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Agostini F, Pereyra L, Dale J, Yambire KF, Maglioni S, Schiavi A, Ventura N, Milosevic I, Raimundo N. Up-regulation of cholesterol synthesis by lysosomal defects requires a functional mitochondrial respiratory chain. bioRxiv 2024:2024.03.06.583589. [PMID: 38496624 PMCID: PMC10942416 DOI: 10.1101/2024.03.06.583589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Mitochondria and lysosomes are two organelles that carry out both signaling and metabolic roles in the cells. Recent evidence has shown that mitochondria and lysosomes are dependent on one another, as primary defects in one cause secondary defects in the other. Nevertheless, the signaling consequences of primary mitochondrial malfunction and of primary lysosomal defects are not similar, despite in both cases there are impairments of mitochondria and of lysosomes. Here, we used RNA sequencing to obtain transcriptomes from cells with primary mitochondrial or lysosomal defects, to identify what are the global cellular consequences that are associated with malfunction of mitochondria or lysosomes. We used these data to determine what are the pathways that are affected by defects in both organelles, which revealed a prominent role for the cholesterol synthesis pathway. This pathway is transcriptionally up-regulated in cellular and mouse models of lysosomal defects and is transcriptionally down-regulated in cellular and mouse models of mitochondrial defects. We identified a role for post-transcriptional regulation of the transcription factor SREBF1, a master regulator of cholesterol and lipid biosynthesis, in models of mitochondrial respiratory chain deficiency. Furthermore, the retention of Ca 2+ in the lysosomes of cells with mitochondrial respiratory chain defects contributes to the differential regulation of the cholesterol synthesis pathway in the mitochondrial and lysosomal defects tested. Finally, we verified in vivo , using models of mitochondria-associated diseases in C. elegans , that normalization of lysosomal Ca 2+ levels results in partial rescue of the developmental arrest induced by the respiratory chain deficiency.
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Snooks H, Watkins A, Lyons J, Akbari A, Bailey R, Bethell L, Carson-Stevens A, Dale J, Edwards A, Emery H, Evans BA, Jolles S, John A, Kingston M, Porter A, Sewell B, Williams V, Lyons RA. Corrigendum to "Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in wales? Results of EVITE immunity, a linked data retrospective study" [Public Health 218 (2023) 12-20]. Public Health 2023; 222:229. [PMID: 37463828 PMCID: PMC11021201 DOI: 10.1016/j.puhe.2023.06.001] [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: 07/20/2023]
Affiliation(s)
- H Snooks
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK.
| | - A Watkins
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - J Lyons
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, SA2 8PP, Swansea, UK
| | - A Akbari
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, SA2 8PP, Swansea, UK
| | - R Bailey
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, SA2 8PP, Swansea, UK
| | - L Bethell
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - A Carson-Stevens
- Cardiff University, Division of Population Medicine, University Hospital of Wales, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - J Dale
- The University of Warwick, Medical School, Coventry CV4 7AL, UK
| | - A Edwards
- Cardiff University, Division of Population Medicine, University Hospital of Wales, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - H Emery
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - B A Evans
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - S Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - A John
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, SA2 8PP, Swansea, UK
| | - M Kingston
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - A Porter
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - B Sewell
- Swansea University, School of Health and Social Care, Vivian Tower, Singleton Park, SA2 8PP, Swansea, UK
| | - V Williams
- Swansea University, Medical School, ILS 2, Singleton Park, SA2 8PP, Swansea, UK
| | - R A Lyons
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, SA2 8PP, Swansea, UK
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Waller ESL, Brouwer A, Upton PA, Harris KA, Lawes JR, Duncan D, Avigad R, Dale J. Bovine TB infection status in cattle in Great Britain in 2020. Vet Rec 2022; 191:e2513. [DOI: 10.1002/vetr.2513] [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: 12/03/2022]
Affiliation(s)
- ESL Waller
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - A Brouwer
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - PA Upton
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - KA Harris
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - JR Lawes
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - D Duncan
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - R Avigad
- Department of Epidemiological Sciences APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
| | - J Dale
- Department of Bacteriology APHA Woodham Lane, New Haw Addlestone Surrey KT15 3NB
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McFadzean IJ, Edwards M, Davies F, Cooper A, Price D, Carson-Stevens A, Dale J, Hughes T, Porter A, Harrington B, Evans B, Siriwardena N, Anderson P, Edwards A. Realist analysis of whether emergency departments with primary care services generate 'provider-induced demand'. BMC Emerg Med 2022; 22:155. [PMID: 36068508 PMCID: PMC9450363 DOI: 10.1186/s12873-022-00709-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background It is not known whether emergency departments (EDs) with primary care services influence demand for non-urgent care (‘provider-induced demand’). We proposed that distinct primary care services in EDs encourages primary care demand, whereas primary care integrated within EDs may be less likely to cause additional demand. We aimed to explore this and explain contexts (C), mechanisms (M) and outcomes (O) influencing demand. Methods We used realist evaluation methodology and observed ED service delivery. Twenty-four patients and 106 staff members (including Clinical Directors and General Practitioners) were interviewed at 13 EDs in England and Wales (240 hours of observations across 30 days). Field notes from observations and interviews were analysed by creating ‘CMO’ configurations to develop and refine theories relating to drivers of demand. Results EDs with distinct primary care services were perceived to attract demand for primary care because services were visible, known or enabled direct access to health care services. Other influencing factors included patients’ experiences of accessing primary care, community care capacity, service design and population characteristics. Conclusions Patient, local-system and wider-system factors can contribute to additional demand at EDs that include primary care services. Our findings can inform service providers and policymakers in developing strategies to limit the effect of potential influences on additional demand when demand exceeds capacity. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-022-00709-2.
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Affiliation(s)
- I J McFadzean
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, Wales.
| | - M Edwards
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, Wales.
| | - F Davies
- PRIME Centre Wales, Cardiff University School of Medicine, Cardiff, Wales
| | - A Cooper
- PRIME Centre Wales, Cardiff University School of Medicine, Cardiff, Wales
| | - D Price
- PRIME Centre Wales, Cardiff University School of Medicine, Cardiff, Wales
| | - A Carson-Stevens
- PRIME Centre Wales, Cardiff University School of Medicine, Cardiff, Wales
| | - J Dale
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Warwick, UK
| | - T Hughes
- John Radcliff Hospital, Oxford, UK
| | - A Porter
- Swansea University Medical School, Swansea University, Swansea, Wales
| | - B Harrington
- PRIME Centre Wales, Cardiff University School of Medicine, Cardiff, Wales
| | - B Evans
- Swansea University Medical School, Swansea University, Swansea, Wales
| | - N Siriwardena
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - P Anderson
- Swansea University Medical School, Swansea University, Swansea, Wales
| | - A Edwards
- PRIME Centre Wales, Cardiff University School of Medicine, Cardiff, Wales
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Islam N, Reuben JS, Dale J, Gutman J, McMahon CM, Amaya M, Goodman B, Toninato J, Gasparetto M, Stevens B, Pei S, Gillen A, Staggs S, Engel K, Davis S, Hull M, Burke E, Larchick L, Zane R, Weller G, Jordan C, Smith C. Machine Learning–Based Exploratory Clinical Decision Support for Newly Diagnosed Patients With Acute Myeloid Leukemia Treated With 7 + 3 Type Chemotherapy or Venetoclax/Azacitidine. JCO Clin Cancer Inform 2022; 6:e2200030. [DOI: 10.1200/cci.22.00030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE There are currently limited objective criteria to help assist physicians in determining whether an individual patient with acute myeloid leukemia (AML) is likely to do better with induction with either standard 7 + 3 chemotherapy or targeted therapy with venetoclax plus azacitidine. The study goal was to address this need by developing exploratory clinical decision support methods. PATIENTS AND METHODS Univariable and multivariable analysis as well as comparison of a range of machine learning (ML) predictors were performed using cohorts of 120 newly diagnosed 7 + 3-treated AML patients compared with 101 venetoclax plus azacitidine–treated patients. RESULTS A variety of features in the two patient cohorts were identified that may potentially correlate with short- and long-term outcomes, toxicities, and other considerations. A subset of these diagnostic features was then used to develop ML-based predictors with relatively high areas under the curve of short- and long-term outcomes, hospital stays, transfusion requirements, and toxicities for individual patients treated with either venetoclax/azacitidine or 7 + 3. CONCLUSION Potential ML-based approaches to clinical decision support to help guide individual patients with newly diagnosed AML to either 7 + 3 or venetoclax plus azacitidine induction therapy were identified. Larger cohorts with separate test and validation studies are necessary to confirm these initial findings.
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Affiliation(s)
| | | | - Justin Dale
- Department of Medicine, University of Colorado, Aurora, CO
| | - Jon Gutman
- Department of Medicine, University of Colorado, Aurora, CO
| | | | - Maria Amaya
- Department of Medicine, University of Colorado, Aurora, CO
| | | | | | | | - Brett Stevens
- Department of Medicine, University of Colorado, Aurora, CO
| | - Shanshan Pei
- Department of Medicine, University of Colorado, Aurora, CO
| | - Austin Gillen
- Department of Medicine, University of Colorado, Aurora, CO
| | - Sarah Staggs
- Department of Medicine, University of Colorado, Aurora, CO
| | - Krysta Engel
- Department of Medicine, University of Colorado, Aurora, CO
| | - Sarah Davis
- Department of Medicine, University of Colorado, Aurora, CO
| | - Madelyne Hull
- Health Data Compass, Colorado Center for Personalized Medicine, University of Colorado, Aurora, CO
| | | | | | - Richard Zane
- UCHealth Care Innovations and Department of Emergency Medicine, University of Colorado, Aurora, CO
| | | | - Craig Jordan
- Department of Medicine, University of Colorado, Aurora, CO
| | - Clay Smith
- Department of Medicine, University of Colorado, Aurora, CO
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6
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Dale J, Mclean E, Gupta T, Healy C. 788 Caecal Duplication Cyst: An Unexpected Cause of Bowel Obstruction in a 12-Year-Old. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
We report the case of a rare cause of bowel obstruction in a 12-year-old girl who presented with a short history of abdominal distension and vomiting after a month of unexplained urinary frequency and weight loss. Abdominal radiographs demonstrated small bowel obstruction with an unknown pelvic mass. A raised CA125 suggested a possible ovarian lesion and a magnetic resonance scan was interpreted as supportive of this pathology. Intra-operatively a 120x90x70mm cystic mass was found attached to the caecal serosa, immediately adjacent to the ileocaecal valve. There was an associated 180-degree twist of the terminal ileum and ascending colon. A limited right hemicolectomy was performed, and histopathology confirmed the diagnosis of a caecal intestinal duplication cyst. Post-operatively she has recovered well, with resolution of her obstructive and urinary symptoms. Given the unusual age of presentation, uncommon location of the cyst and the diagnostic challenges incurred, the authors wish to share their experience of managing an atypical duplication cyst.
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Affiliation(s)
- J Dale
- Royal Alexandra Children's Hospital , Brighton , United Kingdom
| | - E Mclean
- Royal Alexandra Children's Hospital , Brighton , United Kingdom
| | - T Gupta
- Royal Alexandra Children's Hospital , Brighton , United Kingdom
| | - C Healy
- Royal Alexandra Children's Hospital , Brighton , United Kingdom
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Rimdap E, Duncan D, Harris KA, Brouwer A, Avigad R, Upton PA, Dale J. Bovine TB infection status in cattle in Great Britain in 2019. Vet Rec 2021; 189:e750. [PMID: 34297396 DOI: 10.1002/vetr.750] [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)
- E Rimdap
- Department of Epidemiological Sciences, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
| | - D Duncan
- Department of Epidemiological Sciences, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
| | - K A Harris
- Department of Epidemiological Sciences, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
| | - A Brouwer
- Department of Epidemiological Sciences, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
| | - R Avigad
- Department of Epidemiological Sciences, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
| | - P A Upton
- Data Systems Workgroup, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
| | - J Dale
- Bacteriology, APHA, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
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Derakhshan MH, Morton F, Fragoulis GE, Paterson C, Dale J, Basu N, Mcinnes I, Porter D, Siebert S. AB0265 OPIOIDS AND ANALGESIC USE IN EARLY RHEUMATOID ARTHRITIS: A LONGITUDINAL ANALYSIS OF LINKED REAL-WORLD PRESCRIPTION DATA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Large numbers of patients with rheumatoid arthritis (RA) receive regular opioids despite significant toxicity and a lack of evidence supporting their use in non-cancer pain. In order to address this situation, we need to understand when opioids are started in early RA where this has not been studied.Objectives:To examine the temporal trend of opioid prescriptions before and after RA symptom onset and to compare this with DMARD and NSAID prescriptions.Methods:RA participants (cases) were recruited as part of the Scottish Early Rheumatoid Arthritis (SERA) inception cohort1. Controls without RA (five per case), matched for sex, age and post code over the same time period, were obtained through routine data linkage. Prescription data between Jan 2009 to Nov 2019 of cases and matched controls were compared using date of RA symptom onset as reference point. The Prescriptions Per Participant (PPP) for each three-month block was estimated by dividing the number of prescribed drugs in the selected drug classes (assigned using the British National Formulary) in that time block by the number of participants in each group. The differences between mean PPP of the RA cases and controls in each time block were tested by t-test for independent groups and subsequent adjustment for multiple testing.Results:1,720,335 prescriptions were available for analysis with 421,961 items for 950 RA cases and 1,299,374 items for 4,558 matched controls. As expected, DMARD prescriptions in the SERA cases increased after the symptom onset period and were then sustained (Figure 1: top left panel). NSAID prescriptions in RA cases peaked during the 3 months after symptom onset and then reduced progressively (top right panel). Opioid analgesic prescriptions for the RA cases increased two-fold during the reference period and then reduced 6-9 months post-symptom onset. However, unlike NSAIDs, after this there was no further significant reduction in opioid prescriptions in the RA cases, which remained stable and significantly higher than in the controls for the remaining study period. The non-opioid analgesic mean PPP increased sharply at the time of symptom onset, with a steady gradual upward trend over time (lower right panel).Conclusion:Opioid prescriptions increase significantly at the time of RA symptoms onset. Despite rapid introduction of DMARDs and resultant reductions in NSAIDs, analgesic use remains significantly higher than in controls. Further research is required to identify the factors associated with persistent opioid use in early RA with interventions aimed at the first 6 months.References:[1]Dale et al. BMC Musculoskelet Disord. 2016;17:461.Acknowledgements:The work was supported by Health Data Research UK which receives its funding from HDR UK Ltd funded by the UKRI MRC, EPSRC, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientists Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust.The SERA study was jointly funded by the Chief Scientists Office Scotland and Pfizer Ltd.Disclosure of Interests:None declared
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Griffiths F, Svantesson M, Bassford C, Dale J, Blake C, McCreedy A, Slowther AM. Decision-making around admission to intensive care in the UK pre-COVID-19: a multicentre ethnographic study. Anaesthesia 2020; 76:489-499. [PMID: 33141939 DOI: 10.1111/anae.15272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 12/24/2022]
Abstract
Predicting who will benefit from admission to an intensive care unit is not straightforward and admission processes vary. Our aim was to understand how decisions to admit or not are made. We observed 55 decision-making events in six NHS hospitals. We interviewed 30 referring and 43 intensive care doctors about these events. We describe the nature and context of the decision-making and analysed how doctors make intensive care admission decisions. Such decisions are complex with intrinsic uncertainty, often urgent and made with incomplete information. While doctors aspire to make patient-centred decisions, key challenges include: being overworked with lack of time; limited support from senior staff; and a lack of adequate staffing in other parts of the hospital that may be compromising patient safety. To reduce decision complexity, heuristic rules based on experience are often used to help think through the problem; for example, the patient's functional status or clinical gestalt. The intensive care doctors actively managed relationships with referring doctors; acted as the hospital generalist for acutely ill patients; and brought calm to crisis situations. However, they frequently failed to elicit values and preferences from patients or family members. They were rarely explicit in balancing burdens and benefits of intensive care for patients, so consistency and equity cannot be judged. The use of a framework for intensive care admission decisions that reminds doctors to seek patient or family views and encourages explicit balancing of burdens and benefits could improve decision-making. However, a supportive, adequately resourced context is also needed.
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Affiliation(s)
- F Griffiths
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - M Svantesson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - C Bassford
- Department of Intensive Care Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - J Dale
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - C Blake
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - A McCreedy
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - A-M Slowther
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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10
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Kahane-Rapport SR, Savoca MS, Cade DE, Segre PS, Bierlich KC, Calambokidis J, Dale J, Fahlbusch JA, Friedlaender AS, Johnston DW, Werth AJ, Goldbogen JA. Lunge filter feeding biomechanics constrain rorqual foraging ecology across scale. J Exp Biol 2020; 223:jeb224196. [PMID: 32820028 DOI: 10.1242/jeb.224196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/26/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
Fundamental scaling relationships influence the physiology of vital rates, which in turn shape the ecology and evolution of organisms. For diving mammals, benefits conferred by large body size include reduced transport costs and enhanced breath-holding capacity, thereby increasing overall foraging efficiency. Rorqual whales feed by engulfing a large mass of prey-laden water at high speed and filtering it through baleen plates. However, as engulfment capacity increases with body length (engulfment volume∝body length3.57), the surface area of the baleen filter does not increase proportionally (baleen area∝body length1.82), and thus the filtration time of larger rorquals predictably increases as the baleen surface area must filter a disproportionally large amount of water. We predicted that filtration time should scale with body length to the power of 1.75 (filter time∝body length1.75). We tested this hypothesis on four rorqual species using multi-sensor tags with corresponding unoccupied aircraft systems-based body length estimates. We found that filter time scales with body length to the power of 1.79 (95% CI: 1.61-1.97). This result highlights a scale-dependent trade-off between engulfment capacity and baleen area that creates a biomechanical constraint to foraging through increased filtration time. Consequently, larger whales must target high-density prey patches commensurate to the gulp size to meet their increased energetic demands. If these optimal patches are absent, larger rorquals may experience reduced foraging efficiency compared with smaller whales if they do not match their engulfment capacity to the size of targeted prey aggregations.
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Affiliation(s)
- S R Kahane-Rapport
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - M S Savoca
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - D E Cade
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
- Institute of Marine Sciences, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - P S Segre
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - K C Bierlich
- Nicholas School of the Environment, Duke University Marine Laboratory, Beaufort, NC 27710, USA
| | - J Calambokidis
- Cascadia Research Collective, 218 W. 4th Ave., Olympia, WA 98501, USA
| | - J Dale
- Nicholas School of the Environment, Duke University Marine Laboratory, Beaufort, NC 27710, USA
| | - J A Fahlbusch
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - A S Friedlaender
- Institute of Marine Sciences, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - D W Johnston
- Nicholas School of the Environment, Duke University Marine Laboratory, Beaufort, NC 27710, USA
| | - A J Werth
- Department of Biology, Hampden-Sydney College, Hampden-Sydney, VA 23943, USA
| | - J A Goldbogen
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
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11
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Duncan D, Brouwer A, Harris KA, Lawes JR, Avigad R, Dale J, Upton PA. Bovine TB infection status in cattle inGreat Britain in 2018. Vet Rec 2020; 186:373-380. [PMID: 32220998 DOI: 10.1136/vr.m1242] [Citation(s) in RCA: 1] [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: 11/04/2022]
Affiliation(s)
- D Duncan
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - A Brouwer
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - K A Harris
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - J R Lawes
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - R Avigad
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - J Dale
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - P A Upton
- APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
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12
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Perrin LD, Harris KA, Reynolds M, Lawes JR, Frost S, Brouwer A, Dale J, Palkopoulou E, Upton PA. Bovine TB infection status in cattle in Great Britain in 2017. Vet Rec 2020; 184:371-378. [PMID: 30902945 DOI: 10.1136/vr.l1321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | - J R Lawes
- Department of Epidemiological Sciences
| | - S Frost
- Department of Epidemiological Sciences
| | - A Brouwer
- Department of Epidemiological Sciences
| | | | | | - P A Upton
- Data Systems Workgroup, APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
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13
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Affiliation(s)
- K. A. Harris
- Department of Epidemiological Sciences; APHA; Woodham Lane, New Haw, Addlestone Surrey KT15 3NB
| | - A. Brouwer
- Department of Epidemiological Sciences; APHA; Woodham Lane, New Haw, Addlestone Surrey KT15 3NB
| | - P. A. Upton
- Department of Epidemiological Sciences; APHA; Woodham Lane, New Haw, Addlestone Surrey KT15 3NB
| | - M. P. Romero Garcia
- Epidemiology Assessment Centre, APHA; Woodham Lane, New Haw, Addlestone Surrey KT15 3NB
| | - J. C. Gibbens
- Epidemiology Assessment Centre, APHA; Woodham Lane, New Haw, Addlestone Surrey KT15 3NB
| | - J. Dale
- Bacteriology; APHA; Woodham Lane, New Haw, Addlestone Surrey KT15 3NB
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Abstract
Background In order to assess the efficacy of adjuvant radiotherapy in the treatment of pathological stage I endometrial carcinoma, we performed a retrospective analysis of 158 patients with this diagnosis who after surgery were either treated with radiation therapy or only followed from January 1980 through December 1987. Methods Patients were divided into two prognostic categories, high and low risk, on the basis of three known predictors of survival: histology, differentiation, and depth of myometrial invasion. All patients underwent total abdominal hysterectomy and bilateral salpingooophorectomy but only the high risk group received radiotherapy as well. Results After a median follow up time of 59 months the survival rates of the two groups were similar. The 5-year disease-free survival of the surgery alone group was 92 % compared to 89 % for the postoperative radiotherapy group. Side effects of treatment were minimal. Conclusions Postoperative radiation therapy for high risk pathological stage I endometrial carcinoma is an effective adjuvant therapy and confers an excellent prognosis.
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Affiliation(s)
- M Barhum
- Northern Israel Oncology Center, Rambam Medical Center, Haifa
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Ytre-Hauge K, Fjæra L, Rørvik E, Dale J, Thörnqvist S, Stokkevåg C. EP-2014: Organ-specific RBE estimates for cranio-spinal irradiation with protons. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32323-5] [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: 10/14/2022]
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16
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Abstract
The general public in the UK often telephone accident and emergency (A&E) departments for medical advice. Such calls are usually dealt with by nursing staff in an informal manner (often with no written record of the call being made). The specific questions addressed in this study are who was calling for advice, when did they call, what were their presenting complaints, and what was the outcome of the call? In addition, the study provided an opportunity to test the implementation of a new system of record-keeping for telephone consultation. A telephone consultation record (TCR) was developed and used to record details of each call made to the A&E department for medical/health advice. An analysis of 597 consecutive documented calls is presented in this paper. The majority of calls were dealt with by 'E' grade nursing staff (42.7%); only four calls (0.7%) were recorded by medical staff. Two hundred and six (43.5%) calls related to patients aged up to 15 years. In 57% of the cases the call was made by a third party. In all, 149 different presenting complaints were recorded on the TCRs. The three most common presenting complaints were dental problems (7.4%), fever (4.3%), and concerns about drug reactions (23%). Seventy-three per cent of callers were advised that a visit to the A&E department was not immediately necessary. The study identifies several important issues for development of a more formal and effective system of telephone advice. The majority of calls made to the A&E department appeared to be of a primary care nature but the extent to which nurses are trained to assess and advise on these problems needs to be questioned. A reluctance to document the calls to A&E was identified, one reason being a concern about accountability. Training and support are clearly required.
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Affiliation(s)
- R Crouch
- Accident & Emergency Department, King's College School of Medicine and Dentistry, London, England
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McPhail P, Sandhu H, Dale J, Stewart-Brown S. Acupuncture in hospice settings: A qualitative exploration of patients' experiences. Eur J Cancer Care (Engl) 2018; 27:e12802. [PMID: 29323766 DOI: 10.1111/ecc.12802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/28/2022]
Abstract
Whilst acupuncture has the potential to impact on many aspects of health and well-being, including end-of-life care, there is little research regarding patients' experiences of its effects within the context of palliative care in hospice settings. The aim of this study was to address this gap, by exploring patients' experiences of acupuncture within this setting. In-depth, semi-structured interviews were conducted with a sample of eighteen patients who had received acupuncture as part of hospice care. Transcription of data, with thematic analysis, identified two overarching themes: (1) participant perceptions of the effects of acupuncture including pain control, improved physical and emotional health, spiritual well-being and awareness of health as a holistic phenomenon; and (2) factors which participants believed enabled acupuncture to have these effects including the quality of the practitioner relationship, engagement of participants in the process of their treatment and prior expectations that acupuncture could work. Acupuncture was found to be a highly acceptable, accessible and popular treatment with positive holistic effects reported across the domains of physical, mental and spiritual health and no serious adverse effects. By enabling awareness of the holistic nature of health and well-being, acupuncture was experienced as having the potential to contribute to a better death, an emergent theory that needs testing in further studies. In the meanwhile, the results of this study offer encouragement to hospices currently providing or considering investing in acupuncture provision.
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Affiliation(s)
- P McPhail
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - H Sandhu
- Division of Health Sciences, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - J Dale
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Stewart-Brown
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Walker PA, Alesini PD, Alexandrova AS, Anania MP, Andreev NE, Andriyash I, Aschikhin A, Assmann RW, Audet T, Bacci A, Barna IF, Beaton A, Beck A, Beluze A, Bernhard A, Bielawski S, Bisesto FG, Boedewadt J, Brandi F, Bringer O, Brinkmann R, Bründermann E, Büscher M, Bussmann M, Bussolino GC, Chance A, Chanteloup JC, Chen M, Chiadroni E, Cianchi A, Clarke J, Cole J, Couprie ME, Croia M, Cros B, Dale J, Dattoli G, Delerue N, Delferriere O, Delinikolas P, Dias J, Dorda U, Ertel K, Ferran Pousa A, Ferrario M, Filippi F, Fils J, Fiorito R, Fonseca RA, Galimberti M, Gallo A, Garzella D, Gastinel P, Giove D, Giribono A, Gizzi LA, Grüner FJ, Habib AF, Haefner LC, Heinemann T, Hidding B, Holzer BJ, Hooker SM, Hosokai T, Irman A, Jaroszynski DA, Jaster-Merz S, Joshi C, Kaluza MC, Kando M, Karger OS, Karsch S, Khazanov E, Khikhlukha D, Knetsch A, Kocon D, Koester P, Kononenko O, Korn G, Kostyukov I, Labate L, Lechner C, Leemans WP, Lehrach A, Li FY, Li X, Libov V, Lifschitz A, Litvinenko V, Lu W, Maier AR, Malka V, Manahan GG, Mangles SPD, Marchetti B, Marocchino A, Martinez de la Ossa A, Martins JL, Massimo F, Mathieu F, Maynard G, Mehrling TJ, Molodozhentsev AY, Mosnier A, Mostacci A, Mueller AS, Najmudin Z, Nghiem PAP, Nguyen F, Niknejadi P, Osterhoff J, Papadopoulos D, Patrizi B, Pattathil R, Petrillo V, Pocsai MA, Poder K, Pompili R, Pribyl L, Pugacheva D, Romeo S, Rossi AR, Roussel E, Sahai AA, Scherkl P, Schramm U, Schroeder CB, Schwindling J, Scifo J, Serafini L, Sheng ZM, Silva LO, Silva T, Simon C, Sinha U, Specka A, Streeter MJV, Svystun EN, Symes D, Szwaj C, Tauscher G, Thomas AGR, Thompson N, Toci G, Tomassini P, Vaccarezza C, Vannini M, Vieira JM, Villa F, Wahlström CG, Walczak R, Weikum MK, Welsch CP, Wiemann C, Wolfenden J, Xia G, Yabashi M, Yu L, Zhu J, Zigler A. Horizon 2020 EuPRAXIA design study. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/874/1/012029] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kaplan A, Neisius A, Radvak D, Shin R, Ackerman A, Chen T, Dale J, Scales C, Ferrandino M, Simmons W, Preminger G, Lipkin M. 1031 Evaluation of a novel single use flexible ureteroscope. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)61032-1] [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: 10/22/2022]
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20
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Dale J, Stirling A, Grigor C, Saunders S, Porter D. SAT0061 Comparison of Outcomes Between Studies of Intensive Treatment Strategies in Early RA from a Single Centre Over 20 Years. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1980] [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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Dale J, Nijjar J, McClure J, McBride M, Porter D, McInnes I. AB0007 Comparison of Peripheral Blood Gene Expression Profiles to Phenotype and Treatment Response in the Taser Early Rheumatoid Arthritis Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1457] [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: 11/03/2022]
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Abstract
The present paper summarizes the key recommendations in a recent publication produced by the Joint British Diabetes Societies for Inpatient Care on the use of variable rate i.v. insulin infusion in 'medical' inpatients. The full guideline is available at http://www.diabetologists-abcd.org.uk/JBDS/JBDS_IP_VRIII.pdf and is designed to be a practical guide that can used by any healthcare professional who manages medical inpatients with hyperglycaemia. Its main aim is to allow variable rate i.v. insulin infusion to be used safely, effectively and efficiently for this specific group of inpatients.
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Affiliation(s)
- S George
- Department of Diabetes and Endocrinology, East and North Herts NHS Trust, Lister Hospital, Stevenage, UK
| | - J Dale
- Dudley Group NHS Foundation Trust, Dudley, UK
| | - D Stanisstreet
- Department of Diabetes and Endocrinology, East and North Herts NHS Trust, Lister Hospital, Stevenage, UK
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Dey CJ, Valcu M, Kempenaers B, Dale J. Carotenoid-based bill coloration functions as a social, not sexual, signal in songbirds (Aves: Passeriformes). J Evol Biol 2015; 28:250-8. [DOI: 10.1111/jeb.12560] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 11/30/2022]
Affiliation(s)
- C. J. Dey
- Department of Biology; McMaster University; Hamilton ON Canada
| | - M. Valcu
- Department of Behavioural Ecology and Evolutionary Genetics; Max Planck Institute for Ornithology; Seewiesen Germany
| | - B. Kempenaers
- Department of Behavioural Ecology and Evolutionary Genetics; Max Planck Institute for Ornithology; Seewiesen Germany
| | - J. Dale
- Institute of Natural and Mathematical Sciences; Albany Campus; Massey University; Auckland New Zealand
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Lewis A, Blackney M, Torvinen S, Holmes J, Osborne M, Dale J, Chandler S, Plich A. The Budget Impact of Duoresp® Spiromax® (Budesonide + Formoterol Fumarate Dihydrate) Compared With Symbicort® Turbohaler® for the Management of Asthma and Chronic Obstructive Pulmonary Disease in the United Kingdom: Impact on Health Care Costs and Inhalation Technique. Value Health 2014; 17:A591. [PMID: 27202019 DOI: 10.1016/j.jval.2014.08.2027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - S Torvinen
- Teva Pharmaceuticals Europe B. V, Amsterdam, The Netherlands
| | | | | | - J Dale
- Teva UK Limited, Essex, UK
| | | | - A Plich
- Teva Pharmaceuticals Europe B. V, Amsterdam, The Netherlands
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25
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Allen AR, Dale J, McCormick C, Mallon TR, Costello E, Gordon SV, Hewinson RG, Skuce RA, Smith NH. The phylogeny and population structure of Mycobacterium bovis in the British Isles. Infect Genet Evol 2013; 20:8-15. [PMID: 23933404 DOI: 10.1016/j.meegid.2013.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/17/2013] [Accepted: 08/02/2013] [Indexed: 11/17/2022]
Abstract
To further understand the epidemic of bovine tuberculosis in Great Britain, Northern Ireland and the Republic of Ireland, we identified 16 mutations that are phylogenetically informative for Mycobacterium bovis strains from these regions. We determined the status of these mutations among a collection of 501 strains representing the molecular diversity found in these three regions of the British Isles. The resulting linear phylogenies from each region were concordant, showing that the same lineage of M. bovis was present. The dominance of this lineage is unique within Europe, and suggests that in the past the populations were homogenous. Comparison of approximately 500 strains isolated in 2005 from each region by spoligotype and 5 locus VNTR profiling, revealed distinct differences in the genotype frequencies and sub-lineage makeup between each region. We concluded that whilst each region shared the same major phylogenetic lineage of M. bovis, more recent evolution had resulted in the development of region-specific populations. Regional differences in the M. bovis populations suggest that it may be possible to identify the movement of strains from one region to another.
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Affiliation(s)
- A R Allen
- Agri-Food and Biosciences Institute, Stoney Road, Belfast, Northern Ireland BT4 3SD, UK.
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26
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Ciechomska A, Dale J, McKay N, Turner D, Youssef H. OP0288 Lessons Learned from the Scottish Rheumatology Ultrasound Mentoring Network Project. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.493] [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: 11/03/2022]
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Robertson J, Dale J, Sattar N, Porter D. FRI0142 Aggressive dmard therapy elevates hdl-cholesterol and lowers the atherogenic index in the taser study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1269] [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: 11/03/2022]
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Abstract
BACKGROUND People with type 2 diabetes have an increased risk of oral health problems; however, oral health is currently not included in structured diabetes reviews and education in the UK. AIM AND OBJECTIVES This study explores the patient's experience related to oral health and diabetes, especially in relation to: • Awareness of the link between oral health and diabetes and oral self-care needs. • Interaction with health professionals in dental and general practice. • Preferences for receiving oral health information and education. Methods This nested qualitative study involved semi-structured telephone interviews with a purposive sample of 20 participants from a questionnaire study on oral health awareness in patients with diabetes. Interview transcripts were analysed using a thematic framework approach. RESULTS Participants were mostly unaware of the link between oral health and diabetes. Those that had been made aware by a health professional were not given concrete self-care advice. Interactions with dental professionals were often limited to informing the dental practice of their diagnosis and current medication. Most participants were in favour of dentists screening for diabetes, but as their general practice was the hub for diabetes care, they felt GPs or nurses should provide oral health information and discuss oral health with patients. CONCLUSIONS Written information regarding diabetes and its possible effects on oral health needs to be more readily available to people with diabetes, especially at diagnosis. There may be a place for introducing a structured oral health question in routine diabetes reviews.
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Affiliation(s)
- A Lindenmeyer
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
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Abstract
Rapid progress in functional genomics is yielding unparalleled opportunities for cancer biomarker discovery. Several procedures including data collection, analysis, verification, and visualization are necessary to identify cancer biomarkers from continuously updated microarray data, which are derived from multiple tissue sources using various methods. BioMarker is designed to integrate these procedures in a user-friendly manner, for practical application by cancer researcher and clinicians. From the feedback of clinical and research application, BioMarker is the first effort to provide a system that facilitates all aspects of biomarker discovery from microarray datasets.
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Affiliation(s)
- W Feng
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, GA, USA
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Crilly A, Burns E, Nickdel MB, Lockhart JC, Perry ME, Ferrell PW, Baxter D, Dale J, Dunning L, Wilson H, Nijjar JS, Gracie JA, Ferrell WR, McInnes IB. PAR(2) expression in peripheral blood monocytes of patients with rheumatoid arthritis. Ann Rheum Dis 2012; 71:1049-54. [PMID: 22294633 DOI: 10.1136/annrheumdis-2011-200703] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Proteinase-activated receptor 2 (PAR(2)) is a G protein-coupled receptor activated by serine proteinases with proinflammatory activity. A study was undertaken to investigate the presence and functional significance of PAR(2) expression on rheumatoid arthritis (RA)-derived leucocyte subsets. METHODS Venous blood was obtained from patients with RA and osteoarthritis (OA) as well as healthy control subjects. Surface expression of PAR(2) on peripheral blood mononuclear cells (PBMCs) was analysed by flow cytometry and interleukin 6 (IL-6) generation by ELISA. RESULTS Patients with RA had elevated but variable surface expression of PAR(2) on CD14+ monocytes compared with control subjects (median (1st to 3rd quartiles) 1.76% (0.86-4.10%) vs 0.06% (0.03-0.81%), p<0.0001). CD3+ T cells showed a similar pattern with significantly higher PAR(2) expression in patients with RA compared with controls (3.05% (0.36-11.82%) vs 0.08% (0.02-0.28%), p<0.0001). For both subsets, PAR(2) expression was significantly higher (p<0.00001) in patients with high levels of disease activity: PAR(2) expression for both CD14+ and CD3+ cells correlated to C reactive protein and erythrocyte sedimentation rate. Furthermore, in a cohort of patients with newly diagnosed RA, elevated PAR(2) expression in both CD14+ and CD3+ cells was significantly reduced 3 months after methotrexate or sulfasalazine treatment and this reduction correlated significantly with the reduction in the 28-joint Disease Activity Scale score (p<0.05). PAR(2) expression on cells from patients with OA was low, similar to levels seen in control subjects. Generation of IL-6 by monocytes in response to a selective PAR(2) agonist was significantly greater in patients with RA than in patients with OA and control subjects (p<0.05). CONCLUSIONS These findings are consistent with a pathogenic role for PAR(2) in RA.
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Affiliation(s)
- A Crilly
- School of Science, University of the West of Scotland, Paisley, UK
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Walsh N, Dale J, McGraw KJ, Pointer MA, Mundy NI. Candidate genes for carotenoid coloration in vertebrates and their expression profiles in the carotenoid-containing plumage and bill of a wild bird. Proc Biol Sci 2012; 279:58-66. [PMID: 21593031 PMCID: PMC3223654 DOI: 10.1098/rspb.2011.0765] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [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: 04/12/2011] [Accepted: 04/28/2011] [Indexed: 12/13/2022] Open
Abstract
Carotenoid-based coloration has attracted much attention in evolutionary biology owing to its role in honest, condition-dependent signalling. Knowledge of the genetic pathways that regulate carotenoid coloration is crucial for an understanding of any trade-offs involved. We identified genes with potential roles in carotenoid coloration in vertebrates via (i) carotenoid uptake (SR-BI, CD36), (ii) binding and deposition (StAR1, MLN64, StAR4, StAR5, APOD, PLIN, GSTA2), and (iii) breakdown (BCO2, BCMO1). We examined the expression of these candidate loci in carotenoid-coloured tissues and several control tissues of the red-billed quelea (Quelea quelea), a species that exhibits a male breeding plumage colour polymorphism and sexually dimorphic variation in bill colour. All of the candidate genes except StAR1 were expressed in both the plumage and bill of queleas, indicating a potential role in carotenoid coloration in the quelea. However, no differences in the relative expression of any of the genes were found among the quelea carotenoid phenotypes, suggesting that other genes control the polymorphic and sexually dimorphic variation in carotenoid coloration observed in this species. Our identification of a number of potential carotenoid genes in different functional categories provides a critical starting point for future work on carotenoid colour regulation in vertebrate taxa.
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Affiliation(s)
- N. Walsh
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 ITN, UK
| | - J. Dale
- Max Planck Institute for Ornithology, Eberhard-Gwinner Strasse, 82319 Seewiesen, Germany
| | - K. J. McGraw
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA
| | - M. A. Pointer
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 ITN, UK
| | - N. I. Mundy
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 ITN, UK
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Martin S*, Sutcliffe P, Griffiths F, Sturt J, Powell J, Adams A, Dale J. The use of communication technologies for the engagement of young adults and adolescents in mental healthcare. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.33] [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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Abstract
The incidence of prostate cancer among African-Caribbean men in the UK is three times that among men from the majority population. Little attention, however, has been given to the perceptions and experiences of treatment and care of men from these communities with prostate cancer. This qualitative study is the first such investigation, situating men's accounts within the context of their personal history and social environment. Using a community-based, snowball sampling method, 16 first generation African-Caribbean men living in Central England were recruited. Similarities and divergence in men's experience were identified through thematic analysis of interview transcripts. Men's responses to their situation were influenced by aspects of migration and historical context as well as culture. While medical treatment was highly valued, common difficulties were compounded by problems of health professional-patient communication, stereotyping and insensitivity of some staff. Lack of coordination between services and agencies adversely affected the well-being of frail men and widowers. Findings suggest the need for a more proactive approach to giving and eliciting information combined with cultural diversity training. More systematic referral procedures and information exchange between African-Caribbean men with prostate cancer and their general practitioner, hospital, social care and voluntary agencies, churches and community organisations are indicated.
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Affiliation(s)
- V Nanton
- Health Sciences Research Institute, Warwick Medical School University of Warwick, Coventry, UK.
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Donaldson A, Barclay S, Dale J, Daveson B, Epiphaniou E, Harding R, Higginson IJ, Mason BL, Munday D, Nanton V, Shipman C, Murray SA. Promoting supportive and palliative care research by a management fellow. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.62] [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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Mason BL, Barclay S, Dale J, Daveson B, Donaldson A, Epiphaniou E, Harding R, Higginson IJ, Kendall M, Munday D, Nanton V, Shipman C, Murray SA. Co-ordination of generalist end of life care in the UK: a multi-site ethnographic study. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.10] [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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Mason BL, Barclay S, Dale J, Daveson B, Donaldson A, Epiphaniou E, Harding R, Higginson IJ, Munday D, Nanton V, Shipman C, Murray SA. Co-ordination of generalist care for patients towards the end of life: a literature review. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.61] [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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Nanton V, Docherty A, Meystre C, Dale J. Finding a pathway: Information and uncertainty along the prostate cancer patient journey. Br J Health Psychol 2010; 14:437-58. [DOI: 10.1348/135910708x342890] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Breithaupt A, Kalthoff D, Dale J, Bairlein F, Beer M, Teifke JP. Neurotropism in blackcaps (Sylvia atricapilla) and red-billed queleas (Quelea quelea) after highly pathogenic avian influenza virus H5N1 infection. Vet Pathol 2010; 48:924-32. [PMID: 20974871 DOI: 10.1177/0300985810386467] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The epidemiologic role of passerine birds in the spread of highly pathogenic avian influenza virus (HPAIV) remains controversial. However, confirmed natural infections with HPAIV in Passeriformes, their close contact to poultry and humans, and their role as a human food source indicate a need for increased research on passerines. To date, there are only a few studies on viral shedding and pathomorphologic changes in songbirds infected with HPAIV. To investigate susceptibility, clinical outcome, virus spread, and pathomorphology, the authors inoculated oculo-oronasally 22 red-billed queleas (Quelea quelea) and 11 blackcaps (Sylvia atricapilla) with A/Cygnus cygnus/Germany/R65/2006 (H5N1) using 2 different doses of either 10(4) EID50 (50% egg infective dose) or 10(6) EID50 per animal. They monitored all birds for clinical signs and oropharyngeal and cloacal virus shedding. They also performed immunohistochemistry and obtained molecular virologic data by real-time reverse transcription polymerase chain reaction in tissue samples. In contrast to blackcaps, where 100% of the infected individuals died, queleas were much less susceptible, with a mortality of 82% and 18%, depending on the doses applied. In both species, the virus was shed within 3 to 6 days postinfection, mainly via the respiratory tract. Viral antigen was detected in 100% of the succumbed birds, particularly in the central nervous system. In blackcaps, the heart, lungs, and pancreas were mainly infected. In contrast, the pancreas was predominantly affected in queleas, whereas the heart and the lower respiratory tract were of minor relevance. The authors hypothesize that neurotropism should be considered a main factor for the fatal course of disease in Passeriformes after infection with HPAIV.
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Affiliation(s)
- A Breithaupt
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Südufer 10, 17493 Greifswald-Insel Riems, Germany
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Ritschard M, Laucht S, Dale J, Brumm H. Enhanced testosterone levels affect singing motivation but not song structure and amplitude in Bengalese finches. Physiol Behav 2010; 102:30-5. [PMID: 20951153 DOI: 10.1016/j.physbeh.2010.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 10/07/2010] [Accepted: 10/08/2010] [Indexed: 10/18/2022]
Abstract
Song is a fundamental component of territory defense and mate attraction in birds, and androgens (like testosterone) are known to play a key role in controlling it. However, little is known about how differences in testosterone levels between males translate into inter-individual song variation. Indeed, testosterone could affect both the motivation to sing and the structure of song itself. Here, we tested whether experimentally elevated testosterone levels in adult Bengalese finches (Lonchura striata var. domestica), an oscine bird species, have an activational effect on 1) song performance, and 2) song structure. Our results show that testosterone-treated males, in contrast to sham-control males, sang more when confronted with a female. Other performance-related traits, however, such as latency to sing and song amplitude, were not affected. Testosterone-treated males also showed no differences in our two measures of song structure: fundamental element frequency and mean song frequency. Because song structure is known to be organizationally affected by testosterone, our results, synthesized together with findings from the current literature, suggest that in oscine birds, song contains multiple messages about the signaler's hormonal status. First, song performance may reflect current hormonal condition, and second, song structure may reflect the past hormonal state.
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Affiliation(s)
- M Ritschard
- Max Planck Institute for Ornithology, Eberhard-Gwinner-Strasse, 82319 Seewiesen, Germany.
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Declercq JP, Germain G, van Meerssche M, Debaerdemaeker T, Dale J, Titlestad K. The Crystal and Molecular Structures of Three Cyclic Tetrapeptides: C-GlySar3, c-GlySarGlySar and c-AlaSar3 (D, L). ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bscb.19750840401] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Shaikh MF, Shenker NG, Dale J, Else S, Stirling A, France J, Gordon MM, Hunter J, Porter D, Smith R, Khan J, Chan A, Paskins Z, John H, Hassell A, Rowe IF, Al-Mossawi MH, Chambers T, Greenbank C, Bronwen E, Halsey J, Bukhari M, Pearce FA, Lanyon P, Zakout S, Clarke L, Kirwan J, Marie Smith A, Lingard L, Heslop P, Walker DJ, Miller A, Johnston M, Timms A, Misbah S, Luqmani R, Bamji A, Lane J, Donnelly AA, Halsey JP, Bukhari MA, van Vollenhoven R, Cifaldi M, Roy S, Chen N, Gotlieb L, Malaise M, Ara R, Rafia R, Packham J, Haywood K, Healey E, Jones EA, Jones GT, Hannaford PC, Keeley P, Lovell K, McBeth J, McNamee P, Prescott GJ, Woby S, Macfarlane GJ, Munir M, Joshi AR, Johnson H, Smith EC, Poole CD, Lebmeier M, Currie CJ, Clark H, Rome K, Atkinson I, Plant M, Dixon J, Baskar S, Erb N, Whallett AJ, Arhinful-Adjapong A, Hawksley J, Tillett W, Green S, Tan WS, Pauling J, Michell L, Russell J, Derham S, Korendowych E, Bojke C, Cifaldi M, Ray S, Van Hout B, Grigor C, Porter D, Toner V, Stirling A, McEntegart A, Seng Edwin Lim C, Low ST, Joshi N, Walton T, Sanderson T, Morris M, Calnan M, Richards P, Hewlett S, Waller RD, Collins DA, Williamson LJ, Price EJ, Judge A, Dieppe PA, Arden NK, Cooper C, Carr A, Javaid K, Field R, Rafia R, Ara R, Lebmeier M. Health Services Research, Economics and Outcomes Research [86-113]: 86. What Happens to Patients with Complex Regional Pain Syndrome of Greater than 12 Months' Duration? Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq720] [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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Kakad R, Anwar A, Dyer P, Webber J, Dale J. Fasting plasma glucose is not sufficient to detect ongoing glucose intolerance after pregnancy complicated by gestational diabetes. Exp Clin Endocrinol Diabetes 2010; 118:234-6. [PMID: 20162508 DOI: 10.1055/s-0029-1241876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIMS Women who develop diabetes during pregnancy are at significant risk of developing Type 2 diabetes later in life, and "should be offered blood glucose testing ... to exclude persisting hyperglycaemia" after delivery. New UK guidelines now recommend that this is done by measurement of fasting blood glucose, rather than an oral glucose tolerance test (OGTT). Our study aims to establish whether assessment by fasting blood glucose gives equivalent results to an OGTT. METHODS Retrospective data were obtained from four centres in the West Midlands, UK, who performed a postnatal OGTT on 470 women during a 12-month period. All centres used a 75 g, 2-h protocol. RESULTS 28 of 470 (6.0%) women had diabetes mellitus after testing of fasting plasma glucose. After OGTT, 70 women (14.9%) were found to have impaired glucose tolerance (IGT), and 10 further cases of diabetes were detected (overall prevalence of DM 8.1%). Of the 400 women with normal fasting plasma glucose. After OGTT, 70 women (14.9%) were found to have impaired glucose tolerance (IGT), and 10 further cases of diabetes were detected (overall prevalence of DM 8.1%). Of the 400 women with normal fasting plasma glucose (< or = 6.0 mmol/l), 55 were found to have impaired glucose tolerance and 4 had overt diabetes. In all, 26% of women with diabetes were missed by FPG. CONCLUSION Fasting plasma glucose alone does not allow detection of IGT, and misses a substantial proportion of women with Type 2 diabetes. Recognition of ongoing IGT or DM is important in identifying women who may benefit from lifestyle modification, and who may need early intervention in subsequent pregnancies. Our results suggest that OGTT should be the investigation of choice in the postnatal assessment of women who have had GDM.
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Affiliation(s)
- R Kakad
- Russells Hall Hospital, Diabetes & Endocrinology, Dudley, United Kingdom.
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Sandhu H, Dale J, Stallard N, Crouch R, Glucksman E. Emergency nurse practitioners and doctors consulting with patients in an emergency department: a comparison of communication skills and satisfaction. Emerg Med J 2009; 26:400-4. [PMID: 19465607 DOI: 10.1136/emj.2008.058917] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Emergency nurse practitioners (ENPs) play an increasingly important role in UK emergency departments (EDs), but there is limited evidence about how this affects patient care and outcome. A study was undertaken to compare the content of, and satisfaction with, consultations made with patients presenting with problems of low acuity to an ED. METHODS Patients presenting with "primary care" problems were allocated to senior house officers (SHOs, n = 10), specialist registrars/staff grades (n = 7), sessionally-employed general practitioners (GPs, n = 12) or ENPs (n = 6) randomly rostered to work in a consulting room that had a wall-mounted video camera. At the end of each consultation the doctor/ENP and the patient were asked to complete the Physician/Patient Satisfaction Questionnaire. A stratified sample of videotaped consultations (n = 296) was analysed in depth using the Roter Interaction Analysis System. The main outcome measures were length of consultation; numbers of utterances of doctor/ENP and patient talk related to building a relationship, data gathering, activating/partnering, and patient education/counselling; doctor/ENP and patient consultation satisfaction scores. RESULTS ENPs and GPs focused more on patient education and counselling about the medical condition or therapeutic regimen than did ED doctors. There were no significant differences in consultation length. ENPs had higher levels of overall self-satisfaction with their consultations than ED doctors. Patient satisfaction with how actively they participated in the consultation was significantly associated with the amount of talk relating to building a relationship and activating and partnering, and patient satisfaction with information giving in the consultation was significantly associated with the amount of talk relating to building a relationship. CONCLUSION These findings suggest differences between ENP and ED doctor consultations which are associated with some aspects of patient satisfaction. In contrast to previous reports, consultation length was not greater for ENPs than for doctors. There is a need for further research to test the generalisability of these findings and their impact on clinical outcome.
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Affiliation(s)
- H Sandhu
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.
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Dale J, Myhre E, Rasmussen K. Elimination of Hemoglobin and Lactate Dehydrogenase from Plasma in Normals and Patients with Intravascular Hemolysis. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 29:389-95. [DOI: 10.3109/00365517209080255] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rothermundt M, Dale J. Experimentelle Untersuchungen über die Arsenfestigkeit der Spirochäten. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0028-1130973] [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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Dale J, Petrova M, Munday D, Koistinen-Harris J, Lall R, Thomas K. A national facilitation project to improve primary palliative care: impact of the Gold Standards Framework on process and self-ratings of quality. Qual Saf Health Care 2009; 18:174-80. [PMID: 19467998 PMCID: PMC2685539 DOI: 10.1136/qshc.2007.024836] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND Improving quality of end-of-life care is a key driver of UK policy. The Gold Standards Framework (GSF) for Palliative Care aims to strengthen primary palliative care through facilitating implementation of systematic clinical and organisational processes. OBJECTIVES To describe the general practices that participated in the GSF programme in 2003-5 and the changes in process and perception of quality that occurred in the year following entry into the programme, and to identify factors associated with the extent of change. METHODS Participating practices completed a questionnaire at baseline and another approximately 12 months later. Data were derived from categorical questions about the implementation of 35 organisational and clinical processes, and self-rated assessments of quality, associated with palliative care provision. PARTICIPANTS 1305 practices (total registered population almost 10 million). Follow-up questionnaire completed by 955 (73.2%) practices (after mean (SD) 12.8 (2.8) months; median 13 months). FINDINGS Mean increase in total number of processes implemented (maximum = 35) was 9.6 (95% CI 9.0 to 10.2; p<0.001; baseline: 15.7 (SD 6.4), follow-up: 25.2 (SD 5.2)). Extent of change was largest for practices with low baseline scores. Aspects of process related to coordination and communication showed the greatest change. All dimensions of quality improved following GSF implementation; change was highest for the "quality of palliative care for cancer patients" and "confidence in assessing, recording and addressing the physical and psychosocial areas of patient care". CONCLUSION Implementation of the GSF seems to have resulted in substantial improvements in process and quality of palliative care. Further research is required of the extent to which this has enhanced care (physical, practical and psychological outcomes) for patients and carers.
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Affiliation(s)
- J Dale
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.
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Thaulow E, Dale J. Effects of timolol on platelets in coronary sinus blood and on myocardial ischemia during pacing-induced angina. Acta Med Scand 2009; 216:193-8. [PMID: 6496177 DOI: 10.1111/j.0954-6820.1984.tb03792.x] [Citation(s) in RCA: 5] [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: 01/20/2023]
Abstract
The effect of timolol on blood platelet function was studied in coronary sinus and caval vein blood at rest and during pacing-induced angina in 20 patients with coronary heart disease. During pacing-induced angina, lactate measurements confirmed that coronary sinus blood was sampled from ischemic regions in 13 men. The ischemia did not influence platelet function. In blood from non-ischemic myocardium, platelet activation was found during pacing: the ADP-induced aggregation, platelet retention and plasma beta-thromboglobulin levels increased moderately but significantly. Timolol administration prevented this platelet activation, possibly by inhibiting catecholamine release from the myocardium, and reduced the ischemic response during pacing as judged from lactate measurements and ST depressions. It is concluded that timolol reduced platelet activation induced in non-ischemic regions of the heart during tachycardia stress as well as myocardial ischemia.
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Dale J, Myhre E. Can acetylsalicylic acid alone prevent arterial thromboembolism? A pilot study in patients with aortic ball valve prostheses. Acta Med Scand Suppl 2009; 645:73-8. [PMID: 6940425 DOI: 10.1111/j.0954-6820.1981.tb02603.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Encouraged by the effective prevention of arterial thromboembolism with a combination of ASA and anticoagulants (9), the present study was done in 77 patients with a single Starr-Edwards aortic ball valve. They received one gm. of ASA daily, then the dose of anticoagulants was reduced gradually and the drug discontinued on average five weeks later. Six arterial embolic episodes occurred in five patients, the incidence being 14.5 complications per 100 patients per year. Five emboli were cerebral, none of them serious, and one was removed from a femoral artery. Four of the embolic episodes occurred in three of the 11 patients with continuous arrhythmia, probably from venus thrombi that developed in the left atrium. The occurrence of only two embolic complications in the 66 patients with sinus rhythm suggests some prevention of arterial thrombus formation on the prosthetic valves. The results indicate that ASA is inferior to anticoagulants in patients with arrhythmia, while it may represent an alternative to anticoagulation in individuals with sinus rhythm. We prefer, however, the combined therapy in patients with aortic valve prostheses because of the strong anti-thrombotic effect achieved by this treatment.
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Wik B, Dale J. Effect of very early intravenous streptokinase infusion in patients with evolving myocardial infarction. Acta Med Scand 2009; 223:15-8. [PMID: 3279722 DOI: 10.1111/j.0954-6820.1988.tb15759.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of very early infusion of 1.5 X 10(6) U of streptokinase intravenously was studied in 29 patients with nitroglycerin-resistant chest pain and ST-segment elevation. Infarct size was estimated from maximal LD1 isoenzyme levels, and the diagnosis confirmed by CK-MB determination. Thrombolytic therapy was started within 1 hour of pain onset in 11 patients (group A), between 1 and 2 hours in 10 (group B), and later than 2 hours in eight patients (group C). Marked differences appeared between the groups. Thus, three patients in group A and one patient in group B did not develop infarction, all had critical LAD stenoses. Three patients in group C died in shock without bleeding. Further, the average maximal LD1 values in the 22 patients who survived their infarction differed significantly between the groups, and were 12.6, 19.1 and 36.2 mu kat/l in groups A, B and C, respectively. In conclusion, very early intravenous streptokinase infusion probably reduces myocardial necrosis, and possible prevents infarction in some patients.
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Affiliation(s)
- B Wik
- Department of Internal Medicine, Vest-Agder Central Hospital, Kristiansand, Norway
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