1
|
Howell TJ, Nieforth L, Thomas-Pino C, Samet L, Agbonika S, Cuevas-Pavincich F, Fry NE, Hill K, Jegatheesan B, Kakinuma M, MacNamara M, Mattila-Rautiainen S, Perry A, Tardif-Williams CY, Walsh EA, Winkle M, Yamamoto M, Yerbury R, Rawat V, Alm K, Avci A, Bailey T, Baker H, Benton P, Binney C, Boyle S, Brandes H, Carr AM, Coombe W, Coulter K, Darby A, Davies L, Delisle E, Enders-Slegers MJ, Fournier A, Fox M, Gee N, Graham TM, Hamilton-Bruce A, Hansen TGB, Hart L, Heirs M, Hooper J, Howe R, Johnson E, Jones M, Karagiannis C, Kieson E, Kim SA, Kivlen C, Lanning B, Lewis H, Linder D, Mai DL, Mariti C, Mead R, Ferreira GM, Ngai D, O’Keeffe S, O’Connor G, Olsen C, Ormerod E, Power ER, Pritchard PA, Rodriguez K, Rook D, Ruby MB, Schofield L, Signal T, Steel J, Stone W, Symonds M, van Rooy D, Warda T, Wilson M, Young J, Bennett P. Defining Terms Used for Animals Working in Support Roles for People with Support Needs. Animals (Basel) 2022; 12:ani12151975. [PMID: 35953965 PMCID: PMC9367407 DOI: 10.3390/ani12151975] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 05/31/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 01/20/2023] Open
Abstract
Simple Summary Although animals are being employed for a growing number of roles to support people, the terms used to describe those animals (e.g., “therapy animal” and “emotional support animal”) can be confusing. The same term may be used to describe different types of work, or the same role can be described with different terms. This paper presents the results of a collaboration between over 100 researchers, practitioners, and end users of animal-based supports from all over the world. We created working definitions for the following nine terms: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. In this paper, we describe the defining characteristics of each animal type and how it is different from the other types. We recommend phasing out the terms “skilled companion animal” and “service animal”, because they are similar to other terms. We discuss how our definitions may be received in different parts of the world. Abstract The nomenclature used to describe animals working in roles supporting people can be confusing. The same term may be used to describe different roles, or two terms may mean the same thing. This confusion is evident among researchers, practitioners, and end users. Because certain animal roles are provided with legal protections and/or government-funding support in some jurisdictions, it is necessary to clearly define the existing terms to avoid confusion. The aim of this paper is to provide operationalized definitions for nine terms, which would be useful in many world regions: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. At the International Society for Anthrozoology (ISAZ) conferences in 2018 and 2020, over 100 delegates participated in workshops to define these terms, many of whom co-authored this paper. Through an iterative process, we have defined the nine terms and explained how they differ from each other. We recommend phasing out two terms (i.e., “skilled companion animal” and “service animal”) due to overlap with other terms that could potentially exacerbate confusion. The implications for several regions of the world are discussed.
Collapse
Affiliation(s)
- Tiffani J. Howell
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia
- Correspondence:
| | - Leanne Nieforth
- OHAIRE, Comparative Pathobiology, Center for the Human Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Clare Thomas-Pino
- Human-Animal Interaction, Department of Animal and Agriculture, Hartpury University, Gloucester GL19 3BE, UK
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA
| | | | | | - Francisca Cuevas-Pavincich
- Centro de Estudios en Bienestar y Convivencia Social, Facultad de Psicología, Universidad del Desarrollo, Santiago 7610658, Chile
| | - Nina Ekholm Fry
- Institute for Human-Animal Connection, University of Denver, Denver, CO 80208, USA
| | - Kristine Hill
- EASE Working Group, College of Social Sciences and International Studies, University of Exeter, Exeter EX4 4PY, UK
| | | | - Miki Kakinuma
- Department of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Tokyo 180-8602, Japan
| | - Maureen MacNamara
- Department of Social Work, Beaver College of Health Sciences, Appalachian State University, Boone, NC 28607, USA
| | - Sanna Mattila-Rautiainen
- Sports and Exercise Medicine, Biomedicine, University of Eastern Finland, Yliopistonranta 1, 70600 Kuopio, Finland
| | - Andy Perry
- Department of Anthrozoology, University of Exeter (alumnus), Exeter EX4 4PY, UK
| | | | | | - Melissa Winkle
- Dogwood Therapy Services, Albuquerque, NM 87120, USA
- Animal Assisted Interventions International, 6537 HN Nijmegen, The Netherlands
| | - Mariko Yamamoto
- Department of Animal Sciences, Teikyo University of Science, Uenohara, Yamanashi 409-0193, Japan
| | - Rachel Yerbury
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Vijay Rawat
- School of Health, Medical & Applied Sciences, Central Queensland University, Melbourne, VIC 3000, Australia
| | - Kathy Alm
- Professional Association of Therapeutic Horsemanship International, Denver, CO 80233, USA
| | - Ashley Avci
- Risk Frontiers, St Leonards, NSW 2065, Australia
- Faculty of Law, Macquarie University, Sydney, NSW 2019, Australia
| | - Tanya Bailey
- Boynton Health, Office of Student Affairs, University of Minnesota, Minneapolis, MN 55455, USA
| | - Hannah Baker
- University Centre Sparsholt, University of Winchester, Sparsholt, Winchester SO21 2NF, UK
| | - Pree Benton
- Dogs for Life, Caulfield South, VIC 3162, Australia
| | | | - Sara Boyle
- Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - Hagit Brandes
- The Program for Animal-Assisted-Psychotherapy, Tel-Hai College, Upper Galilee 1220800, Israel
| | - Alexa M. Carr
- Department of Human Development, Washington State University, Pullman, WA 99164, USA
| | - Wendy Coombe
- Animal Therapies Ltd., Gold Coast, QLD 4209, Australia
| | - Kendra Coulter
- Management and Organizational Studies, Huron University College at Western University, London, ON N6G 1H3, Canada
| | - Audrey Darby
- Equine Therapy Unit, ChildVision National Education Centre for Blind Children, D09 WKOH Dublin, Ireland
| | | | - Esther Delisle
- The Canadian Institute of Animal-Assisted Interventions, Montréal, QC H3V 1C7, Canada
| | - Marie-Jose Enders-Slegers
- Faculty of Psychology and Educational Sciences, Open University the Netherlands, 6419 AT Heerlen, The Netherlands
| | - Angela Fournier
- Department of Psychology, Bemidji State University, Bemidji, MN 56601, USA
| | - Marie Fox
- School of Law & Social Justice, University of Liverpool, Liverpool L69 3BX, UK
| | - Nancy Gee
- Center for Human-Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | | | - Anne Hamilton-Bruce
- Stroke Research Programme, The Queen Elizabeth Hospital & Basil Hetzel Institute for Translational Health Research, Woodville South, SA 5011, Australia
| | - Tia G. B. Hansen
- Center for Human Animal Psychology, Department of Communication and Psychology, Aalborg University, 9000 Aalborg, Denmark
| | - Lynette Hart
- School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Morag Heirs
- Clinical Animal Behaviour, Well Connected Canine, York YO24 3HG, UK
| | - Jade Hooper
- Faculty of Social Science, University of Stirling, Stirling FK9 4LA, UK
| | - Rachel Howe
- School of Nursing, Midwifery & Health Systems, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Elizabeth Johnson
- Department of Anthropology, University of Nevada, Las Vegas, Las Vegas 89183, NV, USA
| | - Melanie Jones
- Orygen Centre for Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC 3000, Australia
- Lead The Way Institute Ferntree Gully, Boronia, VIC 3156, Australia
| | | | | | - Sun-A Kim
- Clinical Animal Behavior Service, Veterinary Medical Teaching Hospital, Chungbuk National University, Cheongju 28644, Korea
| | - Christine Kivlen
- Occupational Therapy, Health Care Sciences, Wayne State University, Detroit, MI 48202, USA
| | - Beth Lanning
- Department of Public Health, Baylor University, Waco, TX 76798, USA
| | - Helen Lewis
- Department of Education and Childhood Studies, Swansea University, Swansea SA2 8PP, UK
| | - Deborah Linder
- Department of Clinical Sciences, Tufts Institute for Human-Animal Interaction, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | - Dac Loc Mai
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia
| | - Chiara Mariti
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy
| | | | - Gilly Mendes Ferreira
- Scottish SPCA (Scottish Society for the Prevention of Cruelty to Animals), Dunfermline KY11 8RY, UK
| | - Debbie Ngai
- Hong Kong Animal Assisted Therapy Association (HKAATA), Hong Kong, China
| | | | | | | | - Elizabeth Ormerod
- Society for Companion Animal Studies, Godmachester, Cambridgeshire PE29 2BQ, UK
| | - Emma R. Power
- Institute for Culture and Society, School of Social Sciences, Western Sydney University, Penrith, NSW 2751, Australia
| | - Peggy A. Pritchard
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Kerri Rodriguez
- Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, CO 80526, USA
| | - Deborah Rook
- Northumbria Law School, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Matthew B. Ruby
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia
| | - Leah Schofield
- Solihull College and University Centre, Solihull B91 1SB, UK
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Midlothian EH25 9RG, UK
| | - Tania Signal
- School of Health, Medical & Applied Sciences, College of Psychology, Central Queensland University, Rockhampton, QLD 4702, Australia
| | - Jill Steel
- Moray House School of Education and Sports Science, University of Edinburgh, Edinburgh EH8 8AQ, UK
| | - Wendy Stone
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC 3000, Australia
| | - Melissa Symonds
- Faculty of Health, Education and Society, The University of Northampton, Northampton NN1 5PH, UK
| | | | - Tiamat Warda
- Institute for Human-Animal Connection, University of Denver, Denver, CO 80208, USA
| | - Monica Wilson
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Janette Young
- Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Pauleen Bennett
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia
| |
Collapse
|
2
|
Murali A, Ramlogan-Steel C, Andrzejewski S, Dhungel B, Steel J, Layton C. The 8-fold quadrant dissection method for ex vivo human interventional retinal experimentation. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01558] [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: 11/29/2022]
Affiliation(s)
- A. Murali
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - C. Ramlogan-Steel
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - S. Andrzejewski
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - B. Dhungel
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Liver Cancer Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - J. Steel
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Liver Cancer Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - C. Layton
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| |
Collapse
|
3
|
Layton C, Dhungel B, Andrzejewski S, Jayachandran A, Murali A, Ramlogan-Steel C, Steel J. Gene therapy targeting of choroidal disease and AAV transcytosis through the outer blood retina barrier epithelium. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02683] [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: 11/30/2022]
Affiliation(s)
- C. Layton
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| | - B. Dhungel
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| | - S. Andrzejewski
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| | - A. Jayachandran
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| | - A. Murali
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| | - C. Ramlogan-Steel
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| | - J. Steel
- Gallipoli Medical Research Institute; University of Queensland; Greenslopes Australia
| |
Collapse
|
4
|
Goh A, Ramlogan-Steel C, Jayachandran A, Steel J, Layton C. Genetic evidence for the role of ultraviolet radiation in the pathogenesis of uveal melanoma. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02787] [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: 11/28/2022]
Affiliation(s)
- A. Goh
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - C. Ramlogan-Steel
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - A. Jayachandran
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Liver Cancer Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - J. Steel
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Liver Cancer Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| | - C. Layton
- Faculty of Medicine; University of Queensland; Brisbane Australia
- Ophthalmology Research Unit; Gallipoli Medical Research Institute; Greenslopes Australia
| |
Collapse
|
5
|
Gilbert A, Steel J, Rachel D, Jaggi A. Identifying barriers and facilitators to engaging in clinical research within an NHS Therapies Department: results of a listening exercise. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.214] [Citation(s) in RCA: 2] [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: 11/28/2022]
|
6
|
Gray R, Porter G, Steel J. PB.22: Does the Nottingham predictor of bidimensional product of calcium accurately predict the success of wide local excision for ductal carcinoma in situ surgery in our centre? Breast Cancer Res 2013. [PMCID: PMC3980307 DOI: 10.1186/bcr3522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
7
|
Gray R, Porter G, Steel J. PB.30: What is your biopsy threshold in symptomatic clinic and what should it be? B2:B5 biopsy ratio: 18 months in our centre. Breast Cancer Res 2013. [PMCID: PMC3980379 DOI: 10.1186/bcr3530] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- R Gray
- Plymouth Hospitals NHS Trust, Plymouth, UK
| | - G Porter
- Plymouth Hospitals NHS Trust, Plymouth, UK
| | - J Steel
- Plymouth Hospitals NHS Trust, Plymouth, UK
| |
Collapse
|
8
|
Sankaye P, Porter G, Steel J, Doyle S. Is ultrasound axillary staging less accurate in invasive lobular breast cancer than in ductal breast cancer? Breast Cancer Res 2012. [PMCID: PMC3542673 DOI: 10.1186/bcr3251] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
9
|
Murphy S, Akinyemi A, Steel J, Petillot Y, Poole I. Multi-compartment heart segmentation in CT angiography using a spatially varying gaussian classifier. Int J Comput Assist Radiol Surg 2012; 7:829-36. [PMID: 22644384 DOI: 10.1007/s11548-012-0695-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 04/19/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE A fully automated and efficient method for segmenting ten major structures within the heart in Cardiac CT Angiography data for the purposes of display or cardiac functional analysis. MATERIALS AND METHODS A spatially varying Gaussian classifier is a flexible model for segmentation, combining the advantages of atlas-based frameworks, with supervised intensity models. It is composed of an independent Gaussian classifier at each voxel and uses non-rigid registration for the initial spatial alignment. We show how this large model can be trained efficiently and present a novel smoothing technique based on normalised convolution to mitigate inherent overfitting issues. The 30 datasets used in this study are selected from a variety of different scanners in order to test the robustness and stability of the algorithm. The datasets were manually segmented by a trained clinician. RESULTS The method was evaluated in a leave-one-out fashion, and the results were compared to other state of the art methods in the field, with a mean surface-to-surface distance of between 0.61 and 2.12 mm for different compartments. CONCLUSION The accuracy of this method is comparable to other state of the art methods in the field. Its benefits lie in its conceptual simplicity and its general applicability. Only one non-rigid registration is required, giving it a speed advantage over multi-atlas approaches. Further accuracy may be achievable through the incorporation of an explicit shape model.
Collapse
Affiliation(s)
- S Murphy
- Toshiba Medical Visualization Systems Europe, Edinburgh, UK.
| | | | | | | | | |
Collapse
|
10
|
Sankaye P, Chhatani S, Doyle S, Steel J, Paisley K, Lyons B, Watkins R, Porter G. Preoperative sonographic axillary staging in breast cancer: correlation with sentinel node sampling. Breast Cancer Res 2011. [PMCID: PMC3238270 DOI: 10.1186/bcr2985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
11
|
Johnson S, Brown S, Porter G, Steel J, Paisley K, Watkins R, Holgate C. Staging primary breast cancer. Are there tumour pathological features that correlate with a false-negative axillary ultrasound? Clin Radiol 2011; 66:497-9. [DOI: 10.1016/j.crad.2010.11.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 11/11/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
|
12
|
Cho SW, Steel J, Tsung A, Marsh JW, Geller DA, Gamblin TC. Safety of liver resection in the elderly: how important is age? Ann Surg Oncol 2010; 18:1088-95. [PMID: 21046265 DOI: 10.1245/s10434-010-1404-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Indexed: 12/15/2022]
Abstract
BACKGROUND With the aging population, more elderly patients are being considered for hepatic resection. We investigated whether advanced age was associated with higher rate and severity of postoperative complications. METHODS A total of 75 patients aged ≥70 years (group E) were matched with 75 patients aged <70 years (group Y) by the extent of liver resection and by operative indications. Primary outcome measures were rates and severity of complications. Secondary outcome measures were length of hospital stay and discharge destination. Univariate analysis was also performed to identify variables associated with higher surgical risk. RESULTS Male-to-female ratio was 43:32 in both groups. Overall complication rates were 44 and 33.3% in group E and Y, respectively (P = 0.241; odds ratio = 1.57; 95% confidence interval [95% CI], 0.81-3.05). There was no mortality in both groups. The only postoperative age-related morbidity was confusion in the elderly. There was no difference in the rates of severe complications (grade ≥3) between group E and group Y (16 vs. 14.7%; P = 0.744; odds ratio = 1.11; 95% CI, 0.46-2.70). Median length of hospital stay were 7 and 6 days, respectively (P = 0.01). Nineteen percent and 1% of patients in group E and group Y were discharge to rehabilitation facilities, respectively (P = 0.001). Univariate analysis showed that preoperative systemic chemotherapy and longer operative time were associated with higher morbidity in the elderly. CONCLUSIONS Liver resection can be performed in patients aged ≥70 years as safely as in younger patients. Duration and timing of systemic chemotherapy before liver resection should be optimized to minimize postoperative morbidity.
Collapse
Affiliation(s)
- S W Cho
- UPMC Liver Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | | | | | | |
Collapse
|
13
|
Bunting D, Holgate C, Steel J, Watkins R. Breast Cancer in Association with Radial Scar/Complex Sclerosing Lesion (rs/csl): Long Term Follow Up and Risk of Subsequent Breast Cancer. Int J Surg 2010. [DOI: 10.1016/j.ijsu.2010.07.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Bunting D, Watkins R, Steel J, Holgate C. Predisposition to breast cancer: the risk associated with radial scar/complex sclerosing lesions (RS/CSL). Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.098] [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
|
15
|
Hall SJ, Brown SE, Porter GJR, Steel J, Paisley K, Watkins RM, Holgate C. Negative axillary ultrasound in primary breast cancer: how reassured should we really be? Breast Cancer Res 2009. [PMCID: PMC4284851 DOI: 10.1186/bcr2390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
16
|
Hall SJ, Brown SE, Porter GJR, Steel J, Paisley K, Watkins RM, Holgate C. Axillary ultrasound in staging breast cancer: diagnostic accuracy and effect on subsequent axillary surgery - the Plymouth experience. Breast Cancer Res 2009. [PMCID: PMC4284852 DOI: 10.1186/bcr2391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
17
|
Steel J, Cole C, Sherlock M. Providing inpatient education on a segregated ward. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Porter G, Steel J, Paisley K, Watkins R, Holgate C. Incidental breast masses detected by computed tomography: are any imaging features predictive of malignancy? Clin Radiol 2009; 64:529-33. [DOI: 10.1016/j.crad.2009.01.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 01/14/2009] [Accepted: 01/20/2009] [Indexed: 11/15/2022]
|
19
|
Abstract
BACKGROUND The Neuroform stent can help in the treatment of difficult, wide-necked intracranial aneurysms. The objective of our study is to report some of the challenges associated with the Neuroform stent in the treatment of intracranial aneurysms. METHODS From January 2003 to August 2006, consecutive patients treated with Neuroform stent for intracranial aneurysms were prospectively enrolled. Information on patient demographics, cerebrovascular risk factors, aneurysm size and location were collected. Technical and clinical complications as well as clinical outcomes were measured. Data were analyzed retrospectively using SPSS software version 11.5. RESULTS Successful deployment of the stent, in the target artery, was achieved in 65/67 (97%) patients. Stent deployment failed in two cases and the migration of stent developed in one during coiling. Postoperative thromboembolic events developed in three patients. These three patients possessed hyperactive platelets, and were treated with intravenous eptifibatide. Intraoperative rupture of aneurysm developed in one patient, which was secured by subsequent coiling. Majority of the patients had good outcomes GOS (Glasgow Outcome Score) 1 or NIHSS (National Institute of Health Stroke Scale) 0 in 63/67 (94%), GOS 2 or NIHSS 2 in one patient and GOS 3 or NIHSS 4 was observed in three cases. CONCLUSION Despite a low rate of intraoperative complications, post-procedural thromboembolic events were common in Neuroform stent-treated patients, which might be associated with hyperactive platelets. Further studies are warranted to identify any potential relationship between post-stent hyperactive platelets and thromboembolism.
Collapse
Affiliation(s)
- Abutaher M Yahia
- Department of Neurology, Neurosurgery & Radiology, Upstate Medical University, 750 E Adams Street, Syracuse, NY 13210, USA.
| | | | | | | | | | | |
Collapse
|
20
|
Affiliation(s)
- A Loewenstein
- Tennent Memorial Institute, University of Glasgow, Glasgow
| | | |
Collapse
|
21
|
Abstract
OBJECTIVE To examine changes in perinatal mortality and birth weight of babies born to mothers with pregestational type 1 diabetes over 40 years in a single teaching hospital clinic. METHODS This was a retrospective survey of cases from the combined diabetes and obstetrics antenatal clinic at the Royal Infirmary of Edinburgh and Simpson Memorial Maternity Pavilion, Edinburgh, Scotland. Birth weight, standardized birth weight, and perinatal mortality were obtained from 643 singleton babies born after 28 weeks of gestation to mothers with pregestational type 1 diabetes between 1960 and 1999. RESULTS There was a dramatic improvement in perinatal mortality rate, falling from 225 (per 1,000 total births after 28 weeks of gestation) in the 1960s to 102 in the 1970s, 21 in the 1980s, and 10 in the 1990s (P < .001 for effect of birth year). In contrast, standardized birth weight (adjusted for sex, gestational age, and parity), which was significantly higher than the background population (+1.41 standard deviations above the population norm, P < .001) showed no significant change over time. CONCLUSION Changes in diabetic management and obstetric practice over the 40 years of our survey have resulted in enormous improvements in the outlook for offspring of mothers with diabetes. Somewhat surprisingly this has not been associated with a reduction in overgrowth of the fetus. LEVEL OF EVIDENCE II-2.
Collapse
Affiliation(s)
- F D Johnstone
- Obstetrics Department, University of Edinburgh, Edinburgh, United Kindgom
| | | | | |
Collapse
|
22
|
Abstract
This paper reviews a project which opened up a multi-million pound market to Hallite Seals for a new and innovative range of thermoplastic seals and at the same time drastically reduced the cost of existing products. The project duration was kept to one year by taking advantage of new technologies wherever possible. The project not only achieved the marketing objectives within the planned time-scales, it also provided a payback on capital expenditure of over £330 000 in less than 12 months. Severe customer service problems on existing products were eliminated and the value of stocks and work-in-progress was significantly reduced.
Collapse
Affiliation(s)
- V L Clark
- Hallite Seals International, Hampton, Middlesex
| | | | - J Steel
- Hallite Seals International, Hampton, Middlesex
| | - S Smith
- Hallite Seals International, Hampton, Middlesex
| |
Collapse
|
23
|
Gorla SR, Steel J, Cohn R, Khan SA. Impact of surgical resection of primary breast tumor in stage IV breast cancer on local control and survival. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.629] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. R. Gorla
- Northwestern Univ Sch of Medicine, Chicago, IL; Northwestern Univ, Chicago, IL
| | - J. Steel
- Northwestern Univ Sch of Medicine, Chicago, IL; Northwestern Univ, Chicago, IL
| | - R. Cohn
- Northwestern Univ Sch of Medicine, Chicago, IL; Northwestern Univ, Chicago, IL
| | - S. A. Khan
- Northwestern Univ Sch of Medicine, Chicago, IL; Northwestern Univ, Chicago, IL
| |
Collapse
|
24
|
Parker M, White R, Leonardsson G, Milligan S, Steel J. Identification of RIP140 as a nuclear receptor cofactor with a role in female reproduction. Ernst Schering Res Found Workshop 2004:23-31. [PMID: 15248502 DOI: 10.1007/978-3-662-05386-7_2] [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] [Indexed: 04/30/2023]
Affiliation(s)
- M Parker
- Institute of Reproduction and Developmental Biology, Faculty of Medicine, Imperial College, London, UK.
| | | | | | | | | |
Collapse
|
25
|
Abstract
Organisms appear to be present in human fetal membranes without any apparent impact on pregnancy maintenance or the fetal brain. A clear link between chorioamnionitis and fetal brain damage suggests that tissue responses at the feto-maternal interface may be the key determinant of whether preterm labour and brain damage occur.
Collapse
Affiliation(s)
- M H F Sullivan
- Department of Obstetrics & Gynaecology, Imperial College of Science, Technology & Medicine, Institute of Reproductive & Developmental Biology, Hammersmith Hospital, DuCane Road, London, UK
| | | | | | | | | |
Collapse
|
26
|
Abstract
The number of deaths per year from hepatocellular carcinoma (HCC) exceeds 250000, placing it sixth as the cause of death from cancer worldwide. The primary etiology of most cases of HCC in the US is hepatitis B and/or C. Extensive research has demonstrated that the relationship between hepatitis B infection and the progression to HCC is mediated by the immune system. A substantial, but unrelated literature, describes the relationship between psychosocial factors (e.g., stress, psychiatric morbidity), immune system reactivity, and disease progression in patients with cancer. However, the role of these factors in the progression of HBV-HCC has not been explored. An understanding of the relationship among virology, immunology, and behavior in the development and recurrence of HCC may provide alternative methods for secondary prevention of HCC (e.g., behavioral) until a vaccine and/or pharmacological treatments are developed, feasible, and affordable.
Collapse
Affiliation(s)
- J Steel
- Department of Hematology and Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
| | | | | | | |
Collapse
|
27
|
Abstract
The consequences of late referrals for nephrological care include: increased morbidity, poorer quality of life on dialysis and probably increased mortality. Few studies look at the socio-demographic factors which influence referral to the nephrologist. There is good evidence from studies in other areas of health care that socio-demographic and economic factors influence access to health care. It is important that the nephrology community understand whom the individuals are who likely to be referred late so that we can address any inequality in access to services. We studied all of the patients who started renal replacement therapy in our unit over a five-year period, 1st January 1996 to 31st December 2000 (n = 494). We collected data on gender, age at referral, ethnicity, the date that the individual started dialysis as well as the date they were first seen by a nephrologist. We analysed the data to see if age, gender or ethnicity was associated with timing of referral. If an individual had seen a nephrologist more than three months prior to starting dialysis, they were termed 'early referred', if not they were termed 'late referred' Since this was a sociologically driven research project, we set statistical significance at the 10% (0.1) level. Our data showed that gender did not affect the timing of referral (p = ns), ethnicity affected referral in so much as whites were more likely to be referred late than blacks (p = 0.08) but no more so than non-whites (p = ns). People under the age of 30 were statistically more likely to be referred late than people over the age of 30 years (p = 0.027) as were people under the age of 40 (p = 0.047). We interpret these finding as demonstrating that health care professionals are referring older people and people from the black community in good time and that, in contrast to other studies of inequalities in health, these findings demonstrate that the elderly and ethnic minorities are not being disadvantaged.
Collapse
Affiliation(s)
- J Steel
- King's College Hospital, London, UK
| | | |
Collapse
|
28
|
Abstract
Understanding of how to analyse and interpret quality of life (QoL) data from clinical trials in patients with advanced cancer is limited. In order to increase the knowledge about the possibilities of drawing conclusions from QoL data of these patients, data from 2 trials were reanalysed. A total of 113 patients with pancreatic, biliary or gastric cancer were included in 2 randomised trials comparing chemotherapy and best supportive care (BSC) with BSC alone. Patient benefit was evaluated by the treating physician (subjective response) and by using selected scales and different summary measures of the EORTC QLQ-C30 questionnaire. An increasing number of drop-outs (mainly due to death) with time did not occur in a random fashion. Therefore, the mean scores in the different subscales of the QLQ-C30 obtained during the follow-up of interviewed patients did not reflect the outcome of the randomised population. The scores of the patient-provided summary measure, 'Global health status/QoL', were stable in a rather high proportion of the patients and could not discriminate between the 2 groups. 3 other summary measures revealed greater variability, and they all discriminated between the 2 groups. A high agreement was also seen between the changes in the summary measures and the subjective response. A categorisation of whether an individual patient had benefited or not from the intervention could overcome the problem with the selective attrition.
Collapse
Affiliation(s)
- K Nordin
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | | | | | | |
Collapse
|
29
|
Abstract
Adenoviral vectors remain one of the most promising methods of gene delivery but are plagued by several inherent problems including immune inactivation and transient expression. This paper reports a novel microparticle-based delivery system for adenovirus that allows high uptake of virus, stable complex formation and extended release. In addition, this microparticle/adenovirus complex has been demonstrated to only release virus upon cell contact. The significant clinical implications of this delivery system are discussed.
Collapse
Affiliation(s)
- H M Cavanagh
- School of Biomedical Sciences, Charles Sturt University, Locked Bag 588, NSW 2678, Wagga Wagga, Australia.
| | | | | | | | | |
Collapse
|
30
|
Abstract
AIMS In the light of goals for reducing blindness due to diabetes, published in the St Vincent Declaration, 1989, the aim of this study was to find the incidence and prevalence of blindness in the diabetic population of Fife. METHODS All blind registrations for the period 1990-9 were studied. Those with diabetes as the first or main diagnosis were included as new diabetic blind. The prevalence of diabetes was studied in a large sample population and extrapolated to the estimated population of Fife. RESULTS The incidence of blindness due to diabetes was 64 (SD 24, 95% CI 49-79) per 100 000 diabetic population/year. The point prevalence of blindness due to diabetes on 31 December 1999 was 210 per 100 000 diabetic population. CONCLUSION The incidence of blindness due to diabetes, in a diabetic population, is now known. Without this benchmark it is impossible to assess the implementation of the St Vincent Declaration.
Collapse
|
31
|
Hartnell A, Steel J, Turley H, Jones M, Jackson DG, Crocker PR. Characterization of human sialoadhesin, a sialic acid binding receptor expressed by resident and inflammatory macrophage populations. Blood 2001; 97:288-96. [PMID: 11133773 DOI: 10.1182/blood.v97.1.288] [Citation(s) in RCA: 224] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Sialoadhesin is a macrophage-restricted cellular interaction molecule and a prototypic member of the Siglec family of sialic acid binding immunoglobulin (Ig)-like lectins. So far, it has only been characterized in rodents. Here, we report the molecular cloning, binding properties, and expression pattern of human sialoadhesin. The predicted protein sequences of human and mouse sialoadhesin are about 72% identical, with the greatest similarity in the extracellular region, which comprises 17 Ig domains in both species. A recombinant protein consisting of the first 4 N-terminal domains of human sialoadhesin fused to the Fc region of human IgG1 mediated sialic acid-dependent binding with a specificity similar to its mouse counterpart, preferring sialic acid in the alpha2,3 glycosidic linkage over the alpha2,6 linkage. By flow cytometry with peripheral blood leukocytes, recombinant sialoadhesin bound strongly to granulocytes with intermediate binding to monocytes, natural killer cells, B cells, and a subset of CD8 T cells. Using antibodies raised to the recombinant protein, sialoadhesin was immunoprecipitated from the THP-1 human monocytic cell line as an approximate 200-kd glycoprotein. The expression pattern of human sialoadhesin was found to be similar to that of the mouse receptor, being absent from monocytes and other peripheral blood leukocytes, but expressed strongly by tissue macrophages in the spleen, lymph node, bone marrow, liver, colon, and lungs. High expression was also found on inflammatory macrophages present in affected tissues from patients with rheumatoid arthritis.
Collapse
Affiliation(s)
- A Hartnell
- Imperial Cancer Research Fund Laboratories, Oxford, United Kingdom
| | | | | | | | | | | |
Collapse
|
32
|
Floyd H, Ni J, Cornish AL, Zeng Z, Liu D, Carter KC, Steel J, Crocker PR. Siglec-8. A novel eosinophil-specific member of the immunoglobulin superfamily. J Biol Chem 2000; 275:861-6. [PMID: 10625619 DOI: 10.1074/jbc.275.2.861] [Citation(s) in RCA: 160] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We describe the characterization of siglec-8, a novel sialic acid-binding immunoglobulin-like lectin that is expressed specifically by eosinophils. A full-length cDNA encoding siglec-8 was isolated from a human eosinophil cDNA library. Siglec-8 is predicted to contain three extracellular immunoglobulin-like domains, a transmembrane region, and a cytoplasmic tail of 47 amino acids. The siglec-8 gene mapped on chromosome 19q13.33-41, closely linked to genes encoding CD33 (siglec-3), siglec-5, siglec-6, and siglec-7. When siglec-8 was expressed on COS cells or as a recombinant protein fused to the Fc region of human IgG(1), it was able to mediate sialic acid-dependent binding to human erythrocytes and to soluble sialoglycoconjugates. Using specific monoclonal antibodies, siglec-8 could be detected only on eosinophils and hence appears to be the first example of an eosinophil-specific transmembrane receptor.
Collapse
MESH Headings
- Amino Acid Sequence
- Animals
- Antigens, CD/chemistry
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Antigens, Differentiation, B-Lymphocyte/chemistry
- Antigens, Differentiation, B-Lymphocyte/genetics
- Antigens, Differentiation, B-Lymphocyte/metabolism
- Antigens, Differentiation, Myelomonocytic/chemistry
- Antigens, Differentiation, Myelomonocytic/genetics
- COS Cells
- Chromosome Mapping
- Chromosomes, Human, Pair 19
- Eosinophils/immunology
- Erythrocytes/immunology
- Gene Library
- Genetic Linkage
- Granulocytes/immunology
- Humans
- Immunoglobulin Fc Fragments/genetics
- Immunoglobulin G/genetics
- Lectins
- Lymphocytes/immunology
- Molecular Sequence Data
- Monocytes/immunology
- Recombinant Fusion Proteins/metabolism
- Sequence Alignment
- Sequence Homology, Amino Acid
- Sialic Acid Binding Ig-like Lectin 3
- Sialic Acids/blood
- Transfection
Collapse
Affiliation(s)
- H Floyd
- The Wellcome Trust Biocentre at Dundee, Department of Biochemistry, University of Dundee, Dundee DD1 5EH, Scotland, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Affiliation(s)
- C L Thomas
- Molecular Neuropathobiology, Imperial Cancer Research Fund, London, UK
| | | | | | | |
Collapse
|
34
|
Bahl S, Martin S, Rawlins P, Sadeghi R, Smith PM, Steel J, Shanu-Wilson P, Wood KA, Wrigley SK. XR651, a novel naphthacene-5,12-dione. J Antibiot (Tokyo) 1997; 50:169-71. [PMID: 9099228 DOI: 10.7164/antibiotics.50.169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- S Bahl
- London International Group, Research and Development, Cambridge, U.K
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Brown CJ, Dawson A, Dodds R, Gamsu H, Gillmer M, Hall M, Hounsome B, Knopfler A, Ostler J, Peacock I, Rothman D, Steel J. Report of the Pregnancy and Neonatal Care Group. Diabet Med 1996; 13:S43-53. [PMID: 8894455] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- C J Brown
- Department of Maternity and Gynaecology, North Hampshire Hospital, Basingstoke
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Knox M, Steel J. Nutritional enhancement of parasite control in small ruminant production systems in developing countries of South-East Asia and the Pacific. Int J Parasitol 1996; 26:963-70. [PMID: 8923143 DOI: 10.1016/s0020-7519(96)80072-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Nutritional insufficiency and gastrointestinal nematode parasitism are major constraints to small ruminant production in south-east Asia and the Pacific Islands. Research on the effects of low cost supplements which supply nitrogen and essential minerals on the ability of small ruminants to resist infection is summarised. In controlled pen studies in young Merino sheep offered a low quality roughage diet of oaten chaff and essential minerals, supplementation with urea reduced the effects of parasitic infection by increasing weight gain and wool production and reducing faecal egg output and parasite burden. In Fiji, field studies have shown that supplementation with urea-molasses blocks can result in increased live-weights of lambs at weaning, increased reproduction rates in maiden ewes and reduction in faecal egg output in grazing sheep. Additional benefits were derived from the inclusion of anthelmintic in the blocks in similar groups of sheep particularly during periods of greater susceptibility to parasites. Pen studies with young goats have shown that urea supplements alone gave no production benefits, but when accompanied by 100 g/d of cotton seed meal beneficial responses were observed. It is expected that parasite control in the small ruminant production systems of developing countries in south-east Asia and the Pacific Islands will benefit from the introduction of low cost nitrogen supplements along with anthelmintic therapy delivered strategically by molasses blocks.
Collapse
Affiliation(s)
- M Knox
- CSIRO, Division of Animal Production, Armidale, NSW, Australia.
| | | |
Collapse
|
37
|
|
38
|
Steel J. What next in the treatment of diabetes? Practitioner 1996; 240:116-9. [PMID: 8736200] [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] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- J Steel
- Victoria Hospital, Kirkcaldy
| |
Collapse
|
39
|
Brown D, Sadeghi R, Steel J, Moore M, Gammon G. Detection of interleukin-1 signal transduction inhibitors: action of protein kinase inhibitors. Int J Immunopharmacol 1995; 17:887-94. [PMID: 8788118 DOI: 10.1016/0192-0561(95)00085-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The dysregulated production of IL-1 has been shown to play an important role in many pathological processes. Despite the apparent value of compounds able to inhibit either the secretion of IL-1 or its signal transduction pathway in a specific manner, there are no such compounds suitable for clinical use. A major problem in identifying novel and specific inhibitors of signal transduction is the lack of knowledge of the intracellular events which mediate the cellular actions of IL-1. In this study a simple cellular assay has been established to screen natural product and synthetic compound libraries for low molecular weight inhibitors of the cytokine signalling pathways of potential therapeutic value. In addition, we have studied the action of several known modulators of signal transduction on the actions of IL-1.
Collapse
|
40
|
Abstract
The inappropriate use of Accident and Emergency (A & E) departments by the public has been the subject of debate for many years. Patients often attend departments with problems which could equally have been treated by the primary care services in the community. However, despite much research into why patients choose to visit A & E departments rather than their general practitioners, efforts to reverse this trend have generally failed. If the professional view of what is appropriate cannot be enforced, perhaps the label 'inappropriate' belongs to the A & E services rather than the patient.
Collapse
|
41
|
Affiliation(s)
- J Steel
- Aged Care Services, Heidelberg Hospital, Victoria, Australia
| | | |
Collapse
|
42
|
Clochesy JM, Daly BJ, Idemoto BK, Steel J, Fitzpatrick JJ. Preparing advanced practice nurses for acute care. Am J Crit Care 1994; 3:255-9. [PMID: 7920952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND As a result of changes occurring in healthcare, providers have become increasingly specialized, resulting in fragmented care of patients and their families. With these changes, the need has developed for professionals who possess both advanced clinical decision-making ability and expanded psychomotor skills to serve as case managers in collaboration with physicians. As a result, evolving and innovative roles for advanced practice nurses have developed in American hospitals. The development of such roles, within the acute care hospital environment, has led directly to the creation of graduate programs to prepare acute care nurse practitioners. OBJECTIVE This article describes the efforts to develop a specific graduate program to prepare nurses as acute care nurse practitioners. These efforts include the needs assessment, curriculum and role development, implementation, and evaluation of the program. RESULTS Phase 1 evaluation showed significant support for acute care nurse practitioners. External support for the training and use of nurse practitioners in acute care was evidenced by significant financial support for this program provided by an acute care hospital and a private foundation. The first graduates are now practicing as acute care nurse practitioners; Phase 2 evaluation of patient outcomes is under way. CONCLUSION The emergence of acute care nurse practitioners has been stimulated by changes in American healthcare. Support for the use of acute care nurse practitioners is significant, but barriers to implementing the role and patient and fiscal outcomes must be studied.
Collapse
Affiliation(s)
- J M Clochesy
- Case Western Reserve University, Cleveland, Ohio
| | | | | | | | | |
Collapse
|
43
|
Abstract
BACKGROUND: As a result of changes occurring in healthcare, providers have become increasingly specialized, resulting in fragmented care of patients and their families. With these changes, the need has developed for professionals who possess both advanced clinical decision-making ability and expanded psychomotor skills to serve as case managers in collaboration with physicians. As a result, evolving and innovative roles for advanced practice nurses have developed in American hospitals. The development of such roles, within the acute care hospital environment, has led directly to the creation of graduate programs to prepare acute care nurse practitioners. OBJECTIVE: This article describes the efforts to develop a specific graduate program to prepare nurses as acute care nurse practitioners. These efforts include the needs assessment, curriculum and role development, implementation, and evaluation of the program. RESULTS: Phase 1 evaluation showed significant support for acute care nurse practitioners. External support for the training and use of nurse practitioners in acute care was evidenced by significant financial support for this program provided by an acute care hospital and a private foundation. The first graduates are now practicing as acute care nurse practitioners; Phase 2 evaluation of patient outcomes is under way. CONCLUSION: The emergence of acute care nurse practitioners has been stimulated by changes in American healthcare. Support for the use of acute care nurse practitioners is significant, but barriers to implementing the role and patient and fiscal outcomes must be studied.
Collapse
|
44
|
Johnstone FD, West JD, Steel J, Whitehouse DB, Drago GA, Greer IA, Prescott RJ. Lack of association between maternal phosphoglucomutase-1 phenotype and fetal macrosomia in diabetic pregnancy. Br J Obstet Gynaecol 1994; 101:239-45. [PMID: 8193100 DOI: 10.1111/j.1471-0528.1994.tb13117.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To assess the reports that maternal phosphoglucomutase-1 (PGM1) phenotype is highly related to macrosomia in diabetic pregnancy. This could be either a direct metabolic phenomenon, or the PGM1 locus could be a marker for a tightly linked gene involved in the maternal control of fetal growth. DESIGN A comparative biochemical genetic study. SETTING A large diabetic pregnancy clinic. SUBJECTS One hundred and fifty-two women who had diabetes during pregnancy, 136 being insulin dependent before pregnancy. Two hundred and thirty-six women without pre-existing medical or pregnancy complications who functioned as a control group. MEASURES PGM1 phenotype was assessed by conventional electrophoresis and subgroups were examined using iso-electric focusing. OUTCOME Standardised birthweight was corrected for sex, maternal parity and gestation confirmed in every case by early pregnancy ultrasound. Maternal diabetes control was assessed by glycosylated haemoglobin. RESULTS No differences were found in the observed phenotype frequencies for diabetics and control pregnant women. No association between PGM1 phenotype and macrosomia in diabetic pregnancy was found. PGM1 did not make a significant contribution to birthweight, standardised birthweight, length or ponderal index of the baby as assessed by multiple regression. CONCLUSIONS Our study of a larger number of insulin dependent diabetics in Scotland makes the claim that macrosomia in diabetic pregnancy is associated with PGM1 phenotype unlikely to be of general significance.
Collapse
Affiliation(s)
- F D Johnstone
- Department of Obstetrics and Gynaecology, University of Edinburgh, UK
| | | | | | | | | | | | | |
Collapse
|
45
|
Tenchini ML, Adams JC, Gilberty C, Steel J, Hudson DL, Malcovati M, Watt FM. Evidence against a major role for integrins in calcium-dependent intercellular adhesion of epidermal keratinocytes. Cell Adhes Commun 1993; 1:55-66. [PMID: 7521749 DOI: 10.3109/15419069309095681] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
It is well established that integrins mediate keratinocyte adhesion to extracellular matrix proteins, but, in addition, there is some evidence that they mediate intercellular adhesion. We have investigated the role of integrins in keratinocyte-keratinocyte adhesion by adding anti-integrin antibodies to cells in three assays that differ according to the calcium ion concentration of the medium, the presence or absence of an adhesive substrate (glass or tissue culture plastic) and the timing of antibody addition. As previously reported by Larjava et al., (J. Cell Biol. 110:803-815), a monoclonal antibody to the beta 1 subunit perturbed cell-cell adhesion when added to adherent monolayers in low calcium medium (0.1 mM calcium ions), but did not prevent cell-cell adhesion or stratification induced by raising the level of calcium ions to 1.8mM (the concentration in standard medium). Monoclonal antibodies to both the alpha 3 and beta 1 subunits inhibited the attachment, spreading and motility of keratinocytes in low or standard calcium medium when added at the time of plating; however, they had only a modest effect on the accumulation of cells in adherent clusters. Aggregation of keratinocytes in suspension required a calcium ion concentration of greater than 0.1mM and was not inhibited by any of a large panel of anti-integrin antibodies, including three new antibodies that recognise alpha 2 beta 1. We conclude that any inhibitory effects of individual anti-integrin antibodies on cell-cell adhesion are abrogated by a calcium ion concentration above 0.1mM and that in low calcium medium at least some of the inhibition of cell-cell adhesion is a consequence of the inhibition of cell-substrate adhesion and motility.
Collapse
Affiliation(s)
- M L Tenchini
- Università degli Studi di Milano, Dipartimento di Biologie e Genetica per le Scienze Mediche, Italy
| | | | | | | | | | | | | |
Collapse
|
46
|
Illingworth PJ, Johnstone FD, Steel J, Seth J. Luteoma of pregnancy: masculinisation of a female fetus prevented by placental aromatisation. Br J Obstet Gynaecol 1992; 99:1019-20. [PMID: 1335753 DOI: 10.1111/j.1471-0528.1992.tb13712.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- P J Illingworth
- Department of Obstetrics and Gynaecology, University of Edinburgh, UK
| | | | | | | |
Collapse
|
47
|
Steel J, Allwinkle J, Hunter R. Edinburgh and Lothians self-help group for visually impaired diabetic patients. Diabet Med 1992; 9:295. [PMID: 1576818 DOI: 10.1111/j.1464-5491.1992.tb01782.x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- J Steel
- Department of Diabetes, Royal Infirmary, Edinburgh
| | | | | |
Collapse
|
48
|
Steel J, Perry J. Reducing repeat films through a total quality management approach. Adm Radiol 1992; 11:47-9. [PMID: 10117444] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- J Steel
- Mount Vernon Hospital, Alexandria, VA
| | | |
Collapse
|
49
|
Abstract
During a 21-year period, 66 patients with uterine sarcomas were treated at California Medical Center. Histological diagnoses were mixed mesodermal sarcoma in 32 patients (48%), leiomyosarcoma in 24 (36%), and endometrial stromal sarcoma in 10 (15%) patients. The majority of patients (73%) had Stage I tumors. The treatment consisted of surgery alone in 27 (41%), surgery in combination with radiation therapy in 36 (55%), and radiation therapy alone in three (4%) patients. The overall 1-, 2-, and 5-year actuarial survival was 74%, 57%, and 38%, respectively. The 1-, 2-, and 5-year actuarial survival for the 27 surgery alone patients was 73%, 50%, and 25%, which compared with 75%, 61%, and 44% for the 36 surgery plus radiation therapy patients (P = 0.12). The disease-free survival was better for the surgery plus radiation therapy patients, as compared with the surgery alone group (38% vs. 18% at 5 years, P = 0.081). The 5-year survival by histology was 70% for the 10 endometrial stromal sarcoma patients, 40% for the 24 leiomyosarcoma patients, and 23% for the 32 mesodermal sarcoma patients (P = 0.064). As expected, survival depended on the stage of disease (P less than 0.0001). Treatment failure was observed in 35 (53%) patients, which included 9 (14%) with failure in the pelvis. There was no difference in the incidence of failure among patients in the three treatment groups and also in the three histologic groups. There was, however, a significant difference in the incidence of pelvic failure between surgery alone and surgery plus radiation therapy patients. In the 27 surgery alone patients, nine (33%) relapsed in the pelvis, whereas none of the 36 surgery plus radiation therapy patients had locoregional failure, P less than 0.0001. Adjuvant radiation therapy is an important treatment in the management of patients with sarcoma of the uterus.
Collapse
Affiliation(s)
- G Echt
- USC School of Medicine, Department of Radiation Oncology, Los Angeles 90033
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
During a 21-year period, 66 patients with uterine sarcomas were treated at California Medical Center. Histological diagnoses were mixed mesodermal sarcoma in 32 patients (48%), leiomyosarcoma in 24 (36%), and endometrial stromal sarcoma in 10 (15%) patients. The majority of patients (73%) had Stage I tumors. The treatment consisted of surgery alone in 27 (41%), surgery in combination with radiation therapy in 36 (55%), and radiation therapy alone in three (4%) patients. The overall 1-, 2-, and 5-year actuarial survival was 74%, 57%, and 38%, respectively. The 1-, 2-, and 5-year actuarial survival for the 27 surgery alone patients was 73%, 50%, and 25%, which compared with 75%, 61%, and 44% for the 36 surgery plus radiation therapy patients (P = 0.12). The disease-free survival was better for the surgery plus radiation therapy patients, as compared with the surgery alone group (38% vs. 18% at 5 years, P = 0.081). The 5-year survival by histology was 70% for the 10 endometrial stromal sarcoma patients, 40% for the 24 leiomyosarcoma patients, and 23% for the 32 mesodermal sarcoma patients (P = 0.064). As expected, survival depended on the stage of disease (P less than 0.0001). Treatment failure was observed in 35 (53%) patients, which included 9 (14%) with failure in the pelvis. There was no difference in the incidence of failure among patients in the three treatment groups and also in the three histologic groups. There was, however, a significant difference in the incidence of pelvic failure between surgery alone and surgery plus radiation therapy patients. In the 27 surgery alone patients, nine (33%) relapsed in the pelvis, whereas none of the 36 surgery plus radiation therapy patients had locoregional failure, P less than 0.0001. Adjuvant radiation therapy is an important treatment in the management of patients with sarcoma of the uterus.
Collapse
Affiliation(s)
- G Echt
- USC School of Medicine, Department of Radiation Oncology, Los Angeles 90033
| | | | | | | | | | | | | | | |
Collapse
|