdoch, Western Australia 6150 Australia
| | - U Ryan
- School of Veterinary and Life Sciences; Murdoch University; Murdoch, Western Australia 6150 Australia
| | - G Gardner
- School of Veterinary and Life Sciences; Murdoch University; Murdoch, Western Australia 6150 Australia
| | - I Carmichael
- South Australian Research and Development Institute; Glenside SA Australia
| | - AJD Campbell
- Mackinnon Project, Faculty of Veterinary Science; University of Melbourne; Werribee VIC Australia
| | - C Jacobson
- School of Veterinary and Life Sciences; Murdoch University; Murdoch, Western Australia 6150 Australia
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Hajj C, Kollmeier M, Gardner G, Sonoda Y, Abu-Rustum N, Alektiar K. Patterns of Relapse in Patients With Endometrial Cancer Treated With Postoperative Intensity Modulated Radiation Therapy (IMRT). Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1249] [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]
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Zumsteg Z, Kollmeier M, Gardner G, Abu-Rustum N, Alektiar K. A Redefined Risk Stratification System for Patients With Stage I-II Myometrial Invasive Endometrioid Adenocarcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.483] [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: 10/22/2022]
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Abstract
ACCESSIBLE SUMMARY Recent evidence suggests that the interactional work of mental health nursing has been eroded and redirected to the task-based roles of medicine. This study utilized work sampling methodology to observe the proportion of time nurses working in a mental health setting spend in direct care, indirect care and service-related activities. Nurses spent 32% of their time in direct care, 52% in indirect care and 17% in service-related activities. Mental health nurses need to re-establish their therapeutic availability to maximize consumer experiences and outcomes. ABSTRACT The foundation of mental health nursing has historically been grounded in an interpersonal, person-centred process of health care, yet recent evidence suggests that the interactional work of mental health nursing is being eroded. Literature emphasizes the importance of person-centred care on consumer outcomes, a model reliant upon the intimate engagement of nurses and consumers. Yet, the arrival of medical interventions in psychiatry has diverted nursing work from the therapeutic nursing role to task-based roles delegated by medicine, distancing nurses from consumers. This study used work sampling methodology to observe the proportion of time nurses working in an inpatient mental health setting spend in the activities of direct care, indirect care and service-related activities. Nurses spent 32 of their time in direct care, 52% in indirect care and 17% in service-related activities. Mental health nurses need to re-establish their therapeutic availability to maximize consumer experiences and outcomes.
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Affiliation(s)
- N Goulter
- Metro North Mental Health Services, Royal Brisbane & Women's Hospital & Queensland University of Technology, Brisbane, QLD, Australia
| | - D J Kavanagh
- School of Psychology, Queensland University of Technology & Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia
| | - G Gardner
- School of Nursing, Queensland University of Technology & Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia
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Wilson MB, Brinkman D, Spivak M, Gardner G, Cohen JD. Regional variation in composition and antimicrobial activity of US propolis against Paenibacillus larvae and Ascosphaera apis. J Invertebr Pathol 2014; 124:44-50. [PMID: 25450740 DOI: 10.1016/j.jip.2014.10.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [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: 08/07/2014] [Revised: 10/16/2014] [Accepted: 10/20/2014] [Indexed: 12/11/2022]
Abstract
Propolis is a substance derived from antimicrobial plant resins that honey bees use in the construction of their nests. Propolis use in the hive is an important component of honey bee social immunity and confers a number of positive physiological benefits to bees. The benefits that bees derive from resins are mostly due to their antimicrobial properties, but it is unknown how the diversity of antimicrobial activities among resins might impact bee health. In our previous work, we found that resins from different North American Populus spp. differed in their ability to inhibit in vitro growth of the bee bacterial pathogen Paenibacillus larvae. The goal of our current work was to characterize the antimicrobial activity of propolis from 12 climatically diverse regions across the US against the bee pathogens P. larvae and Ascosphaera apis and compare the metabolite profiles among those samples using LC-MS-based metabolomic methods. Samples differed greatly in their ability to inhibit both bacterial and fungal growth in vitro, but propolis from Nevada, Texas, and California displayed high activity against both pathogens. Interestingly, propolis from Georgia, New York, Louisiana, and Minnesota were active against A. apis, but not very active against P. larvae. Metabolomic analysis of regional propolis samples revealed that each sample was compositionally distinct, and LC-FTMS profiles from each sample contained a unique number of shared and exclusive peaks. Propolis from Aspen, CO, Tuscon, AZ, and Raleigh, NC, contained relatively large numbers of exclusive peaks, which may indicate that these samples originated from relatively unique botanical sources. This is the first study to characterize how the diversity of bee preferred resinous plants in the US may affect bee health, and could guide future studies on the therapeutic potential of propolis for bees.
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Affiliation(s)
- M B Wilson
- Department of Entomology, University of Minnesota, 219 Hodson Hall, 1980 Folwell Ave, St. Paul, MN 55108, USA.
| | - D Brinkman
- Department of Horticultural Science, University of Minnesota, 305 Alderman Hall, 1970 Folwell Ave, St. Paul, MN 55108, USA.
| | - M Spivak
- Department of Entomology, University of Minnesota, 219 Hodson Hall, 1980 Folwell Ave, St. Paul, MN 55108, USA.
| | - G Gardner
- Department of Horticultural Science, University of Minnesota, 305 Alderman Hall, 1970 Folwell Ave, St. Paul, MN 55108, USA; Microbial and Plant Genomics Institute, University of Minnesota, USA.
| | - J D Cohen
- Department of Horticultural Science, University of Minnesota, 305 Alderman Hall, 1970 Folwell Ave, St. Paul, MN 55108, USA; Microbial and Plant Genomics Institute, University of Minnesota, USA.
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Jewell E, Juan J, Gardner G, Abu-Rustum N, Brown C, Sonoda Y, Barakat R, Levine D, Leitao M. Detection of sentinel lymph nodes using indocyanine green and near-in- frared fluorescence imaging for gynecological malignancies. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.082] [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: 10/26/2022]
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Barlin J, Long K, Tanner E, Gardner G, Leitao M, Levine D, Sonoda Y, Abu-Rustum N, Barakat R, Chi D. Optimal but visible residual disease: Is extensive debulking warranted? Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Shorter C, Connor D, Thakur J, Gardner G, Guthikonda B. Repair of Middle Fossa Cerebrospinal Fluid Leaks Using a Novel Combination of Materials: A Technical Note. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314258] [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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Cormier B, Tanner E, Ducie J, Long K, Wethington S, Wadhawan I, Leitao M, Barakat R, Chi D, Gardner G. Isolated Lymph Node Recurrence is Associated with Improved Survival in Advanced Stage Ovarian Cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.01.024] [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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Tanner E, Long K, Feffer J, Leitao M, Abu-Rustum N, Barakat R, Chi D, Gardner G. Parenchymal Splenic Metastasis is an Independent Negative Predictor of Overall Survival in Advanced Ovarian, Fallopian Tube and Primary Peritoneal Cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.01.042] [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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Cormier B, Long K, Ducie J, Tanner E, Wadhawan I, Jewell E, Leitao M, Barakat R, Chi D, Gardner G. Do patients with complete gross resection of advanced stage ovarian cancer benefit from lymphadenectomy? Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.056] [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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Cormier B, Tanner E, Ducie J, Long K, Wethington S, Wadhawan I, Leitao M, Barakat R, Chi D, Gardner G. Isolated lymph node recurrence is associated with improved survival in advanced stage ovarian cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.250] [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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Leitao M, Calderon B, Gardner G, Chi D, Sonoda Y, Barakat R. Feasibility and safety of same-day discharge after minimally invasive hysterectomy alone or with other procedures for benign and malignant indications. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.097] [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: 11/27/2022]
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Long K, Tanner E, Frey M, Cormier B, Gardner G, Sonoda Y, Levine D, Brown C, Barakat R, Chi D. Does intraoperative hypothermia contribute to postoperative morbidity in patients undergoing optimal primary surgical cytoreduction for advanced ovarian cancer? Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.249] [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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Wethington S, Park K, Soslow R, Kauff N, Brown C, Sonoda Y, Abu-Rustum N, Barakat R, Levine D, Gardner G. Clinical outcome of Serous Tubal Intraepithelial Carcinomas (STIC). Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.100] [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: 11/27/2022]
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Gradisar M, Dohnt H, Gardner G, Paine S, Starkey K, Menne A, Slater A, Wright H, Hudson JL, Weaver E, Trenowden S. A randomized controlled trial of cognitive-behavior therapy plus bright light therapy for adolescent delayed sleep phase disorder. Sleep 2011; 34:1671-80. [PMID: 22131604 DOI: 10.5665/sleep.1432] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate cognitive-behavior therapy plus bright light therapy (CBT plus BLT) for adolescents diagnosed with delayed sleep phase disorder (DSPD). DESIGN Randomized controlled trial of CBT plus BLT vs. waitlist (WL) control with comparisons at pre- and post-treatment. There was 6-month follow-up for the CBT plus BLT group only. SETTING Flinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia. PATIENTS 49 adolescents (mean age 14.6 ± 1.0 y, 53% males) diagnosed with DSPD; mean chronicity 4 y 8 months; 16% not attending school. Eighteen percent of adolescents dropped out of the study (CBT plus BLT: N = 23 vs. WL: N = 17). INTERVENTIONS CBT plus BLT consisted of 6 individual sessions, including morning bright light therapy to advance adolescents' circadian rhythms, and cognitive restructuring and sleep education to target associated insomnia and sleep hygiene. MEASUREMENTS AND RESULTS DSPD diagnosis was performed via a clinical interview and 7-day sleep diary. Measurements at each time-point included online sleep diaries and scales measuring sleepiness, fatigue, and depression symptoms. Compared to WL, moderate-to-large improvements (d = 0.65-1.24) were found at post-treatment for CBT plus BLT adolescents, including reduced sleep latency, earlier sleep onset and rise times, total sleep time (school nights), wake after sleep onset, sleepiness, and fatigue. At 6-month follow-up (N = 15), small-to-large improvements (d = 0.24-1.53) continued for CBT plus BLT adolescents, with effects found for all measures. Significantly fewer adolescents receiving CBT plus BLT met DPSD criteria at post-treatment (WL = 82% vs. CBT plus BLT = 13%, P < 0.0001), yet 13% still met DSPD criteria at the 6-month follow-up. CONCLUSIONS CBT plus BLT for adolescent DSPD is effective for improving multiple sleep and daytime impairments in the immediate and long-term. Studies evaluating the treatment effectiveness of each treatment component are needed. CLINICAL TRIAL INFORMATION Australia-New Zealand Trials Registry Number: ACTRN12610001041044.
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Affiliation(s)
- Michael Gradisar
- Child & Adolescent Sleep Clinic, School of Psychology, Flinders University, Adelaide, SA, Australia.
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Abstract
Meningiomas involving the temporal bone may originate from arachnoid cell nests present within the temporal bone (intratemporal), but more frequently originate from arachnoid cell nests of the posterior or middle cranial fossa with secondary invasion of the TB (extratemporal). In this study, we retrospectively reviewed the charts of 13 patients with meningiomas involving the temporal bone who underwent surgery. Tumors of the posterior fossa with only temporal bone hyperostosis, but without invasion, were excluded. Patients presented primarily with otologic symptoms and signs. The tumors originated in the temporal bone (5/13), jugular foramen (4/13), petroclival region (2/13), the asterion (1/13) or the internal auditory meatus (1/13). All of the intratemporal meningiomas had the radiological appearance of en-plaque menigiomas. The tumor extended into the middle ear (11/13), eustachian tube (5/13), and/or the labyrinth (3/13). A gross total resection was achieved in 11 patients and a subtotal resection in 2 patients. The lower cranial nerves were infiltrated by tumor in 4 patients, and were sacrificed. At a mean follow-up of approximately 6 years, 12 patients are currently alive and doing well and 1 died from tumor progression. Six patients showed tumor recurrence and were reoperated on (5/6) or followed conservatively (1/6). Surgical treatment of temporal bone meningiomas is associated with high recurrence rate due to indiscreet tumor margins. Combined surgical approaches (temporal craniotomy and mastoidectomy) by neurosurgical and otological teams are recommended for meningiomas originating in the temporal bone.
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Tanner E, Long K, Zhou Q, Brightwell R, Gardner G, Abu-Rustum N, Leitao M, Sonoda Y, Barakat R, Iasonos A, Chi D. Does operative start time impact the frequency of complete gross resection in patients undergoing primary cytoreduction for advanced serous ovarian carcinoma? Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.02.027] [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: 11/16/2022]
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Long K, Tanner E, Guy M, Leitao M, Gardner G, Sonoda Y, Brown C, Barakat R, Chi D. Cytoreductive surgery for serous ovarian cancer in patients 75years and older. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.160] [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: 10/18/2022]
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Leitao M, Khoury Collado F, Gardner G, Jewell E, Brown C, Sonoda Y, Levine D, Barakat R, Abu-Rustum N. Sentinel lymph node mapping in patients with endometrial cancer undergoing robot-assisted or standard laparoscopic procedures. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.099] [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]
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Leitao M, Gardner G, Briscoe G, Dholakiya P, Santos K, Jewell E, Abu-Rustum N, Sonoda Y, Barakat R, Malhotra V. Postoperative pain medication requirements in patients undergoing robotically assisted and standard laparoscopic procedures for newly diagnosed endometrial cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.311] [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: 10/18/2022]
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Leitao M, Gardner G, Briscoe G, Santos K, Jewell E, Abu-Rustum N, Brown C, Chi D, Sonoda Y, Barakat R. Comparison of robot-assisted and standard laparoscopic procedures in patients with endometrial cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.303] [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: 11/17/2022]
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Leitao M, Gardner G, Briscoe G, Santos K, Jewell E, Brown C, Chi D, Barakat R. Integration of and training for robot-assisted surgery in a gynecologic oncology fellowship program. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.307] [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: 10/18/2022]
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Kim C, Abu-Rustum N, Chi D, Gardner G, Leitao M, Barakat R, Sonoda Y. Oncologic outcomes of radical trachelectomy at a single institution. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim C, Abu-Rustum N, Chi D, Gardner G, Leitao M, Carter J, Barakat R, Sonoda Y. Reproductive outcomes of patients undergoing radical trachelectomy for early-stage cervical cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.069] [Citation(s) in RCA: 3] [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: 11/25/2022]
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Gardner G, Leitao M, Carreras M, Jewell E, Sonoda Y, Levine D, Abu-Rustum N, Brown C, Chi D, Barakat R. Robotic radical hysterectomy: Extent of tumor resection and operative outcomes compared with laparoscopy and exploratory laparotomy. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.315] [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: 10/18/2022]
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Tanner E, Gardner G, Sonoda Y, Garg K, Chi D, Leitao M, Jewell E. Complete gross resection is associated with improved survival in advanced-stage uterine carcinosarcoma. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.204] [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: 10/18/2022]
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Webster J, Coleman K, Mudge A, Marquart L, Gardner G, Stankiewicz M, Kirby J, Vellacott C, Horton-Breshears M, McClymont A. Pressure ulcers: effectiveness of risk-assessment tools. A randomised controlled trial (the ULCER trial). BMJ Qual Saf 2011; 20:297-306. [DOI: 10.1136/bmjqs.2010.043109] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pfister K, Steinback KE, Gardner G, Arntzen CJ. Photoaffinity labeling of an herbicide receptor protein in chloroplast membranes. Proc Natl Acad Sci U S A 2010; 78:981-5. [PMID: 16592984 PMCID: PMC319929 DOI: 10.1073/pnas.78.2.981] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
2-Azido-4-ethylamino-6-isopropylamino-s-triazine (azido-atrazine) inhibits photosynthetic electron transport at a site identical to that affected by atrazine (2-chloro-4-ethylamino-6-isopropylamino-s-triazine). The latter is a well-characterized inhibitor of photosystem II reactions. Azido-atrazine was used as a photoaffinity label to identify the herbicide receptor protein; UV irradiation of chloroplast thylakoids in the presence of azido[(14)C]atrazine resulted in the covalent attachment of radioactive inhibitor to thylakoid membranes isolated from pea seedlings and from a triazine-susceptible biotype of the weed Amaranthus hybridus. No covalent binding of azido-atrazine was observed for thylakoid membranes isolated from a naturally occurring triazine-resistant biotype of A. hybridus. Analysis of thylakoid polypeptides from both the susceptible and resistant A. hybridus biotypes by sodium dodecyl sulfate/polyacrylamide gel electrophoresis, followed by fluorography to locate (14)C label, demonstrated specific association of the azido[(14)C]atrazine with polypeptides of the 34- to 32-kilodalton size class in susceptible but not in resistant membranes.
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Affiliation(s)
- K Pfister
- United States Department of Agriculture/Science and Education Administration/Agricultural Research, Department of Botany, University of Illinois, Urbana, Illinois 61801
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Sullivan M, Bentley S, Fan MY, Gardner G. A Single-Blind Placebo Run-In Study of Venlafaxine XR for Activity-Limiting Osteoarthritis Pain. Pain Med 2009; 10:806-12. [DOI: 10.1111/j.1526-4637.2009.00637.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sullivan MD, Bentley S, Fan MY, Gardner G. A Single-Blind, Placebo Run-in Study of Duloxetine for Activity-Limiting Osteoarthritis Pain. The Journal of Pain 2009; 10:208-13. [DOI: 10.1016/j.jpain.2008.08.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 08/19/2008] [Accepted: 08/29/2008] [Indexed: 10/21/2022]
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Levy LS, Sexton P, Willeford KS, Barnum MG, Guyer MS, Gardner G, Fincher AL. Clinical Instructor Characteristics, Behaviors and Skills in Allied Health Care Settings: A Literature Review. ACTA ACUST UNITED AC 2009. [DOI: 10.4085/1947-380x-4.1.8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this literature review is to compare both clinical instructor and student perceptions of helpful and hindering clinical instructor characteristics, behaviors and skills in athletic training and allied health care settings. Clinical education in athletic training is similar to that of other allied health care professions. Clinical education is used to practice didactic information in a hands-on environment, with the goal of integrating theory and practice in a controlled setting. Students are taught skills, behaviors and attitudes required to enter into professional practice. Athletic training clinical education evolved from the medical education model for training physicians and is currently based on the nursing model. Other allied health care professionals employ similar practices.
Objective: To provide an overview of helpful and hindering clinical instructor characteristics, behaviors and skills in athletic training and in other allied health professions.
Data Sources: MEDLINE, Health Source: Nursing/Academic, PubMed, SPORTDiscus, Academic Search Premier, ERIC and PsychArticles served as the data sources for the allied health fields that included athletic training, nursing, medicine, optometry, clinical psychology, occupational therapy, physical therapy, speech and language pathology, radiography.
Data Synthesis: Athletic trainer, allied health profession, and student perceptions of clinical instructor characteristics, behaviors and skills were reviewed and summarized.
Conclusions/Recommendations: This review presents literature suggesting that clinical education, regardless of the profession or setting, contains similarities. Clinical instructor characteristics, behaviors and skills are important and need to be the focus of clinical education in order to promote helpful, while minimizing hindering, behaviors. Effective clinical instructors enhance the learning process. Focusing on improved supervisor and supervision services should be employed to teach athletic trainers helpful clinical instructor behaviors.
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Barnum MG, Guyer MS, Levy LS, Willeford KS, Sexton P, Gardner G, Fincher AL. Questioning and Feedback in Athletic Training Clinical Education. ACTA ACUST UNITED AC 2009. [DOI: 10.4085/1947-380x-4.1.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this article is to provide clinical instructors with information and ideas on how to utilize questioning and feedback during clinical experiences. Definitions, purpose, and examples of different questioning skills are provided. Corrective and directive feedback methods are defined with purposes and examples provided of each.
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Pearce KL, Ferguson M, Gardner G, Smith N, Greef J, Pethick DW. Dual X-ray absorptiometry accurately predicts carcass composition from live sheep and chemical composition of live and dead sheep. Meat Sci 2008; 81:285-93. [PMID: 22063997 DOI: 10.1016/j.meatsci.2008.08.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 08/01/2008] [Accepted: 08/08/2008] [Indexed: 11/29/2022]
Abstract
Fifty merino wethers (liveweight range from 44 to 81kg, average of 58.6kg) were lot fed for 42d and scanned through a dual X-ray absorptiometry (DXA) as both a live animal and whole carcass (carcass weight range from 15 to 32kg, average of 22.9kg) producing measures of total tissue, lean, fat and bone content. The carcasses were subsequently boned out into saleable cuts and the weights and yield of boned out muscle, fat and bone recorded. The relationship between chemical lean (protein+water) was highly correlated with DXA carcass lean (r(2)=0.90, RSD=0.674kg) and moderately with DXA live lean (r(2)=0.72, RSD=1.05kg). The relationship between the chemical fat was moderately correlated with DXA carcass fat (r(2)=0.86, RSD=0.42kg) and DXA live fat (r(2)=0.70, RSD=0.71kg). DXA carcass and live animal bone was not well correlated with chemical ash (both r(2)=0.38, RSD=0.3). DXA carcass lean was moderately well predicted from DXA live lean with the inclusion of bodyweight in the regression (r(2)=0.82, RSD=0.87kg). DXA carcass fat was well predicted from DXA live fat (r(2)=0.86, RSD=0.54kg). DXA carcass lean and DXA carcass fat with the inclusion of carcass weight in the regression significantly predicted boned out muscle (r(2)=0.97, RSD=0.32kg) and fat weight, respectively (r(2)=0.92, RSD=0.34kg). The use of DXA live lean and DXA live fat with the inclusion of bodyweight to predict boned out muscle (r(2)=0.83, RSD=0.75kg) and fat (r(2)=0.86, RSD=0.46kg) weight, respectively, was moderate. The use of DXA carcass and live lean and fat to predict boned out muscle and fat yield was not correlated as weight. The future for the DXA will exist in the determination of body composition in live animals and carcasses in research experiments but there is potential for the DXA to be used as an online carcass grading system.
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Affiliation(s)
- K L Pearce
- Division of Veterinary and Biomedical Science, Murdoch University, South Street, Murdoch, WA 6150, Australia; Australian Sheep Industry Cooperative Research Centre, Armidale, NSW 2350, Australia
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Salani R, Kurman RJ, Giuntoli R, Gardner G, Bristow R, Wang TL, Shih IM. Assessment of TP53 mutation using purified tissue samples of ovarian serous carcinomas reveals a higher mutation rate than previously reported and does not correlate with drug resistance. Int J Gynecol Cancer 2007; 18:487-91. [PMID: 17692090 DOI: 10.1111/j.1525-1438.2007.01039.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The TP53 mutation frequency in ovarian serous carcinomas has been reported to range between 50% and 80%, but a stringent analysis of TP53 using purified epithelial samples has not yet been performed to accurately assess the mutation frequency and to correlate it with the histologic grade. The purpose of this study was to assess the TP53 mutational profile in a relatively large series of high-grade (53 primary and 18 recurrent) and 13 low-grade ovarian serous tumors using DNA isolated from affinity-purified tumor cells and to correlate it with in vitro drug resistance. All samples were affinity purified, and the tumor DNA was analyzed for TP53 mutations in exons 4-9. In vitro drug resistance assays to carboplatin, cisplatin, paclitaxel, and taxotere were performed on the same tumor samples and correlated with the TP53 mutation status. TP53 mutations were detected in 57 (80.3%) of 71 high-grade carcinomas and in one (7.8%) of 13 low-grade serous tumors (an invasive low-grade serous carcinoma). The mutations were predominantly missense mutations (59.6%). TP53 mutations were associated with high-grade serous carcinomas and recurrent disease (P < 0.0001). There was no statistically significant correlation between TP53 mutation status and drug resistance assays or clinical stage (P > 0.25). The frequency of TP53 mutations using purified tumor DNA from ovarian serous carcinomas was 80.3%, which is much higher than previously reported. Furthermore, we found that TP53 is not directly involved in the development of drug resistance in high-grade ovarian serous carcinomas.
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Affiliation(s)
- R Salani
- The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
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Abstract
Adult-onset Still disease (AOSD) is an uncommon disorder characterized by fever, polyarthralgia, elevated white blood cell count, and a maculopapular rash, the histologic features of which have not been well-known. A 55-year-old Asian woman presented initially with a "burning" and severely pruritic eruption on her face, hands, and arms, thought clinically to be urticaria. Within 1 month, she began spiking high fevers, developed diffuse joint pain, and had marked elevations of ferritin, C-reactive protein, and erythrocyte sedimentation rate, characteristic of AOSD. The cutaneous eruption became more widespread, involving the trunk, scalp, and remainder of the extremities, with diffuse thickening of the skin with papular and linear hyperpigmentation and accentuation. Biopsies from several locations showed focal hyperkeratosis associated with dyskeratotic keratinocytes with a peculiar, distinctive distribution in the upper epidermis and cornified layers. In addition, increased dermal mucin was present, with minimal fibroblast proliferation and inflammation. This unusual combination of diffuse dermal mucinosis and a unique pattern of dyskeratosis can present a challenge in generating an accurate differential diagnosis, and may represent an unusual response to chronic scratching or be a distinctive histologic manifestation of AOSD.
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Affiliation(s)
- Greg Wolgamot
- Department of Pathology, University of Washington, Seattle, WA 98195-6100, USA
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