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Beqari J, Potter A, Pan M, Copeland J, Lanuti M, Yang C. OA20.04 Survival of Patients with Persistent N1 or N2 Disease After Induction Therapy for Stage IIIA-N2 Non-Small-Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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2
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Copeland J, Neal E, Potter A, Senthil P, Lanuti M, Yang C. P06.03 The Role of Surgery for Stage 0 Adenocarcinoma in Situ of the Lung: A U.S. National Analysis. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.282] [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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3
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Copeland J. Racial discrimination and biological dysregulation among Indigenous adults: The role of culture. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.012] [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: 11/12/2022] Open
Abstract
Abstract
Background
Racial discrimination is an ongoing social concern that requires public health solidarity to address. Indigenous peoples in many countries report high levels of discrimination across a variety of life domains, particularly when they migrate into urban centres for school or work. Discrimination has wide-ranging impacts that go beyond mental distress to include alterations in stress biomarkers across multiple systems. This study examined the impacts of discrimination on multisystem biological dysregulation among urban Indigenous adults in Canada, operationalized through allostatic load; and the role that Indigenous cultural continuity might play in resilience.
Methods
This cross-sectional study collected data from 150 Indigenous adults attending university in a small city in western Canada between 2015 and 2017 (M age: 28 years). Allostatic load (AL) was measured as a composite of 7 biomarkers assessing neuroendocrine, cardiovascular, metabolic, and immune system function. Bias-corrected and accelerated bootstrapped linear regression models examined associations adjusted for confounders.
Results
Past-year discrimination was significantly and linearly associated with increased AL adjusting for age and income (B = 0.17, p = 0.02). Among adults with low cultural continuity, past-year discrimination was associated with AL in models adjusted for age and child discrimination (B = 0.17, p = 0.01), with past-year discrimination and the full model explaining 24% and 41% of the variance in AL; respectively. Among adults with high cultural continuity, past-year discrimination was not associated with AL, and the full model explained 1% of the variance in AL.
Conclusions
Past-year racial discrimination was an adverse event capable of influencing multisystem biological dysregulation among Indigenous adults, independent of age and income. Indigenous cultural continuity may promote biological resilience against racism within this population.
Key messages
Racial discrimination was associated with multisystem biological dysregulation among urban Indigenous adults, controlling for age and income. Indigenous cultural continuity buffered the impact of discrimination on biological health.
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Affiliation(s)
- J Copeland
- Health Sciences, University of Lethbridge, Lethbridge, Canada
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Gilbert A, McParland L, Webster J, Bell S, Copeland J, Adams R, Harrison M, Muirhead R, Renehan A, Sebag-Montefiore D, Hawkins M. Pre-specified pilot analysis of a randomised pilot/phase II/III trial comparing standard dose vs dose-escalated concurrent chemoradiotherapy (CRT) in anal cancer (PLATO-ACT5). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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5
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Jacka B, Larance B, Copeland J, Burns L, Farrell M, Jackson E, Degenhardt L. Health care engagement behaviors of men who use performance- and image-enhancing drugs in Australia. Subst Abus 2019; 41:139-145. [PMID: 31545138 DOI: 10.1080/08897077.2019.1635954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Although people who inject performance- and image-enhancing drugs (PIEDs) report fewer unsafe injecting practices, stigma and discrimination may negatively impact their access to help and information. Engagement with health care services, compared with social networks (friends, relatives, and gym associates) and the Internet and media (steroid user forums, information sites, and magazines), may be important for harm minimization. Methods: A cross-sectional Internet or in-person survey of men who use PIEDs in Australia in 2014-2015 examined differences in sources for PIEDs, injecting equipment, and anabolic-androgenic steroids (AAS) information and factors associated with having periodical medical checks related to PIEDs issues using multivariate logistic regression. Results: In total, 267 men (mean age: 25 years, SD: 8.7 years; 246 of 267 [92%] reported recent AAS injection) were recruited. Most participants sourced injecting equipment from health professionals, PIEDs from their social networks, and AAS information from the Internet and media. Self-reported AAS knowledge was high and frequent. Higher income (adjusted odds ratio [AOR]: 2.04, 95% confidence interval [CI]: 1.03, 4.00), ≥2 different PIEDs used in addition to AAS (AOR: 1.94, 95% CI: 1.08, 3.49), and sourcing AAS information from health care professionals (AOR: 3.14, 95% CI: 1.81, 5.46) were independently associated with periodical medical checks. Participants nominated preference for improved health services through needle-syringe programs, primary care services, and peer educator support groups. Conclusion: Men who use PIEDs in Australia consider themselves well informed but tend to use Internet and media sources, providing potentially misleading or inaccurate information. Increasing trust between men who use PIEDs and health care providers may enable delivery of PIEDs-specific information to those at greatest need.
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Affiliation(s)
- B Jacka
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - B Larance
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - J Copeland
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - L Burns
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - M Farrell
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - E Jackson
- Nepean/Blue Mountains Sexual Health & HIV Clinics, Nepean Hospital, Kingswood, Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Baran D, Copeland H, Copeland J, Gidea C, Camacho M. Forgotten Women: Use of Female Donors and Survival Outcomes. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.331] [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: 10/17/2022] Open
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7
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Albertella L, Le Pelley ME, Copeland J. Cannabis use in early adolescence is associated with higher negative schizotypy in females. Eur Psychiatry 2017; 45:235-241. [PMID: 28957793 DOI: 10.1016/j.eurpsy.2017.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 05/16/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 11/27/2022] Open
Abstract
The current study examined the relationship between early onset cannabis use (before age 16) and different schizotypy dimensions, and whether gender moderates these associations. Participants were 162 cannabis users, aged 15-24 years, who completed an online assessment examining alcohol and other drug use, psychological distress, and schizotypy. Participants were divided according to whether or not they had started using cannabis before the age of 16 (early onset=47; later onset=115) and gender (males=66; females=96). The interaction between gender and onset group was significantly associated with the dimension of introvertive anhedonia. Follow-up analyses showed that early onset cannabis use was associated with higher levels of introvertive anhedonia in females only. The current findings suggest that gender is an important moderator in the association between early onset cannabis use, schizotypy, and possibly, psychosis risk.
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Affiliation(s)
- L Albertella
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia; Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
| | - M E Le Pelley
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia
| | - J Copeland
- Cannabis Information and Support, Sydney, NSW, Australia; National Cannabis Prevention and Information Centre, UNSW Sydney, Randwick, NSW, Australia
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Copeland H, Baran D, Copeland J, Katlaps G, Dharmaraj B. Expanding the Donor Service Area to Greater Than 500 Miles Is Safe and Effective. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1106] [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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Copeland S, Tenneson C, Kulacz W, Copeland J. Effects of the novel formin INF1 on ciliogenesis. Cilia 2015. [PMCID: PMC4519064 DOI: 10.1186/2046-2530-4-s1-p33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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10
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Hynes SL, Harvey I, Thomas K, Copeland J, Borschel GH. CT angiography-guided single-stage release of adjacent webspaces in non-Apert syndactyly. J Hand Surg Eur Vol 2015; 40:625-32. [PMID: 25005563 DOI: 10.1177/1753193414541222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/29/2014] [Accepted: 05/31/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED We describe the CT angiography protocol and surgical technique utilized at our institution for single-stage release of adjacent web-spaces in non-Apert syndactyly. In a series of seven consecutive hands we analyse syndactyly anatomy, CT angiographic findings, operative details, and complications. Outcomes were assessed with a functional activity evaluation, range of motion, and a parental visual analogue scale. Seven affected hands in four patients underwent single-stage release of adjacent webspaces. In all cases, the CT angiogram correctly predicted the presence of at least one artery supplying each digit. There were no cases of digital ischemia or loss. Angiographically guided, single-stage release of adjacent webspaces is technically feasible and benefits patients by reducing the number of surgical stages and allowing complete release to be achieved at an earlier age compared with the standard multi-stage approach. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- S L Hynes
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - I Harvey
- Department of Plastic and Reconstructive Surgery, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - K Thomas
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - J Copeland
- Department of Rehabilitation Services, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - G H Borschel
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Allsop DJ, Lintzeris N, Copeland J, Dunlop A, McGregor IS. Cannabinoid replacement therapy (CRT): Nabiximols (Sativex) as a novel treatment for cannabis withdrawal. Clin Pharmacol Ther 2015; 97:571-4. [DOI: 10.1002/cpt.109] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/05/2015] [Indexed: 11/08/2022]
Affiliation(s)
- DJ Allsop
- Psychopharmacology Laboratory; School of Psychology, Faculty of Science, University of Sydney; NSW Australia
- Discipline of Addiction Medicine, Faculty of Medicine; University of Sydney; NSW Australia
| | - N Lintzeris
- Discipline of Addiction Medicine, Faculty of Medicine; University of Sydney; NSW Australia
- Drug and Alcohol Services, South East Sydney Local Health District, New South Wales Health; NSW Australia
| | - J Copeland
- National Cannabis Prevention and Information Centre; UNSW Medicine; Australia
| | - A Dunlop
- Drug & Alcohol Clinical Services; Hunter New England Local Health District, New South Wales Ministry of Health; Australia
- School of Medicine and Public Health, Faculty of Health, University of Newcastle; Australia
| | - IS McGregor
- Psychopharmacology Laboratory; School of Psychology, Faculty of Science, University of Sydney; NSW Australia
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Banbury A, Zask A, Carter SM, van Beurden E, Tokley R, Passey M, Copeland J. Smoking mull: a grounded theory model on the dynamics of combined tobacco and cannabis use among adult men. Health Promot J Austr 2014; 24:143-50. [PMID: 24168742 DOI: 10.1071/he13037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 08/23/2013] [Indexed: 11/23/2022] Open
Abstract
ISSUE ADDRESSED Australians' use of cannabis has been increasing. Over a third of Australians (35.4%) have used cannabis at some time in their lives and 10.3% are recent users. Almost two-thirds of cannabis users combine cannabis with tobacco. The aim of this study was to understand the process of mulling - smoking tobacco and cannabis together - using a grounded theory approach. METHODS Twenty-one in-depth semistructured interviews were conducted with men aged 25-34 and living on the North Coast of New South Wales. Interviews explored participants' smoking practices, histories and cessation attempts. RESULTS A model describing mulling behaviour and the dynamics of smoking cannabis and tobacco was developed. It provides an explanatory framework that demonstrates the flexibility in smoking practices, including substance substitution - participants changed the type of cannabis they smoked, the amount of tobacco they mixed with it and the devices they used to smoke according to the situations they were in and the effects sought. CONCLUSION Understanding these dynamic smoking practices and the importance of situations and effects, as well as the specific role of tobacco in mulling, may allow health workers to design more relevant and appropriate interventions. SO WHAT? Combining tobacco with cannabis is the most common way of smoking cannabis in Australia. However, tobacco cessation programmes rarely address cannabis use. Further research to develop evidence-based approaches for mull use would improve cessation outcomes.
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Affiliation(s)
- A Banbury
- Southern Cross University, Lismore, NSW 2480, Australia
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Torregrossa G, Gerosa G, Tarzia V, Vida V, Duveau D, Arabia F, Leprince P, Kasirajan V, Beyersdof F, Loforte A, Musumeci F, Hetzer R, Krabatsch T, Gummert J, Morshuis M, Copeland J. Long Term Results with Total Artificial Heart: Is It Prime Time for Destination Therapy? J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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14
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Osmun WE, Copeland J, Boisvert L. Mammography screening: how far is too far? Rural Remote Health 2013; 13:2149. [PMID: 23406261] [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: 06/01/2023] Open
Abstract
INTRODUCTION This study answers the question: 'How far must a Canadian woman travel before the risk of a motor vehicle accident (MVA) outweighs the benefits of mammography screening?'. METHODS Numbers needed to screen and false positive rates were extracted from information in the breast screening guidelines from the Canadian Task Force on screening for breast cancer. Motor vehicle accidents per billion vehicle kilometres were extracted from Transport Canada. The charts of women undergoing screening mammograms were reviewed to determine the average number of extra trips generated from a false positive mammogram. A formula was devised to determine when the distance travelled and risk of MVA outweighed the benefits of mammogram screening. RESULTS How far a woman would need travel before the risk of that travel outweighed the benefits of screening mammography is determined by the province in which she lives (location) and her age. The distance of a round trip before the risk of travel outweighed the benefit of screening mammography varied from 65 km to 1151 km, according the patient's age and location. CONCLUSION Travel risk is rarely discussed in recommending screening examinations. Nevertheless the benefits of screening can be outweighed by the risk of travel. Knowledge of travel risk is essential before recommending screening procedures.
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Affiliation(s)
- W E Osmun
- University of Western Ontario, London, Ontario, Canada
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15
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Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 2010; 97:1638-45. [PMID: 20629110 DOI: 10.1002/bjs.7160] [Citation(s) in RCA: 692] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The UK Medical Research Council CLASICC trial assessed the safety and efficacy of laparoscopically assisted surgery in comparison with open surgery for colorectal cancer. The results of the 5-year follow-up analysis are presented. METHODS Five-year outcomes were analysed and included overall and disease-free survival, and local, distant and wound/port-site recurrences. Two exploratory analyses were performed to evaluate the effect of age (70 years or less, or more than 70 years) on overall survival between the two groups, and the effect of the learning curve. RESULTS No differences were found between laparoscopically assisted and open surgery in terms of overall survival, disease-free survival, and local and distant recurrence. Wound/port-site recurrence rates in the laparoscopic arm remained stable at 2.4 per cent. Conversion to open operation was associated with significantly worse overall but not disease-free survival, which was most marked in the early follow-up period. The effect of surgery did not differ between the age groups, and surgical experience did not impact on the 5-year results. CONCLUSION The 5-year analyses confirm the oncological safety of laparoscopic surgery for both colonic and rectal cancer. The use of laparoscopic surgery to maximize short-term outcomes does not compromise the long-term oncological results. REGISTRATION NUMBER ISRCTN74883561 (http://www.controlled-trials.com).
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Affiliation(s)
- D G Jayne
- Section of Translational Anaesthesia and Surgery, Leeds Institute of Molecular Medicine, St James's University Hospital, Leeds, UK.
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Doan J, Wade R, Brown L, Copeland J. 206 WALKING, WORK ACTIVITY, AND MUSCULOSKELETAL HEALTH EXPERIENCED IN BRIDGE EMPLOYMENT. Parkinsonism Relat Disord 2010. [DOI: 10.1016/s1353-8020(10)70207-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hughes K, Downing J, Bellis MA, Dillon P, Copeland J. The sexual behaviour of British backpackers in Australia. Sex Transm Infect 2009; 85:477-82. [DOI: 10.1136/sti.2009.036921] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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20
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Copeland J, Howard J, Fleischmann S. Gender, HIV knowledge and risk-taking behaviour among substance using adolescents in custody in New South Wales. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/14659899809053503] [Citation(s) in RCA: 2] [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: 11/13/2022]
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21
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Swift W, Copeland J. Treatment needs of women with alcohol and other drug problems: experiences and views of Australian treatment personnel. Drug Alcohol Rev 2009; 17:59-67. [PMID: 16203469 DOI: 10.1080/09595239800187601] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
One hundred treatment personnel completed a structured interview as part of an Australian national study of the treatment needs of women with alcohol and other drug problems. The aim of the survey was to ascertain personnel's experiences of, and beliefs about providing services to women. Respondents had a broad range of qualifications and experience, and were generally supportive of provision of gender-sensitive services to women. The interview addressed a number of issues, including: barriers to treatment access, ability to provide gender-sensitive services, appropriateness of women-only services, and addressing sexual abuse issues. It is concluded that while many agencies attempted to provide appropriate services for women, many experienced difficulties, such as a lack of resources and funding. There is a continuing need for research into the best method of service delivery for women.
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Affiliation(s)
- W Swift
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
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Abstract
Cannabis is the most widely used illicit substance in the world. Estimates suggest that approximately 10-20% of cannabis users meet criteria for cannabis dependence and a significant proportion experience withdrawal discomfort on cessation of use. To date, there has been an absence of any clinically validated treatments to manage withdrawal. The current study is an open-label trial exploring the utility of lithium carbonate for the management of cannabis withdrawal symptoms in treatment seeking adult humans. In total, 20 participants were recruited to the study (19 men). All met DSM-IV cannabis-dependence criteria and had been smoking cannabis daily or almost daily for a mean 9 years. Participants were admitted to an inpatient detoxification facility and prescribed lithium 500 mg b.d. for 7 days. Cannabis withdrawal was assessed daily with the Marijuana Withdrawal Checklist (MWC). Two participants were withdrawn from the trial because of possible adverse effects. Sixty percent of participants completed the 7-day treatment program. Follow-up was conducted at a mean of 107 days following treatment. The mean percentage of days abstinent in the period between treatment cessation and follow-up was 87.57%. Twenty-nine percent of participants (n=5) reported continuous abstinence that was biochemically verified at follow-up. Agreement between self-reported cannabis use and urinalysis at follow-up was moderate (kappa=0.47). Significant reductions in symptoms of depression and anxiety and cannabis-related problems were also reported. This study provides evidence for the potential clinical utility and safety of lithium in the management of cannabis withdrawal. A randomised, placebo-controlled trial is recommended.
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Affiliation(s)
- A R Winstock
- National Drug and Alcohol Research Centre, University of New South Wales, and Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
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MESH Headings
- Antibodies, Monoclonal/analysis
- Antibodies, Monoclonal, Murine-Derived
- Antigens, CD34/analysis
- Biomarkers, Tumor
- Fluorescent Antibody Technique, Direct
- Hemangioma, Capillary/chemistry
- Hemangioma, Capillary/pathology
- Hemangioma, Cavernous/chemistry
- Hemangioma, Cavernous/pathology
- Humans
- Lung/blood supply
- Lung/chemistry
- Lung/pathology
- Lung Neoplasms/chemistry
- Lung Neoplasms/pathology
- Lymphangioma/chemistry
- Lymphangioma/pathology
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Thorpe H, Jayne DG, Guillou PJ, Quirke P, Copeland J, Brown JM. Patient factors influencing conversion from laparoscopically assisted to open surgery for colorectal cancer. Br J Surg 2008; 95:199-205. [PMID: 17696215 DOI: 10.1002/bjs.5907] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [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: 12/14/2022]
Abstract
BACKGROUND Intraoperative conversion from laparoscopically assisted to open surgery for colorectal cancer is thought to be influenced by several patient factors. Analysis of the Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer (CLASICC) Trial data aimed to identify these risk factors. METHODS Of 488 laparoscopically assisted procedures attempted, 143 (29.3 per cent) were converted to open operation. Patient factors considered in multivariable analyses were age, sex, previous abdominal incisions, body mass index (BMI), tumour site, tumour diameter, pathological tumour (pT) and pathological node (pN) stage, extent of tumour spread from the muscularis propria, liver and peritoneal metastases, and American Society of Anesthesiologists (ASA) grade. As BMI was missing for 30.7 per cent of patients, two approaches were employed: one considered BMI as a possible risk factor and one did not. RESULTS When BMI was taken into consideration, male sex (odds ratio (OR) 2.07; P = 0.020), BMI (OR 1.10; P = 0.006) and extent of tumour spread from the muscularis propria (OR 1.08; P < 0.001) were independent predictors of conversion. When BMI was not considered, extent of tumour spread (OR 1.07; P < 0.001) and male sex (OR 2.05; P = 0.004) were again identified, as were tumour site (OR 2.11; P = 0.005) and ASA grade (II versus I, OR 0.92; III versus I, OR 2.74; P = 0.012). CONCLUSION Intraoperative conversion is more likely with larger BMI, in men, patients with rectal cancer, those graded ASA III or when there is greater local tumour spread.
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Affiliation(s)
- H Thorpe
- Clinical Trials Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Leeds UK.
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26
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Frewen A, Arcuri A, Britt H, Copeland J, Harrison C. Management of Cannabis and Psychostimulant Use among General Practice Patients. Aust J Prim Health 2008. [DOI: 10.1071/py08045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
While regular and heavy cannabis and psychostimulant use has been associated with significant health and psychological impairments, the extent to which their use is being identified and managed by general practitioners (GPs) remains unclear. The aim of this study was to explore the management of cannabis- and psychostimulant-related problems in Australian general practice. Data from the Bettering the Evaluation and Care of Health (BEACH) study of general practice between April 2000 and March 2007 were analysed. BEACH is an ongoing national study of general practice activity in Australia. It was estimated that during this period GPs in Australia managed illicit drug use about 55,000 times per year and that cannabis and psychostimulants made up 3.2% and 1.6%, respectively, of all encounters at which the illicit drug was specified. The only difference in patient demographics between patients in the two drug groups was that cannabis users were younger than psychostimulant users. Cannabis users were more likely to be managed concurrently for psychotic symptoms but less likely to be treated with antipsychotics. Conversely, patients using psychostimulants were more likely to be prescribed an antipsychotic and/or an anxiolytic for their presenting drug problem. These results suggest that GPs do manage problematic cannabis and psychostimulant use among their patients, and thus should be supported in carrying out appropriate screening, intervention and referral.
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Penrose L, Seller M, Jabara S, Overley S, Copeland J, Prien S. Subtle changes in culture environmental temperature appear to affect spermatozoan physiology. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.251] [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: 12/01/2022]
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Franks PJ, Bosanquet N, Thorpe H, Brown JM, Copeland J, Smith AMH, Quirke P, Guillou PJ. Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer 2006; 95:6-12. [PMID: 16755298 PMCID: PMC2360504 DOI: 10.1038/sj.bjc.6603203] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The short-term clinical results of the CLASICC trial indicated that clinical outcomes were similar between laparoscopic and open approaches. This study presents the short-term (3 month) cost analysis undertaken on a subset of patients entered into the CLASICC trial (682 of 794 patients). As expected the costs associated with the operation were higher in the 452 patients randomised to laparoscopic surgery (lap) compared with the 230 randomised to open procedure (open), £1703 vs £1386. This was partially offset by the other hospital (nontheatre) costs, which were lower in the lap group (£2930 vs £3176). The average cost to individuals for reoperations was higher in the lap group (£762 vs £553). Overall costs were slightly higher in the lap group (£6899 vs £6631), with mean difference of £268 (95%CI −689 to 1457). Sensitivity analysis made little difference to these results. The cost of rectal surgery was higher than for colon, for lap (£8259 vs £5586) and open procedures (£7820 vs £5503). The short-term cost analysis for the CLASICC trial indicates that the costs of either laparoscopic or open procedure were similar, lap surgery costing marginally more on average than open surgery.
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Affiliation(s)
- P J Franks
- Centre for Research & Implementation of Clinical Practice, Thames Valley University, 32-38 Uxbridge Road, London, W5 2BS, UK.
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Greiten L, Copeland J, Bose R, Sethi G. A Clinical Study of the Efficacy of the Therapeutic Application of Platelet-Rich Plasma Gel on the Saphenous Vein Harvest Site in Coronary Artery Bypass Grafting. J Investig Med 2006. [DOI: 10.1177/108155890605402s105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- L.E. Greiten
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
| | - J. Copeland
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
| | - R. Bose
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
| | - G. Sethi
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
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Greiten LE, Copeland J, Bose R, Sethi G. 26 A CLINICAL STUDY OF THE EFFICACY OF THE THERAPEUTIC APPLICATION OF PLATELET-RICH PLASMA GEL ON THE SAPHENOUS VEIN HARVEST SITE IN CORONARY ARTERY BYPASS GRAFTING. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0015.104] [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: 11/18/2022]
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Greiten L, Copeland J, Bose R, Sethi G. A Clinical Study of the Efficacy of the Therapeutic Application of Platelet-Rich Plasma gel on the Saphenous vein Harvest Site in Coronary Artery Bypass Grafting. J Investig Med 2006. [DOI: 10.1177/108155890605401s94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- L.E. Greiten
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
| | - J. Copeland
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
| | - R. Bose
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
| | - G. Sethi
- Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ
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Greiten LE, Copeland J, Bose R, Sethi G. 211 A CLINICAL STUDY OF THE EFFICACY OF THE THERAPEUTIC APPLICATION OF PLATELET-RICH PLASMA GEL ON THE SAPHENOUS VEIN HARVEST SITE IN CORONARY ARTERY BYPASS GRAFTING. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0004.210] [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: 11/18/2022]
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Copeland J, Rankin J. Maximizing the opportunity for a national minimum data set. Drug Alcohol Rev 2005; 16:205-6. [PMID: 16203428 DOI: 10.1080/09595239800187371] [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: 10/25/2022]
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Lichtenthal P, Phillips R, Sloniger J, Copeland J. Crit Care 2005; 9:P67. [DOI: 10.1186/cc3130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bourbon A, Vionnet M, Leprince P, Vaissier E, Copeland J, McDonagh P, Debré P, Gandjbakhch I. The effect of methylprednisolone treatment on the cardiopulmonary bypass-induced systemic inflammatory response. Eur J Cardiothorac Surg 2004; 26:932-8. [PMID: 15519185 DOI: 10.1016/j.ejcts.2004.07.044] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2003] [Revised: 05/18/2004] [Accepted: 07/01/2004] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Cardiac surgery with cardiopulmonary bypass (CPB) is associated with an inflammatory response caused by contact of blood with artificial surfaces of the extracorporeal circuit, ischemia-reperfusion injury, and release of endotoxin. The inflammatory reaction involves activation of complement leucocytes, and endothelial cells with secretion of cytokines, proteases, arachidonic acid metabolites, and generation of oxygen derived free radicals (OFR) by polymorphonuclear neutrophils (PMN). Although this inflammatory response to CPB often remains at subclinical levels, it can also lead to major organ dysfunction. A number of studies have demonstrated that treatment of patients with a high-dose (30 mg/kg) of corticosteroids (methylprednisolone) attenuates the CPB-induced SIR and improves the outcome of patients undergoing cardiac surgery. However, large doses of steroids can cause abnormal metabolic responses such as metabolic acidosis and hyperglycemia. In the present study, we examined the efficacy of low doses of methylprednisolone (5 and 10 mg/kg) to attenuate the CPB-induced inflammatory response, during and after heart operations. METHODS Thirty-six adult patients undergoing cardiac surgery, were randomized into three groups: (1) control group: group A; (2) methylprednisolone, 5 mg/kg body weight: group B; and (3) methylprednisolone, 10 mg/kg body weight: group C. Plasma levels of the cytokines interleukin-6 (IL-6) and TNF-alpha were analyzed by enzyme-linked immunosorbent assay, before, during, and after CPB. OFR production was determined by cytofluorometry (FACS) at the same end points. RESULTS No significant differences in age, body weight, CPB time, and cross-clamp time were observed among the three groups. CPB induced a marked increased in cytokine release and OFR generation. Low-dose of methylprednisolone (5 mg/kg) effectively reduced the increase in TNF-alpha and IL-6 secretion (P<0.05 compared to control group) after release of the cross-clamp. However, OFR generation was significantly reduced with a greater dose of methylprednisolone (10 mg/kg). CONCLUSIONS The results indicate that a single low-dose of methylprednisolone (10 mg/kg) reduces the inflammatory reaction during and after CPB, by inhibition of proinflammatory cytokine release and OFR generation after release of the aortic cross-clamp.
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Affiliation(s)
- A Bourbon
- Service de chirurgie thoracique et cardio-vasculaire, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'hôpital, 75013 Paris, France
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Müller AM, Copeland J, Franke FE, Müller KM. Expression von CD31, CD34 und CD143 in benignen und malignen primären pulmonalen Gefäßtumoren. Pneumologie 2004. [DOI: 10.1055/s-2004-819515] [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: 10/19/2022]
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Golovin A, Oldfield TJ, Tate JG, Velankar S, Barton GJ, Boutselakis H, Dimitropoulos D, Fillon J, Hussain A, Ionides JMC, John M, Keller PA, Krissinel E, McNeil P, Naim A, Newman R, Pajon A, Pineda J, Rachedi A, Copeland J, Sitnov A, Sobhany S, Suarez-Uruena A, Swaminathan GJ, Tagari M, Tromm S, Vranken W, Henrick K. E-MSD: an integrated data resource for bioinformatics. Nucleic Acids Res 2004; 32:D211-6. [PMID: 14681397 PMCID: PMC308812 DOI: 10.1093/nar/gkh078] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [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: 11/14/2022] Open
Abstract
The Macromolecular Structure Database (MSD) group (http://www.ebi.ac.uk/msd/) continues to enhance the quality and consistency of macromolecular structure data in the Protein Data Bank (PDB) and to work towards the integration of various bioinformatics data resources. We have implemented a simple form-based interface that allows users to query the MSD directly. The MSD 'atlas pages' show all of the information in the MSD for a particular PDB entry. The group has designed new search interfaces aimed at specific areas of interest, such as the environment of ligands and the secondary structures of proteins. We have also implemented a novel search interface that begins to integrate separate MSD search services in a single graphical tool. We have worked closely with collaborators to build a new visualization tool that can present both structure and sequence data in a unified interface, and this data viewer is now used throughout the MSD services for the visualization and presentation of search results. Examples showcasing the functionality and power of these tools are available from tutorial webpages (http://www. ebi.ac.uk/msd-srv/docs/roadshow_tutorial/).
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Affiliation(s)
- A Golovin
- EMBL Outstation, European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SD, UK
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Müller AM, Copeland J, Müller KM. ACE-Expression in benignen und malignen pulmonalen Gefäßtumoren. Pneumologie 2003. [DOI: 10.1055/s-2003-815335] [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: 10/19/2022]
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Müller AM, Copeland J, Müller KM. ACE-Expression in benignen und malignen pulmonalen Gefäßtumoren. Pneumologie 2003. [DOI: 10.1055/s-2003-822440] [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: 10/19/2022]
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Abstract
Young offenders have numerous problems, including increased psychopathology, housing, and psycho-social stresses and increased rates of substance abuse. The current study investigated the contribution that substance use might make to a particularly vulnerable group of young people. Of the 300 young people approached for the study, 23.7% reported a prior suicide attempt. For this group, the most significant predictors of a prior suicide attempt were negative affect, prior exposure to violence, and housing stress. Life-time substance-use variables were most predictive of the number of suicide attempts a young person might make. Self-reported lethality (the expectation that on the last attempt the young person expected to die) was not strongly predicted by any variable. The research identifies the important role that dynamic risk factors (such as mood, substance use, and psychosocial stressors) play in increasing the risk of self-harm for young offenders, and raises the need to provide for more comprehensive discharge planning and support in order to manage these needs.
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Boutselakis H, Dimitropoulos D, Fillon J, Golovin A, Henrick K, Hussain A, Ionides J, John M, Keller PA, Krissinel E, McNeil P, Naim A, Newman R, Oldfield T, Pineda J, Rachedi A, Copeland J, Sitnov A, Sobhany S, Suarez-Uruena A, Swaminathan J, Tagari M, Tate J, Tromm S, Velankar S, Vranken W. E-MSD: the European Bioinformatics Institute Macromolecular Structure Database. Nucleic Acids Res 2003; 31:458-62. [PMID: 12520052 PMCID: PMC165512 DOI: 10.1093/nar/gkg065] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2002] [Accepted: 10/03/2002] [Indexed: 11/14/2022] Open
Abstract
The E-MSD macromolecular structure relational database (http://www.ebi.ac.uk/msd) is designed to be a single access point for protein and nucleic acid structures and related information. The database is derived from Protein Data Bank (PDB) entries. Relational database technologies are used in a comprehensive cleaning procedure to ensure data uniformity across the whole archive. The search database contains an extensive set of derived properties, goodness-of-fit indicators, and links to other EBI databases including InterPro, GO, and SWISS-PROT, together with links to SCOP, CATH, PFAM and PROSITE. A generic search interface is available, coupled with a fast secondary structure domain search tool.
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Affiliation(s)
- H Boutselakis
- EMBL Outstation, The European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SD, UK
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Abstract
Young offenders have numerous problems, including increased psychopathology, housing, and psycho-social stresses and increased rates of substance abuse. The current study investigated the contribution that substance use might make to a particularly vulnerable group of young people. Of the 300 young people approached for the study, 23.7% reported a prior suicide attempt. For this group, the most significant predictors of a prior suicide attempt were negative affect, prior exposure to violence, and housing stress. Life-time substance-use variables were most predictive of the number of suicide attempts a young person might make. Self-reported lethality (the expectation that on the last attempt the young person expected to die) was not strongly predicted by any variable. The research identifies the important role that dynamic risk factors (such as mood, substance use, and psychosocial stressors) play in increasing the risk of self-harm for young offenders, and raises the need to provide for more comprehensive discharge planning and support in order to manage these needs.
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Nasir A, Copeland J, Gillespie JW, Chughtai OR, Andrawis R, Kaiser HE, Manyak MJ. Preneoplastic lesions of the prostate-clinical, pathological and molecular biological aspects. In Vivo 2002; 16:557-66. [PMID: 12494901] [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: 02/28/2023]
Abstract
Needle biopsy is the mainstay of definitive diagnosis of prostate cancer (PCA). While prostate-specific antigen (PSA) screening has facilitated early diagnosis of PCA, it has also resulted in an increase in the proportion of prostate biopsies showing various preneoplastic lesions (PNLs). At times such lesions are the sole finding in the limited amount of tissue available for assessment in an individual biopsy. Hence accurate identification of these lesions is important to avoid errors in the diagnosis of prostatic malignancy and in patient management. Furthermore, some interesting observations have been made regarding the molecular biological aspects of various PNLs during the last decade. In parallel with anatomic and physiological differences in various human races, racial differences have also been observed regarding the incidence of prostatic intra-epithelial neoplasia. This review focuses on prostatic intraepithelial neoplasia (PIN), atypical adenomatous hyperplasia (AAH) and atypical prostatic glands or atypical small acinar proliferation (ASAP) as putative preneoplastic lesions of the prostate. These lesions are reviewed with reference to their overall incidence, histopathological findings, histological differential diagnosis, clinical significance and molecular biological aspects.
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Affiliation(s)
- A Nasir
- International Society for the Study of Comparative Oncology Inc., Silver Spring, Maryland 20901, USA
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Copeland J, Swift W, Roffman R, Stephens R. A randomized controlled trial of brief cognitive-behavioral interventions for cannabis use disorder. J Subst Abuse Treat 2001; 21:55-64; discussion 65-6. [PMID: 11551733 DOI: 10.1016/s0740-5472(01)00179-9] [Citation(s) in RCA: 172] [Impact Index Per Article: 7.5] [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: 11/26/2022]
Abstract
The increasing demand for treatment for cannabis dependence in Australia and internationally has led to the identification of significant gaps in knowledge of effective interventions. A randomized controlled trial of brief cognitive-behavioral interventions (CBT) for cannabis dependence was undertaken to address this issue. A total of 229 participants were assessed and randomly assigned to either a six-session CBT program (6CBT), a single-session CBT intervention (1CBT), or a delayed-treatment control (DTC) group. Participants were assisted in acquiring skills to promote cannabis cessation and maintenance of abstinence. Participants were followed-up a median of 237 days after last attendance. Participants in the treatment groups reported better treatment outcomes than the DTC group. They were more likely to report abstinence, were significantly less concerned about their control over cannabis use, and reported significantly fewer cannabis-related problems than those in the DTC group. Those in the 6CBT group also reported more significantly reduced levels of cannabis consumption than the DTC group. While the therapist variable had no effect on any outcome, a secondary analysis of the 6CBT and 1CBT groups showed that treatment compliance was significantly associated with decreased dependence and cannabis-related problems. This study supports the attractiveness and effectiveness of individual CBT interventions for cannabis use disorders and the need for multisite replication trials.
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Affiliation(s)
- J Copeland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney 2052, Australia.
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McDonagh P, Cerney K, Hokama J, Lai G, Gonzales R, Davis-Gorman G, Copeland J. Perflubron emulsion reduces inflammation during extracorporeal circulation. J Surg Res 2001; 99:7-16. [PMID: 11421598 DOI: 10.1006/jsre.2001.6141] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 11/22/2022]
Abstract
The recovery from cardiac surgery and cardiopulmonary bypass can be complicated by an acute inflammatory response. Circulating blood through an extracorporeal circuit (ECC) contributes to this complication. Perfluorocarbon-based blood substitutes (PFCs) are under investigation for use as a component of the ECC "prime" solution, because PFCs increase the oxygen-carrying capacity of the diluted blood. Some PFCs may provide the additional benefit of attenuating the ECC-induced inflammatory response. Earlier, we reported that perflubron emulsion (PFE, Alliance Pharmaceutical Corp.) reduced neutrophil (PMN) activation in vivo. However, the potential of PFE to reduce ECC-induced PMN activation has not been investigated. In this study, we used a small-scale ECC model to quantify the extent of PMN activation during circulation and to examine if PFE treatment attenuated PMN activation. ECC circuits were filled with a mixture of blood and Plasmalyte. Two groups were studied: an untreated group containing blood plus PlasmaLyte and a treated group in which some of the Plasmalyte was substituted with PFE (4.5 g/100 ml). Hematology and measures of whole blood PMN activation were made from blood samples taken periodically throughout the 120-min ECC circulation period. We found, for the untreated group, a significant decrease in the number of circulating PMNs and an increase in PMN activation with time. PMN activation was demonstrated as a significant increase in the expression of the PMN adhesion protein CD11b (P < 0.05) and an increase in PMN oxygen free radical production (reactive oxygen species (ROS)). After 120 min of circulation, the PMNs remained capable of a significant response to a second inflammatory stimulus, but PFE treatment significantly attenuated the fMLP-induced increase in PMN ROS at t = 120 min (P < 0.05). These results suggest that PFE may have dual utility in cardiac surgery, to increase oxygen delivery and to serve as an antiinflammatory agent.
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Affiliation(s)
- P McDonagh
- Department of Surgery, Cardiovascular and Thoracic Surgery, Tucson, Arizona 85718, USA.
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Livingston G, Kitchen G, Manela M, Katona C, Copeland J. Persecutory symptoms and perceptual disturbance in a community sample of older people: the Islington study. Int J Geriatr Psychiatry 2001; 16:462-8. [PMID: 11376461 DOI: 10.1002/gps.362] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND While there are extensive studies of paranoid symptoms and perceptual disturbance (PPD) in younger adults, relatively little is known about older adults with similar symptoms. METHOD This study took place in Islington, an inner London borough. Enumeration Districts were randomised to provide a sampling frame. Residents aged 65 or over were interviewed at home. The Short-CARE was used to elicit psychiatric symptoms and diagnosis. Sociodemographic particulars were elicited using the Client Sociodemographic and Service Receipt Inventory. Questions were asked regarding sight and hearing. We used subsections of the geriatric mental scale to identify people who had PPD symptoms. Medications taken were recorded. We asked 'Do you have any health problems?' as a screening question for subjective health problems. RESULTS We interviewed 720 people. Twenty-eight (3.9%) participants scored positively on the PPD sub-scales of the GMS. A forward logistic regression analysis for independent predictors of PPD found the significant independent predictors were dementia (p = 0.0000; odds ratio 6.8), drinking alcohol in last 6 months (p < 0.03; odds ratio 0.3), drinking alcohol to help sleep (p < 0.005; odds ratio 9.6), subjective memory loss (p < 0.007; odds ratio 3.3) and uncorrected visual impairment (p < 0.02; odds ratio 2.8). CONCLUSION There is a relatively high prevalence of PPD in older people living in the community. This is not associated with higher use of services despite the increased needs. Further studies should consider interventions to meet this unmet need.
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Affiliation(s)
- G Livingston
- Senior Lecturer in Psychiatry, Royal Free and University College Medical School, Department of Psychiatry and Behavioural Sciences, London, UK.
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Eisen HJ, Hobbs RE, Davis SF, Carrier M, Mancini DM, Smith A, Valantine H, Ventura H, Mehra M, Vachiery JL, Rayburn BK, Canver CC, Laufer G, Costanzo MR, Copeland J, Dureau G, Frazier OH, Dorent R, Hauptman PJ, Kells C, Masters R, Michaud JL, Paradis I, Renlund DG, Vanhaecke J, Mellein B, Mueller EA. Safety, tolerability, and efficacy of cyclosporine microemulsion in heart transplant recipients: a randomized, multicenter, double-blind comparison with the oil-based formulation of cyclosporine--results at 24 months after transplantation. Transplantation 2001; 71:70-8. [PMID: 11211198 DOI: 10.1097/00007890-200101150-00012] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [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: 11/26/2022]
Abstract
BACKGROUND The widespread use of cyclosporine has improved the survival of cardiac transplant patients as a result of reduced morbidity and mortality from rejection and infection. The original oil-based form of cyclosporine demonstrated unpredictable absorption resulting in an increased frequency of acute and chronic rejection in patients with poor bioavailability. The primary end. points of the present, prospective, randomized multicenter, double-blind trial were to compare the efficacy of the micro-emulsion form of cycolsporine (CsA-NL) with the oil-based formulation as determined by cardiac allograft and recipient survival and the incidence and severity of the acute rejection episodes and to determine the safety and tolerability of CsA-NL compared with Sandimmune CsA-(SM) in the study population. The 6-month analysis of the study showed reduced number of CsA-NL patients requiring antilymphocyte antibody therapy for rejection, fewer International Society of Heart and Lung Transplantation grade > or =3A rejections in female patients and fewer infections. Our report represents the final analysis of the results 24 months after transplantation. METHODS A total of 380 patients undergoing de novo cardiac transplants at 24 centers in the United States, Canada, and Europe were enrolled in this double-blind, randomized trial evaluating the efficacy and safety of CsA-NL versus CsA-SM. Acute allograft rejection was diagnosed by endomyocardial biopsy and graded according to the International Society of Heart and Lung Transplantation nomenclature. Kaplan-Meier analysis and Fisher's exact test were used for comparisons between groups. RESULTS After 24 months, allograft and recipient survival were identical in both groups. There were fewer CsA-NL patients (6.9%) requiring antilymphocyte antibody therapy for rejection than in the CsA-SM-treated patient group (17.7%, P=0.002). There were fewer discontinuations of study drug for treatment failures in the CsA-NL groups (7; 3.7%) compared with the CsA-SM group (18; 9.4%, P=0.037). The average corticosteroid dose was lower in the CsA-NL group (0.37 mg/kg/day) compared with the CsA-SM group (0.48 mg/kg/day, P=0.034) over the 24-month study period. Overall, there was no difference in blood pressure or creatinine between the two study groups. CONCLUSIONS The final results of this multi-center, randomized study of two forms of cyclosporine confirmed that there were fewer episodes of rejection requiring antilymphocyte antibodies and fewer study discontinuations for treatment failures in CsA-NL-treated patients compared to those treated with CsA-SM. The use of CsA-NL did not predispose these patients to a higher risk of adverse events.
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Affiliation(s)
- H J Eisen
- Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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