1
|
Rice B, Hawkins J, Nakato S, Kamara N. Mortality after emergency unit fluid bolus in febrile Ugandan children. PLoS One 2023; 18:e0290790. [PMID: 37651354 PMCID: PMC10470955 DOI: 10.1371/journal.pone.0290790] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES Pediatric fluid resuscitation in sub-Saharan Africa has traditionally occurred in inpatients. The landmark Fluid Expansion as Supportive Therapy (FEAST) trial showed fluid boluses for febrile children in this inpatient setting increased mortality. As emergency care expands in sub-Saharan Africa, fluid resuscitation increasingly occurs in the emergency unit. The objective of this study was to determine the mortality impact of emergency unit fluid resuscitation on febrile pediatric patients in Uganda. METHODS This retrospective cohort study used data from 2012-2019 from a single emergency unit in rural Western Uganda to compare three-day mortality for febrile patients that did and did not receive fluids in the emergency unit. Propensity score matching was used to create matched cohorts. Crude and multivariable logistic regression analysis (using both complete case analysis and multiple imputation) were performed on matched and unmatched cohorts. Sensitivity analysis was done separately for patients meeting FEAST inclusion and exclusion criteria. RESULTS The analysis included 3087 febrile patients aged 2 months to 12 years with 1,526 patients receiving fluids and 1,561 not receiving fluids. The matched cohorts each had 1,180 patients. Overall mortality was 4.0%. No significant mortality benefit or harm was shown in the crude unmatched (Odds Ratio [95% Confidence Interval] = 0.88 [0.61-1.26] or crude matched (1.00 [0.66-1.50]) cohorts. Adjusted cohort analysis (including both complete case analysis and multiple imputation) and sensitivity analysis of patients meeting FEAST inclusion and exclusion criteria all also failed to show benefit or harm. Post-hoc power calculations showed the study was powered to detect the absolute harm seen in FEAST but not the relative risk increase. CONCLUSIONS This study's primary finding is that fluid resuscitation in the emergency unit did not significantly increase or decrease three-day mortality for febrile children in Uganda. Universally aggressive or fluid-sparing emergency unit protocols are unlikely to be best practices, and choices about fluid resuscitation should be individualized.
Collapse
Affiliation(s)
- Brian Rice
- Department of Emergency Medicine, Stanford University, Palo Alto, California, United States of America
- Global Emergency Care, Shrewsbury, Massachusetts, United States of America
| | - Jessica Hawkins
- Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School, Cambridge, Massachusetts, United States of America
| | - Serena Nakato
- Global Emergency Care, Shrewsbury, Massachusetts, United States of America
- Karoli Lwanga Hospital, Rukungiri, Uganda
| | | | | |
Collapse
|
2
|
Hawkins J. Quality Assurance: Compounding Record Audits for Error Prevention. Int J Pharm Compd 2023; 27:211-217. [PMID: 37267524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article looks at taking a proactive approach in discovering inconsistencies in pharmaceutical compounding at a facility level. Details on the requirements for master formulation and compounding records in nonsterile and sterile compounding as laid out in the 2022 publications of United States Pharmacopeia Chapter <795> Pharmaceutical Compounding- Nonsterile Preparations and United States Pharmacopeia Chapter <797> Pharmaceutical Compounding-Sterile Preparations are reviewed. Following this summary, information is then presented on how to utilize the record-keeping requirements to a facility's advantage through regular auditing and reporting and how to incorporate these audits or reports into a facility's quality-assurance program to fulfill error detection and prevention requirements.
Collapse
Affiliation(s)
- Jessica Hawkins
- U.S. Department of Veterans Affairs, Lexington VA Health Care System, Lexington, Kentucky.
| |
Collapse
|
3
|
Littlecott HJ, Moore GF, Evans RE, Melendez-Torres GJ, McCann M, Reed H, Mann M, Dobbie F, Jennings S, Donaldson C, Hawkins J. Perceptions of friendship, peers and influence on adolescent smoking according to tobacco control context: a systematic review and meta-ethnography of qualitative research. BMC Public Health 2023; 23:424. [PMID: 36869343 PMCID: PMC9983235 DOI: 10.1186/s12889-022-14727-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/25/2022] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND A relationship between smoking and interpersonal influences has been well established within the literature. There have been cultural shifts in denormalisation and a reduction in tobacco smoking in many countries. Hence there is a need to understand social influences on adolescents' smoking across smoking normalisation contexts. METHODS The search was conducted in July 2019 and updated in March 2022 within 11 databases and secondary sources. Search terms included schools, adolescents, smoking, peers, social norms and qualitative research. Screening was conducted by two researchers independently and in duplicate. Study quality was assessed using the eight-item Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-centre) tool for the appraisal of qualitative studies. Results were synthesised using a meta-narrative lens for meta-ethnography and compared across smoking normalisation contexts. RESULTS Forty one studies were included and five themes were developed, mapping onto the socio ecological model. The social processes by which adolescents take up smoking differed according to a mixture of school type, peer group structure and the smoking culture within the school, as well as the wider cultural context. Data available from smoking denormalised contexts, described changes in social interactions around smoking to cope with its stigmatisation. This was manifested through i) direct peer influence, whereby subtle techniques were employed, ii) group belonging whereby smoking was less likely to be seen as a key determinant of group membership and smoking was less commonly reported to be used as a social tool, and iii) popularity and identity construction, whereby smoking was perceived more negatively in a denormalised context, compared with a normalised context. CONCLUSIONS This meta-ethnography is the first study to demonstrate, drawing on international data, that peer processes in adolescent smoking may undergo changes as smoking norms within society change. Future research should focus on understanding differences across socioeconomic contexts, to inform the adaptation of interventions.
Collapse
Affiliation(s)
- H J Littlecott
- Pettenkofer School of Public Health (PSPH), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich, Elisabeth-Winterhalter-Weg 6, Munich, 81377, Germany. .,Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK.
| | - G F Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - R E Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), South Cloisters, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - M McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - H Reed
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - M Mann
- Specialist Unit for Review Evidence, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park Campus, Cardiff, CF14 4YS, UK
| | - F Dobbie
- Usher Institute- University of Edinburgh, Doorway 1, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - S Jennings
- Teaching and Learning for Health Professionals, Bristol Medical School, Faculty of Health Sciences, University of Bristol, 39-41 St Michael's Hill, Bristol, BS2 8EZ, UK
| | - C Donaldson
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - J Hawkins
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| |
Collapse
|
4
|
Hawkins J, Rangel UJS, Tesfaye A, Gebeyehu N, Weiser TG, Bitew S, Mammo TN, Starr N. Bridging the know-do gap in low-income surgical environments: Creating contextually appropriate training videos to promote safer surgery in Ethiopia. Surg Open Sci 2023; 11:40-44. [PMID: 36466047 PMCID: PMC9709099 DOI: 10.1016/j.sopen.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Although international guidelines exist for the prevention of surgical site infections, their implementation in diverse clinical contexts, especially in low and middle-income countries, is challenging due to the lack of available resources and organizational structure of facilities. The goal of this project was to develop a series of video training aids to highlight best practices in surgical infection prevention in hospitals with limited resources and to provide practical solutions to common challenges faced in these settings. Using the validated Clean Cut education framework for infection prevention developed by Lifebox, a charity devoted to improving surgical and anesthetic safety, we partnered with clinicians in one Ethiopian hospital to create six educational videos giving practical guidelines for infection prevention under resource variable conditions. These include: 1) proper use of the WHO Surgical Safety Checklist, 2) hand and skin antisepsis, 3) confirming instrument sterility, 4) maintaining the sterile field, 5) antibiotic prophylaxis, and 6) gauze counting. Gaps in available online educational materials were identified in each of the six areas. Videos were created providing setting-specific education and addressing gaps in existing materials for each of the infection prevention topics. These videos are now integrated into infection prevention curricula through Lifebox in Ethiopia and ongoing data collection to evaluate acceptability and efficacy is ongoing. Surgical education videos on infection prevention topics addressing location-specific resources and workarounds can be useful to hospitals operating in resource-limited settings for training staff and supporting quality and safety efforts in surgery.
Collapse
Affiliation(s)
- Jessica Hawkins
- Massachusetts General Hospital, Department of Anesthesia, United States of America
| | | | - Assefa Tesfaye
- St. Peter's Specialized Hospital, Department of Surgery, Ethiopia
| | | | - Thomas G. Weiser
- Stanford University School of Medicine, United States of America
- Stanford University, Department of Surgery, United States of America
- Lifebox Foundation, Ethiopia
| | | | | | - Nichole Starr
- Lifebox Foundation, Ethiopia
- University of California, San Francisco, Department of Surgery, United States of America
| |
Collapse
|
5
|
Pironon S, Cantwell-Jones A, Forest F, Ball J, Diazgranados M, Douglas R, Hawkins J, Howes MJR, Ulian T, Vaitla B, Collar D. Towards an action plan for characterizing food plant diversity. Nat Plants 2023; 9:34-35. [PMID: 36543935 DOI: 10.1038/s41477-022-01300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Affiliation(s)
- S Pironon
- Royal Botanic Gardens, Kew, Richmond, UK.
- UN Environment Programme World Conservation Monitoring Centre, Cambridge, UK.
| | - A Cantwell-Jones
- Science and Solutions for a Changing Planet DTP, Imperial College London, Ascot, UK
- Department of Life Sciences, Imperial College London, Ascot, UK
| | - F Forest
- Royal Botanic Gardens, Kew, Richmond, UK
| | - J Ball
- Royal Botanic Gardens, Kew, Richmond, UK
| | | | | | - J Hawkins
- School of Biological Sciences, University of Reading, Reading, UK
| | | | - T Ulian
- Royal Botanic Gardens, Kew, Richmond, UK
| | - B Vaitla
- Department of Nutrition, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - D Collar
- Department of Organismal and Environmental Biology, Christopher Newport University, Newport News, VA, USA
| |
Collapse
|
6
|
Akamatsu H, Yang JH, Wakuda K, Hawkins J, Yanes R, Homann O, Tan M, Finger E, Borghaei H. 384P Prevalence of fibroblast growth factor receptor 2b (FGFR2b) protein overexpression in squamous non-small cell lung cancer (sqNSCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.421] [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: 12/07/2022] Open
|
7
|
Chary A, Hawkins J, Flood D, Martinez B, Colom M, Austad K. Medical students' experiences of compulsory rural service in Guatemala: a qualitative study. Rural Remote Health 2022; 22:6582. [PMID: 35617739 DOI: 10.22605/rrh6582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Compulsory rural service is one method of addressing limitations in health care access in marginalized areas of low- and middle-income countries, including Guatemala. This study aimed to explore Guatemalan medical students' experiences of compulsory rural service and the impact of rural service on their professional development. METHODS Qualitative semi-structured interviews were conducted with 40 medical school graduates who completed compulsory rural service between 2012 and 2017. Interview transcripts were coded for dominant themes using an inductive approach. RESULTS The majority of interviewees felt that rural service contributed to their professional development by increasing their clinical autonomy, awareness of social determinants of health, and humanistic practice. Interviewees identified limited supervision as a key challenge during the rotation. The majority found rural service rewarding. CONCLUSION Guatemalan medical students felt that rural service contributed to their professional and personal development. Rural rotations build primary care skills and may increase awareness of health inequity among clinical trainees. Given ongoing healthcare worker shortages in Guatemala, innovative approaches to improving professional supervision and rural health mentoring are needed.
Collapse
Affiliation(s)
- Anita Chary
- Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala
| | - Jessica Hawkins
- Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala
| | - David Flood
- Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala
| | - Boris Martinez
- Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala
| | - Marcela Colom
- Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala
| | - Kirsten Austad
- Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala. Present address: Boston Medical Center, Boston, MA, USA
| |
Collapse
|
8
|
Burgess A, Hawkins J, Kostovski C, Duncanson K. Assessing cultural appropriateness of patient-reported outcome measures for Aboriginal people with diabetes: study protocol. Public Health Res Pract 2022; 32:31122105. [PMID: 35291000 DOI: 10.17061/phrp31122105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) provide patients with a platform to report on healthcare services and interventions, including the management of diabetes and other chronic diseases. Given the major disparity in incidence and prevalence of diabetes between Aboriginal and non-Aboriginal people, it is crucial that PROMs meet the cultural, spiritual and medical needs of this high-risk population. Anecdotal evidence indicates that PROMs do not capture accurate information about the healthcare of Aboriginal people with Type 2 diabetes. Therefore, the aim of this study is to explore the perceptions of Aboriginal people in regional New South Wales (NSW), Australia, about the cultural appropriateness of a set of PROMs relating to diabetes management. METHODS/DESIGN Up to 50 Aboriginal people aged 18 years or older with type 1 or type 2 diabetes living in the Shoalhaven region in NSW, will be recruited. Eligible, consenting participants will attend a focus group or individual interview where they will review the PROM tools (PROMIS 29 and PAID scale) currently used for diabetes management. Semi-structured questions will be used to gather information about PROMs and discussions will be recorded for analysis. Research team members will yarn about the data with Aboriginal co-researchers and community stakeholders to apply an Indigenous lens to coding and thematic analysis. CONCLUSION This study will explore the cultural appropriateness of government-initiated evaluation of health outcomes, and make recommendations about how these evaluations can be better suited to Aboriginal people. The lessons from this study will be of interest to those conducting research or quality assessment activities related to PROMs, and those involved with Aboriginal-focused research and project implementation.
Collapse
Affiliation(s)
- Alicia Burgess
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; High Risk Foot Service, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; Rural Research Capacity Building Program, Health Education and Training Institute, Sydney, Australia;
| | - Jessica Hawkins
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; High Risk Foot Service, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Catherine Kostovski
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; Aboriginal Chronic Care Unit, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Kerith Duncanson
- Rural and Remote Portfolio, Health Education and Training Institute, Sydney, Australia
| |
Collapse
|
9
|
Cole EJ, Phillips AL, Bentzley BS, Stimpson KH, Nejad R, Barmak F, Veerapal C, Khan N, Cherian K, Felber E, Brown R, Choi E, King S, Pankow H, Bishop JH, Azeez A, Coetzee J, Rapier R, Odenwald N, Carreon D, Hawkins J, Chang M, Keller J, Raj K, DeBattista C, Jo B, Espil FM, Schatzberg AF, Sudheimer KD, Williams NR. Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial. Am J Psychiatry 2022; 179:132-141. [PMID: 34711062 DOI: 10.1176/appi.ajp.2021.20101429] [Citation(s) in RCA: 183] [Impact Index Per Article: 91.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Depression is the leading cause of disability worldwide, and half of patients with depression have treatment-resistant depression. Intermittent theta-burst stimulation (iTBS) is approved by the U.S. Food and Drug Administration for the treatment of treatment-resistant depression but is limited by suboptimal efficacy and a 6-week duration. The authors addressed these limitations by developing a neuroscience-informed accelerated iTBS protocol, Stanford neuromodulation therapy (SNT; previously referred to as Stanford accelerated intelligent neuromodulation therapy, or SAINT). This protocol was associated with a remission rate of ∼90% after 5 days of open-label treatment. Here, the authors report the results of a sham-controlled double-blind trial of SNT for treatment-resistant depression. METHODS Participants with treatment-resistant depression currently experiencing moderate to severe depressive episodes were randomly assigned to receive active or sham SNT. Resting-state functional MRI was used to individually target the region of the left dorsolateral prefrontal cortex most functionally anticorrelated with the subgenual anterior cingulate cortex. The primary outcome was score on the Montgomery-Åsberg Depression Rating Scale (MADRS) 4 weeks after treatment. RESULTS At the planned interim analysis, 32 participants with treatment-resistant depression had been enrolled, and 29 participants who continued to meet inclusion criteria received either active (N=14) or sham (N=15) SNT. The mean percent reduction from baseline in MADRS score 4 weeks after treatment was 52.5% in the active treatment group and 11.1% in the sham treatment group. CONCLUSIONS SNT, a high-dose iTBS protocol with functional-connectivity-guided targeting, was more effective than sham stimulation for treatment-resistant depression. Further trials are needed to determine SNT's durability and to compare it with other treatments.
Collapse
Affiliation(s)
- Eleanor J Cole
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Angela L Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Brandon S Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Katy H Stimpson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Romina Nejad
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Fahim Barmak
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Clive Veerapal
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Naushaba Khan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Kirsten Cherian
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Emily Felber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Randi Brown
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Elizabeth Choi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Sinead King
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Heather Pankow
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - James H Bishop
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Azeezat Azeez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - John Coetzee
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Rachel Rapier
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Nicole Odenwald
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - David Carreon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Maureen Chang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Kristin Raj
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Flint M Espil
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Keith D Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| | - Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors except King and Sudheimer); U.S. Department of Veterans Affairs, Palo Alto, Calif. (Phillips, Azeez, Coetzee); Department of Psychology, Palo Alto University, Palo Alto, Calif. (Stimpson, Cherian, Felber, Brown, Choi); Centre for Neuroimaging and Cognitive Genomics, National University of Ireland, Galway (King); Department of Anatomy, School of Medicine, Southern Illinois University, Carbondale (Sudheimer)
| |
Collapse
|
10
|
McQuillan TJ, Vora M, Hawkins J, Kenney D, Diaz R, Ladd AL. Adhesive Taping Shows Better Cosmetic Outcomes Than Tissue Adhesives for Sutured Upper Extremity Incisions: A Single-Blind Prospective Randomized Controlled Trial. Orthopedics 2022; 45:e42-e46. [PMID: 34734780 DOI: 10.3928/01477447-20211101-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adhesive taping is commonly used to reinforce wound closure and approximate minor lacerations. Recently, tissue adhesives such as 2-octylcyanoacrylate have gained popularity because of their high tensile strength, bacteriostatic properties, and spontaneous peeling. We sought to evaluate the cosmetic result of upper extremity incisions closed primarily by subcuticular suture, randomizing the application of tissue adhesive vs adhesive taping to different halves of the same surgical incision. Subjects were recruited from patients undergoing common procedures at the senior surgeon's hand surgery clinic. After primary closure, we applied either quarter-inch adhesive tape or tissue adhesive to the proximal and distal aspects of the wounds, based on a preoperative randomization protocol. We assessed the scars at approximately 3 months (range, 2-5 months). Subjects completed a validated scar assessment questionnaire, and a blinded photograph was obtained to allow 2 independent surgeons to assess the scar. Mean age was 63 years (SD, 11.8 years; range, 21-88 years); 56% of patients were women, and 44% were men. Most of the incisions were open carpal tunnel release and thumb carpometacarpal arthroplasty (14 each). Adhesive taping showed a better overall mean score based on evaluation by the hand surgeons, a finding that was statistically significant. The greatest differences were observed between color and size, but no subcategories were significantly different. Patients reported nonstatistical, but slightly better overall cosmetic outcomes with adhesive taping rather than tissue adhesive. Adhesive strips provide a modest but significant improvement in cosmetic outcomes vs more expensive tissue adhesive. Future evaluation of closure methods that evaluate cost, speed of application, suture technique, and dressing will optimize scar appearance. [Orthopedics. 2022;45(1):e42-e46.].
Collapse
|
11
|
Littlecott HJ, Moore GF, McCann M, Melendez-Torres GJ, Mercken L, Reed H, Mann M, Dobbie F, Hawkins J. Exploring the association between school-based peer networks and smoking according to socioeconomic status and tobacco control context: a systematic review. BMC Public Health 2022; 22:142. [PMID: 35057769 PMCID: PMC8772141 DOI: 10.1186/s12889-021-12333-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whilst prevalence of youth smoking in middle and high income countries has decreased, inequality has prevailed. The introduction of legislation regulating tobacco use in public spaces varies across countries, impacting the tobacco control context. Thus reviewing our knowledge of how social networks may influence smoking differently within different contexts is required to facilitate the development of context-specific interventions. METHODS The search, conducted on 31st May 2019, included the following smoking-related terms; schools, adolescents, peers and social networks. Inclusion and exclusion criteria were applied throughout the title and abstract screening and full text screening. Quality assessment and synthesis followed. Studies were narratively synthesised to identify changes according to legislative context. This synthesis was conducted separately for findings relating to three categories: socioeconomic status; social selection and influence; and network position. RESULTS Thirty studies were included. Differences in the relationship between network characteristics and smoking according to socioeconomic status were measured in five out of fifteen studies in Europe. Results varied across studies, with differences in network characteristics and their association with smoking varying both between schools of a differing and those of a similar socioeconomic composition. For studies conducted both before and after the introduction of comprehensive smoking legislation, the evidence for selection processes was more consistent than influence, which varied according to reciprocity. Findings showed that isolates were more likely to smoke and in-degree and out-degree centrality were related to smoking both before and after the introduction of legislation. The relationship between popularity and smoking was contingent on school level smoking prevalence in studies conducted before the introduction of legislation, but not after. CONCLUSIONS Overall, effects according to socioeconomic status were underreported in the included studies and no consistent evidence of change after the introduction of a comprehensive smoking ban was observed. Further network analyses are required using more recent data to obtain a comprehensive understanding of how network processes may influence smoking differently according to socioeconomic status, and how adaptation could be used to enhance intervention effectiveness. SYSTEMATIC REVIEW REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42019137358 .
Collapse
Affiliation(s)
- H J Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD, Cardiff, Wales, UK.
| | - G F Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD, Cardiff, Wales, UK
| | - M McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), South Cloisters, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - L Mercken
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - H Reed
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD, Cardiff, Wales, UK
| | - M Mann
- Specialist Unit for Review Evidence, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park Campus, CF14 4YS, Cardiff, Wales, UK
| | - F Dobbie
- Usher Institute- University of Edinburgh, Doorway 1, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - J Hawkins
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD, Cardiff, Wales, UK
| |
Collapse
|
12
|
Burgess A, Hawkins J, Kostovski C, Kennedy M, Penkala S, Duncanson K. Aboriginal people’s perceptions of patient-reported outcome measures in the assessment of diabetes health-related quality of life†. Aust J Prim Health 2022; 29:165-174. [PMID: 37079465 DOI: 10.1071/py22150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) provide clinicians and consumers a platform to inform and improve healthcare planning and management. Aboriginal people experience disproportionately high rates of chronic diseases, including type 2 diabetes. Treatment and management require holistic approaches that draw on culturally relevant resources and assessment tools. This study explored perceptions of Aboriginal people about two diabetes management-related PROMs (PROMIS-29, PAID Scale). METHODS Twenty-nine Aboriginal people living with diabetes in the Shoalhaven discussed two PROMs in one of four focus groups or at an individual interview. Preliminary data coding was conducted by clinician researchers, with thematic analysis overseen by Aboriginal co-researchers. Subsequent individual interviews with participants were undertaken to seek further feedback and articulate what is needed to improve methods of evaluating Aboriginal people's self-reported quality of life and diabetes management. RESULTS The PROMs did not capture information or knowledge that Aboriginal people considered relevant to their diabetes-related health care. Participants' recommendations included adapting survey materials to be more culturally sensitive; for example, by improving the alignment of measures with common day-to-day activities. This study also describes a genuine collaborative, Aboriginal community-guided approach to evaluate 'fit-for-purpose' diabetes management tools. CONCLUSIONS Appropriate evaluation methods are paramount to address the disproportionate burden of diabetes experienced by Aboriginal peoples and overcome inverse diabetes care. Our learnings will contribute to development of tools, resources or methods that capture culturally tailored outcome measures. Study findings are relevant to clinicians and researchers using and/or developing Patient Reported Measures, particularly in relation to the practicality of tools for First Nations peoples.
Collapse
Affiliation(s)
- Alicia Burgess
- University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia; and Illawarra Shoalhaven Local Health District, High Risk Foot Service, Wollongong, NSW, Australia; and NSW Health Education and Training Institute, Rural Research Capacity Building Program, St Leonards, NSW, Australia
| | - Jessica Hawkins
- Illawarra Shoalhaven Local Health District, High Risk Foot Service, Wollongong, NSW, Australia; and NSW Health Education and Training Institute, Rural Research Capacity Building Program, St Leonards, NSW, Australia
| | - Catherine Kostovski
- Illawarra Shoalhaven Local Health District, Aboriginal Chronic Care Unit, Warrawong, NSW, Australia
| | - Michelle Kennedy
- University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia; and Hunter Medical Research Institute, Equity in Health and Wellbeing Research Program, Newcastle, NSW, Australia
| | - Stefania Penkala
- Western Sydney University, School of Health Sciences, Sydney, NSW, Australia; and Western Sydney University, Translational Health Research Institute, Sydney, NSW, Australia
| | - Kerith Duncanson
- NSW Health Education and Training Institute, Rural Research Capacity Building Program, St Leonards, NSW, Australia; and University of Newcastle, Centre of Research Excellence in Digestive Health, Callaghan, NSW, Australia; and Hunter Medical Research Institute, Immune Health Program, Newcastle, NSW, Australia
| |
Collapse
|
13
|
Baskind M, Hawkins J, Heyman MB, Wojcicki JM. Obesity at Age 6 Months Is Associated with Shorter Preschool Leukocyte Telomere Length Independent of Parental Telomere Length. J Pediatr 2021; 233:141-149. [PMID: 33242471 PMCID: PMC8141537 DOI: 10.1016/j.jpeds.2020.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/03/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess whether early modifiable dietary factors and obesity measures are associated with leukocyte telomere length at 3-5 years of age after controlling for the heritability of leukocyte telomere length in a prospective cohort of low-income Latina mothers and their children in San Francisco. STUDY DESIGN We analyzed data from the Latinx, Eating and Diabetes cohort, a prospective study of 97 woman-infant dyads. We used linear regression models to evaluate associations between early dietary factors and obesity measures and child leukocyte telomere length at 3-5 years of age. Multivariable models included child age at the time of telomere collection, breastfeeding at 6 months (yes/no), obesity at 6 months, maternal education, child sex, and maternal and paternal leukocyte telomere length. RESULTS Data for 73 of the 97 children at 3-5 years of age were analyzed. Any breastfeeding at 6 months was positively associated (β = 0.14; P = .02) and obesity at 6 months was negatively associated (β = -0.21; P < .001) with leukocyte telomere length in bivariate analyses. In multivariable models including parental leukocyte telomere length, obesity at 6 months was associated with a shorter leukocyte telomere length at 3-5 years of age (β = -0.15; P = .02). Analyses of dietary factors showed high flavored milk consumption at 3 years of age was associated with shorter leukocyte telomere length after adjustment for possible confounders. CONCLUSIONS In a low-income Latinx population, obesity at 6 months of age is negatively associated with cellular health at 3-5 years of age after controlling for genetic factors (parental leukocyte telomere length) associated with leukocyte telomere length. Early life obesity may be more deleterious for cellular health than obesity later in childhood.
Collapse
Affiliation(s)
- Melanie Baskind
- Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Jessica Hawkins
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Melvin B. Heyman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
| |
Collapse
|
14
|
Sultan P, Ando K, Sultan E, Hawkins J, Blake L, Barwick F, Kawai M, Carvalho B. A systematic review of patient-reported outcome measures used to assess sleep in postpartum women using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Sleep 2021; 44:6278483. [PMID: 34013345 DOI: 10.1093/sleep/zsab128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/02/2021] [Indexed: 12/12/2022] Open
Abstract
STUDY OBJECTIVES We performed a systematic review to identify the best patient-reported outcome measure (PROM) of postpartum sleep in women. METHODS We searched 4 databases for validated PROMs used to assess postpartum sleep. Studies were considered if they evaluated at least 1 psychometric measurement property of a PROM. An overall rating was assigned for each psychometric measurement property of each PROM based upon COSMIN criteria. A modified GRADE approach was used to assess the level of evidence and recommendations were then made for each PROM. RESULTS We identified 15 validation studies of 8 PROMs, in 9,070 postpartum women. An adequate number of sleep domains was assessed by 5 PROMs: Bergen Insomnia Scale (BIS), Pittsburgh Sleep Quality Index (PSQI), General Sleep Disturbance Scale (GSDS), Athens Insomnia Scale (AIS) and the Sleep Symptom Checklist (SSC). BIS and GSDS were the only PROMs to demonstrate adequate content validity and at least a low level of evidence of sufficient internal consistency, resulting in Class A recommendations. The BIS was the only PROM, which is easily accessible and free to use for non-commercial research, that achieved a Class A recommendation. CONCLUSION The BIS is the best currently available PROM of postpartum sleep. However, this PROM fails to assess several important domains such as sleep duration (and efficiency), chronotype, sleep-disordered breathing and medication usage. Future studies should focus on evaluating the psychometric measurement properties of BIS in the North American setting and in different cultural groups, or to develop a more specific PROM of postpartum sleep.
Collapse
Affiliation(s)
- P Sultan
- Associate Professor. Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - K Ando
- Assistant Professor. Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - E Sultan
- Clinical Instructor. Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - J Hawkins
- Medical Student. Stanford University School of Medicine, Stanford, CA, USA
| | - L Blake
- Associate Professor. UAMS Medical Library, UAMS, Little Rock, AR, USA SCIENC ES
| | - F Barwick
- Clinical Associate Professor, Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine
| | - M Kawai
- Clinical Associate Professor, Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine
| | - B Carvalho
- Professor. Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
15
|
Patel D, Hawkins J, Chehab LZ, Martin-Tuite P, Feler J, Tan A, Alpers BS, Pink S, Wang J, Freise J, Kim P, Peabody C, Bowditch J, Williams ER, Sammann A. Developing Virtual Reality Trauma Training Experiences Using 360-Degree Video: Tutorial. J Med Internet Res 2020; 22:e22420. [PMID: 33325836 PMCID: PMC7773512 DOI: 10.2196/22420] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/05/2022] Open
Abstract
Historically, medical trainees were educated in the hospital on real patients. Over the last decade, there has been a shift to practicing skills through simulations with mannequins or patient actors. Virtual reality (VR), and in particular, the use of 360-degree video and audio (cineVR), is the next-generation advancement in medical simulation that has novel applications to augment clinical skill practice, empathy building, and team training. In this paper, we describe methods to design and develop a cineVR medical education curriculum for trauma care training using real patient care scenarios at an urban, safety-net hospital and Level 1 trauma center. The purpose of this publication is to detail the process of finding a cineVR production partner; choosing the camera perspectives; maintaining patient, provider, and staff privacy; ensuring data security; executing the cineVR production process; and building the curriculum.
Collapse
Affiliation(s)
- Devika Patel
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jessica Hawkins
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Lara Zena Chehab
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Patrick Martin-Tuite
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Joshua Feler
- Department of Neurosurgery, Brown University, Providence, RI, United States
| | - Amy Tan
- School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Benjamin S Alpers
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Sophia Pink
- School of Engineering, Stanford University, Stanford, CA, United States
| | - Jerome Wang
- School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Jonathan Freise
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Phillip Kim
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher Peabody
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - John Bowditch
- J. Warren McClure School of Emerging Communication Technologies, Scripps College of Communication, Ohio University, Athens, OH, United States
| | - Eric R Williams
- J. Warren McClure School of Emerging Communication Technologies, Scripps College of Communication, Ohio University, Athens, OH, United States
| | - Amanda Sammann
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
16
|
Phillips AL, Cole EJ, Bentzley BS, Stimpson KH, Nejad R, Tischler C, Barmak F, Veerapal C, Khan N, Cherian K, Felber E, Brown R, Choi E, Bishop J, Azeez PA, Coetzee J, Rapier R, Odenwald N, Carreon D, Hawkins J, Chang M, Espil FM, Schatzberg AF, Sudheimer KD, Williams NR. Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT-TRD) induces rapid remission from treatment-resistant depression in a double-blinded, randomized, and controlled trial. Brain Stimul 2020. [DOI: 10.1016/j.brs.2020.06.071] [Citation(s) in RCA: 1] [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: 11/17/2022] Open
|
17
|
Cole EJ, Stimpson KH, Bentzley BS, Gulser M, Cherian K, Tischler C, Nejad R, Pankow H, Choi E, Aaron H, Espil FM, Pannu J, Xiao X, Duvio D, Solvason HB, Hawkins J, Guerra A, Jo B, Raj KS, Phillips AL, Barmak F, Bishop JH, Coetzee JP, DeBattista C, Keller J, Schatzberg AF, Sudheimer KD, Williams NR. Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression. Am J Psychiatry 2020; 177:716-726. [PMID: 32252538 DOI: 10.1176/appi.ajp.2019.19070720] [Citation(s) in RCA: 261] [Impact Index Per Article: 65.3] [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] [Indexed: 12/24/2022]
Abstract
OBJECTIVE New antidepressant treatments are needed that are effective, rapid acting, safe, and tolerable. Intermittent theta-burst stimulation (iTBS) is a noninvasive brain stimulation treatment that has been approved by the U.S. Food and Drug Administration for treatment-resistant depression. Recent methodological advances suggest that the current iTBS protocol might be improved through 1) treating patients with multiple sessions per day at optimally spaced intervals, 2) applying a higher overall pulse dose of stimulation, and 3) precision targeting of the left dorsolateral prefrontal cortex (DLPFC) to subgenual anterior cingulate cortex (sgACC) circuit. The authors examined the feasibility, tolerability, and preliminary efficacy of Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), an accelerated, high-dose resting-state functional connectivity MRI (fcMRI)-guided iTBS protocol for treatment-resistant depression. METHODS Twenty-two participants with treatment-resistant depression received open-label SAINT. fcMRI was used to individually target the region of the left DLPFC most anticorrelated with sgACC in each participant. Fifty iTBS sessions (1,800 pulses per session, 50-minute intersession interval) were delivered as 10 daily sessions over 5 consecutive days at 90% resting motor threshold (adjusted for cortical depth). Neuropsychological testing was conducted before and after SAINT. RESULTS One participant withdrew, leaving a sample size of 21. Nineteen of 21 participants (90.5%) met remission criteria (defined as a score <11 on the Montgomery-Åsberg Depression Rating Scale). In the intent-to-treat analysis, 19 of 22 participants (86.4%) met remission criteria. Neuropsychological testing demonstrated no negative cognitive side effects. CONCLUSIONS SAINT, an accelerated, high-dose, iTBS protocol with fcMRI-guided targeting, was well tolerated and safe. Double-blinded sham-controlled trials are needed to confirm the remission rate observed in this initial study.
Collapse
Affiliation(s)
- Eleanor J Cole
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Katy H Stimpson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Brandon S Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Merve Gulser
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Kirsten Cherian
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Claudia Tischler
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Romina Nejad
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Heather Pankow
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Elizabeth Choi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Haley Aaron
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Flint M Espil
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Xiaoqian Xiao
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Dalton Duvio
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Hugh B Solvason
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Austin Guerra
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Kristin S Raj
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Angela L Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Fahim Barmak
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - James H Bishop
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - John P Coetzee
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Keith D Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| |
Collapse
|
18
|
Littlecott HJ, Hawkins J, Mann M, Melendez-Torres GJ, Dobbie F, Moore G. Associations between school-based peer networks and smoking according to socioeconomic status and tobacco control context: protocol for a mixed method systematic review. Syst Rev 2019; 8:313. [PMID: 31810493 PMCID: PMC6896310 DOI: 10.1186/s13643-019-1225-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/08/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Smoking remains a major public health concern. School-based social networks influence uptake of smoking among peers. During the past two decades, the UK macro-systemic context within which schools are nested and interact with has changed, with anti-smoking norms having become set at a more macro-systemic level. Whilst the overall prevalence of smoking in the UK has decreased, inequality has prevailed. It is plausible that the influence of school-based social networks on smoking uptake may vary according to socioeconomic status. Therefore, this study aims to understand how social influence on smoking among adolescents has changed in line with variance within and between contexts according to time and geography. METHODS The following databases will be searched: Medline, PsycINFO, Embase, Applied Social Sciences Index and Abstracts (ASSIA), British Education Index, Sociological abstracts, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC) and Scopus. Additional searches will include reference checking of key papers, citation tracking, word of mouth and grey literature searches. The search strategies will incorporate terms relating to smoking, adolescents, schools, peers, network analysis and qualitative research. Titles and abstracts and full texts will be independently screened and assessed for quality by at least two researchers. Included studies will be assessed for quality, and data will be extracted for synthesis, including participant characteristics, setting and tobacco control context, study design and methods, analysis and results and conclusions. Quantitative findings will be narratively synthesised, whilst a lines of argument synthesis combined with refutational analysis will be employed to synthesise qualitative data. Both sets of findings will be charted on a timeline to add context to network findings and obtain an enhanced understanding of changes over time. DISCUSSION This protocol is for a mixed methods synthesis of both social network findings, to investigate social structures and qualitative studies, to elicit contextual information. The review will synthesise changes in the context of social influence on adolescent smoking over time and geographically. As context is increasingly recognised as a key source of complexity, this enhanced understanding will help to inform future interventions targeting smoking through social influence. This will help to enhance their relevance to context, subsequent effectiveness and targeting of inequalities. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019137358.
Collapse
Affiliation(s)
- H. J. Littlecott
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), 1-3 Museum Place, Cardiff, CF10 3BD UK
| | - J. Hawkins
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), 1-3 Museum Place, Cardiff, CF10 3BD UK
| | - M. Mann
- Specialist Unit for Review Evidence (SURE), Cardiff University, Level 5, Neuadd Meirionnydd, Cardiff, CF10 3AT UK
| | - G. J. Melendez-Torres
- Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter, Exeter, UK
| | - F. Dobbie
- Usher Institute, University of Edinburgh, Doorway 1, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK
| | - G. Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), 1-3 Museum Place, Cardiff, CF10 3BD UK
| |
Collapse
|
19
|
Williams NR, Sudheimer KD, Bentzley BS, Pannu J, Stimpson KH, Duvio D, Cherian K, Hawkins J, Scherrer KH, Vyssoki B, DeSouza D, Raj KS, Keller J, Schatzberg AF. High-dose spaced theta-burst TMS as a rapid-acting antidepressant in highly refractory depression. Brain 2019; 141:e18. [PMID: 29415152 DOI: 10.1093/brain/awx379] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Keith D Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Brandon S Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Katy H Stimpson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Dalton Duvio
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Kirsten Cherian
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | | | - Benjamin Vyssoki
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Danielle DeSouza
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, USA
| | - Kristin S Raj
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| |
Collapse
|
20
|
Bartelink NHM, van Assema P, Jansen MWJ, Savelberg HHCM, Moore GF, Hawkins J, Kremers SPJ. Process evaluation of the healthy primary School of the Future: the key learning points. BMC Public Health 2019; 19:698. [PMID: 31170941 PMCID: PMC6554901 DOI: 10.1186/s12889-019-6947-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/07/2019] [Indexed: 11/23/2022] Open
Abstract
Background While schools have potential to contribute to children’s health and healthy behaviour, embedding health promotion within complex school systems is challenging. The ‘Healthy Primary School of the Future’ (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes that are hypothesized as being positively disruptive to the Dutch school system: daily free healthy lunches and structured physical activity sessions. These changes are expected to create momentum for bottom-up processes leading to additional health-promoting changes. Using a programme theory, this paper explores the processes through which HPSF and the school context adapt to one another. The aim is to generate and share knowledge and experiences on how to implement changes in the complex school system to integrate school health promotion. Methods The current study involved a mixed methods process evaluation with a contextual action-oriented research approach. The processes of change were investigated in four Dutch primary schools during the development year (2014–2015) and the first two years of implementation (2015–2017) of HPSF. The schools (each with 15–26 teachers and 233–389 children) were in low socio-economic status areas. Measurements included interviews, questionnaires, observations, and analysis of minutes of meetings. Results Top-down advice, combined with bottom-up involvement and external practical support were key facilitators in embedding HPSF within the schools’ contexts. Sufficient coordination and communication at the school level, team cohesion, and feedback loops enhanced implementation of the changes. Implementation of the healthy lunch appeared to be disruptive and create momentum for additional health-promoting changes. Conclusions Initiating highly visible positive disruptions to improve school health can act as a catalyst for wider school health promotion efforts. Conditions to create a positive disruption are enough time, and sufficient bottom-up involvement, external support, team cohesion and coordination. The focus should be on each specific school, as each school has their own starting point and process of change. Trial registration The study was retrospectively registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616). Electronic supplementary material The online version of this article (10.1186/s12889-019-6947-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- N H M Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands. .,Public Health Services, Academic Collaborative Centre for Public Health Limburg, P.O. Box 33, 6400, AA, Heerlen, The Netherlands.
| | - P van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - M W J Jansen
- Public Health Services, Academic Collaborative Centre for Public Health Limburg, P.O. Box 33, 6400, AA, Heerlen, The Netherlands.,Department of Health Services Research, CAPHRI, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - H H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - G F Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales
| | - J Hawkins
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales
| | - S P J Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| |
Collapse
|
21
|
Cole E, Gulser M, Stimpson K, Bentzley B, Hawkins J, Xiao X, Schatzberg A, Sudheimer K, Williams N. Stanford accelerated intelligent neuromodulation therapy for treatment-resistant depression (SAINT-TRD). Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
22
|
Bentzley B, Cole E, Gulser M, Stimpson K, Hawkins J, Xiao X, Schatzberg A, Sudheimer K, Williams N. Accelerated intermittent theta-burst stimulation suppresses suicidal ideation in patients with treatment-resistant depression. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
23
|
Williams NR, Heifets BD, Blasey C, Sudheimer K, Pannu J, Pankow H, Hawkins J, Birnbaum J, Lyons DM, Rodriguez CI, Schatzberg AF. Attenuation of Antidepressant Effects of Ketamine by Opioid Receptor Antagonism. Am J Psychiatry 2018; 175:1205-1215. [PMID: 30153752 PMCID: PMC6395554 DOI: 10.1176/appi.ajp.2018.18020138] [Citation(s) in RCA: 284] [Impact Index Per Article: 47.3] [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] [Indexed: 12/28/2022]
Abstract
OBJECTIVE In addition to N-methyl-d-aspartate receptor antagonism, ketamine produces opioid system activation. The objective of this study was to determine whether opioid receptor antagonism prior to administration of intravenous ketamine attenuates its acute antidepressant or dissociative effects. METHOD In a proposed double-blind crossover study of 30 adults with treatment-resistant depression, the authors performed a planned interim analysis after studying 14 participants, 12 of whom completed both conditions in randomized order: placebo or 50 mg of naltrexone preceding intravenous infusion of 0.5 mg/kg of ketamine. Response was defined as a reduction ≥50% in score on the 17-item Hamilton Depression Rating Scale (HAM-D) score on postinfusion day 1. RESULTS In the interim analysis, seven of 12 adults with treatment-resistant depression met the response criterion during the ketamine plus placebo condition. Reductions in 6-item and 17-item HAM-D scores among participants in the ketamine plus naltrexone condition were significantly lower than those of participants in the ketamine plus placebo condition on postinfusion days 1 and 3. Secondary analysis of all participants who completed the placebo and naltrexone conditions, regardless of the robustness of response to ketamine, showed similar results. There were no differences in ketamine-induced dissociation between conditions. Because naltrexone dramatically blocked the antidepressant but not the dissociative effects of ketamine, the trial was halted at the interim analysis. CONCLUSIONS The findings suggest that ketamine's acute antidepressant effect requires opioid system activation. The dissociative effects of ketamine are not mediated by the opioid system, and they do not appear sufficient without the opioid effect to produce the acute antidepressant effects of ketamine in adults with treatment-resistant depression.
Collapse
Affiliation(s)
- Nolan R. Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Address correspondence to: Nolan Williams, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5717, , Alan Schatzberg, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5797,
| | - Boris D. Heifets
- Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University
| | - Christine Blasey
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto University
| | - Keith Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Heather Pankow
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Justin Birnbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - David M. Lyons
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Carolyn I. Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Veterans Affairs Palo Alto Health Care System
| | - Alan F. Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Address correspondence to: Nolan Williams, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5717, , Alan Schatzberg, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5797,
| |
Collapse
|
24
|
Morgan K, Hawkins J, Hallingberg B, Roberts C, Murphy S, Moore G. Energy drink use and health complaints: findings from the 2013/14 HBSC study in Wales. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.514] [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: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | - G Moore
- Cardiff University, Cardiff, UK
| |
Collapse
|
25
|
Flood D, Garcia P, Douglas K, Hawkins J, Rohloff P. Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study. BMJ Open 2018; 8:e019778. [PMID: 29358450 PMCID: PMC5781190 DOI: 10.1136/bmjopen-2017-019778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/03/2017] [Accepted: 11/24/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Screening is a key strategy to address the rising burden of chronic kidney disease (CKD) in low-income and middle-income countries. However, there are few reports regarding the implementation of screening programmes in resource-limited settings. The objectives of this study are to (1) to share programmatic experiences implementing CKD screening in a rural, resource-limited setting and (2) to assess the burden of renal disease in a community-based diabetes programme in rural Guatemala. DESIGN Cross-sectional assessment of glomerular filtration rate (GFR) and urine albumin. SETTING Central Highlands of Guatemala. PARTICIPANTS We enrolled 144 adults with type 2 diabetes in a community-based CKD screening activity carried out by the sponsoring institution. OUTCOME MEASURES Prevalence of renal disease and risk of CKD progression using Kidney Disease: Improving Global Outcomes definitions and classifications. RESULTS We found that 57% of the sample met GFR and/or albuminuria criteria suggestive of CKD. Over half of the sample had moderate or greater increased risk for CKD progression, including nearly 20% who were classified as high or very high risk. Hypertension was common in the sample (42%), and glycaemic control was suboptimal (mean haemoglobin A1c 9.4%±2.5% at programme enrolment and 8.6%±2.3% at time of CKD screening). CONCLUSIONS The high burden of renal disease in our patient sample suggests an imperative to better understand the burden and risk factors of CKD in Guatemala. The implementation details we share reveal the tension between evidence-based CKD screening versus screening that can feasibly be delivered in resource-limited global settings.
Collapse
Affiliation(s)
- David Flood
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Pablo Garcia
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
| | - Kate Douglas
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
| | | | - Peter Rohloff
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA
| |
Collapse
|
26
|
Hawkins J, Morrison M, Hawkins M, Byrne E, Kitchen S, Jennings I, Makris M, Preston F, Metcalfe P, Gray E. Establishment of the 1st International Genetic Reference Panel for Factor V Leiden, human gDNA. Thromb Haemost 2017. [DOI: 10.1160/th05-11-0767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryForty-one laboratories participated in an international collaborative study to assess the suitability of a panel of three genomic DNA samples as the 1st International Genetic Reference Panel for the Factor V Leiden (FVL) variant.The code numbers of the materials were 03/254 (FV wild type), 03/260 (FVL homozygote) and 03/248 (FVL heterozygote).The participants evaluated the panel against their in-house controls which were known patient samples and commercial controls. In total, 859 genotype tests were carried out on the panel, with an error rate of 0.7%.The errors were not related to specific samples of the panel or to any specific techniques.The findings of this study have indicated that this panel is suitable to be used as a reference material for genotyping of factor V Leiden. It was therefore recommended that the three genomic DNA samples be established as the 1st International Genetic Reference Panel for Factor V Leiden, Human gDNA, 04/224. This recommendation was approved by the Scientific and Standardization Committee (SSC) of the ISTH (International Society on Thrombosis and Haemostasis) in June 2004 and the Expert Committee on Biological Standardization (ECBS) of theWorld Health Organization (WHO) in November 2004.
Collapse
|
27
|
Riveros-Perez E, Hermesch A, Barbour L, Hawkins J. Aplastic anemia in two consecutive pregnancies: obstetric and anesthetic management. Int J Obstet Anesth 2017; 33:71-75. [PMID: 29108725 DOI: 10.1016/j.ijoa.2017.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
Abstract
Aplastic anemia is a serious condition occasionally coexisting with pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management are particularly challenging, and treatment requires knowledge of pathophysiologic mechanisms in order to provide safe care to this group of patients. We describe the successful obstetric management and labor analgesia of a patient with a diagnosis of aplastic anemia in two consecutive pregnancies.
Collapse
Affiliation(s)
- E Riveros-Perez
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, United States.
| | - A Hermesch
- Maternal Fetal Medicine, University of Colorado School of Medicine, United States
| | - L Barbour
- Medicine and Obstetrics and Gynecology, University of Colorado School of Medicine, United States
| | - J Hawkins
- Department of Anesthesiology, Director of Obstetric Anesthesia, University of Colorado School of Medicine, United States
| |
Collapse
|
28
|
McConnon L, Godwin J, Hawkins J, Bond A, Fletcher A. Use of the school setting during the summer holidays: formative process evaluation of ‘Food and Fun’. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.441] [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: 11/13/2022] Open
Affiliation(s)
| | | | | | - A Bond
- Cardiff University, Cardiff, UK
| | | |
Collapse
|
29
|
Hawkins J. Using activity monitors to support physical activity changes: experiences from exercise referral schemes in Wales. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.058] [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: 11/13/2022] Open
|
30
|
Chary A, Flood D, Austad K, Colom M, Hawkins J, Cnop K, Martinez B, Lopez W, Rohloff P. Accompanying indigenous Maya patients with complex medical needs: A patient navigation system in rural Guatemala. Healthc (Amst) 2017; 6:144-149. [PMID: 28919513 DOI: 10.1016/j.hjdsi.2017.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 08/26/2017] [Indexed: 10/24/2022]
Affiliation(s)
- Anita Chary
- Wuqu' Kawoq
- Maya Health Alliance, Guatemala; Department of Emergency Medicine, Massachusetts General Hospital, United States.
| | - David Flood
- Wuqu' Kawoq
- Maya Health Alliance, Guatemala; Departments of Internal Medicine and Pediatrics, University of Minnesota, United States
| | - Kirsten Austad
- Wuqu' Kawoq
- Maya Health Alliance, Guatemala; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, United States
| | | | - Jessica Hawkins
- Wuqu' Kawoq
- Maya Health Alliance, Guatemala; University of California, San Francisco, United States
| | - Katia Cnop
- Wuqu' Kawoq
- Maya Health Alliance, Guatemala; Burrell College of Osteopathic Medicine, United States
| | | | | | - Peter Rohloff
- Wuqu' Kawoq
- Maya Health Alliance, Guatemala; Division of Global Health Equity, Brigham and Women's Hospital, United States
| |
Collapse
|
31
|
Abstract
INTRODUCTION Diabetes self-management education (DSME) is a fundamental element of type 2 diabetes care. Although 75% of adults with diabetes worldwide live in low-income and middle-income countries (LMICs), limited DSME research has been conducted in LMICs. The objective of this study was to evaluate a home-based DSME intervention in rural Guatemala. METHODS We conducted a prospective study of a DSME intervention using a quasi-experimental, single-group pretest-posttest design. We enrolled 90 participants in the intervention, which consisted of 6 home visits (May 2014-July 2016) conducted by a diabetes educator using a curriculum culturally and linguistically tailored to rural Mayan populations. Primary outcomes were changes in mean hemoglobin A1c (HbA1c) and mean systolic and diastolic blood pressure at baseline and at 12 months. Secondary outcomes were diabetes knowledge and self-care activities at baseline and intervention completion. RESULTS HbA1c decreased significantly from baseline to 12 months (absolute mean change, -1.5%; 95% confidence interval [CI], -1.9% to -1.0%; P < .001). Systolic blood pressure also improved significantly at 12 months (-6.2 mm Hg; 95% CI, -10.1 to -2.2 mm Hg; P = .002); changes in diastolic blood pressure were not significant (-1.6 mm Hg; 95% CI, -3.9 to -0.7 mm Hg; P = .17). We also found significant improvements in diabetes knowledge and self-care activities from baseline to intervention completion. CONCLUSION DSME interventions can be successfully delivered in a setting with an underresourced health system, high poverty rate, and unique cultural characteristics like Mayan Guatemala. Our findings point to the need for more DSME research in resource-limited settings globally.
Collapse
Affiliation(s)
- David Flood
- Wuqu' Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala.,Medicine Pediatric Residency Program, University of Minnesota, Minneapolis, Minnesota
| | | | - Peter Rohloff
- Wuqu' Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala.,Division of Global Health Equity, Brigham and Women's Hospital, 75 Francis St, Boston MA 02115.
| |
Collapse
|
32
|
Joshi LT, Welsch A, Hawkins J, Baillie L. The effect of hospital biocide sodium dichloroisocyanurate on the viability and properties of Clostridium difficile spores. Lett Appl Microbiol 2017. [PMID: 28639362 DOI: 10.1111/lam.12768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clostridium difficile is the primary cause of healthcare-associated diarrhoea globally and produces spores which are resistant to commonly used biocides and are able persist on contaminated surfaces for months. This study examined the effect of sublethal concentrations of the biocide sodium dichloroisocyanurate (NaDCC) on the viability of spores produced by 21 clinical isolates of C. difficile representing a range of PCR ribotypes. Spores exposed to 500 ppm NaDCC for 10 min exhibited between a 4-6 log10 reduction in viability which was independent of spore PCR ribotype. The effect of sublethal concentrations of biocide on the surface properties of exosporium positive and negative clinical isolates was determined using a spore adhesion to hydrocarbon (SATH) assay. These isolates differed markedly in their responses suggesting that exposure to biocide can have a profound effect on hydrophobicity and thus the ability of spores to adhere to surfaces. This raises the intriguing possibility that sublethal exposure to NaDCC could inadvertently promote the spread of the pathogen in healthcare facilities. SIGNIFICANCE AND IMPACT OF THE STUDY This study is the first to report on changes in Clostridium difficile spore surface property after exposure to sublethal levels of the commonly used biocide sodium dichloroisocyanurate. The implications of these changes to the spore surface include increased adherence of the spores to inorganic surfaces which can directly contribute to persistence and spread of spores within the hospital environment.
Collapse
Affiliation(s)
- L T Joshi
- Peninsula Schools of Medicine and Dentistry, Portland Square, Plymouth University, Plymouth, UK
| | - A Welsch
- Peninsula Schools of Medicine and Dentistry, Portland Square, Plymouth University, Plymouth, UK
| | - J Hawkins
- Peninsula Schools of Medicine and Dentistry, Portland Square, Plymouth University, Plymouth, UK
| | - L Baillie
- Peninsula Schools of Medicine and Dentistry, Portland Square, Plymouth University, Plymouth, UK
| |
Collapse
|
33
|
Torabinejad M, Moazzami SM, Moaddel H, Hawkins J, Gustefson C, Faras H, Wright K, Shabahang S. Effect of MTA particle size on periapical healing. Int Endod J 2017; 50 Suppl 2:e3-e8. [PMID: 27977855 DOI: 10.1111/iej.12738] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 12/08/2016] [Indexed: 12/01/2022]
Abstract
AIM To examine the effect of reduction in MTA particle size on dento-alveolar and osseous healing in dogs. METHODOLOGY Root canals of 24 mandibular premolars in four 2-year-old beagles were prepared and filled with gutta-percha and sealer. Two to four weeks later, during periapical surgery, the root-end cavity preparations in these teeth were filled with either grey ProRoot MTA or modified (reduced particle sizes with faster setting time) MTA. The animals were sacrificed 4 months later. Degrees of inflammation, type of inflammatory cells, fibrous connective tissue adjacent to the root-end filling materials, cementum formation over the resected roots and root-end filling materials and bone healing were examined. Data were analysed using the McNemar test. RESULTS No significant differences in healing of periapical tissues were found when comparing ProRoot MTA to a modified MTA containing reduced particle sizes. CONCLUSION Reducing the particle sizes of MTA did not impact its biological properties.
Collapse
Affiliation(s)
- M Torabinejad
- Department of Endodontics, Loma Linda University, Loma Linda, CA, USA
| | - S M Moazzami
- Department of Endodontics, Mashad University, Mashad, Iran
| | - H Moaddel
- Department of Endodontics, Loma Linda University, Loma Linda, CA, USA
| | - J Hawkins
- Private Practice, Kennewick, WA, USA
| | | | - H Faras
- Department of Endodontics, Kuwait University, Kuwait City, Kuwait
| | - K Wright
- Department of Anatomy, Loma Linda University, Loma Linda, CA, USA
| | - S Shabahang
- Department of Endodontics, Loma Linda University, Loma Linda, CA, USA
| |
Collapse
|
34
|
Alhamlan FS, Majumder MS, Brownstein JS, Hawkins J, Al-Abdely HM, Alzahrani A, Obaid DA, Al-Ahdal MN, BinSaeed A. Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. BMJ Open 2017; 7:e011865. [PMID: 28082362 PMCID: PMC5253590 DOI: 10.1136/bmjopen-2016-011865] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. DESIGN Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. RESULTS A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). CONCLUSIONS To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed.
Collapse
Affiliation(s)
- F S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - M S Majumder
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - J Hawkins
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - H M Al-Abdely
- Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia
| | - A Alzahrani
- Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia
| | - D A Obaid
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - M N Al-Ahdal
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - A BinSaeed
- Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia
| |
Collapse
|
35
|
Nsoesie E, Hawkins J, Tuli G, Kluberg S, Brownstein J. The Use of Social Media and Business Reviews for Foodborne Illness Surveillance. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.177] [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] Open
|
36
|
Brooks J, Kahler M, Frantz J, Wood R, Hawkins J, Mora T, Dominguez S, Perez R. Enhanced Recovery for Elective Colorectal Surgery. J Perianesth Nurs 2016. [DOI: 10.1016/j.jopan.2016.04.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
37
|
Benson RA, Hawkins J, Pherwani AD. Novel technique for tunnelling paediatric cuffed venous catheters. Ann R Coll Surg Engl 2016; 98:522. [PMID: 27241602 DOI: 10.1308/rcsann.2016.0168] [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: 11/22/2022] Open
Affiliation(s)
- R A Benson
- University Hospitals of North Midlands NHS Trust , UK
| | - J Hawkins
- University Hospitals of North Midlands NHS Trust , UK
| | - A D Pherwani
- University Hospitals of North Midlands NHS Trust , UK
| |
Collapse
|
38
|
Richardson S, Kacmar R, Hawkins J, Eltzschig HK, Kleck C, Burger E, Hodges J. Use of continuous fetal heart rate monitoring during discectomy at 24weeks of gestation. Int J Obstet Anesth 2015; 25:95-6. [PMID: 26597410 DOI: 10.1016/j.ijoa.2015.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/19/2015] [Accepted: 08/30/2015] [Indexed: 11/26/2022]
Affiliation(s)
- S Richardson
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - R Kacmar
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - J Hawkins
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - H K Eltzschig
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - C Kleck
- Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - E Burger
- Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - J Hodges
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
39
|
Beynon R, Hawkins J, Laing R, Higgins N, Whiting P, Jameson C, Sterne JAC, Vergara P, Hollingworth W. The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model. Health Technol Assess 2014; 17:1-88, v-vi. [PMID: 23673151 DOI: 10.3310/hta17190] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diagnostic selective nerve root block (SNRB) involves injection of local anaesthetic, sometimes in conjunction with corticosteroids, around spinal nerves. It is used to identify symptomatic nerve roots in patients with probable radicular pain that is not fully concordant with imaging findings. OBJECTIVES (1) Determine the diagnostic accuracy of SNRB in patients with low back and radiating pain in a lower limb; (2) evaluate whether or not accuracy varies by patient subgroups; (3) review injection-related adverse events; and (4) evaluate the cost-effectiveness of SNRB. DATA SOURCES MEDLINE, EMBASE, Science Citation Index, Bioscience Information Service (BIOSIS), Latin American and Caribbean Health Sciences Literature (LILACS) and grey literature databases were searched from inception to August 2011. Reference lists of included studies were screened. METHODS A systematic review (SR) of studies that assessed the accuracy of SNRB or adverse events in patients with low back pain and symptoms in a lower limb for the diagnosis of lumbar radiculopathy. Study quality was assessed using the quality assessment of diagnostic accuracy studies (QUADAS)-2 checklist. We used random-effects meta-analysis to pool diagnostic accuracy data. Decision tree and Markov models were developed, combining SR results with information on the costs and outcomes of surgical and non-surgical care. Uncertainty was assessed using probabilistic and deterministic sensitivity analyses. RESULTS Five studies assessed diagnostic accuracy: three diagnostic cohort and two within-patient case-control studies. All were judged to be at high risk of bias and had high concerns regarding applicability. In individual studies, sensitivity ranged from 57% [95% confidence interval (CI) 43% to 70%] to 100% (95% CI 76% to 100%) and specificity from 9.5% (95% CI 1% to 30%) to 86% (95% CI 76% to 93%). The most reliable estimate was judged to come from two cohort studies that used post-surgery outcome as the reference standard; summary sensitivity and specificity were 93% (95% CI 86% to 97%) and 26% (95% CI 5% to 68%), respectively. No study provided sufficient detail to judge whether or not accuracy varied by patient subgroup. Seven studies assessed adverse events. There were no major or permanent complications; minor complications were reported in 0-6% of patients. The addition of SNRB to the diagnostic work-up was not cost-effective with an incremental cost per quality-adjusted life-year of £1,576,007. Sensitivity analyses confirmed that SNRB was unlikely to be a cost-effective method for diagnosis and planning surgical therapy. LIMITATIONS We identified very few studies; all were at high risk of bias. The conduct and interpretation of SNRBs varied and there was no gold standard for diagnosis. Limited information about the impact of SNRB on subsequent care and the long-term costs and benefits of surgery increased uncertainty about cost-effectiveness. CONCLUSIONS There were few studies that estimated the diagnostic accuracy of SNRB in patients with radiculopathy and all were limited by the difficulty of making a reference standard diagnosis. Summary estimates suggest that specificity is low, but results are based on a small number of studies at a high risk of bias. Based on current weak evidence, it is unlikely that SNRB is a cost-effective method for identifying the symptomatic nerve root prior to lumbar spine surgery. Future research should focus on randomised controlled trials to evaluate whether or not SNRB improves patient outcomes at acceptable cost. FUNDING The National Institute for Health Research Health Technology Assessment programme.
Collapse
Affiliation(s)
- R Beynon
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Cheng Q, Park KH, Macdougall JD, Zindler A, Lugmair GW, Staudigel H, Hawkins J, Lonsdale P. Isotopic Evidence for a Hotspot Origin of the Louisville Seamount Chain. Seamounts, Islands, and Atolls 2013. [DOI: 10.1029/gm043p0283] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
41
|
|
42
|
White C, Hawkins J, Pone E, Al-Qahtani A, Mai T, Zan H, Casali P. AID dysregulation in lupus-prone MRL/ Faslpr/lpr mice promotes interchromosomal c-Myc/IgH loci translocations, increased class switch DNA recombination and production of anti-dsDNA IgG autoantibodies: modulation by HoxC4 (148.25). The Journal of Immunology 2011. [DOI: 10.4049/jimmunol.186.supp.148.25] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Activation-induced cytidine deaminase (AID) initiates immunoglobulin (Ig) gene somatic hypermutation (SHM) and class switch DNA recombination (CSR), which are critical in the generation of pathogenic autoantibodies. In these studies, we addressed the regulation of AID by HoxC4 in lupus. We found that SLE patients and lupus-prone MRL/Faslpr/lpr mice displayed increased expression of HoxC4, which directly activates the promoter of the AID gene, and increased expression of AID. Dysregulation of these proteins was associated with increased CSR in B cells of MRL/Faslpr/lpr mice. In the HoxC4-/- MRL/Faslpr/lpr mice we generated, HoxC4-deficiency resulted in reduced AID expression, impaired CSR and decreased serum anti-dsDNA IgG, particularly IgG2a production, in association with a reduction in IgG deposition in kidney glomeruli. Consistent with our previous findings that upregulated AID expression is associated with extensive DNA lesions, we found a high frequency of c-Myc to IgH translocations in MRL/Faslpr/lpr mice. The frequency of c-Myc to IgH translocations was significantly reduced in autoimmune MRL/Faslpr/lpr mice deficient in HoxC4. Our findings showed that HoxC4 is upregulated in lupus B cells, and this plays a major role in dysregulating AID expression, increasing CSR and autoantibody production, and promoting c-Myc to IgH translocations.
Collapse
Affiliation(s)
| | - J. Hawkins
- 1University of California, Irvine, Irvine, CA
| | - Egest Pone
- 1University of California, Irvine, Irvine, CA
| | | | - Thach Mai
- 1University of California, Irvine, Irvine, CA
| | - Hong Zan
- 1University of California, Irvine, Irvine, CA
| | | |
Collapse
|
43
|
Spiess FN, Macdonald KC, Atwater T, Ballard R, Carranza A, Cordoba D, Cox C, Garcia VM, Francheteau J, Guerrero J, Hawkins J, Haymon R, Hessler R, Juteau T, Kastner M, Larson R, Luyendyk B, Macdougall JD, Miller S, Normark W, Orcutt J, Rangin C. East pacific rise: hot springs and geophysical experiments. Science 2010; 207:1421-33. [PMID: 17779602 DOI: 10.1126/science.207.4438.1421] [Citation(s) in RCA: 574] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Hydrothermal vents jetting out water at 380 degrees +/- 30 degrees C have been discovered on the axis of the East Pacific Rise. The hottest waters issue from mineralized chimneys and are blackened by sulfide precipitates. These hydrothermal springs are the sites of actively forming massive sulfide mineral deposits. Cooler springs are clear to milky and support exotic benthic communities of giant tube worms, clams, and crabs similar to those found at the Galápagos spreading center. Four prototype geophysical experiments were successfully conducted in and near the vent area: seismic refraction measurements with both source (thumper) and receivers on the sea floor, on-bottom gravity measurements, in situ magnetic gradiometer measurements from the submersible Alvin over a sea-floor magnetic reversal boundary, and an active electrical sounding experiment. These high-resolution determinations of crustal properties along the spreading center were made to gain knowledge of the source of new oceanic crust and marine magnetic anomalies, the nature of the axial magma chamber, and the depth of hydrothermal circulation.
Collapse
|
44
|
Rodgers M, Hodges R, Hawkins J, Hollingworth W, Duffy S, McKibbin M, Mansfield M, Harbord R, Sterne J, Glasziou P, Whiting P, Westwood M. Colour vision testing for diabetic retinopathy: a systematic review of diagnostic accuracy and economic evaluation. Health Technol Assess 2010; 13:1-160. [PMID: 20003824 DOI: 10.3310/hta13600] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the diagnostic performance and cost-effectiveness of colour vision testing (CVT) to identify and monitor the progression of diabetic retinopathy (DR). DATA SOURCES Major electronic databases including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Database of Systematic Reviews were searched from inception to September 2008. REVIEW METHODS A systematic review of the evidence was carried out according to standard methods. An online survey of National Screening Programme for Diabetic Retinopathy (NSPDR) clinical leads and programme managers assessed the diagnostic tools used routinely by local centres and their views on future research priorities. A decision tree and Markov model was developed to estimate the incremental costs and effects of adding CVT to the current NSPDR. RESULTS In total, 25 studies on CVT met the inclusion criteria for the review, including 18 presenting 2 x 2 diagnostic accuracy data. The quality of studies and reporting was generally poor. Automated or computerised CVTs reported variable sensitivities (63-97%) and specificities (71-95%). One study reported good diagnostic accuracy estimates for computerised CVT plus retinal photography for detection of sight-threatening DR, but it included few cases of retinopathy in total. Results for pseudoisochromatic plates, anomaloscopes and colour arrangement tests were largely inadequate for DR screening, with Youden indices (sensitivity + specificity - 100%) close to zero. No studies were located that addressed patient preferences relating to CVT for DR. Retinal photography is universally employed as the primary method for retinal screening by centres responding to the online survey; none used CVT. The review of the economic evaluation literature found no previous studies describing the cost and effects of any type of CVT. Our economic evaluation suggested that adding CVT to the current national screening programme could be cost-effective if it adequately increases sensitivity and is relatively inexpensive. The deterministic base-case analysis indicated that the cost per quality-adjusted life-year gained may be 6364 pounds and 12,432 pounds for type 1 and type 2 diabetes respectively. However, probabilistic sensitivity analysis highlighted the substantial probability that CVT is not diagnostically accurate enough to be either an effective or a cost-effective addition to current screening methods. The results of the economic model should be treated with caution as the model is based on only one small study. CONCLUSIONS There is insufficient evidence to support the use of CVT alone, or in combination with retinal photography, as a method for screening for retinopathy in patients with diabetes. Better quality diagnostic accuracy studies directly comparing the incremental value of CVT in addition to retinal photography are needed before drawing conclusions on cost-effectiveness. The most frequently cited preference for future research was the use of optical coherence tomography for the detection of clinically significant macular oedema.
Collapse
Affiliation(s)
- M Rodgers
- Centre for Reviews and Dissemination, University of York, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
Many patients fail to achieve an adequate response to antidepressant medication. Growing evidence suggests that atypical antipsychotics may augment antidepressant effects, resulting in a greater potential for response. Atypical antipsychotics possess pharmacological actions that are associated with antidepressant properties, including serotonin 5-HT(2) receptor antagonist and 5-HT(1A) and dopamine receptor partial agonist activity. In fact, the term 'atypical antipsychotic' is an unfortunate remnant of the early indication of these drugs in the treatment of schizophrenia. Soon after their introduction, the usefulness of atypical antipsychotics in bipolar disorder was firmly established and their use in the treatment of mood disorders has far outpaced their use in schizophrenia and other psychotic disorders. Aripiprazole has become the first agent to receive US FDA approval for the adjunctive treatment of unipolar depression. Most recently, Symbyax, a fluoxetine/olanzapine combination, received FDA approval for the acute treatment of treatment-resistant depression. This is the first medication to be FDA approved for this indication. In the present article, the usefulness of antipsychotics in the treatment of resistant unipolar depression is reviewed.
Collapse
Affiliation(s)
- Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, California 94305, USA.
| | | |
Collapse
|
46
|
Parker G, Hawkins J, Weigel C, Fanning L, Round T, Reyna K. Adolescent Suicide Prevention: The Oklahoma Community Reaches Out. J Contin Educ Nurs 2009; 40:177-80. [DOI: 10.3928/00220124-20090401-08] [Citation(s) in RCA: 4] [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: 11/20/2022]
|
47
|
Marks BL, Katz LM, Styner M, Smith JK, Babbitt M, Hawkins J, Bullitt E. Impact of Aerobic Fitness on Cerebral White Matter Integrity in the Cingulum. Med Sci Sports Exerc 2008. [DOI: 10.1249/01.mss.0000323623.14074.b6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
48
|
Shapiro M, Duca KA, Lee K, Delgado-Eckert E, Hawkins J, Jarrah AS, Laubenbacher R, Polys NF, Hadinoto V, Thorley-Lawson DA. A virtual look at Epstein-Barr virus infection: simulation mechanism. J Theor Biol 2008; 252:633-48. [PMID: 18371986 DOI: 10.1016/j.jtbi.2008.01.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Revised: 01/09/2008] [Accepted: 01/28/2008] [Indexed: 10/22/2022]
Abstract
Epstein-Barr virus (EBV) is an important human pathogen that establishes a life-long persistent infection and for which no precise animal model exists. In this paper, we describe in detail an agent-based model and computer simulation of EBV infection. Agents representing EBV and sets of B and T lymphocytes move and interact on a three-dimensional grid approximating Waldeyer's ring, together with abstract compartments for lymph and blood. The simulation allows us to explore the development and resolution of virtual infections in a manner not possible in actual human experiments. Specifically, we identify parameters capable of inducing clearance, persistent infection, or death.
Collapse
Affiliation(s)
- M Shapiro
- Department of Pathology, Jaharis Building, Tufts University School of Medicine, 150 Harrison Ave., Boston, MA 02111, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Hawkins J, Wells J. How infrastructure procurement can enhance social development. Proceedings of the Institution of Civil Engineers - Management, Procurement and Law 2007. [DOI: 10.1680/mpal.2007.160.1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper reports the findings of a study by Engineers Against Poverty and the Institution of Civil Engineers into the factors in infrastructure procurement that are currently inhibiting the achievement of social development objectives. The paper explores the impact/performance of the asset and the service it delivers (the product), and the opportunities during the project's construction and operation (the process). The study adopted a very broad definition of ‘procurement’ to embrace all stages from project identification to the final monitoring, enforcement and evaluation. Methods included reviews of procurement documentation and practice in four case-study countries (India, Indonesia, Kenya and Nigeria), round-table discussions and in-depth interviews with stakeholders. This yielded a long list of inhibiting factors but also some encouraging efforts at reform. The paper concludes that procurement procedures and contract agreement have the potential to promote social objectives. However, the objectives should be clearly identified in the project design; the budget and procurement strategy have to be appropriate; and implementation must be monitored and enforced.
Collapse
Affiliation(s)
- J. Hawkins
- Institution of Civil Engineers London, UK
| | - J. Wells
- Engineers Against Poverty London, UK
| |
Collapse
|
50
|
|