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Cuffe C, Giglia R, Cooper MN, Hill J, Silva D, Moorhead AM, Verhasselt V, Lewis JR, Ireson D, Demirci JR, Cotte T, Webb K, Patey F, O’Sullivan TA. Study Protocol for a Stepped-Wedge Cluster (Nested) Randomized Controlled Trial of Antenatal Colostrum Expression (ACE) Instruction in First-Time Mothers: The ACE Study. J Hum Lact 2024; 40:80-95. [PMID: 38158697 PMCID: PMC10799540 DOI: 10.1177/08903344231215074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 10/30/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers. METHODS AND PLANNED ANALYSIS This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. During Phase 2, participants are randomized to ACE instruction via a pre-recorded online video or a one-on-one session with a midwife. Adjusted logistic regression analysis will be used to examine the relationship between ACE instruction and breastfeeding outcomes. RESEARCH AIMS AND QUESTIONS Primary aim: (1) Does advising pregnant individuals to practice ACE and providing instruction improve exclusive breastfeeding rates at 4 months postpartum? Secondary research questions: (2) Do individuals who practice ACE have higher rates of exclusive breastfeeding during the initial hospital stay after birth? (3) Is teaching ACE via an online video non-inferior to one-on-one instruction from a midwife? (4) Does expressing colostrum in pregnancy influence time to secretory activation, or (5) result in any differences in the composition of postnatal colostrum? DISCUSSION Trial findings have important implications for maternity practice, with the online video providing an easily accessible opportunity for ACE education as part of standard antenatal care.
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Affiliation(s)
- Cassandra Cuffe
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Roslyn Giglia
- Adjunct Academic, Curtin University Kent St, Bentley WA, Australia
| | - Matthew N. Cooper
- Telethon Kids Institute, University of Western Australia, Perth Children’s Hospital, Perth, WA, Australia
| | - Julie Hill
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Desiree Silva
- Telethon Kids Institute, Perth, WA, Australia
- School of Medicine, The University of Western Australia, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Anita M. Moorhead
- La Trobe University, Judith Lumley Centre, Melbourne, VIC, Australia
- The Royal Women’s Hospital, Parkville, VIC, Australia
| | - Valerie Verhasselt
- Telethon Kids Institute, Perth, WA, Australia
- Larsson-Rosenquist Foundation Centre for Immunology and Breastfeeding, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Joshua R. Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Deborah Ireson
- School of Nursing and Midwifery, Edith Cowan University, Bunbury, WA, Australia
| | - Jill R. Demirci
- Department of Health Promotion & Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Talea Cotte
- Armadale Kalamunda Group, Armadale Hospital, Perth, WA, Australia
| | - Kathryn Webb
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Frances Patey
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Therese A. O’Sullivan
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Webb K, Gothard L, Mohammed K, Kirby AM, Locke I, Somaiah N. Locoregional control and toxicity following high-dose hypofractionated and accelerated palliative radiotherapy regimens in breast cancer. Clin Oncol (R Coll Radiol) 2023; 35:e469-e477. [PMID: 37422360 DOI: 10.1016/j.clon.2023.06.006] [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: 12/13/2022] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 07/10/2023]
Abstract
AIMS For patients with locally advanced primary/recurrent breast cancer, radiotherapy is an effective treatment for locoregional control. 36 Gy in 6 Gy once-weekly fractions is a commonly used schedule, but there are no data comparing local control and toxicity between 36 Gy delivered once-weekly versus accelerated schedules of multiple 6 Gy fractions per week. This retrospective study compared local control rates and acute and late toxicity in patients undergoing 30-36 Gy in 6 Gy fractions over 6 weeks versus more accelerated schedules over 2-3 weeks for an unresected breast cancer. MATERIALS AND METHODS Patients who received 30-36 Gy in 6 Gy fractions to an unresected breast cancer ± involved lymph nodes between December 2011 and August 2020 were identified. Patients were grouped into once-weekly versus accelerated fractionation schedules. Response rates, local control and toxicity data were analysed. RESULTS In total, 109 patients were identified. The median follow-up duration was 46 months. Forty-seven patients (43%) received once-weekly fractions and 62 patients (57%) received accelerated fractionation schedules. There were no significant differences in baseline tumour characteristics between the groups. Eighty-seven per cent of patients had an objective (complete or partial) response (81% in the once-weekly group; 91% in the accelerated group). The median time to local progression was 23.5 months overall (95% confidence interval 17.8-29.2); 23.5 months (95% confidence interval 18.8-28.1) in the once-weekly group and 19.0 months (95% confidence interval 7.0-31.1) in the accelerated group (P = 0.99). Acute toxicity of any grade occurred in 75% of patients (76% in the once-weekly group; 74% in the accelerated group) and grade 3 toxicity occurred in 7% of patients (7% in the once-weekly group; 8% in the accelerated group). There were no associations between the groups and acute or late toxicity grade (P = 0.78 and P = 0.26, respectively), although one grade 4 late toxicity (skin radionecrosis) occurred in a patient who received five fractions a week and therefore this regimen is not recommended. Study limitations included a lack of statistical power analysis, the necessary grouping of all accelerated patients for analysis and a high rate of censored data. CONCLUSION There were no apparent differences in response rate, time to local progression or toxicity between patients who received 30-36 Gy in 6 Gy fractions once-weekly compared with twice-weekly as palliative treatment for locally advanced breast cancer. This regimen appears to be a safe alternative and may be preferred by patients.
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Affiliation(s)
- K Webb
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Institute of Cancer Research, London, UK
| | - L Gothard
- Institute of Cancer Research, London, UK
| | - K Mohammed
- The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - A M Kirby
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Institute of Cancer Research, London, UK
| | - I Locke
- The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - N Somaiah
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Institute of Cancer Research, London, UK.
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Webb K, Gothard L, Mohammed K, Kirby A, Locke I, Somaiah N. PD-0748 Local control and toxicity after hypofractionated accelerated palliative RT in breast cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02943-7] [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: 10/18/2022]
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4
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Abell B, Eagleson K, Auld B, Bora S, Webb K, McPhail S. Characteristics, Barriers, and Enablers of Models of Care Supporting Neurodevelopmental Follow-Up Of Children With Congenital Heart Disease: A Scoping Review. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.446] [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: 10/16/2022]
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Akhalwaya SY, Webb K, Scott C. P046 A review and retrospective case series of paediatric Sjögren’s syndrome from Southern Africa. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.038] [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: 11/14/2022] Open
Abstract
Abstract
Background
Paediatric Sjögren’s syndrome (pSS) is an uncommon autoimmune paediatric disease, rarely reported in children in Africa. It remains an important consideration in a child with parotid swelling. Here, we present a retrospective case-series of four patients from a paediatric rheumatology clinic in South Africa and discuss some of the difficulties of diagnosis in our context.
Methods
We performed a retrospective analysis of patients who attend the Red Cross War Memorial Hospital Paediatric Rheumatology clinic between 2010 and 2019.
Result
The four patients diagnosed with Sjögren’s all had varied presentations and disease courses. There were 3 females and 1 male and the ages at diagnosis ranged from 6 to 19 years old. The time to diagnosis was prolonged and ranged from 1 month to 10 years. Two patients with primary pSS presented with extra-articular manifestations of arthritis, abdominal pain and fatigue, followed by dry mouth, dry eyes, parotid swelling and and suggestive histopathology. The remaining 2 patients had a secondary pSS due to juvenile onset SLE and tuberculosis respectively.
Conclusion
In less resourced settings the diagnosis of pSS is often delayed. Both patients with primary pSS had preceding extra-glandular manifestations. In less resourced settings, infectious diseases may present as pSS and associated rheumatic diseases causing secondary pSS must be considered.
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Affiliation(s)
- S Y Akhalwaya
- Department of Paediatric Rheumatology, University of Cape Town, South Africa
| | - K Webb
- Department of Paediatric Rheumatology, University of Cape Town, South Africa
| | - C Scott
- Department of Paediatric Rheumatology, University of Cape Town, South Africa
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Webb K, Cámara M, Zain N, Halliday N, Bruce K, Nash E, Whitehouse J, Knox A, Forrester D, Smyth A, Williams P, Fogarty A, Barr H. 446: Novel detection of specific bacterial quorum-sensing molecules in saliva: Potential noninvasive biomarkers for pulmonary Pseudomonas aeruginosa in cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01870-1] [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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The PAMI ED-ALT Group, Sheikh S, Schmitzberger M, Liao R, Brailsford J, Fishe J, Norse A, Webb K, Spindle N, Suffield D, Hendry P. 222 Preliminary Results of PAMI-ED ALT: An Emergency Department Opioid-Alternatives Program. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.234] [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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Frampton K, Sharma S, Behr ER, Webb K, Parry-Williams G, Specterman M, Potterton A, Simmons R, Macallister M. Psychosocial outcomes of peer support for patients with an inherited cardiac condition. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.104] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Inherited cardiac conditions (ICCs) are feared for their risk of sudden death. Individuals are often young and diagnosed after the sudden death of an apparently healthy family member. A diagnosis can have a profound psychological impact and negative effect on quality of life. Uncertainty surrounding the natural history of some diseases causes anxiety and concern about existing children or starting a family. Necessary lifestyle adjustments are often associated with a sense of isolation during social engagement with peers. Psychological support for such patients is scarce. However, a specialist nurse led peer group support within the ICC service may improve psychological outcomes and empower patients to support others.
Purpose
To determine the effect of a nurse led peer support group on subjective psychological symptoms for patients with ICCs.
Methods
A pilot specialist nurse support group was established in February 2020 including 30 patients with ICCs. This consisted of a meeting in person followed by 6 subsequent 2 monthly online video meetings. Each session lasted 2 hours and included a talk by a healthcare professional on an ICC related topic, followed by an open forum for group discussion facilitated by the specialist nurse. An online social media chat forum was also developed. After 1 year, a bespoke questionnaire was distributed to all participants enquiring about the effect of group support on anxiety level, sense of isolation, knowledge about their condition and empowerment to support themselves and others.
Results
21 (70%) patients aged between 20 and 65 years old (mean age 49) responded. Diagnoses included Brugada syndrome, arrhythmogenic cardiomyopathy, dilated cardiomyopathy, hypertrophic cardiomyopathy and long QT syndrome. All participants agreed that the group provided a comfortable platform to ask questions about their condition. 95% of participants were keen to know more about their condition after diagnosis of which 86% agreed that knowledge about their condition had improved since joining the group. 90% of participants experienced anxiety related to their condition before joining the group of which 76% reported reduced levels since joining. 76% felt isolated after their diagnosis of which 86% reported that these feelings had lessened since joining the group. 86% of the group agreed that group discussion empowered them and helped them support other affected individuals.
Conclusion
A pilot study support group for patients with ICCs reduced anxiety and sense of isolation, improved knowledge, and sense of empowerment and willingness to support other patients in ≥ 80% of attendees. There is potential that patient support groups can be kick started by specialist nurses and subsequently allowed to run by patients themselves. Apart from improving psychological outcomes, such practice may reduce the workload for the ICC multidisciplinary team.
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Affiliation(s)
- K Frampton
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - S Sharma
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - ER Behr
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - K Webb
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - G Parry-Williams
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - M Specterman
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - A Potterton
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - R Simmons
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - M Macallister
- St George"s University Hospital NHS Foundation Trust, London, United Kingdom of Great Britain & Northern Ireland
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9
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Iqbal Z, Airey ND, Brown SR, Wright NMJ, Miklova D, Nielsen V, Webb K, Sajjad A. Waiting list eradication in secondary care psychology: Addressing a National Health Service blind spot. Clin Psychol Psychother 2021; 28:969-977. [PMID: 33415754 DOI: 10.1002/cpp.2551] [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: 12/05/2020] [Accepted: 12/17/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Waiting times for secondary care psychological therapy remain a 'blind spot' in serious mental illness (SMI) provision, and their reduction is a priority within the National Health Service (NHS) Five Year Forward View. The paper describes the eradication of waiting times within a community-based NHS service and the effectiveness of strategies whilst examining help-seeking behaviour, compliance and therapeutic need. METHODS Analyses are reported for treatment compliance and therapeutic outcomes for 208 waiting-list cohort individuals seen by the SMI psychology service over an 18-month period between October 2014 and March 2016. RESULTS No significant clinical or demographic differentiation between individuals who successfully completed therapy compared to those who disengaged was observed. Despite an average 2.20-year waiting time, this alone did not significantly impact engagement with psychological treatment and all psychological therapies provided led to a significant clinical improvement and no individuals who completed therapy required re-referral at 12-month follow-up. CONCLUSIONS If imposed appropriately over a suitable time frame evidence-based practice coupled with effective operationalization can result in efficient needs-led psychological provision within SMI and secondary care. Potentially debilitating waiting times for service users and other referring professionals can be avoided, whilst psychology provision retains a flexible, formulation-based and person-centred approach.
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Affiliation(s)
- Zaffer Iqbal
- Faculty of Health Sciences, University of Hull, Hull, UK.,Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK
| | - Nicola D Airey
- Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK
| | - Sophie R Brown
- Faculty of Health Sciences, University of Hull, Hull, UK.,Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK
| | | | - Deborah Miklova
- Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK
| | - Victoria Nielsen
- Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK
| | - Kathryn Webb
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, Oxford, UK.,Oxford Institute of Clinical Psychology Training, Isis Education Centre, Warneford Hospital, Oxford, UK
| | - Aamer Sajjad
- Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK
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Zain N, Webb K, Halliday N, Barrett D, Nash E, Whitehouse J, Honeybourne D, Smyth A, Forrester D, Dewar J, Knox A, Williams P, Fogarty A, Cámara M, Bruce K, Barr H. ePS6.04 2-Alkyl-4-quinolone quorum sensing signal molecules are potential biomarkers in cystic fibrosis pseudomonal infection. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30332-5] [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: 11/26/2022]
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11
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Geisler J, Webb K, Moore C, King K, Manahan K. Further use of liposomal doxorubicin regimen after initial dose hypersensitivity. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.625] [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: 10/26/2022]
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12
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Green H, Smith M, Edwards G, Barry P, Brennan A, Bright-Thomas R, Horsley A, Webb K, Jones A. P158 A single centre experience of Mycobacterium abscessus culture, treatment and eradication data in adults with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30452-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Collie-Akers VL, Schultz JA, Fawcett SB, Obermeier SM, Pate RR, John LV, Weber SA, Logan A, Arteaga SS, Loria CM, Webb K. The prevalence of community programmes and policies to prevent childhood obesity in a diverse sample of US communities: the Healthy Communities Study. Pediatr Obes 2018; 13 Suppl 1:64-71. [PMID: 30270519 DOI: 10.1111/ijpo.12475] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 06/02/2018] [Accepted: 08/15/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This manuscript describes the prevalence and attributes of community programmes and policies (CPPs) to address childhood obesity documented as occurring in 130 diverse US communities. METHODS Key informant interviews (N = 1420) and document abstraction were used to identify and characterize CPPs to promote physical activity and healthy nutrition occurring during a 10-year retrospective study period. Data were collected in 2013-2015 and analysed in 2016. RESULTS Across all 130 communities, 9681 distinct CPPs were reported as occurring by key informants. Of these, 5574 (58%) focused on increasing physical activity, 2596 (27%) on improving nutrition and 1511 (16%) on both behaviours. The mean number of CPPs per community was 74.0, with a range of 25 to 295 across all communities. Most CPPs occurred more than once (63%) and on average lasted 6.1 years. The greatest number of reported CPPs occurred in school settings (44%). CONCLUSIONS Communities showed a wide range of investment in the amount of CPPs occurring in settings that affect opportunities for children to engage in physical activity and healthy nutrition. The pattern of implementation of CPPs showed variation over time, with an increase in more recent years. This observational study provides new and valuable information about what US communities are doing to prevent childhood obesity.
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Affiliation(s)
- V L Collie-Akers
- Center for Community Health and Development, University of Kansas, Lawrence, KS, USA
| | - J A Schultz
- Center for Community Health and Development, University of Kansas, Lawrence, KS, USA
| | - S B Fawcett
- Center for Community Health and Development, University of Kansas, Lawrence, KS, USA
| | - S M Obermeier
- Center for Community Health and Development, University of Kansas, Lawrence, KS, USA
| | - R R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - L V John
- Battelle Health and Analytics, St. Louis, MO, USA
| | - S A Weber
- Battelle Health and Analytics, Columbus, OH, USA
| | - A Logan
- Battelle Health and Analytics, Columbus, OH, USA
| | - S S Arteaga
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - C M Loria
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - K Webb
- Division of Agriculture and Natural Resources, University of California, Nutrition Policy Institute, Oakland, CA, USA
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Strauss WJ, Nagaraja J, Landgraf AJ, Arteaga SS, Fawcett SB, Ritchie LD, John LV, Gregoriou M, Frongillo EA, Loria CM, Weber SA, Collie-Akers VL, McIver KL, Schultz J, Sagatov RDF, Leifer ES, Webb K, Pate RR. The longitudinal relationship between community programmes and policies to prevent childhood obesity and BMI in children: the Healthy Communities Study. Pediatr Obes 2018; 13 Suppl 1:82-92. [PMID: 29493122 DOI: 10.1111/ijpo.12266] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 12/12/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although a national epidemic of childhood obesity is apparent, how community-based programmes and policies (CPPs) affect this outcome is not well understood. OBJECTIVES This study examined the longitudinal relationship between the intensity of CPPs in 130 communities over 10 years and body mass index (BMI) of resident children. We also examined whether these relationships differ by key family or community characteristics. METHODS Five thousand one hundred thirty-eight children in grades K-8 were recruited through 436 schools located within 130 diverse US communities. Measures of height, weight, nutrition, physical activity and behavioural and demographic family characteristics were obtained during in-home visits. A subsample of families consented to medical record review; these weight and height measures were used to calculate BMI over time for 3227 children. A total of 9681 CPPs were reported during structured interviews of 1421 community key informants, and used to calculate a time series of CPP intensity scores within each community over the previous decade. Linear mixed effect models were used to assess longitudinal relationships between childhood BMI and CPP intensity. RESULTS An average BMI difference of 1.4 kg/m2 (p-value < 0.01) was observed between communities with the highest and lowest observed CPP intensity scores, after adjusting for community and child level covariates. BMI/CPP relationships differed significantly by child grade, race/ethnicity, family income and parental education; as well as community-level race/ethnicity. CONCLUSIONS These results indicate that, over time, more intense CPP interventions are related to lower childhood BMI, and that there are disparities in this association by sociodemographic characteristics of families and communities.
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Affiliation(s)
- W J Strauss
- Health and Analytics, Battelle, Columbus, Ohio, USA
| | - J Nagaraja
- Health and Analytics, Battelle, Columbus, Ohio, USA
| | - A J Landgraf
- Health and Analytics, Battelle, Columbus, Ohio, USA
| | - S S Arteaga
- Clinical Applications and Prevention, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - S B Fawcett
- Center for Community Health and Development, University of Kansas, Lawrence, Kansas, USA
| | - L D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California, USA
| | - L V John
- Health and Analytics, Battelle, St. Louis, Missouri, USA
| | - M Gregoriou
- Health and Analytics, Battelle, Arlington, Virginia, USA
| | - E A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - C M Loria
- Epidemiology Branch at National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - S A Weber
- Health and Analytics, Battelle, Columbus, Ohio, USA
| | - V L Collie-Akers
- Center for Community Health and Development, University of Kansas, Lawrence, Kansas, USA
| | - K L McIver
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - J Schultz
- Center for Community Health and Development, University of Kansas, Lawrence, Kansas, USA
| | - R D F Sagatov
- Health and Analytics, Battelle, Baltimore, Maryland, USA
| | - E S Leifer
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - K Webb
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California, USA
| | - R R Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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Webb K, Logantha SJ, Absi M, Cartwright E, Zhang H, Monfredi O, Boyett MR. P5702Obesity causes cardiac ion channel remodelling and increases the propensity for atrial arrhythmias. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Webb
- University of Manchester, Manchester, United Kingdom
| | - S J Logantha
- University of Manchester, Manchester, United Kingdom
| | - M Absi
- University of Manchester, Manchester, United Kingdom
| | - E Cartwright
- University of Manchester, Manchester, United Kingdom
| | - H Zhang
- University of Manchester, Manchester, United Kingdom
| | - O Monfredi
- University of Manchester, Manchester, United Kingdom
| | - M R Boyett
- University of Manchester, Manchester, United Kingdom
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Webb K, Franklin A, Stewart A, Otter S. Implementing Radiographer-led Online Soft Tissue Verification in Cervical Cancer IMRT to Improve Planning Target Volume Coverage. Clin Oncol (R Coll Radiol) 2018. [DOI: 10.1016/j.clon.2018.03.034] [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: 11/25/2022]
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Campbell M, Eagleson K, Hooke B, Macaulay C, Gavranich J, Reeves B, Newcomb D, Webb K, Justo R. At the Heart of the Matter: Developing a Statewide Approach to the Developmental Needs of Children with Congenital Heart Disease Following Early Open Heart Surgery. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.790] [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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Campbell M, Macaulay C, Eagleson K, Hooke B, Williams H, Justo R, Webb K. Improving Paediatric Health Service Translation Through Consumer Co-Design. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.796] [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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Eagleson K, Campbell M, Stocker C, Webb K, Heussler H, McAlinden B, Alphonso N, Justo R. Congenital Heart Disease Long-Term Improvement in Functional Health Program: A Partnership and Integrated Approach to Improving the Long-Term Functional Health of Children with Congenital Heart Disease. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Webb K, Heneghan N, Mahoney T. The contribution of the thoracic spine to functional shoulder mobility in athletes: a systematic review. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Webb K, Absi M, Logantha S, Zaborska K, Gurney A, Heagarty A, Cartwright E, Zhang H, Monfredi O, Boyett M. P3011Obesity increases the propensity for atrial arrhythmias. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Karantana A, Downs-Wheeler MJ, Webb K, Pearce CA, Johnson A, Bannister GC. The Effects of Scaphoid and Colles Casts on Hand Function. ACTA ACUST UNITED AC 2016; 31:436-8. [PMID: 16690180 DOI: 10.1016/j.jhsb.2006.03.163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2005] [Revised: 03/12/2006] [Accepted: 03/16/2006] [Indexed: 11/21/2022]
Abstract
Although necessary for bone healing, immobilisation temporarily prevents hand function and may necessitate corrective physiotherapy later. Scaphoid and Colles casts are both commonly used to immobilize scaphoid fractures. Non-union rates are comparable with both casts. The Scaphoid cast incorporates the thumb, whereas the Colles cast leaves the thumb free. We compared the effect of the two casts on hand function in 20 healthy right-hand-dominant volunteers using the Jebsen–Taylor Hand Function Test. Data were obtained through a mixed between and within subject design. Both casts prolonged the time taken to complete the hand function test compared to controls. Testing in the Scaphoid cast took significantly longer than in the Colles cast.
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Affiliation(s)
- A Karantana
- Department of Orthopaedic Surgery and the Hand Centre, Frenchay Hospital, Bristol, UK.
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Williams SH, Gende SM, Lukacs PM, Webb K. Factors affecting whale detection from large ships in Alaska with implications for whale avoidance. ENDANGER SPECIES RES 2016. [DOI: 10.3354/esr00736] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Webb K, Connor S, Wilson K, Cooper S, Jiang D. Tough choices: The challenges of cochlear implantation when there is 'something to lose'. Cochlear Implants Int 2015; 16 Suppl 1:S50-2. [PMID: 25614270 DOI: 10.1179/1467010014z.000000000236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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25
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Webb K, Scott C, Brice N. PReS-FINAL-2253: A case series of HIV arthropathy in Cape Town. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042450 DOI: 10.1186/1546-0096-11-s2-p243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Okong'o LO, Scott C, Webb K. PReS-FINAL-2268: Sarcoidosis in children seen at the pediatric rheumatology clinics of two referral hospitals in Cape Town, South Africa. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044771 DOI: 10.1186/1546-0096-11-s2-p258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Webb K, Hlela C, Scott C. PW03-022 – Neutrophilic skin disease and inflammation. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952516 DOI: 10.1186/1546-0096-11-s1-a248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fernandes BN, Jones A, Simpson A, Webb K, Custovic A. P94 Should Adrenaline Auto-Injectors Be Prescribed For Cystic Fibrosis Patients Having Home Intravenous Antibiotics? - A UK National Audit. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.336] [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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Spiegel DR, Webb K. A case of treatment refractory hyperemesis gravidarum in a patient with comorbid anxiety, treated successfully with adjunctive gabapentin: a review and the potential role of neurogastroentereology in understanding its pathogenesis and treatment. Innov Clin Neurosci 2012; 9:31-38. [PMID: 23346516 PMCID: PMC3552461] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hyperemesis gravidarum occurs in 0.3 to 10 percent of pregnant women, with a 0.8 percent hospital admission rate. While older theories supported the psychosocial model as a cause for hyperemesis gravidarum, more recent studies have shown significant data to support a biological etiology. Hyperemesis gravidarum has serious complications including include increased risk for miscarriage, low birth weight infants, dehydration, Wernicke's encephalopathy, secondary depression, and negative attitudes toward a consecutive pregnancy. Because of these life-threatening complications and complexity of the disease, it is important to treat both somatic and psychosocial causes of hyperemesis gravidarum to provide the best care for the patient. This paper presents a case of a woman with anxiety symptoms who was experiencing severe nausea and vomiting since Week 2 of pregnancy, with minimal reduction of these symptoms on standard medications utilized in hyperemesis gravidarum. The patient had marked reduction of nausea and vomiting with adjunctive gabapentin. After a brief review of relevant neurogastroenterology, we discuss a possible mechanism for the added gabapentin.
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Affiliation(s)
- David R Spiegel
- Drs. Spiegel and Webb are from Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia
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Robinson C, Harris S, Steward K, Webb K, Efstratiou A, Darby A, Holden M, Waller A. The population diversity of Streptococcus zooepidemicus. J Equine Vet Sci 2012. [DOI: 10.1016/j.jevs.2012.08.038] [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]
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Webb K, Barker C, Harrison T, Heather Z, Steward K, Robinson C, Newton J, Waller A. A rapid triplex qPCR assay for the detection of Streptococcus equi. J Equine Vet Sci 2012. [DOI: 10.1016/j.jevs.2012.08.132] [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]
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Ioos R, Fourrier C, Wilson V, Webb K, Schereffer JL, de Labrouhe DT. An optimized duplex real-time PCR tool for sensitive detection of the quarantine oomycete Plasmopara halstedii in sunflower seeds. Phytopathology 2012; 102:908-917. [PMID: 22671026 DOI: 10.1094/phyto-04-12-0068-r] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Plasmopara halstedii, the causal agent of downy mildew of sunflower, is an oomycete listed as a quarantine pathogen. This obligate parasite resides in a quiescent state in seeds of sunflower and can be spread from seed production areas to areas of crop production by international seed trade. To prevent the spread or the introduction of potentially new genotypes or fungicide-tolerant strains, an efficient method to detect P. halstedii in sunflower seed is required. This work reports the optimization of a real-time detection tool that targets the pathogen within sunflower seeds, and provides statistically validated data for that tool. The tool proved to be specific and inclusive, based on computer simulation and in vitro assessments, and could detect as few as 45 copies of target DNA. A fully optimized DNA extraction protocol was also developed starting from a sample of 1,000 sunflower seeds, and enabled the detection of <1 infected seed/1,000 seeds. To ensure reliability of the results, a set of controls was used systematically during the assays, including a plant-specific probe used in a duplex quantitative polymerase chain reaction that enabled the assessment of the quality of each DNA extract.
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Affiliation(s)
- Renaud Ioos
- Laboratoire de la Santé des Végétaux, Unité de Mycologie, Malzéville, France.
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Yohannes AM, Willgoss TG, Fatoye FA, Dip MD, Webb K. Relationship Between Anxiety, Depression, and Quality of Life in Adult Patients With Cystic Fibrosis. Respir Care 2012; 57:550-6. [DOI: 10.4187/respcare.01328] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Jones AM, Flight W, Isalska B, Cullen M, Mutton K, Bowling A, Riley D, Webb K, Bright-Thomas R. Diagnosis of respiratory viral infections in cystic fibrosis by PCR using sputum samples. Eur Respir J 2011; 38:1486-7. [DOI: 10.1183/09031936.00061711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Devigny C, Perez-Balderas F, Hoogeland B, Cuboni S, Webb K, Deussing JM, Hausch F. Biomimetic screening of class B G protein-coupled receptors. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Affiliation(s)
- A. S. G. Ling
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms Hertfordshire AL9 7TA
| | - M. M. Upjohn
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms Hertfordshire AL9 7TA
| | - K. Webb
- Animal Health Trust; Lanwades Park, Kentford Newmarket Suffolk CB8 7UU
| | - A. S. Waller
- Animal Health Trust; Lanwades Park, Kentford Newmarket Suffolk CB8 7UU
| | - K. L. P. Verheyen
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms Hertfordshire AL9 7TA
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Gilchrist F, Alcock A, Belcher J, Brady M, Jones A, David S, Patrik S, Webb K, Lenney W. 157 Variation in canide production between different strains of Pseudomonas aeruginosa. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60173-2] [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: 10/18/2022]
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Horsley A, Carassale E, Cullen M, Isalska B, Bright-Thomas R, Webb K, Jones A. 132 Non-respiratory swabs have little role in the detection of methicillin resistant Staphylococcus aureus in cystic fibrosis. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60149-5] [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: 10/18/2022]
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Gilchrist FJ, Alcock A, Belcher J, Brady M, Jones A, Smith D, Spanel P, Webb K, Lenney W. Variation in hydrogen cyanide production between different strains of Pseudomonas aeruginosa. Eur Respir J 2011; 38:409-14. [DOI: 10.1183/09031936.00166510] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Horsley A, Perry C, Martin K, Webb K, Kenna D, Jones A. P105 Burkholderia latens--a new infection in CF patients. Thorax 2010. [DOI: 10.1136/thx.2010.150987.6] [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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Ivens PAS, Matthews D, Webb K, Newton JR, Steward K, Waller AS, Robinson C, Slater JD. Molecular characterisation of 'strangles' outbreaks in the UK: the use of M-protein typing of Streptococcus equi ssp. equi. Equine Vet J 2010; 43:359-64. [PMID: 21492215 DOI: 10.1111/j.2042-3306.2010.00177.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
REASONS FOR PERFORMING STUDY Strangles is the most commonly diagnosed and important infectious disease of horses worldwide. Very little is known about the temporo-spatial and molecular epidemiology of strangles. The disease is not notifiable in the UK and there are few published data on the geographical locations of outbreaks. OBJECTIVE To investigate whether typing of a surface protein (SeM) of Streptococcus equi ssp. equi (S. equi), the causative agent of strangles, is a useful epidemiological tool. METHODS The variable region of the SeM gene was amplified from 145 isolates of S. equi by PCR and sequenced. Different SeM gene alleles were assigned based on the SeM database, grouped into phylogenetic clusters using split decomposition analysis and plotted against the submitting veterinary practices. RESULTS In this study 21 S. equi SeM alleles were found, including 9 previously unidentified alleles and representing 4 phylogenetic groups. S. equi containing SeM alleles 9 and 7 were the most commonly isolated and there was a high number of low frequency alleles. The occurrence of an outbreak cluster in the north-west of the UK is also reported. CONCLUSIONS Strangles outbreaks can be differentiated on the basis of their SeM allele sequences. The data provide further evidence of SeM mutation leading to the emergence of novel, but related SeM alleles that are geographically linked. Sequencing of the SeM gene is a useful tool for the elucidation of strangles epidemiology at a regional and a national level. POTENTIAL RELEVANCE This technique may allow differentiation or linkage of strangles outbreaks and as such may be an effective tool for local as well as national and international disease surveillance.
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Affiliation(s)
- P A S Ivens
- Equine Referral Hospital, The Royal Veterinary College, UK.
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Baxter C, Jones A, Webb K, Denning D. A comparison of the precipitation technique and ImmunoCAP® FIEA for measurement of IgG antibodies to Aspergillus. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60189-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Baxter C, Jones A, Webb K, Moody A, Follett S, Denning D. Role of real time PCR and specific IgG in identifying patients with Aspergillus colonisation. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60135-x] [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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Helm J, Bright-Thomas R, Brennan A, Webb K, Mutton K, Jones A. Is rhinovirus associated with exacerbations in adults with CF? J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60145-2] [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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Annemans L, Marbaix S, Webb K, Van Gaal L, Scheen A. Cost effectiveness of atorvastatin in patients with type 2 diabetes mellitus: a pharmacoeconomic analysis of the collaborative atorvastatin diabetes study in the belgian population. Clin Drug Investig 2010; 30:133-42. [PMID: 20067331 DOI: 10.2165/11531910-000000000-00000] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND OBJECTIVE Patients with type 2 diabetes mellitus have a high risk of developing cardiovascular (CV) disease. The clinical benefit of use of statins in patients with type 2 diabetes has been demonstrated in several randomized, controlled trials, including the CARDS clinical trial. Based on the clinical CARDS data, the favourable cost effectiveness of atorvastatin 10 mg in patients with type 2 diabetes has been demonstrated in countries such as the UK and France. This study aimed to estimate the cost effectiveness in the Belgian setting of atorvastatin 10 mg compared with no treatment for the primary prevention of CV events in type 2 diabetes patients without a history of CV disease. METHODS A Markov model with 1-year cycles was developed to simulate the CV event and death risk according to the therapeutic approach initiated. The transition probabilities for CV events in the 'no statin treatment' group were derived from the risk equations reported from the large UKPDS. Risk reductions from the CARDS clinical trial were used to adjust these CV event probabilities in the atorvastatin 10 mg treatment group. The characteristics of type 2 diabetes patients without a CV history were derived from the Belgian OCAPI survey. The public healthcare payers' perspective was taken into account for costing. The direct medical costs of CV events were based on the Public Health Authorities' hospital database for acute care costs and on the literature for the follow-up costs. The impact on the reimbursement system of generic entry to the market was considered in the drug cost. Costs were valued as at year 2009; costs and outcomes were discounted at 3% and 1.5%, respectively. RESULTS Based on a 5-year time horizon, atorvastatin was demonstrated to be cost effective with an incremental cost/quality-adjusted life-year (QALY) of euro 16,681. Over a lifetime horizon (25 years), atorvastatin was demonstrated to be a cost-saving therapeutic intervention. At a threshold of euro 30,000/QALY, atorvastatin had a 98.8% probability of being cost effective. CONCLUSION Compared with 'no treatment', use of atorvastatin 10 mg as a primary prevention intervention in Belgian type 2 diabetes patients not only improves CV outcomes, but also appears to be cost saving over a lifetime horizon.
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Affiliation(s)
- L Annemans
- Department of Public Health, Ghent University, Ghent, Belgium
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Abstract
PURPOSE How individuals cope with aspects of cystic fibrosis (CF) has the potential to influence their self management and the course of their disease. To evaluate how individuals cope with CF, a disease specific coping scale was developed and validated. A second objective of the work was to examine the relationship between coping styles and treatment adherence. METHODS The development of the coping scale constituted a longitudinal design. A cross-sectional questionnaire design was used to examine the coping-adherence relationship. The development and validation of the coping scale comprised three phases: (1) Initially, 60 patients were interviewed to identify CF concerns. From this information a list of 23 concerns were recorded; (2) Eighty-three patients were interviewed to identify CF coping responses. For each concern, they were asked what they did or thought to ease the worry. A list of 24 coping strategies were recorded that formed a comprehensive set of items as to how people with CF act, feel and think about aspects of their disease; and (3) Further development and testing of the questionnaire involved 174 patients completing the measure. Four distinct ways of coping with CF were identified by factor analysis. These were termed optimistic acceptance, hopefulness, distraction and avoidance. The cronbach alpha coefficients were 0.74 (optimistic acceptance), 0.69 (hopefulness). 0.71 (distraction) and 0.76 (avoidance). To evaluate the relationship between coping and treatment adherence 60 patients completed the CF Coping Questionnaire and the Manchester Adult Cystic Fibrosis Compliance Questionnaire. RESULTS Compared with patients who were non-adherent, those who were adherent scored higher on the optimistic acceptance scale (physiotherapy p < 0.05, enzymes p < 0.003, vitamins p < 0.05) and hopefulness scale (physiotherapy p < 0.002, enzymes p < 0.001). Those who were partially adherent reported using distraction as a way of coping to a greater extent than adherent or non-adherent patients (all p's < 0.05). Non-adherent patients used avoidance strategies to a greater extent than those who were adherent (physiotherapy p < 0.05, enzymes p < 0.04), although interestingly, adherence with exercise was associated with avoidant coping (p < 0.004). CONCLUSIONS The degree of adherence to treatments was influenced by a person's style of coping. The identification of effective coping strategies to aid both long-term psychological and clinical well-being should improve the management of non-adherence.
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Affiliation(s)
- J Abbott
- Postgraduate School of Medicine and Health, University of Central Lancashire, Preston, UK.
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Bahrami S, Malone J, Webb K, Callen J. Tissue Eosinophilia as an Indicator of Drug-Induced Leukocytoclastic Vasculitis: A Clinicopathologic Investigation. J Cutan Pathol 2008. [DOI: 10.1111/j.0303-6987.2005.0320o.x] [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: 11/30/2022]
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