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Berger E, Findlay H, Giguère CE, Lupien S, Ouellet-Morin I. Hair cortisol stability after 5-year storage: Insights from a sample of 17-year-old adolescents. Compr Psychoneuroendocrinol 2024; 18:100234. [PMID: 38660593 PMCID: PMC11039327 DOI: 10.1016/j.cpnec.2024.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
Background Hair has become an increasingly valuable medium to investigate the association between chronic stress, stable differences in systemic cortisol secretion and later health. Assessing cortisol in hair has many advantages, notably its non-invasive and retrospective nature, the need for a single biospecimen and convenient storage until analysis. However, few studies offered empirical evidence documenting the long-term temporal stability of hair cortisol concentration (HCC) prior to analysis, especially in humans. Yet, knowing how long hair samples can be stored without compromising the accuracy of cortisol measurement is of crucial importance when planning data collection and analysis. This study examined the stability of HCC in hair samples assayed twice, five years apart. Methods We randomly selected from a larger distribution of HCC measured in 17-year-old participants 39 hair samples to be reanalyzed five years later, under the same general conditions. Samples were assayed in duplicate using a luminescence immunoassay and compared with the original HCC using the Lin's concordance correlation coefficient (CCC), Bland-Altman plot analysis and Wilcoxon rank test. Results Findings indicated a good concordance and temporal stability between the two samples assayed five years apart (CCC [95% confidence interval] = 0.84 [0.72-0.91]), although a small decrease in HCC was noted 5 years later (8.4% reduction, p = 0.001). Conclusion Our study confirms that hair samples, when stored at room temperature and away from sunlight, can be assayed for at least five years without risking a loss of precision in HCC measurement.
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Affiliation(s)
- Eloïse Berger
- School of Criminology, University of Montreal, Montreal, Quebec, Canada
| | - Helen Findlay
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
| | - Charles-Edouard Giguère
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
| | - Sonia Lupien
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
- Centre for Studies on Human Stress, Department Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
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Kerr P, Le Page C, Giguère CÉ, Marin MF, Trudel-Fitzgerald C, Romain AJ, Taschereau-Dumouchel V, Ouellet-Morin I, Lecomte T, Potvin S, Geoffrion S, Sasseville M, Caihol L, Lipp O, Pelletier JF, Dumais A, Lesage A, Labelle R, Lavoie M, Godbout R, Vincent P, Boissonneault J, Findlay H, Lupien SJ, Guay S, Juster RP, Consortium S. The Signature Biobank: A longitudinal biopsychosocial repository of psychiatric emergency patients. Psychiatry Res 2024; 332:115718. [PMID: 38198857 DOI: 10.1016/j.psychres.2024.115718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
The Signature Biobank is a longitudinal repository of biospecimen, psychological, sociodemographic, and diagnostic data that was created in 2012. The Signature Consortium represents a group of approximately one hundred Quebec-based transdisciplinary clinicians and research scientists with various expertise in the field of psychiatry. The objective of the Signature Biobank is to investigate the multi-faceted underpinnings of psychiatric disorders among patients in crisis. The Signature Consortium is expanding and includes new active members that seek to highlight the contributions made by Signature Biobank since its inception. This article details our research protocol, directions, and summarizes contributions. To date, we have collected biological samples (n = 1,986), and questionnaire data (n = 2,085) from psychiatric emergency patients of the Institut universitaire en santé mentale de Montréal (Quebec, Canada), with a large proportion from whom both data types were collected (n = 1,926). In addition to this, a subsample of patients was followed-up at hospital discharge, and two additional outpatient clinic appointments (n = 958 with at least one follow-up). In addition, a socio-demographically matched comparison group of individuals who were not hospitalized for psychiatric disorders (n = 149) was recruited from the surrounding catchment area. To summarize, a systematic review of the literature shows that the Signature Biobank has contributed to better characterizing psychiatric comorbidities, biological profiles, and psychosocial functioning across some of the most common psychiatric disorders, including psychosis, mood, anxiety, and substance use disorders. The Signature Biobank is now one of the world's largest repositories of data collected from patients receiving care at a psychiatric emergency unit.
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Affiliation(s)
- Philippe Kerr
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Cécile Le Page
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Charles-Édouard Giguère
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Marie-France Marin
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Département de Psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Claudia Trudel-Fitzgerald
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Ahmed Jérôme Romain
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Québec, Canada
| | - Vincent Taschereau-Dumouchel
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Isabelle Ouellet-Morin
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; School of Criminology, Université de Montréal, Montréal, Québec, Canada
| | - Tania Lecomte
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Steve Geoffrion
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Marc Sasseville
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Lionel Caihol
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Olivier Lipp
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Jean-François Pelletier
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry, Yale University, New Haven, Connecticut, United States; CISSS de la Montérégie-Ouest, Québec, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Alain Lesage
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Réal Labelle
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Département de Psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Marc Lavoie
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Roger Godbout
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Philippe Vincent
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
| | - Janick Boissonneault
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Helen Findlay
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Sonia J Lupien
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Stéphane Guay
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada; School of Criminology, Université de Montréal, Montréal, Québec, Canada
| | - Robert-Paul Juster
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada.
| | - Signature Consortium
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
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Wilson WT, Pickup AR, Findlay H, Gupta S, Mahendra A. Stabilisation of pathological humerus fractures using cement augmented plating: A case series. J Clin Orthop Trauma 2021; 15:93-98. [PMID: 33680826 PMCID: PMC7919932 DOI: 10.1016/j.jcot.2020.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022] Open
Abstract
The humerus is the second most common long bone for metastatic tumours. These lesions result in weakened bone architecture and increased fracture risk with patients suffering pain, loss of function and diminished quality of life, often when life expectancy is short. Fractures or impending fractures require surgical stabilisation to relieve pain and restore function for the remainder of the patient's life without the need for further surgery. Conventional management of these lesions in the humerus is intramedullary nailing, however there are issues with this technique, particularly regarding rigidity of fixation. Advances in contoured locking plates have led to the development of different stabilisation techniques. The preferred technique in our regional oncology unit is curettage of the tumour and plating, augmented with cement to fill the defect and restore the structural morphology. In this case series we evaluate the survivorship of the construct and the clinical outcomes in patients who had an established or prospective pathological humeral fracture treated with curettage and cement augmented plating, since 2010. We identified 19 patients; 17 had metastasis and 2 myeloma of whom 15 had established fractures and four impending. The mean age at surgery was 69 years (51-86), and mean time since surgery 3.2 years. Overall mean follow up time was 20 months with 14 patients deceased and 5 surviving. There was 100% survivorship of the construct with no mechanical failures and no re-operations. There were no post-operative wound complications. Excellent early pain control was achieved in 18 patients with one experiencing pain controlled by analgesia. Function was assessed using Toronto Extremity Salvage Score (TESS) and was satisfactory; mean 79/100 (range 72-85). Cement augmented plating for pathological humerus fractures is a suitable alternative to intramedullary nailing and addresses several of the concerns with that technique. It provides immediate rigidity and allows early unrestricted function.
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Affiliation(s)
- William T. Wilson
- Department of Orthopaedic Oncology, Glasgow Royal Infirmary, Glasgow, UK
| | - Alan R. Pickup
- Department of Orthopaedic Oncology, Glasgow Royal Infirmary, Glasgow, UK
| | - Helen Findlay
- Department of Orthopaedic Oncology, Glasgow Royal Infirmary, Glasgow, UK
| | - Sanjay Gupta
- Department of Orthopaedic Oncology, Glasgow Royal Infirmary, Glasgow, UK
| | - Ashish Mahendra
- Department of Orthopaedic Oncology, Glasgow Royal Infirmary, Glasgow, UK
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Kitidis V, Shutler JD, Ashton I, Warren M, Brown I, Findlay H, Hartman SE, Sanders R, Humphreys M, Kivimäe C, Greenwood N, Hull T, Pearce D, McGrath T, Stewart BM, Walsham P, McGovern E, Bozec Y, Gac JP, van Heuven SMAC, Hoppema M, Schuster U, Johannessen T, Omar A, Lauvset SK, Skjelvan I, Olsen A, Steinhoff T, Körtzinger A, Becker M, Lefevre N, Diverrès D, Gkritzalis T, Cattrijsse A, Petersen W, Voynova YG, Chapron B, Grouazel A, Land PE, Sharples J, Nightingale PD. Winter weather controls net influx of atmospheric CO 2 on the north-west European shelf. Sci Rep 2019; 9:20153. [PMID: 31882779 PMCID: PMC6934492 DOI: 10.1038/s41598-019-56363-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/06/2019] [Indexed: 11/08/2022] Open
Abstract
Shelf seas play an important role in the global carbon cycle, absorbing atmospheric carbon dioxide (CO2) and exporting carbon (C) to the open ocean and sediments. The magnitude of these processes is poorly constrained, because observations are typically interpolated over multiple years. Here, we used 298500 observations of CO2 fugacity (fCO2) from a single year (2015), to estimate the net influx of atmospheric CO2 as 26.2 ± 4.7 Tg C yr-1 over the open NW European shelf. CO2 influx from the atmosphere was dominated by influx during winter as a consequence of high winds, despite a smaller, thermally-driven, air-sea fCO2 gradient compared to the larger, biologically-driven summer gradient. In order to understand this climate regulation service, we constructed a carbon-budget supplemented by data from the literature, where the NW European shelf is treated as a box with carbon entering and leaving the box. This budget showed that net C-burial was a small sink of 1.3 ± 3.1 Tg C yr-1, while CO2 efflux from estuaries to the atmosphere, removed the majority of river C-inputs. In contrast, the input from the Baltic Sea likely contributes to net export via the continental shelf pump and advection (34.4 ± 6.0 Tg C yr-1).
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Affiliation(s)
| | - Jamie D Shutler
- University of Exeter, College of Life and Environmental Sciences, Exeter, UK
| | - Ian Ashton
- University of Exeter, College of Life and Environmental Sciences, Exeter, UK
| | | | - Ian Brown
- Plymouth Marine Laboratory, Plymouth, UK
| | | | | | | | - Matthew Humphreys
- Ocean and Earth Science, University of Southampton, Southampton, UK
- School of Environmental Sciences, University of East Anglia, Norwich, UK
| | | | - Naomi Greenwood
- Centre for Environment Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - Tom Hull
- Centre for Environment Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - David Pearce
- Centre for Environment Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | | | | | | | | | - Yann Bozec
- Station Biologique de Roscoff, UMR CNRS - UPMC 7144 - Equipe Chimie Marine, Roscoff, France
| | - Jean-Philippe Gac
- Station Biologique de Roscoff, UMR CNRS - UPMC 7144 - Equipe Chimie Marine, Roscoff, France
| | | | - Mario Hoppema
- Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | - Ute Schuster
- University of Exeter, College of Life and Environmental Sciences, Exeter, UK
| | - Truls Johannessen
- Geophysical Institute, University of Bergen and Bjerknes Center for Climate Research, Bergen, Norway
| | - Abdirahman Omar
- NORCE Norwegian Research Centre, Bjerknes Center for Climate Research, Bergen, Norway
| | - Siv K Lauvset
- NORCE Norwegian Research Centre, Bjerknes Center for Climate Research, Bergen, Norway
| | - Ingunn Skjelvan
- NORCE Norwegian Research Centre, Bjerknes Center for Climate Research, Bergen, Norway
| | - Are Olsen
- Geophysical Institute, University of Bergen and Bjerknes Center for Climate Research, Bergen, Norway
| | | | - Arne Körtzinger
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
| | - Meike Becker
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
- Geophysical Institute, University of Bergen and Bjerknes Center for Climate Research, Bergen, Norway
| | - Nathalie Lefevre
- Sorbonne Universités (UPMC, Univ Paris 06)-IRD-CNRS-MNHN, LOCEAN, Paris, France
| | - Denis Diverrès
- Institut de Recherche pour le Développement (IRD), centre de Bretagne, Plouzané, France
| | | | | | - Wilhelm Petersen
- Helmholtz Zentrum Geesthacht, Centre for Materials and Coastal Research, Geesthacht, Germany
| | - Yoana G Voynova
- Helmholtz Zentrum Geesthacht, Centre for Materials and Coastal Research, Geesthacht, Germany
| | - Bertrand Chapron
- Institut Francais Recherche Pour ĹExploitation de la Mer, Pointe du Diable, 29280, Plouzané, France
| | - Antoine Grouazel
- Institut Francais Recherche Pour ĹExploitation de la Mer, Pointe du Diable, 29280, Plouzané, France
| | | | - Jonathan Sharples
- University of Liverpool, School of Environmental Sciences, Liverpool, UK
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5
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Calvi JL, Chen FR, Benson VB, Brindle E, Bristow M, De A, Entringer S, Findlay H, Heim C, Hodges EA, Klawitter H, Lupien S, Rus HM, Tiemensma J, Verlezza S, Walker CD, Granger DA. Measurement of cortisol in saliva: a comparison of measurement error within and between international academic-research laboratories. BMC Res Notes 2017; 10:479. [PMID: 28903752 PMCID: PMC5598071 DOI: 10.1186/s13104-017-2805-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 03/21/2017] [Accepted: 09/07/2017] [Indexed: 01/19/2023] Open
Abstract
Objective Hundreds of scientific publications are produced annually that involve the measurement of cortisol in saliva. Intra- and inter-laboratory variation in salivary cortisol results has the potential to contribute to cross-study inconsistencies in findings, and the perception that salivary cortisol results are unreliable. This study rigorously estimates sources of measurement variability in the assay of salivary cortisol within and between established international academic-based laboratories that specialize in saliva analyses. One hundred young adults (Mean age: 23.10 years; 62 females) donated 2 mL of whole saliva by passive drool. Each sample was split into multiple- 100 µL aliquots and immediately frozen. One aliquot of each of the 100 participants’ saliva was transported to academic laboratories (N = 9) in the United States, Canada, UK, and Germany and assayed for cortisol by the same commercially available immunoassay. Results 1.76% of the variance in salivary cortisol levels was attributable to differences between duplicate assays of the same sample within laboratories, 7.93% of the variance was associated with differences between laboratories, and 90.31% to differences between samples. In established-qualified laboratories, measurement error of salivary cortisol is minimal, and inter-laboratory differences in measurement are unlikely to have a major influence on the determined values.
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Affiliation(s)
- Jessica L Calvi
- Salivary Bioscience Laboratory, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA.
| | - Frances R Chen
- Department of Criminal Justice and Criminology, Georgia State University, Atlanta, GA, 30302, USA
| | - Victoria Brann Benson
- Biobehavioral Laboratory, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7460, USA
| | - Eleanor Brindle
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, 98195, USA
| | - Matt Bristow
- Department of Psychology, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Alpana De
- Department of Psychology, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Sonja Entringer
- Department of Medical Psychology, Charité Universitätsmedizin, 10117, Berlin, Germany.,Development, Health, and Disease Research Program, University of California, Irvine, Irvine, CA, 92868, USA
| | - Helen Findlay
- Centre for Studies on Human Stress, Montreal Mental Health University Institute, Montreal, QC, H1N 3V2, Canada
| | - Christine Heim
- Department of Medical Psychology, Charité Universitätsmedizin, 10117, Berlin, Germany.,Department of Biobehavioral Health, Pennsylvania State University, State College, PA, 16802, USA
| | - Eric A Hodges
- Biobehavioral Laboratory, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7460, USA
| | - Heiko Klawitter
- Department of Medical Psychology, Charité Universitätsmedizin, 10117, Berlin, Germany
| | - Sonia Lupien
- Centre for Studies on Human Stress, Montreal Mental Health University Institute, Montreal, QC, H1N 3V2, Canada
| | - Holly M Rus
- Psychological Sciences, University of California, Merced, CA, 95343, USA
| | - Jitske Tiemensma
- Psychological Sciences, University of California, Merced, CA, 95343, USA
| | - Silvanna Verlezza
- The Douglas Hospital Research Centre, McGill University, Montreal, QC, H4H 1R3, Canada
| | | | - Douglas A Granger
- Salivary Bioscience Laboratory, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA.,Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, 21218, USA.,School of Nursing, The Johns Hopkins University, Baltimore, MD, 21218, USA.,School of Medicine, The Johns Hopkins University, Baltimore, MD, 21218, USA.,Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, 92697-7085, USA
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Abstract
The aging population is recognized by many as a unique global phenomenon and has become a subject of interest among multidisciplinary professionals. Perhaps one of the most common key concerns among individuals and family members in many countries today is to meet the increasing demand for elderly healthcare, particularly the real challenges and crisis in old age morbidity and health. As the socioeconomic, demographic and cultural context of populations varies from one setting to another, the intergenerational support as well as responsibility for the cost of care also varies across the globe. In particular, issues related to elderly healthcare financing and its support are growing steadily and are becoming dominant topics in social gerontology. The aim of this study is to examine the effects of age, gender and employment on the perceptions of people with regard to their own care costs in later life. The data for the study come from the global aging study (GLAS), popularly known as “The Future of Retirement.” The initial field surveys were completed in two successive years—2004 and 2005—and involved interviewing around 22,329 individuals aged 18 years and over across 20 countries and territories covering four major regions of the world. A cross-sectional survey design was employed in which respondents were selected randomly. Each respondent was asked a number of questions on their socioeconomic and demographic situation; their retirement and pension plans; health, wellbeing and quality of life, and voluntary contributions and inter-generational support. Among others two questions were asked directly about the responsibility of the financial cost of care in retirement and these were: “who should bear” as well as “who will bear” most of the financial costs of care in retirement. These questions were then further explored to see how the responses varied with respect to the age, gender and employment status of the respondents. It has been found that age, gender and employment status play significant roles in determining people's perceptions towards bearing the cost of care in retirement or old age. There is a significant gap between the respondents' perceptions of who “should” and “will” bear the cost of care. The article concludes with a brief discussion on policy implications.
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Abstract
The aim of this study was to assess patterns of weight loss/gain following total hip or knee joint replacement. Four hundred and fifty primary lower limb arthroplasty patients, where the current surgery was the last limiting factor to improved mobility, were selected. Over a one year period 212 gained weight (mean 5.03kg), 92 remained static, and 146 lost weight. The median change was a weight gain of 0.50Kg (p=0.002). All patients had a significant improvement in Oxford outcome scores. Hip arthroplasty patients were statistically more likely to gain weight than knee arthroplasty patients. A successful arthroplasty, restoring a patient's mobility, does not necessarily lead to subsequent weight loss. The majority of patients put on weight with an overall net weight gain. No adverse effect on functional outcome was noted.
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Affiliation(s)
- RB Abu-Rajab
- Orthopaedic Department, Royal Alexandra Hospital, Corsebar Road, Paisley PA2 9PN
| | - H Findlay
- Orthopaedic Department, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF
| | - D Young
- Statistics Department, Livingston Tower, University of Strathclyde, Richmond Street, Glasgow, G1 1XH
| | - B Jones
- Orthopaedic Department, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF
| | - R Ingram
- Orthopaedic Department, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF
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Robarts S, Kennedy D, MacLeod AM, Findlay H, Gollish J. A framework for the development and implementation of an advanced practice role for physiotherapists that improves access and quality of care for patients. Healthc Q 2008; 11:67-75. [PMID: 18362523 DOI: 10.12927/hcq.2008.19619] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [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: 05/26/2023]
Abstract
A new model of care has been implemented at the Sunnybrook Holland Orthopaedic and Arthritic Centre that expands the role of physiotherapists to improve access and quality of care for patients requiring hip and knee replacement surgery. An advanced practice physiotherapist (APP) role was created to support both referral management and post-operative care to reduce surgeon workload and better streamline services. This article describes our nine-step framework for implementing an APP role and can be used as a template for other organizations evolving similar roles. The framework was adapted from the participatory, evidence-based, patient-focused process for the development of an advanced practice nurse role. Key steps include (1) obtaining stakeholder consensus, (2) identifying barriers and facilitators and (3) developing the necessary administrative and training supports as well as clinical protocols and an evaluation framework. Approaching change in a series of small steps (plan-do-study-act [PDSA] methodology) alongside existing processes has facilitated buy-in and role acceptance. The early and continued involvement of decision-makers within the organization has been paramount to successful implementation. In addition, patient input has been central to the evolution of the role, with patient satisfaction a key indicator. The new role and model of care reconfigures traditional roles and introduces a team approach that results in timely access to care for patients. Benefits include an improved assessment process, enhanced education across the care continuum and improved coordination and delivery of services.
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Affiliation(s)
- Susan Robarts
- Holland Orthopaedic and Arthritic Centre of Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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Mak BC, McConkey F, Feng N, O’Reilly K, Rubinstein D, Kasprzyk PG, Hahn SE, Pereira DS, Findlay H, Young DS. AR36A36.11.1, a monoclonal antibody targeting CD59, enhances complement activity and exhibits potent in vivo efficacy in multiple human cancer models. Mol Immunol 2007. [DOI: 10.1016/j.molimm.2007.06.094] [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: 11/25/2022]
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10
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Hahn SE, da Cruz LA, Sayegh D, Ferry A, O’Reilly K, Pereira DS, Rubinstein DB, Findlay H, Young DS. Therapeutic monoclonal antibodies target phenotypically-differing human breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.13510] [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
13510 Background: CD44 (an adhesion molecule and stem cell antigen), CD59 (a complement-inhibitory molecule), MCSP (an adhesion and cell-cell interactions), and Trop-2 (EpCam a related signaling molecule) represent a group of biologically-significant cancer proteins acting through distinct mechanisms. We have described Abs with in vitro and in vivo cancer suppressive activity to this group of targets. However, their effectiveness depends on the phenotype of malignant cells; cell response should correlate with expression of its Ag, and tumor cells represent a heterogeneous group of non-synchronous cells. The present study describes the efficacy of those antibodies in breast cancer models and the prevalence of their antigen targets in a survey of human breast cancer tissues. Methods: In vivo activity of antibodies ARH460–16–2 (anti-CD44), AR36A36.11.1 (anti-CD59), AR11BD-2E11–2 (anti-MCSP), and AR47A6.4.2 (anti-Trop-2) in estrogen-dependent and hormone sensitive xenograft models of human breast cancer was examined. In addition, distribution of the antigens in breast cancer was determined by immunohistochemistry using tumor tissue arrays of breast cancer sections from distinct patients. Results: Treatment of an established breast cancer model with ARH460–16–2 resulted in 51% median tumor xenograft suppression (p<0.05), as well as increased survival in an MDA-MB-231 (breast cancer) grafted model. 63% of human breast cancer sections expressed the CD44 antigen. Treatment with anti-CD59 antibody AR36A36.11.1 resulted in 68% xenograft tumor suppression (p<0.005). AR47A6.4.2 anti-Trop-2 antibody bound to 100% of human breast cancer sections tested, and showed efficacy in the estrogen- dependent MCF-7 breast cancer model. Anti-MCSP antibody AR11BD-2E11–2 demonstrated 80% tumor growth inhibition (p<0.001), increased survival in an estrogen-dependent model of breast cancer, and was found to stain 62% of breast cancer tissues examined. Conclusions: The heterogeneity of breast cancer cell phenotypes in in vitro and in vivo studies and variable composite cellular antigen targets is the basis for the therapeutic use of multiple antibodies, each with independent mechanisms of action, and offers a rationale for combined antibody therapy in selected patients. [Table: see text]
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Affiliation(s)
| | | | - D. Sayegh
- Arius Research Inc, Toronto, ON, Canada
| | - A. Ferry
- Arius Research Inc, Toronto, ON, Canada
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11
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Abstract
Cancer patients (n = 913) who received treatment within the previous 2 years were interviewed to quantify reports of symptoms associated with cancer, measure the impact of symptoms on lifestyles, document experiences with accessing information and treatment for cancer and its symptoms, and record attitudes about the level of care received. Cancer patients were primarily recruited through newspaper ads placed throughout Canada and asked to complete a self-report questionnaire. Patients called a toll-free number and were interviewed to ensure eligibility. Most respondents were female (66%) with breast cancer (64%). Prostate cancer (40%) was the most common diagnosis among males. Almost all respondents (94%) reported experiencing one or more symptoms. Fatigue and anxiety were the most frequently reported symptoms (78% and 77%, respectively). Fatigue was most likely to be self-rated as moderate to severe and was most likely to interfere in normal daily activities. Respondents who experienced fatigue reported a more frequent use of healthcare services (including complementary therapies) than those who did not experience fatigue. Half of the respondents reported trying to find information on fatigue, but only half of these said they had obtained information. The most helpful sources of information were nurses, specialists, and other cancer patients. Respondents were more likely to be dissatisfied with their treatments for their symptoms than for their cancer. This survey indicates that most cancer patients experience symptoms related to the disease and its treatment. The most prevalent symptoms are fatigue and anxiety; fatigue is the most debilitating.
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Affiliation(s)
- F D Ashbury
- Department of Public Health Sciences, University of Toronto, Canada
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12
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Rusthoven JJ, Osoba D, Butts CA, Yelle L, Findlay H, Grenville A. The impact of postchemotherapy nausea and vomiting on quality of life after moderately emetogenic chemotherapy. Support Care Cancer 1998; 6:389-95. [PMID: 9695208 DOI: 10.1007/s005200050182] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [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: 10/28/2022]
Abstract
The purpose of the study was to assess the impact of postchemotherapy nausea and vomiting (PCNV) after moderately emetogenic chemotherapy on health-related quality of life (HRQOL) in patients with cancer being treated in a routine clinical practice setting. The European Organization for Research and Treatment in Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) was administered on day 2 and day 6 following moderately emetogenic chemotherapy to 119 patients with a variety of cancers. Patients kept daily diaries to record the occurrence and severity of nausea and vomiting. The QLQ-C30 questions were modified, for this study only, to assess the impact of nausea and vomiting on HRQOL in patients who experienced nausea and/or vomiting during the six days following chemotherapy. Those patients who experienced either nausea or vomiting experienced a decrease in HRQOL from prechemotherapy levels on six functioning and five symptom scales at day 2, and on four functioning and four symptom scales on day 6. Comparison of mean scores between the unmodified QLQ-30 and the nausea and vomiting versions demonstrated that the HRQOL rating attributed to nausea and vomiting accounted for much, but not all, of the deterioration in HRQOL scores in patients who experienced these symptoms. It can be concluded that patients who experience PCNV experience a significant negative impact on their HRQOL and that this impact can be attributed in large part to their experience of nausea and vomiting. However, since not all of the deterioration is attributable to these symptoms, other reasons for some of the decrease in HRQOL must also be identified in future studies.
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Affiliation(s)
- J J Rusthoven
- Department of Medical Oncology, Hamilton Regional Cancer Centre, Ont., Canada
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13
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Ashbury FD, Lockyer L, McKerracher K, Findlay H. Focus groups with cancer patients: toward a more comprehensive understanding of the cancer experience. Cancer Prev Control 1997; 1:222-7. [PMID: 9765747] [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] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Six focus groups of 58 individuals (30 women and 28 men) were held in 3 Canadian cities to help develop a survey instrument to be implemented nationally to identify cancer patients' experiences with cancer: treatment, symptoms and symptom management. Patient participants had different cancer diagnoses, but their experience with cancer had been within the year preceding the study. Our intent was to identify as many themes as possible to allow for comparison of different experiences in a national survey. This paper reports on what was learned substantively from these focus groups and discusses the methodological contribution of focus groups in developing survey tools.
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Affiliation(s)
- F D Ashbury
- Centre for Behavioural Research and Program Evaluation, National Cancer Institute of Canada, Toronto, Ont.
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14
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Edmeads J, Findlay H, Tugwell P, Pryse-Phillips W, Nelson RF, Murray TJ. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci 1993; 20:131-7. [PMID: 8334575 DOI: 10.1017/s0317167100047697] [Citation(s) in RCA: 307] [Impact Index Per Article: 9.9] [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: 01/30/2023]
Abstract
A large sample of Canadian adults was surveyed by telephone to determine the prevalence and characterization of headache, and the effects of headache on life-style, consulting behaviours and medication use. We reported prevalence and characterization in a previous issue; here, we detail the effects of headaches on sufferers. Sixteen and one-half percent of adult Canadians experience migraine and 29% tension-type headaches. In over 70% of headache sufferers interpersonal relationships are impaired. Regular activities are limited in 78% of migraine attacks and 38% of tension-type headaches. Despite this, only 64% of migraine and 45% of tension-type headache sufferers had ever sought medical attention, and of these only 32% returned for ongoing care. Fourteen percent of migraine and 8% of tension-type headache sufferers had used emergency departments. Most headache sufferers take medication, primarily over-the-counter varieties. Measures to reach the headache population are needed, as are safe effective treatment options that will encourage them to participate in their medical care.
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Affiliation(s)
- J Edmeads
- Department of Neurology, University of Toronto, Ontario, Canada
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15
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Pryse-Phillips W, Findlay H, Tugwell P, Edmeads J, Murray TJ, Nelson RF. A Canadian population survey on the clinical, epidemiologic and societal impact of migraine and tension-type headache. Neurol Sci 1992; 19:333-9. [PMID: 1393842] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Trained telephone interviewers contacted 1,573 adults across Canada about the nature and frequency of headaches suffered by them or by others in their households. Using a table of pain symptoms and other characteristics abstracted from the International Headache Society (IHS) classification, the headaches were assigned to migraine headache, tension-type headache or other diagnostic groups. Of the households sampled, 59% had at least one headache sufferer in residence. The proportion of headache sufferers with migraine was 14%; with tension-type, 36%; and with both, 14%. Migraine headache caused more disability than tension-type headache, with nearly 20% of migraine sufferers taking time off work and disability lasting for a mean of 1 day. It is concluded that the current prevalences of migraine and tension-type headache in Canada fall around the mean of previous studies, that the IHS criteria can form a basis for diagnostic classification and that the functional impact of migraine has been seriously underestimated in the past.
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Affiliation(s)
- W Pryse-Phillips
- Division of Neurology, Health Sciences Centre, St. John's Newfoundland
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Zamble E, Mitchell JB, Findlay H. Pavlovian conditioning of sexual arousal: parametric and background manipulations. J Exp Psychol Anim Behav Process 1986; 12:403-11. [PMID: 3772304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Recent studies have shown that a Pavlovian conditioned stimulus (CS) for unconsummated sexual arousal can increase the rate of copulation in the rat. This report includes five experiments examining the effects of parametric manipulations on the conditioned arousal response. Results show that between six and nine trials are necessary for reliable conditioning, but extinction is somewhat slower than acquisition. The function for the CS-US (unconditioned stimulus) interval is quadratic, with a minimum of several minutes required for effective conditioning. In the first three experiments, it appeared that background cues were conditioned as well as the designated CSs, and this was tested explicitly in the last two studies. In one, the effect of background cues was shown by training and testing in different situations; in the second, background cues were shown to be subject to latent inhibition. These results demonstrate the influence of Pavlovian learning in sexual behavior and help to provide the basis for an animal model of the acquisition of deviant sexual arousal in humans.
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