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Airody A, Baseler HA, Seymour J, Allgar V, Mukherjee R, Downey L, Dhar-Munshi S, Mahmood S, Balaskas K, Empeslidis T, Hanson RLW, Dorey T, Szczerbicki T, Sivaprasad S, Gale RP. Treatment of age-related macular degeneration with aflibercept using a treat, extend and fixed protocol; A 4-year study of treatment outcomes, durability, safety and quality of life (An extension to the MATE randomised controlled trial). Acta Ophthalmol 2024; 102:e328-e338. [PMID: 37776074 DOI: 10.1111/aos.15774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 07/05/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Data are limited pertaining to the long-term benefits of aflibercept treatment for neovascular age-related macular degeneration (nAMD). The aim of this study was to provide outcomes, safety, durability and quality-of-life data with aflibercept using a modified treat, extend and fixed regime over 4 years. METHODS Prospective, multicentre, single cohort observational study of treatment-naïve nAMD participants treated with aflibercept as 2-year extension of the MATE-trial that compared early and late Treat-and-Extend for 2 years. Refracted ETDRS best corrected visual acuity (BCVA), central retinal thickness (CRT), treatment interval and adverse events were assessed. Quality-of-life was measured using the Macular Disease Dependent Quality of Life (MacDQoL) and Macular Disease Treatment Satisfaction Questionnaires (MacTSQ). RESULTS Twenty-six of 40 participants completing the MATE-trial were enrolled with 20 completing the total 4-year study. Mean BCVA was 60.7 at Month 0 and 64.8 ETDRS letters at Month 48 while CRT decreased from 423.7 μm to 292.2 μm. Five participants discontinued treatment due to inactivity. The mean number of treatments and visits for the remaining participants was 27 and 30.0, respectively, with treatment intervals extended to 12 weeks in four participants at Month 48. Both AMD-specific QoL and treatment satisfaction remained stable between Months 0 and 48 and mean BCVA significantly correlated with AMD-specific QoL scores at Months 12, 24 and 48. CONCLUSIONS Results suggest that BCVA can be maintained over 48 months when following a treat-extend-and-fix regimen of aflibercept with intervals out to 12 weeks, while maintaining AMD-specific QoL and treatment satisfaction.
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Affiliation(s)
- Archana Airody
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
- Hull York Medical School, University of York, York, UK
| | - Heidi A Baseler
- Hull York Medical School, University of York, York, UK
- Department of Psychology, University of York, York, UK
| | - Julie Seymour
- Hull York Medical School, University of Hull, Hull, UK
| | - Victoria Allgar
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | | | | | - Sushma Dhar-Munshi
- Kings Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | | | - Konstantinos Balaskas
- University of Manchester, Manchester, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Theo Empeslidis
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachel L W Hanson
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
- Hull York Medical School, University of York, York, UK
| | - Tracey Dorey
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Tom Szczerbicki
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Richard P Gale
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
- Hull York Medical School, University of York, York, UK
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Airody A, Baseler HA, Seymour J, Allgar V, Mukherjee R, Downey L, Dhar-Munshi S, Mahmood S, Balaskas K, Empeslidis T, Hanson RLW, Dorey T, Szczerbicki T, Sivaprasad S, Gale RP. The MATE trial: a multicentre, mixed-methodology, pilot, randomised controlled trial in neovascular age-related macular degeneration. Pilot Feasibility Stud 2023; 9:63. [PMID: 37081576 PMCID: PMC10116669 DOI: 10.1186/s40814-023-01288-0] [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] [Received: 07/15/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND/OBJECTIVES In healthcare research investigating complex interventions, gaps in understanding of processes can be filled by using qualitative methods alongside a quantitative approach. The aim of this mixed-methods pilot trial was to provide feasibility evidence comparing two treatment regimens for neovascular age-related macular degeneration (nAMD) to inform a future large-scale randomised controlled trial (RCT). SUBJECTS/METHODS Forty-four treatment-naïve nAMD patients were followed over 24 months and randomised to one of two treatment regimens: standard care (SC) or treat and extend (T&E). The primary objective evaluated feasibility of the MATE trial via evaluations of screening logs for recruitment rates, nonparticipation and screen fails, whilst qualitative in-depth interviews with key study staff evaluated the recruitment phase and running of the trial. The secondary objective assessed changes in visual acuity and central retinal thickness (CRT) between the two treatment arms. RESULTS The overall recruitment rate was 3.07 participants per month with a 40.8% non-participation rate, 18.51% screen-failure rate and 15% withdrawal/non-completion rate. Key themes in the recruitment phase included human factors, protocol-related issues, recruitment processes and challenges. Both treatment regimens showed a trend towards a visual acuity gain at month 12 which was not maintained at month 24, whilst CRT reduced similarly in both regimens over the same time period. These were achieved with one less treatment following a T&E regimen. CONCLUSION This mixed-methodology, pilot RCT achieved its pre-defined recruitment, nonparticipation and screen failure rates, thus deeming it a success. With some minor protocol amendments, progression to a large-scale RCT will be achievable.
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Affiliation(s)
- Archana Airody
- Academic Unit of Ophthalmology, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK.
| | - Heidi A Baseler
- Department of Psychology, University of York, York, UK
- Hull York Medical School, University of York, York, UK
| | - Julie Seymour
- Hull York Medical School, University of Hull, Hull, UK
| | - Victoria Allgar
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | | | | | - Sushma Dhar-Munshi
- Kings Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | | | - Konstantinos Balaskas
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Theo Empeslidis
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachel L W Hanson
- Academic Unit of Ophthalmology, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK
| | - Tracey Dorey
- Research and Development, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Tom Szczerbicki
- Research and Development, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Richard P Gale
- Academic Unit of Ophthalmology, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK
- Hull York Medical School, University of York, York, UK
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O'Hara E, Seymour J. Inducing metamorphosis in the irukandji jellyfish Carukia barnesi. Sci Rep 2022; 12:9052. [PMID: 35641559 PMCID: PMC9156746 DOI: 10.1038/s41598-022-12812-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/13/2022] [Indexed: 11/08/2022] Open
Abstract
Here we utilize chemical ecology as a tool to manipulate the biological system of a small, but highly venomous to humans, cubozoan jellyfish, Carukia barnesi. We trialled a range of chemical reagents including indole compounds, 9-cis-retinoic acid and lugols solution to induce metamorphosis between the polyp and medusa life stages. An optimum method was determined resulting in a 90% metamorphosis rate to healthy medusa by exposing the polyps to 1 μM of 5-methoxy-2-methylindole for 24 h. Of note is that chemical exposure time significantly impacts health and metamorphosis rates in this species. We also present a theoretical mechanism for the chemical/biological interactions occurring during metamorphosis. This is a significant methodological advancement which now enables rearing of this animal en mass in aquaria-a world first for this species-which will subsequently supply and facilitate venom research into this understudied jellyfish.
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Affiliation(s)
- E O'Hara
- Australian Institute for Tropical Health and Medicine, James Cook University, 1/14-88 McGregor Road, Smithfield, QLD, 4878, Australia.
| | - J Seymour
- Australian Institute for Tropical Health and Medicine, James Cook University, 1/14-88 McGregor Road, Smithfield, QLD, 4878, Australia
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Xu M, Lasocki A, Bressel M, Goroncy N, Seymour J, Wheeler G, Dwyer M, Wiltshire K, Haghighi N, Mason K, Tange D, Campbell B. OC-0760 Active surveillance is safe for asymptomatic radiation-induced meningiomas in cancer survivors. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02666-4] [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: 11/26/2022]
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Wray A, Seymour J, Greenley S, Boland JW. Parental terminal cancer and dependent children: a systematic review. BMJ Support Palliat Care 2022:bmjspcare-2021-003094. [PMID: 35091436 DOI: 10.1136/bmjspcare-2021-003094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND When a parent has terminal cancer, their children are part of that experience. Parents often want to protect their children from their disease and prognosis. Knowledge of dependent children's experience will help ensure they receive appropriate support. To date, there is lack of synthesis of this evidence examining children's perspectives. OBJECTIVES To systematically search and synthesise the qualitative literature exploring the experiences of dependent children when their parent has terminal cancer. METHODS Databases of MEDLINE, Embase, PsycINFO, CINAHL, Assia and the Cochrane library were searched systematically from inception to July 2020 to determine eligible studies. Included studies were appraised for quality and thematically synthesised using Thomas and Harden's thematic synthesis framework. RESULTS Fourteen studies were included, which interviewed children about their experiences (n=654 children aged 4-18 years at the time of parental death), from six countries. Five descriptive themes were identified, further categorised into two broad themes: (1) finding out about parental cancer and its impact on the family and (2) coping with life with parental cancer, death and beyond. CONCLUSION Children want to be involved in their parent's cancer experience and to help support the family. Healthcare professionals are ideally placed to support and encourage parents to include their children. They should reassure parents that children can cope well and that maintaining normality will help, and explain the benefits of honest and open communication and how they can include dependent children from diagnosis and beyond.
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Affiliation(s)
- Alexandra Wray
- Wolfson Palliative Care Research Centre, Hull York Medical School, Univeristy of Hull, Hull, UK
| | - Julie Seymour
- Institiute of Clinical Applied Health Research, Hull York Medical School, Univeristy of Hull, Hull, UK
| | - Sarah Greenley
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Jason W Boland
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
- Palliative Medicine, Care Plus Group and St Andrew's Hospice, NE Lincolnshire, UK
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Abrantes K, Barnett A, Soetaert M, Kyne PM, Laird A, Squire L, Seymour J, Wueringer BE, Sleeman J, Huveneers C. Potential of electric fields to reduce bycatch of highly threatened sawfishes. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sawfishes are among the most threatened families of marine fishes and are susceptible to incidental capture in net fisheries. Since bycatch reduction devices currently used in trawl fisheries are not effective at reducing sawfish catches, new methods to minimise sawfish bycatch are needed. Ideally, these should affect sawfish behaviour and prevent contact with the fishing gear. We tested the effects of electric fields on sawfish behaviour to assess the potential of electric pulses in mitigating sawfish bycatch. Experiments were conducted in a tank where 2 electrodes were suspended in the water column, connected to a pulse generator, and placed across the swimming path of sawfish. Two largetooth sawfish Pristis pristis were tested in control conditions, in the presence of a baseline pulse, and of 5 variations of that pulse where 1 parameter (polarity, voltage, frequency, pulse shape, pulse duration) was altered at a time. Conditional inference trees were used to identify the effects of various parameters (e.g. treatment, individual) on reaction type, reaction distance, twitching presence and duration, and inter-approach times. Sawfish reacted to electric fields, but reaction distances were small (typically <1.2 m), and no field tested consistently led to reactions conducive to escaping from moving nets. The following parameters induced the most response in both individuals: bipolar current, rectangular shaped, 5-10 Hz, ~1500 µs duration, and 100 V. We recommend further research focussing on moving nets, testing a V-shaped electric array preceding the net mouth by at least 5 m, and testing a setup similar to electrotrawling.
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Affiliation(s)
- K Abrantes
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
- Biopixel Oceans Foundation, Cairns, Qld 4870, Australia
| | - A Barnett
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
- Biopixel Oceans Foundation, Cairns, Qld 4870, Australia
| | - M Soetaert
- Institute for Agricultural and Fisheries Research, Animal Sciences - Fisheries, Ankerstraat 1, 8400 Oostende, Belgium
| | - PM Kyne
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, NT 0815, Australia
| | - A Laird
- Northern Prawn Fishery Industry Pty Ltd, Caloundra, Qld 4551, Australia
| | - L Squire
- Cairns Marine, Cairns, Qld 4870, Australia
| | - J Seymour
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Qld 4870, Australia
| | - BE Wueringer
- Sharks and Rays Australia, PO Box 575, Bungalow, Cairns, Qld 4870, Australia
| | - J Sleeman
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Qld 4870, Australia
| | - C Huveneers
- College of Science and Engineering, Flinders University, Bedford Park, Adelaide, SA 5042, Australia
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Campbell B, Lasocki A, Bressel M, Oon S, Goroncy N, Seymour J, Dwyer M, Wiltshire K, Mason K, Tange D, Xu M, Wheeler G. OC-0209 Radiation-induced cavernomas: investigating the role of MRI-SWI for screening and surveillance in long-term cancer survivors. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06824-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zwakman M, Pollock K, Bulli F, Caswell G, Červ B, van Delden JJM, Deliens L, van der Heide A, Jabbarian LJ, Koba-Čeh H, Lunder U, Miccinesi G, Arnfeldt CAM, Seymour J, Toccafondi A, Verkissen MN, Kars MC. Trained facilitators' experiences with structured advance care planning conversations in oncology: an international focus group study within the ACTION trial. BMC Cancer 2019; 19:1026. [PMID: 31672145 PMCID: PMC6822448 DOI: 10.1186/s12885-019-6170-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 09/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In oncology, Health Care Professionals often experience conducting Advance Care Planning (ACP) conversations as difficult and are hesitant to start them. A structured approach could help to overcome this. In the ACTION trial, a Phase III multi-center cluster-randomized clinical trial in six European countries (Belgium, Denmark, Italy, the Netherlands, Slovenia, United Kingdom), patients with advanced lung or colorectal cancer are invited to have one or two structured ACP conversations with a trained facilitator. It is unclear how trained facilitators experience conducting structured ACP conversations. This study aims to understand how facilitators experience delivering the ACTION Respecting Choices (RC) ACP conversation. METHODS A qualitative study involving focus groups with RC facilitators. Focus group interviews were recorded, transcribed, anonymized, translated into English, and thematically analysed, supported by NVivo 11. The international research team was involved in data analysis from initial coding and discussion towards final themes. RESULTS Seven focus groups were conducted, involving 28 of in total 39 trained facilitators, with different professional backgrounds from all participating countries. Alongside some cultural differences, six themes were identified. These reflect that most facilitators welcomed the opportunity to participate in the ACTION trial, seeing it as a means of learning new skills in an important area. The RC script was seen as supportive to ask questions, including those perceived as difficult to ask, but was also experienced as a barrier to a spontaneous conversation. Facilitators noticed that most patients were positive about their ACTION RC ACP conversation, which had prompted them to become aware of their wishes and to share these with others. The facilitators observed that it took patients substantial effort to have these conversations. In response, facilitators took responsibility for enabling patients to experience a conversation from which they could benefit. Facilitators emphasized the need for training, support and advanced communication skills to be able to work with the script. CONCLUSIONS Facilitators experienced benefits and challenges in conducting scripted ACP conversations. They mentioned the importance of being skilled and experienced in carrying out ACP conversations in order to be able to explore the patients' preferences while staying attuned to patients' needs. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number registry 63110516 ( ISRCTN63110516 ) per 10/3/2014.
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Affiliation(s)
- M Zwakman
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - K Pollock
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - F Bulli
- Oncological network, research and prevention Institute - ISPRO, Florence, Italy
| | - G Caswell
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - B Červ
- University Clinic for Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - J J M van Delden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - L Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - L J Jabbarian
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - H Koba-Čeh
- University Clinic for Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - U Lunder
- University Clinic for Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - G Miccinesi
- Oncological network, research and prevention Institute - ISPRO, Florence, Italy
| | - C A Møller Arnfeldt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, The Research Unit, Copenhagen, Denmark
| | - J Seymour
- University of Sheffield, Sheffield, UK
| | - A Toccafondi
- Oncological network, research and prevention Institute - ISPRO, Florence, Italy
| | - M N Verkissen
- End-of-life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Ghent University, Brussels, Belgium
| | - M C Kars
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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MacManus M, Campbell B, Wirth A, Hofman M, Hicks R, Seymour J, Burbury K. ABSCOPAL REGRESSION OF LYMPHOMA AT DISTANT SITES AFTER LOCAL RADIOTHERAPY, DETECTED BY POSITRON EMISSION TOMOGRAPHY IN SIX CASES. Hematol Oncol 2019. [DOI: 10.1002/hon.236_2631] [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: 11/07/2022]
Affiliation(s)
- M.P. MacManus
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - B. Campbell
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - A. Wirth
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - M. Hofman
- Molecular Imaging; Peter MacCallum Cancer Centre; Melbourne Australia
| | - R. Hicks
- Molecular Imaging; Peter MacCallum Cancer Centre; Melbourne Australia
| | - J. Seymour
- Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - K. Burbury
- Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
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MacManus M, Roos D, O'Brien P, Tsang R, Wirth A, Capp A, Bressel M, Seymour J. RESULTS OF A MULTICENTER PHASE2 TRIAL OF INVOLVED FIELD RADIOTHERAPY ALONE FOR LOCALIZED NON-GASTRIC MARGINAL ZONE LYMPHOMA: TROG 05.02. Hematol Oncol 2019. [DOI: 10.1002/hon.36_2630] [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: 11/06/2022]
Affiliation(s)
- M.P. MacManus
- Radiation Oncology; Peter MacCallum cancer Centre; Melbourne Australia
| | - D. Roos
- Radiation Oncology; Royal Adelaide Hospital; Adelaide Australia
| | - P. O'Brien
- Radiation Oncology; Genesis Care Lake Macquarie Private Hospital; Gateshead Australia
| | - R. Tsang
- Radiation Oncology; Princess Margaret Hospital; Totonto Canada
| | - A. Wirth
- Radiation Oncology; Peter MacCallum cancer Centre; Melbourne Australia
| | - A. Capp
- Radiation Oncology; Calvary Mater Hospital; Waratah Australia
| | - M. Bressel
- Radiation Oncology; Peter MacCallum cancer Centre; Melbourne Australia
| | - J. Seymour
- Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
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MacManus M, Fisher R, Roos D, O'Brien P, Macann A, Tsang R, Davis S, Christie D, McClure B, Joseph D, Seymour J. SYSTEMIC THERAPY AFTER RADIATION THERAPY IN STAGE I-II FOLLICULAR LYMPHOMA: FINAL RESULTS OF AN INTERNATIONAL RANDOMIZED TRIAL TROG 99.03. Hematol Oncol 2019. [DOI: 10.1002/hon.35_2630] [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: 11/07/2022]
Affiliation(s)
- M.P. MacManus
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - R. Fisher
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - D. Roos
- Radiation Oncology; Royal Adelaide Hospital; Adelaide Australia
| | - P. O'Brien
- Radiation Oncology; GenesisCare Lake Macquarie Private Hospital; Gateshead Australia
| | - A. Macann
- Radiation Oncology; Auckland City Hospital; Auckland New Zealand
| | - R. Tsang
- Radiation Oncology; Princess Margaret Hospital; Toronto Canada
| | - S. Davis
- Radiation Oncology; Alfred Hospital; Melbourne Australia
| | - D. Christie
- Radiation Oncology; Genesis Care Premion; Southport Australia
| | - B. McClure
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - D. Joseph
- Radiation Oncology; Sir Charles Gairdner Hospital; Perth Australia
| | - J. Seymour
- Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
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Çağlayan Ç, Dixon J, Salles G, Wall A, Schmitz N, Cunningham D, Poeschel V, Seymour J, Jaeger U, Habermann T, Merli F, Haioun C, Tilly H, Ghesiquieres H, Ziepert M, Flament J, Shi Q, Flowers C. THE CLINICAL COURSE OF DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) OVER TIME: A MULTISTATE SURVIVAL ANALYSIS USING META-DATA FROM 13 FIRST-LINE RANDOMIZED TRIALS. Hematol Oncol 2019. [DOI: 10.1002/hon.56_2630] [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: 11/07/2022]
Affiliation(s)
- Ç. Çağlayan
- Industrial and Systems Engineering; Georgia Institute of Technology; Atlanta GA United States
| | - J.G. Dixon
- Department of Health Sciences Research; Mayo Clinic; Rochester MN United States
| | - G. Salles
- Hematology; Hospices Civils de Lyon; Lyon France
| | - A. Wall
- Department of Health Sciences Research; Mayo Clinic; Rochester MN United States
| | - N. Schmitz
- Hematology and Oncology; University Hospital Muenster; Muenster Germany
| | - D. Cunningham
- Department of Medicine; The Royal Marsden Hospital; Sutton United Kingdom
| | - V. Poeschel
- Medical School; Saarland University; Homburg Germany
| | - J. Seymour
- Clinical Research; Integrated Haematology, Peter MacCallum Cancer Centre; Melbourne Australia
| | - U. Jaeger
- Department of Medicine I; Medical University of Vienna; Vienna Austria
| | - T. Habermann
- Cancer Center; Hematology, Mayo Clinic; Rochester MN United States
| | - F. Merli
- Hematology; AUSL-IRCCS; Reggio Emilia Italy
| | - C. Haioun
- Unite Hemopathies Lymphoides; Hopital Henri Mondor; Creteil France
| | - H. Tilly
- Hématologie; Centre Henri-Becquerel; Rouen France
| | - H. Ghesiquieres
- Service d'Hématologie; Centre Hospitalier Lyon-Sud, Pierre Bénite CEDEX; France
| | - M. Ziepert
- Institut für Medizinische Informatik; Statistik und Epidemiologie, Universität Leipzig; Leipzig Germany
| | - J. Flament
- Medicine and Biology; Celgene Corporation; Boudry Switzerland
| | - Q. Shi
- Department of Health Sciences Research; Mayo Clinic; Rochester MN United States
| | - C. Flowers
- Winship Cancer Institute; Emory University; Atlanta GA United States
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Chen H, Walabyeki J, Johnson M, Boland E, Seymour J, Macleod U. An integrated understanding of the complex drivers of emergency presentations and admissions in cancer patients: Qualitative modelling of secondary-care health professionals' experiences and views. PLoS One 2019; 14:e0216430. [PMID: 31048875 PMCID: PMC6497383 DOI: 10.1371/journal.pone.0216430] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/20/2019] [Indexed: 11/18/2022] Open
Abstract
The number of cancer-related emergency presentations and admissions has been steadily increasing in the UK. Drivers of this phenomenon are complex, multifactorial and interlinked. The main objective of this study was to understand the complexity of emergency hospital use in cancer patients. We conducted semi-structured interviews with 42 senior clinicians (20 doctors, 22 nurses) with diverse expertise and experience in caring for acutely ill cancer patients in the secondary care setting. Data analysis included thematic analysis and purposive text analysis to develop Causal Loop Diagrams. Our Causal Loop Diagrams represent an integrated understanding of the complex factors (13) influencing emergency hospital use in cancer patients. Eight factors formed five reinforcing feedback loops and therefore were high-leverage influences: Ability of patients and carers to self-care and cope; Effective and timely management of ambulatory care sensitive conditions by primary and community care; Sufficient and effective social care for patients and carers; Avoidable emergency hospital use; Bed capacity; Patients accessing timely appropriate specialist inpatient or ambulatory care; Prompt and effective management and prevention of acute episode; Timely and safe discharge with appropriate support. The loops show that reduction of avoidable hospital use helps relieve hospital bed pressure; improved bed capacity then has a decisive, positive influence on patient pathway and thus outcome and experience in the hospital; in turn, better in-hospital care and discharge help patients and carers self-care and cope better back home with better support from community-based health and social care services, which then reduces their future emergency hospital use. To optimise acute and emergency cancer care, it is also essential that patients, carers and other clinicians caring for cancer patients have prompt access to senior cancer specialists for advice, assessment, clinical decision and other support. The findings provide a useful framework and focus for service planners aiming to optimise care.
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Affiliation(s)
- Hong Chen
- Academy of Primary Care, Institute of Clinical and Applied Heath Research, Hull York Medical School, University of Hull, Hull, United Kingdom
- * E-mail:
| | - Julie Walabyeki
- Academy of Primary Care, Institute of Clinical and Applied Heath Research, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Miriam Johnson
- Wolfson Palliative Care Research Centre, Institute of Clinical and Applied Heath Research, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Elaine Boland
- Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Hull, United Kingdom
| | - Julie Seymour
- Academy of Primary Care, Institute of Clinical and Applied Heath Research, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Una Macleod
- Academy of Primary Care, Institute of Clinical and Applied Heath Research, Hull York Medical School, University of Hull, Hull, United Kingdom
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Fessler L, Wright K, Pace G, Andrews S, Davis M, Raffensperger K, Seymour J, Lagergren M, West N, Merlo C, Shah P. Assessment of Pre-Transplant Perceptions during Transition to Lung Transplant. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Little M, Pereira P, Mulcahy R, Cullen P, Carrette T, Seymour J. Severe Cardiac Failure Associated with Presumed Jellyfish Sting. Irukandji Syndrome? Anaesth Intensive Care 2019; 31:642-7. [PMID: 14719425 DOI: 10.1177/0310057x0303100605] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present a retrospective review of twelve cases of Irukandji syndrome associated with pulmonary oedema. This is a life-threatening envenoming due to a presumed jellyfish sting throughout Northern Australia, although only one case occurred outside North Queensland. Patients presented with significant and ongoing pain, tachycardia and hypertension. Half the patients became hypotensive requiring inotropic support. Cardiac echocardiography revealed significant cardiac dysfunction. Six patients required ventilatory support. There was no death reported due to pulmonary oedema, but one patient died of intracerebral haemorrhage. We believe patients may develop a toxin associated cardiomyopathy, and jellyfish other than Carukia barnesi may be responsible. As there is confusion with nomenclature, Carukia barnesi should be known as the Barnes jellyfish, and the diagnosis of cardiotoxic marine envenoming is suggested for any patient who has been stung by a jellyfish, develops no or minimal skin markings, and develops cardiogenic pulmonary oedema associated with Irukandji syndrome.
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Affiliation(s)
- M Little
- Department of Emergency Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia
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Seymour J, Snow J, Thompson TA, Garnsey C, Kohn J, Grossman D. Patient-reported acceptability of receiving medication for abortion via telemedicine at Planned Parenthood health centers in seven states. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zwakman M, Jabbarian LJ, van Delden JJM, van der Heide A, Korfage IJ, Pollock K, Rietjens JAC, Seymour J, Kars MC. Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness. Palliat Med 2018; 32:1305-1321. [PMID: 29956558 PMCID: PMC6088519 DOI: 10.1177/0269216318784474] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [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: 12/22/2022]
Abstract
BACKGROUND Advance care planning is seen as an important strategy to improve end-of-life communication and the quality of life of patients and their relatives. However, the frequency of advance care planning conversations in practice remains low. In-depth understanding of patients' experiences with advance care planning might provide clues to optimise its value to patients and improve implementation. AIM To synthesise and describe the research findings on the experiences with advance care planning of patients with a life-threatening or life-limiting illness. DESIGN A systematic literature review, using an iterative search strategy. A thematic synthesis was conducted and was supported by NVivo 11. DATA SOURCES The search was performed in MEDLINE, Embase, PsycINFO and CINAHL on 7 November 2016. RESULTS Of the 3555 articles found, 20 were included. We identified three themes in patients' experiences with advance care planning. 'Ambivalence' refers to patients simultaneously experiencing benefits from advance care planning as well as unpleasant feelings. 'Readiness' for advance care planning is a necessary prerequisite for taking up its benefits but can also be promoted by the process of advance care planning itself. 'Openness' refers to patients' need to feel comfortable in being open about their preferences for future care towards relevant others. CONCLUSION Although participation in advance care planning can be accompanied by unpleasant feelings, many patients reported benefits of advance care planning as well. This suggests a need for advance care planning to be personalised in a form which is both feasible and relevant at moments suitable for the individual patient.
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Affiliation(s)
- M Zwakman
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Marieke Zwakman, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - LJ Jabbarian
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - JJM van Delden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A van der Heide
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - IJ Korfage
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - K Pollock
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - JAC Rietjens
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Seymour
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - MC Kars
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Kampasi K, Seymour J, Stark E, Buzsaki G, Wise KD, Yoon E. Efficient assembly of multi-color fiberless optoelectrodes with on-board light sources for neural stimulation and recording. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:4479-4482. [PMID: 28269273 DOI: 10.1109/embc.2016.7591722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Fiberless optoelectrodes are an emerging tool to enable brain circuit mapping by providing precise optical modulation and electrical monitoring of many neurons. While optoelectrodes having an on-board light source offer compact and optically efficient device solutions, many of them fail to provide robust thermal and electrical design to fully exploit the recording capabilities of the device. In this work, we present a novel fiberless multicolor optoelectrode solution, which meets the optical and thermal design requirements of an in vivo neural optoelectrode and offers potential for low-noise neural recording. The total optical loss measured for 405 nm and 635 nm wavelengths through the waveguide is 11.7±1.1 dB and 9.9±0.7 dB, corresponding to respective irradiances of 1928 mW/mm2 and 2905 mW/mm2 at the waveguide tip from 6 mW laser diode chips. The efficient thermal packaging enables continuous device operation for up to 190 seconds at 10% duty cycle. We validated the fully packaged device in the intact brain of anesthetized mice co-expressing Channelrhodopsin-2 and Archaerhodopsin in the hippocampal CA1 region and achieved activation and silencing of the same neurons. We discuss improvements made to reduce the stimulation artifact induced by applying currents to the laser diode chips.
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Reid C, Seymour J, Jones C. A Thematic Synthesis of the Experiences of Adults Living with Hemodialysis. Clin J Am Soc Nephrol 2016; 11:1206-1218. [PMID: 27246010 PMCID: PMC4934845 DOI: 10.2215/cjn.10561015] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 03/16/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients on in-center dialysis spend significant amounts of time in the dialysis unit; additionally, managing ESRD affects many aspects of life outside the dialysis unit. To improve the care provided to patients requiring hemodialysis, their experiences and beliefs regarding treatment must be understood. This systematic review aimed to synthesize the experiences of patients receiving in-center hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We searched Embase, MEDLINE, CINAHL, PsychINFO, Google Scholar, and reference lists for primary qualitative studies published from 1995 to 2015 that explored the experiences of adult patients receiving treatment with in-center hemodialysis. A thematic synthesis was conducted. RESULTS Seventeen studies involving 576 patients were included in the synthesis. Four analytic themes were developed. The first theme (a new dialysis-dependent self) describes the changes in identity and perceptions of self that could result from dialysis dependence. The second theme (a restricted life) describes the physical and emotional constraints that patients described as a consequence of their dependence. Some patients reported strategies that allowed them to regain a sense of optimism and influence over the future, and these contributed to the third theme (regaining control). The first three themes describe a potential for change through acceptance, adaption, and regaining a sense of control. The final theme (relationships with health professionals) describes the importance of these relationships for in-center patients and their influence on perceptions of power and support. These relationships are seen to influence the other three themes through information sharing, continuity, and personalized support. CONCLUSIONS Our synthesis has resulted in a framework that can be used to consider interventions to improve patients' experiences of in-center hemodialysis care. Focusing on interventions that are incorporated into the established relationships that patients have with their health care professionals may enable patients to progress toward a sense of control and improve satisfaction with care.
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Affiliation(s)
- Claire Reid
- Supportive Care, Early Diagnosis and Advanced Disease Research Group, Hull York Medical School, University of York, York, United Kingdom; and
| | - Julie Seymour
- Supportive Care, Early Diagnosis and Advanced Disease Research Group, Hull York Medical School, University of York, York, United Kingdom; and
| | - Colin Jones
- York Hospitals National Health Service Trust
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MacManus M, Wirth A, Campbell B, Khor R, Ryan G, Seymour J. High Rate of Progression Free Survival and Exceptional Overall Survival in FDG-PET-Staged Patients With Stage III Follicular Lymphoma Treated With Comprehensive Lymphatic Irradiation. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1712] [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]
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Ng S, Khor R, Bressel M, MacManus M, Seymour J, Hicks R, Wirth A. Impact of 18-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) Stage on Outcomes Among Patients With Early-Stage Follicular Lymphoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1705] [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]
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Hillen M, Seymour J, Yeo J, Griffiths G, Howd A. A prospective study to establish whether the malnutrition universal screening tool (MUST) score can independently predict outcomes of patients undergoing reconstructive surgery or amputation for critical limb ischaemia (CLI). Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Musa I, Seymour J, Wada T, Narayanasamy M, Conroy S. 50 * A SURVEY OF OLDER PEOPLES' ATTITUDES TOWARDS ADVANCE CARE PLANNING. Age Ageing 2015. [DOI: 10.1093/ageing/afv033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ewing G, Ngwenya N, Farquhar M, Benson J, Gilligan D, Seymour J, Bailey S. HOW DO PATIENTS SHARE NEWS OF A CANCER DIAGNOSIS WITH FAMILY/FRIENDS; NEW UNDERSTANDINGS OF THE PROCESS AFTER BAD NEWS HAS BEEN BROKEN. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2014-000838.32] [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: 11/04/2022]
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Seymour J, Nedelcu D. P154 The Impact Of A Discharge Care Bundle On The 30-day Readmission Rate Following Hospitalisation For Acute Copd Exacerbation. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Seymour J, Horstmann-Dehn L, Wooller MJ. Proportion of higher trophic-level prey in the diet of Pacific walruses (Odobenus rosmarus divergens). Polar Biol 2014. [DOI: 10.1007/s00300-014-1492-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wilson E, Morbey H, Brown J, Payne S, Seale C, Seymour J. HOW DO COMMUNITY NURSES DECIDE WHEN TO USE ANTICIPATORY PRESCRIPTIONS IN END OF LIFE CARE AND WHAT DO THEY WORRY ABOUT? FINDINGS FROM A QUALITATIVE STUDY. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.3] [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: 11/04/2022]
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Hardy B, Caswell G, Ewing G, Grande G, Kennedy S, Tabreham J, Seymour J. DEVELOPING TRAINING FOR SUPPORTERS OF LAY-CARERS INVOLVED WITH HOME BASED END OF LIFE CARE: A PARTICIPATORY APPROACH. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ewing G, Ngwenya N, Farquhar M, Gilligan D, Bailey S, Benson J, Seymour J. SHARING BAD NEWS: DEVELOPMENT OF AN INTERVENTION TO SUPPORT PATIENTS WITH LUNG CANCER SHARE NEWS OF THEIR CANCER DIAGNOSIS WITH FAMILY MEMBERS AND FRIENDS. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.29] [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: 11/04/2022]
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Seymour J, Horstmann-Dehn L, Wooller MJ. Inter-annual variability in the proportional contribution of higher trophic levels to the diet of Pacific walruses. Polar Biol 2014. [DOI: 10.1007/s00300-014-1460-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Seymour J, Horstmann-Dehn L, Rosa C, Lopez J. Occurrence and genotypic analysis of Trichinella species in Alaska marine-associated mammals of the Bering and Chukchi seas. Vet Parasitol 2014; 200:153-64. [DOI: 10.1016/j.vetpar.2013.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 11/13/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
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Ngwenya N, Farquhar M, Benson J, Gilligan D, Bailey S, Seymour J, Ewing G. 102 Sharing Bad News: Understanding the communication processes of a lung cancer diagnosis. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gott M, Ingleton C, Gardiner C, Richards N, Cobb M, Ryan T, Noble B, Bennett M, Seymour J, Ward S, Parker C. Transitions to palliative care for older people in acute hospitals: a mixed-methods study. Health Services and Delivery Research 2013. [DOI: 10.3310/hsdr01110] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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
BackgroundImproving the provision of palliative and end-of-life care is a priority for the NHS. Ensuring an appropriately managed ‘transition’ to a palliative approach for care when patients are likely to be entering the last year of life is central to current policy. Acute hospitals represent a significant site of palliative care delivery and specific guidance has been published regarding the management of palliative care transitions within this setting.Aims(1) to explore how transitions to a palliative care approach are managed and experienced in acute hospitals and to identify best practice from the perspective of clinicians and service users; (2) to examine the extent of potentially avoidable hospital admissions amongst hospital inpatients with palliative care needs.DesignA mixed-methods design was adopted in two hospitals in England, serving diverse patient populations. Methods included (1) two systematic reviews; (2) focus groups and interviews with 58 health-care professionals to explore barriers to, and facilitators of, palliative care transitions in hospital; (3) a hospital inpatient survey examining palliative care needs and aspects of management including a self-/proxy-completed questionnaire, a survey of medical and nursing staff and a case note review; (4) in-depth interviews with 15 patients with palliative care needs; (5) a retrospective case note review of all inpatients present in the hospital at the time of the survey who had died within the subsequent 12 months; and (6) focus groups with 83 key decision-makers to explore the implications of the findings for service delivery and policy.ResultsOf the 514 patients in the inpatient survey sample, just over one-third (n = 185, 36.0%) met one or more of the Gold Standards Framework (GSF) prognostic indicator criteria for palliative care needs. The most common GSF prognostic indicator was frailty, with almost one-third of patients (27%) meeting this criteria. Agreement between medical and nursing staff and the GSF with respect to identifying patients with palliative care needs was poor. In focus groups, health professionals reported difficulties in recognising that a patient had entered the last 12 months of life. In-depth interviews with patients found that many of those interviewed were unaware of their prognosis and showed little insight into what they could expect from the trajectory of their disease. The retrospective case note review found that 35 (7.2%) admissions were potentially avoidable. The potential annual cost saving across both hospitals of preventing these admissions was approximately £5.3M. However, a 2- or 3-day reduction in length of stay for these admissions would result in an annual cost saving of £21.6M or £32.4M respectively.ConclusionsPatients with palliative care needs represent a significant proportion of the hospital inpatient population. There is a significant gap between NHS policy regarding palliative and end-of-life care management in acute hospitals in England and current practice.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- M Gott
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - C Ingleton
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - C Gardiner
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - N Richards
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - M Cobb
- Directorate of Professional Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - T Ryan
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - B Noble
- Department of Oncology, University of Sheffield, Sheffield, UK
| | - M Bennett
- School of Medicine, University of Leeds, Leeds, UK
| | - J Seymour
- School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Nottingham, UK
| | - S Ward
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - C Parker
- No affiliation (retired) – medical statistician
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McDermott E, Bingley AF, Thomas C, Payne S, Seymour J, Clark D. Viewing patient need through professional writings: a systematic 'ethnographic' review of palliative care professionals' experiences of caring for people with cancer at the end of life. Progress in Palliative Care 2013. [DOI: 10.1179/096992606x93362] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hanratty B, Lowson E, Grande G, Addington-Hall J, Seymour J, Payne S. A STUDY OF SOCIOECONOMIC DISADVANTAGE AND END-OF-LIFE HOSPITAL ADMISSIONS FOR OLDER PEOPLE WITH HEART FAILURE AND LUNG CANCER IN ENGLAND. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000453b.22] [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: 11/04/2022]
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Parry RH, Land V, Seymour J. ENCOURAGING AND DISCOURAGING TALK ABOUT ILLNESS PROGRESSION, DYING AND DEATH: A SYSTEMATIC REVIEW OF COMMUNICATION RESEARCH. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000453b.17] [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: 11/04/2022]
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Valtorta N, Hanratty B, Lowson E, Grande G, Addington-Hall J, Seymour J, Payne S. RECOGNISING THE INFLUENCE OF INTER-PROFESSIONAL RELATIONS ON END OF LIFE CARE TRANSITIONS: VIEWS OF BEREAVED CARERS AND PROFESSIONALS. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000453b.23] [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: 11/04/2022]
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Puthucheary ZA, Rawal J, Mcphail M, Connolly B, Ratnayake G, Sidhu PS, Seymour J, Chan P, Hopkins P, Shrikrishna D, Hopkinson N, Polkey MI, Velloso C, Agley CC, Selby A, Limb M, Edwards L, Smith K, Rennie M, Rowlerson A, Moxham J, Harridge SDR, Hart N, Montgomery H. T3 Acute Muscle Loss in the Critically Ill: From Bedside to Bench. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.003] [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: 11/03/2022]
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Germing U, Lauseker M, Hildebrandt B, Symeonidis A, Cermak J, Fenaux P, Kelaidi C, Pfeilstöcker M, Nösslinger T, Sekeres M, Maciejewski J, Haase D, Schanz J, Seymour J, Kenealy M, Weide R, Lübbert M, Platzbecker U, Valent P, Götze K, Stauder R, Blum S, Kreuzer KA, Schlenk R, Ganser A, Hofmann WK, Aul C, Krieger O, Kündgen A, Haas R, Hasford J, Giagounidis A. Survival, prognostic factors and rates of leukemic transformation in 381 untreated patients with MDS and del(5q): A multicenter study. Leukemia 2012; 26:1286-92. [PMID: 22289990 DOI: 10.1038/leu.2011.391] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Poplawski NK, Rawlings L, Seymour J, Vakulin C, Tirimacco A, Benn DE, Gill AJ. Genetic testing and immunohistochemistry for SDHB in phaeochromocytoma-paraganglioma syndromes: the South Australian experience. Hered Cancer Clin Pract 2012. [PMCID: PMC3326727 DOI: 10.1186/1897-4287-10-s2-a60] [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: 11/10/2022] Open
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Aranda S, Jefford M, Yates P, Gough K, Seymour J, Francis P, Baravelli C, Breen S, Schofield P. Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs: results from a randomised, controlled trial. Ann Oncol 2012; 23:222-231. [PMID: 21471562 DOI: 10.1093/annonc/mdr042] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND High levels of distress and need for self-care information by patients commencing chemotherapy suggest that current prechemotherapy education is suboptimal. We conducted a randomised, controlled trial of a prechemotherapy education intervention (ChemoEd) to assess impact on patient distress, treatment-related concerns, and the prevalence and severity of and bother caused by six chemotherapy side-effects. PATIENTS AND METHODS One hundred and ninety-two breast, gastrointestinal, and haematologic cancer patients were recruited before the trial closing prematurely (original target 352). ChemoEd patients received a DVD, question-prompt list, self-care information, an education consultation≥24 h before first treatment (intervention 1), telephone follow-up 48 h after first treatment (intervention 2), and a face-to-face review immediately before second treatment (intervention 3). Patient outcomes were measured at baseline (T1: pre-education) and immediately preceding treatment cycles 1 (T2) and 3 (T3). RESULTS ChemoEd did not significantly reduce patient distress. However, a significant decrease in sensory/psychological (P=0.027) and procedural (P=0.03) concerns, as well as prevalence and severity of and bother due to vomiting (all P=0.001), were observed at T3. In addition, subgroup analysis of patients with elevated distress at T1 indicated a significant decrease (P=0.035) at T2 but not at T3 (P=0.055) in ChemoEd patients. CONCLUSIONS ChemoEd holds promise to improve patient treatment-related concerns and some physical/psychological outcomes; however, further research is required on more diverse patient populations to ensure generalisability.
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Affiliation(s)
- S Aranda
- Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.
| | - M Jefford
- Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne; Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne
| | - P Yates
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - K Gough
- Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne
| | - J Seymour
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne; Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne
| | - P Francis
- Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne
| | - C Baravelli
- Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne
| | - S Breen
- Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne
| | - P Schofield
- Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne
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Seymour J, DeRosier DJ. The projection of a negatively-stained filamentous object down its central axis as revealed by image reconstruction from tilt series. J Microsc 2011. [DOI: 10.1111/j.1365-2818.1987.tb02866.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Venkatasalu MR, Seymour J, Arthur T. Understanding the meaning of end-of-life discussions and related decisions among older South Asians living in East London: a qualitative inquiry. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000053.48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Seymour J, Henry C, Sherwen E. Developing guidance in ACP for health and social care staff: experiences from the UK. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000053.51] [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: 11/04/2022]
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Payne S, Seymour J, Molassiotis A, Froggatt K, Grande G, Lloyd-Williams M, Foster C, Wilson R, Rolls L, Todd C, Addington-Hall J. Benefits and challenges of collaborative research: lessons from supportive and palliative care. BMJ Support Palliat Care 2011; 1:5-11. [DOI: 10.1136/bmjspcare-2011-000018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wueringer B, Peverell S, Seymour J, Squire, Jr. L, Collin S. Sensory Systems in Sawfishes. 2. The Lateral Line. Brain Behav Evol 2011; 78:150-61. [DOI: 10.1159/000329518] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 03/14/2011] [Indexed: 11/19/2022]
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