1
|
Flegg D, Lima LV, Woznowski-Vu A, Aternali A, Gervais A, Stone L, Wideman TH. Are biomarkers associated with sensitivity to physical activity? Eur J Pain 2024; 28:120-132. [PMID: 37593830 DOI: 10.1002/ejp.2167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 04/12/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Activity-based treatments play an integral role in managing musculoskeletal conditions including low back pain. However, while therapeutic exercise has been shown to reduce pain in such conditions, certain individuals experience a paradoxical pain increase in response to exercise. The physiological processes underlying this sensitivity to physical activity (SPA) are not fully understood, however stress and inflammation have been shown to contribute to SPA. The present cross-sectional study investigated whether physiological indicators of stress (cortisol) and inflammation (IL-6) help explain SPA. METHODS Twenty-seven patients with chronic low back pain and 21 healthy controls completed a 1-h exercise session of standardized physical tasks. SPA was calculated from the difference between post- and pre-exercise pain levels. Participant's saliva was collected at several timepoints for cortisol and IL-6 levels quantification. Their waking cortisol response was calculated to reflect their cortisol regulation. Reactivity of IL-6 and cortisol was calculated to reflect changes in these measures during exercise. RESULTS IL-6 reactivity was significantly and positively correlated with SPA among participants with low back pain. In contrast, neither cortisol waking response nor cortisol reactivity was significantly correlated within the low back pain group. No significant differences in IL-6 reactivity, cortisol reactivity or cortisol waking response were observed. CONCLUSION These findings are the first to link SPA to an objective biomarker among people with low back pain. These findings help describe the physiological mechanisms of SPA and can support new clinical research that targets the inflammatory response of patients with chronic low-back pain and elevated SPA. SIGNIFICANCE This study reveals a correlation between SPA and an objective salivary biomarker of IL-6 in people with low back pain, improving our understanding of this clinically relevant subjective experience.
Collapse
Affiliation(s)
- D Flegg
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
- Department of Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - L V Lima
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - A Woznowski-Vu
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
| | - A Aternali
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - A Gervais
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
| | - L Stone
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
- Department of Psychology, York University, Toronto, Ontario, Canada
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Department of Anesthesiology, Faculty of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - T H Wideman
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
2
|
Merianos AL, Matt GE, Stone TM, Jandarov RA, Hoh E, Dodder NG, Quintana PJE, Lopez-Galvez N, Stone L, Mahabee-Gittens EM. Contamination of surfaces in children's homes with nicotine and the potent carcinogenic tobacco-specific nitrosamine NNK. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00629-8. [PMID: 38104233 DOI: 10.1038/s41370-023-00629-8] [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] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE) through secondhand and thirdhand smoke is a modifiable risk factor that contributes to childhood morbidity. Limited research has assessed surface TSE pollution in children's environments as a potential source of thirdhand smoke exposure, and none have examined levels of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) on surfaces. OBJECTIVE This study measured surface NNK and nicotine in children's homes and associations with sociodemographics and parent-reported TSE behaviors. We assessed correlations of surface NNK and nicotine with dust NNK, dust nicotine, and child cotinine. METHODS Home surface wipe NNK and nicotine data from 84 children who lived with smokers were analyzed. Tobit and simple linear regression analyses were conducted to assess associations of surface NNK and nicotine with child characteristics. Spearman's (ρ) correlations assessed the strength of associations between environmental markers and child cotinine. RESULTS Nearly half (48.8%) of children's home surfaces had detectable NNK and 100% had detectable nicotine. The respective geometric means (GMs) of surface NNK and nicotine loadings were 14.0 ng/m2 and 16.4 µg/m2. Surface NNK positively correlated with surface nicotine (ρ = 0.54, p < 0.001) and dust NNK (ρ = 0.30, p = 0.020). Surface nicotine positively correlated with dust NNK (ρ = 0.42, p < 0.001) and dust nicotine (ρ = 0.24, p = 0.041). Children with household incomes ≤$15,000 had higher surface NNK levels (GM = 18.7 ng/m2, p = 0.017) compared to children with household incomes >$15,000 (GM = 7.1 ng/m2). Children with no home smoking bans had higher surface NNK (GM = 18.1 ng/m2, p = 0.020) and surface nicotine (GM = 17.7 µg/m2, p = 0.019) levels compared to children with smoking bans (GM = 7.5 ng/m2, 4.8 µg/m2, respectively). IMPACT Although nicotine on surfaces is an established marker of thirdhand smoke pollution, other thirdhand smoke contaminants have not been measured on surfaces in the homes of children living with smokers. We provide evidence that the potent carcinogenic tobacco-specific nitrosamine NNK was detectable on surfaces in nearly half of children's homes, and nicotine was detectable on all surfaces. Surface NNK was positively correlated with surface nicotine and dust NNK. Detectable surface NNK levels were found in homes with indoor smoking bans, indicating the role of NNK as a persistent thirdhand smoke pollutant accumulating on surfaces as well as in dust.
Collapse
Affiliation(s)
- Ashley L Merianos
- University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH, 45221-0068, USA.
| | - Georg E Matt
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA
| | - Timothy M Stone
- Department of Environmental and Public Health Sciences, Division of Biostatistics and Bioinformatics, University of Cincinnati, College of Medicine, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Roman A Jandarov
- Department of Environmental and Public Health Sciences, Division of Biostatistics and Bioinformatics, University of Cincinnati, College of Medicine, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Eunha Hoh
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Nathan G Dodder
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Penelope J E Quintana
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Nicolas Lopez-Galvez
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Lara Stone
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
| | - E Melinda Mahabee-Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
| |
Collapse
|
3
|
Matt GE, Merianos AL, Stone L, Wullenweber C, Quintana PJE, Hoh E, Dodder NG, Lopez Galvez N, Mahabee-Gittens EM. Changes and stability of hand nicotine levels in children of smokers: Associations with urinary biomarkers, reported child tobacco smoke exposure, and home smoking bans. Environ Int 2023; 181:108239. [PMID: 37852151 DOI: 10.1016/j.envint.2023.108239] [Citation(s) in RCA: 1] [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: 05/22/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Exposure to thirdhand smoke (THS) residue takes place through inhalation, ingestion, and dermal transfer. Hand nicotine levels have been proposed to measure THS pollution in the environment of children, but little is known about its variability and stability over time and correlates of change. OBJECTIVES The goal was to determine the stability of hand nicotine in comparison to urinary biomarkers and to explore factors that influence changes in hand nicotine. METHODS Data were collected from 0 to 11-year-old children (Mean age = 5.9) who lived with ≥1 tobacco smokers (N = 129). At a 6-week interval, we collected repeated measures of hand nicotine, four urinary biomarkers (cotinine, trans-3'-hydroxycotinine, nicotelline N-oxides, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), and parent-reported child tobacco smoke exposure (TSE). Dependent sample t-tests, correlations, and multivariable regression analyses were conducted to examine the changes in child TSE. RESULTS Hand nicotine levels (r = 0.63, p < 0.001) showed similar correlations between repeated measures to urinary biomarkers (r = 0.58-0.71; p < 0.001). Different from urinary biomarkers, mean hand nicotine levels increased over time (t(113) = 3.37, p < 0.001) being significantly higher in children from homes without smoking bans at Time 2 (p = 0.016) compared to Time 1 (p = 0.003). Changes in hand nicotine correlated with changes in cotinine and trans-3'-hydroxycotinine (r = 0.30 and r = 0.19, respectively, p < 0.05). Children with home smoking bans at Time 1 and 2 showed significantly lower hand nicotine levels compared to children without home smoking bans. DISCUSSION Findings indicate that hand nicotine levels provide additional insights into children's exposure to tobacco smoke pollutants than reported child TSE and urinary biomarkers. Changes in hand nicotine levels show that consistent home smoking bans in homes of children of smokers can lower THS exposure. Hand nicotine levels may be influenced by the environmental settings in which they are collected.
Collapse
Affiliation(s)
- Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, USA
| | - Chase Wullenweber
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, USA
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, San Diego, CA, USA; San Diego State University Research Foundation, San Diego, CA, USA
| | | | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
4
|
Toraman Turk S, Merianos AL, Stone L, Schnadower D, Bouvay K, Mahabee-Gittens EM. "I Don't Want My Child to Be a Guinea Pig": Reasons for Non-Participation in a Parental Tobacco Cessation Trial in the Pediatric Emergency Department Setting. Toxics 2023; 11:655. [PMID: 37624161 PMCID: PMC10458252 DOI: 10.3390/toxics11080655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 08/26/2023]
Abstract
(1) Background: Pediatric emergency department (PED) settings are opportune venues in which to recruit parental smokers into tobacco cessation interventions. However, the barriers associated with parents' participation in PED-based cessation trials are unknown. The objective was to explore parents' reasons for non-participation in a PED-based tobacco cessation trial. (2) Methods: We employed the framework method and conducted a qualitative data analysis of parental smokers who were eligible to participate in a PED-based tobacco cessation trial and did not choose to participate (n = 371). (3) Results: Two main themes emerged about reasons for non-participation: (a) Not interested in participating in a research study, and (b) concerns specific to the study. Parents had various reasons for not participating in the cessation trial including not being interested in quitting, parents' health and well-being, parents' beliefs about research, and time required for the study and follow-up visits. (4) Conclusion: General disinterest and specific study-related concerns were touted as reasons for non-participation in a PED-based tobacco cessation trial. Given the potential reductions in tobacco-related morbidity to both parents and children that tobacco control interventions can facilitate, future tobacco interventions should consider alterations in study design and recruitment strategies to encourage all eligible parental smokers to participate.
Collapse
Affiliation(s)
- Sinem Toraman Turk
- Department of Health Policy and Management, Global Health Leadership Initiative, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH 45229, USA; (L.S.); (E.M.M.-G.)
| | - David Schnadower
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH 45229, USA; (L.S.); (E.M.M.-G.)
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Kamali Bouvay
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH 45229, USA; (L.S.); (E.M.M.-G.)
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH 45229, USA; (L.S.); (E.M.M.-G.)
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| |
Collapse
|
5
|
Mahabee-Gittens EM, Merianos AL, Stone L, Wullenweber CA, Quintana PJE, Hoh E, Dodder NG, Lopez-Galvez N, Matt GE. Hand nicotine as an independent marker of thirdhand smoke pollution in children's environments. Sci Total Environ 2022; 849:157914. [PMID: 35952873 PMCID: PMC10199779 DOI: 10.1016/j.scitotenv.2022.157914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/22/2022] [Accepted: 08/04/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Hand nicotine (HN) levels measure children's exposure to tobacco smoke pollutants from thirdhand and secondhand smoke. HN is associated with urinary and salivary cotinine, but the associations of HN with other tobacco smoke exposure (TSE) markers remain unknown. OBJECTIVES We compared levels of HN and four urinary TSE biomarkers: cotinine, trans-3'-hydroxycotinine (3HC), nicotelline N-oxides, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and children's sociodemographic and TSE patterns. We also examined if HN is a plausible pathway for children's exposure to active smoking. METHODS Data were collected from 175 non-smoking patients (Mean (SD) age = 5.4 (3.4) years) who lived with ≥1 cigarette smoker(s). HN and TSE biomarker levels were determined using LC-MS/MS. Multivariate and multivariable regression analyses were conducted to examine associations between TSE markers and parent-reported measures, controlling for sociodemographics. RESULTS Of the five markers of TSE, cotinine (R2 = 0.221; p = 0.003) and HN (R2 = 0.247; p = 0.001) showed the strongest overall associations. Of the five markers, only cotinine showed significantly higher levels among Black children (β^=0.307,p<0.05) independent of age, reported exposure, and home smoking bans. Cotinine (β^=0.010,p<0.05), NNAL (β^=0.012,p<0.05), and HN (β^=0.011,p<0.05) showed significant positive associations with reported exposure independent of race, age, and home smoking bans. NNAL (β^=-0.285,p<0.05) and HN (β^=-0.336,p<0.05), but not cotinine, 3HC, and N-oxides, showed significantly lower levels among children who lived in homes with smoking bans. Child age, hand surface area, home smoking ban, and reported exposure independently accounted for 21 % of the variance in HN levels (p = 0.002). HN accounted for 30 % of the variance in cotinine independent of child race and child age. DISCUSSION HN levels were associated with modifiable tobacco-related behaviors and shows promise as a marker of sources of THS pollution in a child's environment not captured by measurement of urinary cotinine alone. HN levels provide additional information about TSE, complementing other biomarkers when assessing children's overall TSE.
Collapse
Affiliation(s)
- E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Chase A Wullenweber
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, San Diego, CA, USA; San Diego State University Research Foundation, San Diego, CA, USA
| | - Nicolas Lopez-Galvez
- School of Public Health, San Diego State University, San Diego, CA, USA; San Diego State University Research Foundation, San Diego, CA, USA
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA
| |
Collapse
|
6
|
Grosjean A, Stone L, Bouillot C, Vieira A, Antonopoulou K, Koelewijn-Tukker J, Oosterbaan M. OP0041-PARE SJÖGREN EUROPE: REVIEW OF ITS FIRST THREE YEARS OF ACTIVITY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4891] [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
BackgroundSjögren Europe was founded on 23 February 2019 by several European patient organisations representing Sjögren’s patient to help to address the lack of visibility, attention, and solutions for Sjögren’s.ObjectivesTo show the first achievements and contributions of the federation.MethodsSjögren Europe’s purpose is to promote the advancement of knowledge, research, information, treatment, and care, to foster patient involvement and participation in research and any other relevant area, to increase awareness, identify the different unmet needs and articulate patient voices throughout Europe.ResultsFinding one’s bearings and the right rhythm during the first years of an organisation’s life is a challenge in itself. The Covid-19 pandemic has made this process even more difficult. Our first goal was to organise a first face-to-face European patient conference. This meeting had to be postponed. However, we were able to adapt and develop a range of activities.We organised a series of informative webinars on different topics by leading European experts for patients and others interested in the subject. We have organised various awareness campaigns such as a campaign for Sjögren Awareness Month in 2021 for which we have created 2 awareness videos and published several testimonials. We also created a 3-axis campaign about fatigue for World Sjögren’s Day 2021 which won the Best Practice Award at the 2021 PARE Conference, and during which we shared the patients’ perspective on fatigue in publications in 13 languages on social media. We published a booklet about fatigue developed by a specialist and produced 3 informative leaflets for patients. We also subtitled 2 videos made by one of our members in 10 European languages to disseminate quality information that many patients miss. We have been involved in various research projects, working groups and patient panels and have been able to bring the patient perspective to various stakeholders on many occasions.ConclusionDespite the limited contacts, we were able to create strong links and rich discussions that stimulated our creativity. Sjögren Europe has become a privileged partner, recognised, and appreciated by the various stakeholders. Patients with Sjögren’s are better represented at the supranational level. It is our members, the national patient organisations, who by their trust give us our legitimacy. In return, Sjögren Europe has been able to inject a new energy and dynamism that can be felt at the different national levels and that opens up many perspectives and opportunities. We have been able to strengthen our presence and visibility with patients on social networks, where our audience is constantly growing, as well as in the rheumatology field with researchers, clinicians, industry, and associations such as EULAR. The resumption of face-to-face contacts is eagerly awaited to consolidate the links already created and to feed the richness, relevance, originality and diversity of our discussions and activities.Disclosure of InterestsNone declared.
Collapse
|
7
|
Mahabee-Gittens EM, Quintana PJE, Hoh E, Merianos AL, Stone L, Lopez-Galvez N, Matt GE. Collecting Hand Wipe Samples to Assess Thirdhand Smoke Exposure. Front Public Health 2021; 9:770505. [PMID: 34988051 PMCID: PMC8720752 DOI: 10.3389/fpubh.2021.770505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- *Correspondence: E. Melinda Mahabee-Gittens
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA, United States
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, United States
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Nicolas Lopez-Galvez
- School of Public Health, San Diego State University, San Diego, CA, United States
| | - Georg E. Matt
- Department of Psychology, San Diego State University, San Diego, CA, United States
| |
Collapse
|
8
|
Merianos AL, Fiser K, Mahabee-Gittens EM, Lyons MS, Stone L, Gordon JS. Clinical decision support for tobacco screening and counseling parents of pediatric patients: A qualitative analysis of pediatric emergency department and urgent care professionals. Drug Alcohol Depend Rep 2021; 2:100019. [PMID: 36845898 PMCID: PMC9948809 DOI: 10.1016/j.dadr.2021.100019] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
Background Clinical Decision Support Systems (CDSS) embedded into electronic medical records is a best practices approach. However, information is needed on how to incorporate a CDSS to facilitate parental tobacco cessation counseling and reduce child tobacco smoke exposure (TSE) in Pediatric Emergency Department (PED) and Urgent Care (UC) settings. The objective was to explore the barriers and enablers of CDSS use to facilitate child TSE screening and parental tobacco cessation counseling by PED/UC nurses and physicians. Methods We conducted 29 semi-structured, focused interviews with nurses (n = 17) and physicians (n = 12) at a children's hospital PED/UC. The interview guide included a brief presentation about the design and components of a prior CDSS tobacco intervention. Participants were asked their opinions about CDSS components and recommendations for adapting and implementing the CDSS tobacco intervention in the PED/UC setting. A thematic framework analysis method was used to code and analyze qualitative data. Results Participant mean (± SD) age was 42 (± 10.1) years; the majority were female (82.8%), non-Hispanic white (93.1%), and never tobacco users (86.2%); all were never electronic cigarette users. Four themes emerged: (1) explore optimal timing to complete CDSS screening and counseling during visits; (2) CDSS additional information and feedback needs; (3) perceived enablers to CDSS use, such as the systematic approach; and (4) perceived barriers to CDSS use, such as lack of time and staff. Conclusions The CDSS intervention for child TSE screening and parental tobacco cessation during PED/UC visits received endorsements and suggestions for optimal implementation from nurses and physicians.
Collapse
Affiliation(s)
- Ashley L. Merianos
- University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH, 45221-0068, United States
- University of Cincinnati, College of Medicine, Center for Addiction Research, Cincinnati, OH, United States
- Corresponding author at: PO Box 210068, Cincinnati, OH, 45221-0068, United States
| | - Kayleigh Fiser
- University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH, 45221-0068, United States
| | - E. Melinda Mahabee-Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH, 45229, United States
| | - Michael S. Lyons
- University of Cincinnati, College of Medicine, Center for Addiction Research, Cincinnati, OH, United States
- University of Cincinnati, College of Medicine, Department of Emergency Medicine, 231 Albert Sabin Way, ML 0769, Cincinnati, OH, 45267-0769, United States
| | - Lara Stone
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH, 45229, United States
| | - Judith S. Gordon
- The University of Arizona, College of Nursing, 1305 N Martin Avenue, PO Box 210203, Tucson, AZ, 85721-0203, United States
| |
Collapse
|
9
|
Mahabee-Gittens EM, Ammerman RT, Khoury JC, Tabangin ME, Ding L, Merianos AL, Stone L, Gordon JS. A Parental Smoking Cessation Intervention in the Pediatric Emergency Setting: A Randomized Trial. Int J Environ Res Public Health 2020; 17:ijerph17218151. [PMID: 33158230 PMCID: PMC7663571 DOI: 10.3390/ijerph17218151] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 01/05/2023]
Abstract
We examined the efficacy of a pediatric emergency visit-based screening, brief intervention, and referral to treatment (SBIRT) condition compared to a control condition (Healthy Habits Control, HHC) to help parental smokers quit smoking. We enrolled 750 parental smokers who presented to the pediatric emergency setting with their child into a two-group randomized controlled clinical trial. SBIRT participants received brief cessation coaching, quitting resources, and up to 12-weeks of nicotine replacement therapy (NRT). HHC participants received healthy lifestyle coaching and resources. The primary outcome was point-prevalence tobacco abstinence at six weeks (T1) and six months (T2). The mean (SD) age of parents was 31.8 (7.7) years, and 86.8% were female, 52.7% were Black, and 64.6% had an income of ≤$15,000. Overall abstinence rates were not statistically significant with 4.2% in both groups at T1 and 12.9% and 8.3% in the SBIRT and HHC groups, respectively, at T2. There were statistically significant differences in SBIRT versus HHC participants on the median (IQR) reduction of daily cigarettes smoked at T1 from baseline (−2 [−5, 0] versus 0 [−4, 0], p = 0.0008),at T2 from baseline (−4 [−9, −1] vs. −2 [−5, 0], p = 0.0006), and on the mean (SD) number of quit attempts at T2 from baseline (1.25 (6.5) vs. 0.02 (4.71), p = 0.02). Self-reported quitting rates were higher in SBIRT parents who received NRT (83.3% vs. 50.9%, p = 0.04). The novel use of the pediatric emergency visit to conduct cessation interventions helped parents quit smoking. The near equivalent abstinence rates in both the SBIRT and HHC groups may be due to underlying parental concern about their child’s health. Cessation interventions in this setting may result in adult and pediatric public health benefits.
Collapse
Affiliation(s)
- E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229–3026, USA;
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (R.T.A.); (J.C.K.); (M.E.T.); (L.D.)
- Correspondence: ; Tel.: +1-513-636-7966
| | - Robert T. Ammerman
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (R.T.A.); (J.C.K.); (M.E.T.); (L.D.)
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229–3026, USA
| | - Jane C. Khoury
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (R.T.A.); (J.C.K.); (M.E.T.); (L.D.)
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229–3026, USA
| | - Meredith E. Tabangin
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (R.T.A.); (J.C.K.); (M.E.T.); (L.D.)
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229–3026, USA
| | - Lili Ding
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (R.T.A.); (J.C.K.); (M.E.T.); (L.D.)
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229–3026, USA
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229–3026, USA;
| | - Judith S. Gordon
- College of Nursing, University of Arizona, Tucson, AZ 85721, USA;
| |
Collapse
|
10
|
Mahabee-Gittens EM, Merianos AL, Dexheimer JW, Meyers GT, Stone L, Tabangin M, Khoury JC, Gordon JS. Utilization of a Clinical Decision Support Tool to Reduce Child Tobacco Smoke Exposure in the Urgent Care Setting. Pediatr Emerg Care 2020; 36:527-531. [PMID: 30346363 PMCID: PMC6474832 DOI: 10.1097/pec.0000000000001646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Clinical decision support systems (CDSS) may facilitate caregiver tobacco screening and counseling by pediatric urgent care (UC) nurses. OBJECTIVE This study aimed to assess the feasibility of a CDSS to address caregivers' tobacco use and child tobacco smoke exposure (TSE). METHODS We conducted a 3-month prospective study on caregivers screened using a CDSS. Nurses used the CDSS to advise, assess, and assist caregivers to quit. We assessed caregiver sociodemographics, smoking habits, and child TSE. RESULTS We screened 185 caregivers whose children were exposed to TSE for study inclusion; 155 (84%) met the eligibility criteria, and 149 (80.5%) were included in the study. Study nurses advised 35.2% of the caregivers to quit, assessed 35.9% for readiness to quit, and assisted 32.4%. Of the 149 participants, 83.1% were female; 47.0% were white and 45.6% African American; 84.6% had public insurance or were self-pay; 71.1% were highly nicotine dependent; 50.0% and 50.7% allowed smoking in the home and car, respectively; and 81.3% of children were biochemically confirmed to be exposed to tobacco smoke. At follow-up (86.6% retention), 58.9% reported quit attempts at 3 months. There was a significant decrease in nicotine dependence and a significant increase in motivation to quit. Self-reported quit rate was 7.8% at 3 months. CONCLUSIONS An electronic health record-embedded CDSS was feasible to incorporate into busy UC nurses' workloads and was associated with encouraging changes in the smoking behavior of caregivers. More research on the use of CDSS to screen and counsel caregivers who smoke in the UC and other acute care settings is warranted.
Collapse
Affiliation(s)
| | | | - Judith W. Dexheimer
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Gabe T. Meyers
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Meredith Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jane C. Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | |
Collapse
|
11
|
Mahabee-Gittens EM, Merianos AL, Tabangin ME, Stone L, Gordon JS, Khoury JC. Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting. Tob Prev Cessat 2020; 6:30. [PMID: 32760865 PMCID: PMC7398133 DOI: 10.18332/tpc/119125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/06/2020] [Accepted: 03/17/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Although the administration of free Nicotine Replacement Therapy (NRT) is effective in helping smokers quit, the feasibility, acceptability and safety of this practice have not been examined in the emergency setting of the pediatric emergency department (PED) or urgent care (UC). We examined the characteristics of parental smokers who were interested and eligible for free NRT during their child's emergency visit and the uptake, usage, and associated side effects of NRT use. METHODS We analyzed data from 377 parental smokers who were randomized to receive cessation counseling and free NRT as part of an emergency visit-based randomized controlled trial. Parents interested in NRT were screened for medical contraindications; eligible parents were given a 6-week supply of NRT patches or lozenges during their child's emergency visit and offered another supply 6 weeks later. We conducted Wilcoxon rank-sum tests and chi-squared tests to address our main study objective. RESULTS The majority of parents were female (87.5%), non-Hispanic Black (52.5%), and mean (SD) age was 33.1 (8.2) years. A total of 252 (66.8%) parents were interested in receiving NRT. Compared to uninterested parents, interested parents were more likely to: be older [33.6 (8.2) vs 31.9 (8.2), years]; be non-Hispanic Black (54.0% vs 49.6%); have older children [5.5 (5.0) vs 4.2 (4.6)]; have a higher readiness to quit [7.0 (2.4) vs 5.2 (2.6)]; and have a child being evaluated in UC compared to the PED (72.4% vs 56.5%). A total of 53 (21%) interested parents had >1 NRT contraindications. At 6 weeks, 94 (79.0%) parents reported some ≥NRT usage and 50 (53.2%) requested an additional 6-week supply. There were no serious adverse events and 5 (5.3%) reported minor side effects. CONCLUSIONS Parental smokers in the emergency setting are interested in receiving free NRT, the majority use it, and use is not associated with adverse side effects. The emergency visit may be an optimal time to offer NRT to parental smokers.
Collapse
Affiliation(s)
- E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, United States
| | - Meredith E. Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Judith S. Gordon
- College of Nursing, University of Arizona, Tucson, United States
| | - Jane C. Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States
| |
Collapse
|
12
|
Mahabee-Gittens EM, Merianos AL, Gordon JS, Stone L, Semenova O, Matt GE. Electronic Health Record Classification of Tobacco Smoke Exposure and Cotinine Levels in Hospitalized Pediatric Patients. Hosp Pediatr 2020; 9:659-664. [PMID: 31451583 DOI: 10.1542/hpeds.2018-0247] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Documentation of children's tobacco smoke exposure (TSE) in the electronic health record (EHR) can have important implications for clinical care. However, it may not be accurate if it is not based on biochemical assessment, the most reliable method of verifying TSE. Our objectives were to compare the accuracy of EHR classification of TSE with cotinine verification and to explore parent and child variables associated with biochemically verified TSE. METHODS Participants were 171 hospitalized pediatric patients (ages 0-17 years; mean age 5.1 [SD 3.7] years) who had EHR documentation of TSE and measured salivary cotinine. Children with cotinine levels >1 ng/mL were classified as having biochemical verification of TSE. Parents reported sociodemographic characteristics, and children's EHRs were abstracted for TSE status, past medical history, and diagnoses. We conducted χ2 tests to assess the agreement between EHR classification of TSE status and cotinine levels. Then, we assessed the relationship between sociodemographic and clinical variables and cotinine using crude and adjusted logistic regression models. RESULTS Overall, 71% (121 of 171) of EHR classifications were correct on the basis of cotinine levels. Specificity analyses showed that 77% (53 of 69) were correctly identified as exposed to tobacco smoke. Sensitivity analyses showed that 67% (68 of 102) were correctly identified as unexposed. The negative predictive value was 0.61 (53 of 87); 39% (34 of 87) were misclassified as unexposed. The positive predictive value was 0.81 (68 of 84); 19% (16 of 84) were misclassified as exposed. CONCLUSIONS Almost 40% of children were misclassified in the EHR as unexposed to tobacco smoke. Biochemical verification should be used as part of universal TSE screening during pediatric hospitalizations.
Collapse
Affiliation(s)
- E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; .,College of Medicine and
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio
| | - Judith S Gordon
- College of Nursing, The University of Arizona, Tucson, Arizona; and
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Olga Semenova
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, California
| |
Collapse
|
13
|
Al-Waeli H, Nicolau B, Stone L, Abu Nada L, Gao Q, Abdallah MN, Abdulkader E, Suzuki M, Mansour A, Al Subaie A, Tamimi F. Chronotherapy of Non-Steroidal Anti-Inflammatory Drugs May Enhance Postoperative Recovery. Sci Rep 2020; 10:468. [PMID: 31949183 PMCID: PMC6965200 DOI: 10.1038/s41598-019-57215-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023] Open
Abstract
Postoperative pain relief is crucial for full recovery. With the ongoing opioid epidemic and the insufficient effect of acetaminophen on severe pain; non-steroidal anti-inflammatory drugs (NSAIDs) are heavily used to alleviate this pain. However, NSAIDs are known to inhibit postoperative healing of connective tissues by inhibiting prostaglandin signaling. Pain intensity, inflammatory mediators associated with wound healing and the pharmacological action of NSAIDs vary throughout the day due to the circadian rhythm regulated by the clock genes. According to this rhythm, most of wound healing mediators and connective tissue formation occurs during the resting phase, while pain, inflammation and tissue resorption occur during the active period of the day. Here we show, in a murine tibia fracture surgical model, that NSAIDs are most effective in managing postoperative pain, healing and recovery when drug administration is limited to the active phase of the circadian rhythm. Limiting NSAID treatment to the active phase of the circadian rhythm resulted in overexpression of circadian clock genes, such as Period 2 (Per2) at the healing callus, and increased serum levels of anti-inflammatory cytokines interleukin-13 (IL-13), interleukin-4 (IL-4) and vascular endothelial growth factor. By contrast, NSAID administration during the resting phase resulted in severe bone healing impairment.
Collapse
Affiliation(s)
- H Al-Waeli
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College Suite 500, Montréal, QC, H3A 1G1, Canada
| | - B Nicolau
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College Suite 500, Montréal, QC, H3A 1G1, Canada
| | - L Stone
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada
| | - L Abu Nada
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada
| | - Q Gao
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada
| | - M N Abdallah
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, Ontario, M5G 1G, Canada
| | - E Abdulkader
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College Suite 500, Montréal, QC, H3A 1G1, Canada
| | - M Suzuki
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada
| | - A Mansour
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada
| | - A Al Subaie
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada
| | - F Tamimi
- Faculty of Dentistry, McGill University, Strathcona Anatomy and Dentistry Building, Montreal, QC, H3A 0C7, Canada.
| |
Collapse
|
14
|
Stone L, Arneil M, Coventry L, Casey V, Moss S, Cavadino A, Laing B, McCarthy AL. Benchmarking nurse outcomes in Australian Magnet® hospitals: cross-sectional survey. BMC Nurs 2019; 18:62. [PMID: 31827388 PMCID: PMC6892144 DOI: 10.1186/s12912-019-0383-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background Positive reports of nursing-related outcomes such as quality nursing care, nursing engagement with work and good practice environment are crucial in attaining and maintaining Magnet® designation. The majority of Magnet®-designated organisations (N = 482) are in the USA, with their aggregate nursing outcomes widely published as benchmark data. Australian Magnet® outcomes have not been aggregated or published to date. Methods The aims are to benchmark educational preparation, occupational burnout, job satisfaction, intention to leave and working environment of nurses in Australian Magnet®-designated facilities and to determine the reliability of the Practice Environment Scale-Australia. The design is a cross-sectional multisite survey set in all three Australian Magnet®-designated organisations. The demographics included age, gender, level of education, years in practice, level of seniority and position title. Two items measured job satisfaction and intent to stay in current employment. The Maslach Burnout Inventory explored the three domains of nursing engagement: depersonalisation, personal achievement and emotional exhaustion. The Australian version of the Practice Environment Scale interrogated participants’ perceptions of their work environments. Results 2004 nurses participated (response rate 45.9%). Respondents’ mean age was 39.2 years (range 20–72). They were predominantly female and had worked in their current facility for more than 5 years. Eighty five percent had a minimum of a Bachelor’s degree. Eighty-six percent of respondents were satisfied or very satisfied with their current position. Eighty eight percent had no intention of leaving their current employer within the next 12 months. Participants rated their hospitals highly in all domains of the practice environment. Respondents reported less burnout in the personal accomplishment and depersonalisation domains than in the emotional exhaustion domain, in which they reported average levels of burnout. The internal consistency of the Practice Environment Scale-Australia was confirmed in this sample (Cronbach α’s 0.87–0.9 for subscales and 0.89 for composite score). Conclusion In this paper, we present nursing outcome data from all Australian Magnet® hospitals for the first time. This provides a benchmark that facilitates comparison with nursing outcomes published by Australian non-Magnet® hospitals and with international Magnet® organisations.
Collapse
Affiliation(s)
- L Stone
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia.,2University of Queenland, Brisbane, Queensland Australia
| | - M Arneil
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia
| | - L Coventry
- 3Sir Charles Gairdner Hospital, Nedlands, Western Australia.,4Edith Cowan University, Joondalup, Western Australia
| | - V Casey
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia.,2University of Queenland, Brisbane, Queensland Australia.,5University of Queensland, Brisbane, Queensland Australia
| | - S Moss
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia
| | - A Cavadino
- 6University of Auckland, Auckland, New Zealand
| | - B Laing
- 5University of Queensland, Brisbane, Queensland Australia
| | - A L McCarthy
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia.,5University of Queensland, Brisbane, Queensland Australia.,6University of Auckland, Auckland, New Zealand.,7Mater Health Services, South Brisbane, Queensland Australia
| |
Collapse
|
15
|
Grupp-Phelan J, Stevens J, Boyd S, Cohen DM, Ammerman RT, Liddy-Hicks S, Heck K, Marcus SC, Stone L, Campo JV, Bridge JA. Effect of a Motivational Interviewing-Based Intervention on Initiation of Mental Health Treatment and Mental Health After an Emergency Department Visit Among Suicidal Adolescents: A Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1917941. [PMID: 31860104 PMCID: PMC6991223 DOI: 10.1001/jamanetworkopen.2019.17941] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 10/27/2019] [Indexed: 11/14/2022] Open
Abstract
Importance Emergency department (ED) visits present opportunities to identify and refer suicidal youth for outpatient mental health care, although this practice is not routine. Objective To examine whether a motivational interviewing-based intervention increases linkage of adolescents to outpatient mental health services and reduces depression symptoms and suicidal ideation in adolescents seeking emergency care for non-mental health-related concerns who screen positive for suicide risk. Design, Setting, and Participants In this randomized clinical trial, adolescents aged 12 to 17 years who screened positive on the Ask Suicide Screening Questions (ASQ) during a nonpsychiatric ED visit at 2 academic pediatric EDs in Ohio were recruited from April 2013 to July 2015. Intention-to-treat analyses were performed from September 2018 to October 2019. Interventions The Suicidal Teens Accessing Treatment After an Emergency Department Visit (STAT-ED) intervention included motivational interviewing to target family engagement, problem solving, referral assistance, and limited case management. The enhanced usual care (EUC) intervention consisted of brief mental health care consultation and referral. Main Outcomes and Measures Primary outcomes were mental health treatment initiation and attendance within 2 months of ED discharge and suicidal ideation (assessed by the Suicidal Ideation Questionnaire JR) and depression symptoms (assessed by the Center for Epidemiologic Studies-Depression scale) at 2 and 6 months. Exploratory outcomes included treatment initiation and attendance and suicide attempts at 6 months. Results A total of 168 participants were randomized and 159 included in the intention-to-treat analyses (mean [SD] age, 15.0 [1.5] years; 126 [79.2%] female; and 80 [50.3%] white). Seventy-nine participants were randomized to receive the STAT-ED intervention and 80 to receive EUC. At 2 months, youth in the STAT-ED group had similar rates of mental health treatment initiation compared with youth in the EUC group as assessed by parent report (29 [50.9%] vs 22 [34.9%]; adjusted odds ratio [OR], 2.08; 95% CI, 0.97-4.45) and administrative data from mental health care agencies (19 [29.7%] vs 11 [19.3%]; adjusted OR, 1.77; 95% CI, 0.76-4.15). At 2 months, youth in the STAT-ED group and the EUC group had similar rates of treatment attendance (1 appointment: 6 [9.7%] vs 2 [3.6%]; adjusted OR, 2.97; 95% CI, 0.56-15.73; ≥2 appointments: 10 [16.1%] vs 7 [12.7%]; adjusted OR, 1.43; 95% CI, 0.50-4.11). There were no significant group × time differences in suicidal ideation (F = 0.28; P = .72) and depression symptoms (F = 0.49; P = .60) during the 6-month follow-up period. In exploratory analyses, at 6 months, STAT-ED participants had significantly higher rates of agency-reported mental health treatment initiation (adjusted OR, 2.48; 95% CI, 1.16-5.28) and more completed appointments (t99.7 = 2.58; P = .01). Conclusions and Relevance This study's findings indicate that no differences were found on any primary outcome by study condition. However, STAT-ED was more efficacious than EUC at increasing mental health treatment initiation and attendance at 6 months. Trial Registration ClinicalTrials.gov identifier: NCT01779414.
Collapse
Affiliation(s)
- Jacqueline Grupp-Phelan
- Division of Pediatric Emergency Medicine, UCSF (University of California, San Francisco) Benioff Children’s Hospitals, San Francisco, California
| | - Jack Stevens
- Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | - Stephanie Boyd
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Daniel M. Cohen
- Division of Emergency Medicine, Nationwide Children’s Hospital, The Ohio State University, Columbus
| | - Robert T. Ammerman
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Stacey Liddy-Hicks
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Kendra Heck
- Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | - Steven C. Marcus
- University of Pennsylvania School of Social Policy and Practice, Philadelphia
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - John V. Campo
- Department of Behavioral Medicine and Psychiatry, West Virginia University and the Rockefeller Neuroscience Institute, Morgantown
| | - Jeffrey A. Bridge
- Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus
| |
Collapse
|
16
|
Mahabee-Gittens EM, Merianos AL, Fulkerson PC, Stone L, Matt GE. The Association of Environmental Tobacco Smoke Exposure and Inflammatory Markers in Hospitalized Children. Int J Environ Res Public Health 2019; 16:ijerph16234625. [PMID: 31766400 PMCID: PMC6926853 DOI: 10.3390/ijerph16234625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/07/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
Abstract
Background: Environmental tobacco smoke (ETS) exposure is associated with altered cytokine levels in children. We sought to examine ETS exposure prevalence and the relationship between ETS exposure and cytokine levels in a sample of hospitalized children. (2) Methods: Inflammatory markers (IL-8, IL-1β, IL-10, and TNF-α) and cotinine were measured in saliva of hospitalized, nonsmoking children (N = 112). To assess the association between ETS exposure and immune system response, we built a multivariate regression model including the four inflammatory markers as the response variables and cotinine, age, sex, and discharge diagnosis as explanatory variables while assessing possible interaction effects. (3) Results: Mean age (SD) was 5.8(5.0) years; Geometric Mean (GeoM) cotinine = 1.8 [95% CI = 1.4–2.2]. Children with non-inflammatory other diagnoses had lower IL-10 (p = 0.003) and TNF-α (p = 0.009) levels than children with inflammatory other diagnoses. Children with asthma (p = 0.01) and bacterial illnesses and/or pneumonia (p = 0.002) had higher IL-8 levels. Independent of diagnosis, there was a significant curvilinear association between cotinine and IL-1β (p = 0.002) reflecting no association for cotinine levels <5 ng/mL and a positive association for >5 ng/mL. (4) Conclusions: Children with higher ETS exposure levels have higher IL-1β levels regardless of age, sex, and diagnosis. ETS exposure may increase pro-inflammatory immune responses in children and may interfere with native immune responses and the ability to heal and fight infection.
Collapse
Affiliation(s)
- E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA;
- Correspondence: ; Tel.: +1-513-636-7966
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Patricia C. Fulkerson
- Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati; College of Medicine, Cincinnati, OH 45229, USA;
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA;
| | - Georg E. Matt
- Department of Psychology, San Diego State University, San Diego, CA 92123, USA;
| |
Collapse
|
17
|
Mahabee-Gittens EM, Merianos AL, Stone L, Tabangin ME, Khoury JC, Gordon JS. Tobacco Use Behaviors and Perceptions of Parental Smokers in the Emergency Department Setting. Tob Use Insights 2019; 12:1179173X19841392. [PMID: 31258335 PMCID: PMC6585244 DOI: 10.1177/1179173x19841392] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 03/10/2019] [Indexed: 11/15/2022] Open
Abstract
Background More information is needed about modifiable child tobacco smoke exposure (TSE) patterns in racially diverse parental smokers to tailor interventions designed to help parents quit smoking and reduce their child's TSE. Our objectives were to determine whether there were differences in smoking and TSE patterns based on parental race and child age and whether these patterns differed based on child age within black and white parental smokers. Secondary objectives were to assess the relationship between parental perceptions about the effects of smoking and the benefits of quitting on their child based on child age, race, and reported TSE patterns and to examine biochemically verified TSE levels by child age, race, and parent-reported TSE patterns. Methods Participants (N = 415) were non-Hispanic black and non-Hispanic white parental smokers, mean age (standard deviation [SD]) = 31.2 (7.2) years, who visited the Pediatric Emergency Department (PED) or Urgent Care (UC) with their child, mean age (SD) = 4.7 (4.6) years. Parents reported sociodemographics, smoking, and child TSE patterns. We conducted chi-square tests, independent t-tests, and general linear regression models to answer our primary objectives and linear regression models to answer our secondary objectives. Results Parents were 56.1% non-Hispanic black; 87.5% women; mean (SD) number of cigarettes smoked/day was 10.5(6.8). A higher proportion of parents with younger children <3 years old reported smoking bans compared with parents with older children ⩾3 to <18 years old (41.3% vs 19.7%, P < .0001). Subsequent analyses revealed this pattern for both black and white parents. A total of 212 (51%) of children had biochemical assessment of TSE; 89.6% had detectable TSE. Younger children had significantly higher cotinine levels than older children independent of their race (P < .001). Conclusions Children of parental smokers who visit the PED/UC were highly tobacco smoke exposed. Both black and white parental smokers with younger children were more likely to enforce smoking bans, but younger children had higher TSE levels than older children. Interventions that target this group of parental smokers with younger children may be more effective than interventions geared to all parental smokers.
Collapse
Affiliation(s)
- E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Meredith E Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | |
Collapse
|
18
|
Mahabee-Gittens EM, Matt GE, Hoh E, Quintana PJE, Stone L, Geraci MA, Wullenweber CA, Koutsounadis GN, Ruwe AG, Meyers GT, Zakrajsek MA, Witry JK, Merianos AL. Contribution of thirdhand smoke to overall tobacco smoke exposure in pediatric patients: study protocol. BMC Public Health 2019; 19:491. [PMID: 31046729 PMCID: PMC6498613 DOI: 10.1186/s12889-019-6829-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thirdhand smoke (THS) is the persistent residue resulting from secondhand smoke (SHS) that accumulates in dust, objects, and on surfaces in homes where tobacco has been used, and is reemitted into air. Very little is known about the extent to which THS contributes to children's overall tobacco smoke exposure (OTS) levels, defined as their combined THS and SHS exposure. Even less is known about the effect of OTS and THS on children's health. This project will examine how different home smoking behaviors contribute to THS and OTS and if levels of THS are associated with respiratory illnesses in nonsmoking children. METHODS This project leverages the experimental design from an ongoing pediatric emergency department-based tobacco cessation trial of caregivers who smoke and their children (NIHR01HD083354). At baseline and follow-up, we will collect urine and handwipe samples from children and samples of dust and air from the homes of smokers who smoke indoors, have smoking bans or who have quit smoking. These samples will be analyzed to examine to what extent THS pollution at home contributes to OTS exposure over and above SHS and to what extent THS continues to persist and contribute to OTS in homes of smokers who have quit or have smoking bans. Targeted and nontargeted chemical analyses of home dust samples will explore which types of THS pollutants are present in homes. Electronic medical record review will examine if THS and OTS levels are associated with child respiratory illness. Additionally, a repository of child and environmental samples will be created. DISCUSSION The results of this study will be crucial to help close gaps in our understanding of the types, quantity, and clinical effects of OTS, THS exposure, and THS pollutants in a unique sample of tobacco smoke-exposed ill children and their homes. The potential impact of these findings is substantial, as currently the level of risk in OTS attributable to THS is unknown. This research has the potential to change how we protect children from OTS, by recognizing that SHS and THS exposure needs to be addressed separately and jointly as sources of pollution and exposure. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02531594 . Date of registration: August 24, 2015.
Collapse
Affiliation(s)
- E Melinda Mahabee-Gittens
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA. .,University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 3230 Eden Avenue, Cincinnati, Ohio, 45267, USA.
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Eunha Hoh
- San Diego State University Graduate School of Public Health, San Diego, CA, USA
| | | | - Lara Stone
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Maegan A Geraci
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Chase A Wullenweber
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Gena N Koutsounadis
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Abigail G Ruwe
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Gabriel T Meyers
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Mark A Zakrajsek
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - John K Witry
- Divison of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2008, Cincinnati, Ohio, 45229-3039, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, PO Box 210002, Cincinnati, Ohio, 45221, USA
| |
Collapse
|
19
|
Bentley E, Wright E, Hassall M, Myhill S, Rigsby P, Wilkinson D, Stone L, Page M, Mattiuzzo G. Use of Pseudotyped viruses for the production of reference materials as part of emerging viral outbreak preparedness. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
20
|
Traboulsee A, Oh J, Barlow L, Chan J, Cohen B, Costello K, Halper J, Harris C, Jones D, Kanal E, Li D, Maravilla K, Nelson F, Newsome S, Pelletier D, Rammohan K, Reich D, Rovira A, Stone L, Wolinsky J. Consensus statement on the use of gadolinium for magnetic resonance imaging (MRI) used in the diagnosis and follow-up of patients with multiple sclerosis (MS). J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2695] [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: 11/27/2022]
|
21
|
Stone L, Heward J, Paddick SM, Gray K, Dotchin C, Walker R. 55EXTERNAL VALIDATION OF A SHORT SCREENING TOOL FOR DEMENTIA IN A RESOURCE POOR, LOW LITERACY SETTING. Age Ageing 2017. [DOI: 10.1093/ageing/afx112.55] [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: 11/14/2022] Open
|
22
|
Heward J, Stone L, Dotchin C, Walker R, Paddick SM, Gray K, Kissima J. 56PREDICTORS OF COGNITIVE DECLINE IN RURAL TANZANIA. Age Ageing 2017. [DOI: 10.1093/ageing/afx112.56] [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
|
23
|
Mahabee-Gittens EM, Ammerman RT, Khoury JC, Stone L, Meyers GT, Witry JK, Merianos AL, Mancuso TF, Stackpole KMW, Bennett BL, Akers L, Gordon JS. Healthy families: study protocol for a randomized controlled trial of a screening, brief intervention, and referral to treatment intervention for caregivers to reduce secondhand smoke exposure among pediatric emergency patients. BMC Public Health 2017; 17:374. [PMID: 28464887 PMCID: PMC5414142 DOI: 10.1186/s12889-017-4278-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 01/31/2017] [Accepted: 04/21/2017] [Indexed: 11/15/2022] Open
Abstract
Background Involuntary exposure to secondhand smoke (SHSe) is an important cause of morbidity in children who present to the pediatric emergency department (PED) and urgent care (UC). SHSe interventions delivered in the PED and UC would benefit both the smoker and child, but there have been no large trials testing the efficacy of such interventions. The Healthy Families program is the first randomized controlled trial to test whether a screening, brief intervention, and referral to treatment (SBIRT) intervention delivered in the PED and UC will be effective in decreasing SHSe in children and increasing cessation in smokers. Methods/design This trial uses a randomized, two-group design in which caregiver-smokers of children 0–17 years old are recruited from the PED and UC. Eligible caregiver-smokers are randomized to either the: 1) SBIRT Condition with face-to-face, tailored counseling that focuses on the child’s illness, the importance of reducing child SHSe, caregiver smoking cessation, and the option to receive nicotine replacement therapy; or 2) Healthy Habits Control Condition which includes face-to-face, tailored attention control “5–2–1-0” counseling that focuses on improving the child’s health. Dyadic assessments are conducted in-person at baseline, and via email, phone, or in-person at 6-weeks and 6-months. The primary outcomes are biochemically-verified, 7-day point prevalence and prolonged smoking abstinence. Secondary outcomes are cigarettes smoked per week, 24 h quit attempts, and biochemically validated child SHSe at each time point. The costs of this intervention will also be analyzed. Discussion This study will test an innovative, multilevel intervention designed to reduce child SHSe and increase smoking cessation in caregivers. If effective and routinely used, this SBIRT model could reach at least one million smokers a year in the U.S., resulting in significant reductions in caregivers’ tobacco use, SHSe-related pediatric illness, and healthcare costs in this population of children. Trial registration ClinicalTrials.gov Identifier: NCT02531594. Date of registration: August 4, 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4278-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- E Melinda Mahabee-Gittens
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA. .,Division of Pediatric Emergency Medicine, Cincinnati, Ohio, USA.
| | - Robert T Ammerman
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Division of Behavioral Medicine & Clinical Psychology, Cincinnati, Ohio, USA
| | - Jane C Khoury
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Division of Biostatistics and Epidemiology, Cincinnati, Ohio, USA
| | - Lara Stone
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Division of Pediatric Emergency Medicine, Cincinnati, Ohio, USA
| | - Gabe T Meyers
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Division of Pediatric Emergency Medicine, Cincinnati, Ohio, USA
| | - John K Witry
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Division of Pediatric Emergency Medicine, Cincinnati, Ohio, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, PO Box 210002, Cincinnati, OH, 45221, USA
| | - Tierney F Mancuso
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Pediatric Residency Training Program, Cincinnati, Ohio, USA
| | - Kristin M W Stackpole
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Center for Better Health and Nutrition (HealthWorks!), Cincinnati, Ohio, USA
| | - Berkeley L Bennett
- Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.,Division of Pediatric Emergency Medicine, Cincinnati, Ohio, USA
| | - Laura Akers
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA
| | - Judith S Gordon
- College of Nursing University of Arizona, 1305 N. Martin Avenue, Tucson, AZ, 85721, USA
| |
Collapse
|
24
|
Flynn-Evans EE, Tyson T, Cravalho P, Feick N, Stone L. 0186 OCULOMOTOR BEHAVIOR METRICS CHANGE ACCORDING TO CIRCADIAN PHASE AND TIME AWAKE. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.185] [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
|
25
|
Yaari R, Katriel G, Stone L, Mendelson E, Mandelboim M, Huppert A. Model-based reconstruction of an epidemic using multiple datasets: understanding influenza A/H1N1 pandemic dynamics in Israel. J R Soc Interface 2016; 13:rsif.2016.0099. [PMID: 27030041 DOI: 10.1098/rsif.2016.0099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/08/2016] [Indexed: 11/12/2022] Open
Abstract
Intensified surveillance during the 2009 A/H1N1 influenza pandemic in Israel resulted in large virological and serological datasets, presenting a unique opportunity for investigating the pandemic dynamics. We employ a conditional likelihood approach for fitting a disease transmission model to virological and serological data, conditional on clinical data. The model is used to reconstruct the temporal pattern of the pandemic in Israel in five age-groups and evaluate the factors that shaped it. We estimate the reproductive number at the beginning of the pandemic to beR= 1.4. We find that the combined effect of varying absolute humidity conditions and school vacations (SVs) is responsible for the infection pattern, characterized by three epidemic waves. Overall attack rate is estimated at 32% (28-35%) with a large variation among the age-groups: the highest attack rates within school children and the lowest within the elderly. This pattern of infection is explained by a combination of the age-group contact structure and increasing immunity with age. We assess that SVs increased the overall attack rates by prolonging the pandemic into the winter. Vaccinating school children would have been the optimal strategy for minimizing infection rates in all age-groups.
Collapse
Affiliation(s)
- R Yaari
- Bio-statistical Unit, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel Zoology Department, Tel-Aviv University, Ramat Aviv 69778, Israel
| | - G Katriel
- Department of Mathematics, ORT Braude College, Karmiel 21610, Israel
| | - L Stone
- Zoology Department, Tel-Aviv University, Ramat Aviv 69778, Israel School of Mathematical and Geospatial Sciences, RMIT University, Melbourne, Victoria 3001, Australia
| | - E Mendelson
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
| | - M Mandelboim
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
| | - A Huppert
- Bio-statistical Unit, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv 69778, Israel
| |
Collapse
|
26
|
Traboulsee A, Simon JH, Stone L, Fisher E, Jones DE, Malhotra A, Newsome SD, Oh J, Reich DS, Richert N, Rammohan K, Khan O, Radue EW, Ford C, Halper J, Li D. Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis. AJNR Am J Neuroradiol 2015; 37:394-401. [PMID: 26564433 DOI: 10.3174/ajnr.a4539] [Citation(s) in RCA: 227] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An international group of neurologists and radiologists developed revised guidelines for standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS. A brain MR imaging with gadolinium is recommended for the diagnosis of MS. A spinal cord MR imaging is recommended if the brain MR imaging is nondiagnostic or if the presenting symptoms are at the level of the spinal cord. A follow-up brain MR imaging with gadolinium is recommended to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, to re-assess the original diagnosis, and as a new baseline before starting or modifying therapy. A routine brain MR imaging should be considered every 6 months to 2 years for all patients with relapsing MS. The brain MR imaging protocol includes 3D T1-weighted, 3D T2-FLAIR, 3D T2-weighted, post-single-dose gadolinium-enhanced T1-weighted sequences, and a DWI sequence. The progressive multifocal leukoencephalopathy surveillance protocol includes FLAIR and DWI sequences only. The spinal cord MR imaging protocol includes sagittal T1-weighted and proton attenuation, STIR or phase-sensitive inversion recovery, axial T2- or T2*-weighted imaging through suspicious lesions, and, in some cases, postcontrast gadolinium-enhanced T1-weighted imaging. The clinical question being addressed should be provided in the requisition for the MR imaging. The radiology report should be descriptive, with results referenced to previous studies. MR imaging studies should be permanently retained and available. The current revision incorporates new clinical information and imaging techniques that have become more available.
Collapse
Affiliation(s)
- A Traboulsee
- From the Department of Medicine (Neurology) (A.T.), University of British Columbia, Vancouver, Canada
| | - J H Simon
- Portland VA Research Foundation and Oregon Health and Sciences University (J.H.S.), Portland, Oregon
| | - L Stone
- Mellen Center for MS Treatment and Research (L.S.), Cleveland Clinic, Cleveland, Ohio
| | - E Fisher
- Department of Biomedical Engineering, Cleveland Clinic (E.F.). Cleveland, Ohio
| | - D E Jones
- Department of Neurology, University of Virginia (D.E.J.), Charlottesville, Virginia
| | - A Malhotra
- Department of Radiology and Biomedical Imaging, Yale University (A.M.), New Haven, Connecticut
| | - S D Newsome
- Department of Neurology (S.D.N.), Johns Hopkins School of Medicine, Baltimore, Maryland
| | - J Oh
- St. Michael's Hospital (J.O.), University of Toronto, Toronto, Ontario, Canada
| | - D S Reich
- Translational Neuroradiology Unit (D.S.R.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - N Richert
- Biogen Idec (N.R.), Cambridge, Massachusetts
| | - K Rammohan
- University of Miami Multiple Sclerosis Center (K.R.), Miami, Florida
| | - O Khan
- Department of Neurology (O.K.), Wayne State University School of Medicine, Detroit, Michigan
| | - E-W Radue
- Department of Radiology (E.-W.R.), University Hospital, Basel, Switzerland
| | - C Ford
- University of New Mexico Health Science Center (C.F.), Albuquerque, New Mexico
| | - J Halper
- Consortium of Multiple Sclerosis Centers (J.H.), Hackensack, New Jersey
| | - D Li
- Departments of Radiology (D.L.), University of British Columbia, Vancouver, British Columbia Canada
| |
Collapse
|
27
|
Perrone J, Liston D, Stone L. Dissecting the oblique effect: Replicating the expansion of motion direction space around the cardinal axes with a computer model built from V1 and MT neuron inputs. J Vis 2014. [DOI: 10.1167/14.10.469] [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: 11/24/2022] Open
|
28
|
Liston D, Stone L. Oculometric assessment of visual motion processing. J Vis 2014. [DOI: 10.1167/14.10.640] [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: 11/24/2022] Open
|
29
|
van West H, Hodgson B, Parent E, Samuel S, Hodgson B, Ferland C, Soroceanu A, Soroceanu A, Protopsaltis T, Protopsaltis T, Radovanovic I, Amritanand R, Shamji M, Haugo K, Malham G, Jarzem P, Rampersaud Y, Tomkins-Lane C, Manson N, Malham G, Rampersaud Y, Malham G, Malham G, King V, Goldstein C, Fisher C, Fehlings M, Fisher C, Wong E, Sardar Z, Christie S, Patel A, Pinkoski C, Ahn H, Drew B, Dvorak M, Pezeshki P, Altaf F, Wilde P, Rampersaud Y, Sparrey C, Tetreault L, Fehlings M, Tetreault L, Rampersaud R, Jack A, Johnstone R, Fernandes A, Urquhart J, Morokoff A, Manson N, Tomkins-Lane C, Phan P, Evaniew N, Shamji M, Manson J, Rampersaud Y, Nault ML, St-Pierre GH, Larouche J, Lewis S, Wilgenbusch C, Lewis S, Rampersaud Y, Johnson R, Cushnie D, Sridharan S, Street J, Gregg C, Missiuna P, Abraham E, Abraham E, Manson N, Huang E, Passmore S, Mac-Thiong JM, Labelle H, Moulin D, Turgeon I, Roy-Beaudry M, Bourassa N, Petit Y, Parent. S, Chabot S, Westover L, Hill D, Moreau M, Hedden D, Lou E, Adeeb. S, Smith M, Bridge C, Hsu B, Gray. R, Group PORSCHES, Saran N, Mac-Thiong JM, Stone L, Ouellet. J, Protopsaltis T, Terran J, Bronsard N, Smith J, Klineberg E, Mundis G, Hostin R, Hart R, Shaffrey C, Bess S, Ames C, Schwab F, Lafage. V, Schwab F, Lafage V, Protopsaltis T, Ames C, Bess S, Smith J, Errico. T, Schwab F, Soroceanu A, Bronsard N, Smith J, Klineberg E, Mundis G, Hostin R, Hart R, Burton D, Ames C, Shaffrey C, Bess S, Errico T, Lafage. V, Terran J, Soroceanu A, Bronsard N, Smith J, Klineberg E, Mundis G, Kim HJ, Hostin R, Hart R, Shaffrey C, Bess S, Ames C, Schwab F, Lafage. V, Urquhart J, Gananapathy V, Siddiqi F, Gurr K, Bailey C, Ravi B, David K, Rampersaud. R, Tu Y, Salter. M, Nichol H, Fourney D, Kelly. M, Parker R, Ellis N, Blecher C, Chow F, Claydon. M, Sardar Z, Alexander D, Oxner W, Plessis SD, Yee A, Wai. E, Lewis S, Davey J, Gandhi R, Mahomed. N, Hu R, Thomas K, Hepler C, Choi K, Rowed K, Haig. A, Lam. K, Parker R, Blecher C, Seex. K, Perruccio A, Gandhi R, Program. UHNA, Ellis N, Parker R, Goss B, Blecher C, Ballok. Z, Parker R, Ellis N, Chan P, Varma. D, Swart A, Winder M, Varga PP, Gokaslan Z, Boriani S, Luzzati A, Rhines L, Fisher C, Chou D, Williams R, Dekutoski M, Quraishi N, Bettegowda C, Kawahara N, Fehlings. M, Versteeg A, Boriani S, Varga PP, Dekutoski M, Luzzati A, Gokaslan Z, Williams R, Reynolds J, Fehlings M, Bettegowda C, Rhines. L, Zamorano J, Nater A, Tetrault L, Varga P, Gokaslan Z, Boriani S, Fisher C, Rhines L, Bettegowda C, Kawahara N, Chou. D, Fehlings M, Kopjar B, Vaccaro A, Arnold P, Schuster J, Finkelstein J, Rhines L, Dekutoski M, Gokaslan Z, France. J, Whyne C, Singh D, Ford. M, Aldebeyan W, Ouellet J, Steffen T, Beckman L, Weber M, Jarzem. P, Kwon B, Ahn H, Bailey C, Fehlings M, Fourney D, Gagnon D, Tsai E, Tsui D, Parent S, Chen J, Dvorak M, Noonan V, Rivers C, Network RHSCIR, Batke J, Lenehan B, Fisher C, Dvorak M, Street. J, Fox R, Nataraj A, Bailey C, Christie S, Duggal N, Fehlings M, Finkelstein J, Fourney D, Hurlbert R, Kwon B, Townson A, Tsai E, Attabib N, Chen J, Dvorak M, Noonan V, Rivers C, Network. RHSCIR, Fehlings M, Paquet J, Ahn H, Attabib N, Bailey C, Christie S, Duggal N, Finkelstein J, Fourney D, Hurlbert R, Johnson M, Kwon B, Parent S, Tsai E, Dvorak M, Noonan V, Rivers C, Shen T, Network. RHSCIR, Fisher C, Kwon B, Drew B, Fehlings M, Paquet J, Ahn H, Attabib N, Bailey C, Christie S, Duggal N, Finkelstein J, Fourney D, Hurlbert R, Johnson M, Mac-Thiong JM, Parent S, Tsai E, Fallah N, Noonan V, Rivers C, Network RHSCIR, Davidson S, McCann C, Akens M, Murphy K, Whyne C, Sherar M, Yee. A, Belanger L, Ronco J, Dea N, Paquette S, Boyd M, Street J, Fisher C, Dvorak M, Kwon B, Gonzalvo A, Fitt G, Liew S, de la Harpe D, Turner P, Rogers M, Bidos A, Fanti C, Young B, Drew B, Puskas. D, Tam H, Manansala S, Nosov V, Delva M, Alshafai N, Kopjar B, Tan G, Arnold P, Fehlings. M, Kopjar B, Arnold P, Ibrahim A, Tetrault. L, Kopjar B, Arnold P, Fehlings. M, Sundararajan K, Eng. S, St-Pierre G, Nataraj A, Urquhart J, Rosas-Arellano P, Tallon C, Gurr K, Siddiqi F, Bailey S, Bailey C, Sundararajan K, Rampersaud. R, Rosa-Arellano P, Tallon C, Bailey S, Gurr K, Bailey. C, Parker R, Milili L, Goss B, Malham. G, Green A, McKeon M, Abraham. E, Lafave L, Parnell J, Rempel J, Moriartey S, Andreas Y, Wilson P, Hepler C, Ray H, Hu. R, Ploumis A, Hess K, Wood. K, Yarascavitch B, Madden K, Ghert M, Drew B, Bhandari M, Kwok D, Tu YS, Salter. M, Hadlow. A, Tso P, Walker K, Lewis S, Davey J, Mahomed N, Coyte. P, Mac-Thiong JM, Roy-Beaudry M, Turgeon I, Labelle H, deGuise J, Parent. S, Jack A, Fox R, Nataraj A, Paquette S, Leroux T, Yee A, Ahn H, Broad R, Fisher C, Hall H, Nataraj A, Hedden D, Christie S, Carey T, Mehta V, Fehlings M, Wadey. V, Dear T, Hashem. M, Fourney D, Goldstein S, Bodrogi A, Lipkus M, Dear T, Keshen S, Veillette C, Gandhi R, Adams D, Briggs N, Davey J, Fehlings M, Lau J, Lewis S, Magtoto R, Marshall K, Massicotte E, Ogilvie-Harris D, Sarro A, Syed K, Mohamed. N, Perera S, Taha A, Urquhart J, Gurr K, Siddiqi F, Bailey C, Thomas K, Cho R, Swamy G, Power C, Henari S, Lenehan. B, McIntosh G, Hall H, Hoffman. C, Karachi A, Pazionis T, AlShaya O, Green A, McKeon M, Manson. N, Green A, McKeon M, Manson. N, Green A, McKeon M, Murray J, Abraham. E, Thomas K, Suttor S, Goyal T, Littlewood J, Bains I, Bouchard J, Hu R, Jacobs B, Cho R, Swamy G, Johnson M, Pelleck V, Amad Y, Ramos E, Glazebrook C. Combined Spine Conference of the Canadian Spine Society New Zealand Orthopaedic Spine Society, Spine Society of Australia: Fairmont Château Lake Louise, Lake, Louise, Alberta, Tuesday, Feb. 25 to Saturday, Mar. 1, 20141.1.01 The use of suspension radiographs to predict LIV tilt.1.1.02 Surgical correction of adolescent idiopathic scoliosis without fusion: an animal model.1.1.03 Are full torso surface topography postural measurements more sensitive to change than back only parameters in adolescents with idiopathic scoliosis and a main thoracic curve?1.2.04 Restoration of thoracic kyphosis in adolescent idiopathic kyphosis: comparative radiographic analysis of round versus rail rods.1.2.05 Scoliosis surgery in spastic quadriplegic cerebral palsy: Is fusion to the pelvis always necessary? A 4–18-year follow-up study.1.2.06 Identification and validation of pain-related biomarkers surrounding spinal surgery in adolescents.1.3.07 Cervical sagittal deformity develops after PJK in adult throacolumbar deformity correction: radiographic analysis using a novel global sagittal angular parameter, the CTPA.1.3.08 Impact of obesity on complications and patient-reported outcomes in adult spinal deformity surgery.1.3.09 The T1 pelvic angle, a novel radiographic measure of sagittal deformity, accounts for both pelvic retroversion and truncal inclination and correlates strongly with HRQOL.1.4.10 Determining cervical sagittal deformity when it is concurrent with thoracolumbar deformity.1.4.11 The influence of sagittal balance and pelvic parameters on the outcome of surgically treated patients with degenerative spondylolisthesis.1.4.12 Predictors of degenerative spondylolisthesis and loading translation in surgical lumbar spinal stenosis patients.2.1.13 Mechanical allodynia following disc herniation requires intraneural macrophage infiltration and can be blocked by systemic selenium delivery or attenuation of BDNF activity.2.1.14 The effect of alanyl-glutamine on epidural fibrosis in a rat laminectomy model.2.1.15 Anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2: a prospective study of complications.2.2.16 2-year results of a Canadian, multicentre, blinded, pilot study of a novel peptide in promoting lumbar spine fusion.2.2.17 Comparative outcomes and cost-utility following surgical treatment of focal lumbar spinal stenosis compared with osteoarthritis of the hip or knee: long-term change in health-related quality of life.2.2.18 Changes in objectively measured walking performance, function, and pain following surgery for spondylolisthesis and lumbar spinal stenosis.2.3.19 A prospective multicentre observational data-monitored study of minimally invasive fusion to treat degenerative lumbar disorders: complications and outcomes at 1-year follow-up.2.3.20 Assessment and classification of subsidence in lateral interbody fusion using serial computed tomography.2.3.21 Predictors of willingness to undergo spinal and orthopaedic surgery after surgical consultation.2.4.22 Indirect foraminal decompression is independent of facet arthropathy in extreme lateral interbody fusion.2.4.23 Cervical artificial disc replacement with ProDisc-C: clinical and radiographic outcomes with long-term follow-up.2.4.24 Tantalum trabecular metal implants in anterior cervical corpectomy and fusion.3.1.25 Hemangiomas of the spine: results of surgical management and prognostic variables for local recurrence and mortality in a multicentre study.3.1.26 Chondrosarcomas of the spine: prognostic variables for local recurrence and mortality in a multicentre study.3.1.27 Risk factors for recurrence of surgically treated spine schwannomas: analysis of 169 patients from a multicentre international database.3.2.28 Survival pattern and the effect of surgery on health related quality of life and functional outcome in patients with metastatic epidural spinal cord compression from lung cancer — the AOSpine North America prospective multicentre study.3.2.29 A biomechanical assessment of kyphoplasty as a stand-alone treatment in a human cadaveric burst fracture model.3.2.30 What is safer in incompetent vertebrae with posterior wall defects, kyphoplasty or vertebroplasty: a study in vertebral analogs.3.3.31 Feasibility of recruiting subjects for acute spinal cord injury (SCI) clinical trials in Canada.3.3.32 Prospective analysis of adverse events in elderly patients with traumatic spinal cord injury.3.3.33 Does traction before surgery influence time to neural decompression in patients with spinal cord injury?3.4.34 Current treatment of individuals with traumatic spinal cord injury: Do we need age-specific guidelines?3.4.35 Current surgical practice for traumatic spinal cord injury in Canada.3.4.36 The importance of “time to surgery” for traumatic spinal cord injured patients: results from an ambispective Canadian cohort of 949 patients.3.5.37 Assessment of a novel coil-shaped radiofrequency probe in the porcine spine.3.5.38 The effect of norepinephrine and dopamine on cerebrospinal fluid pressure after acute spinal cord injury.3.5.39 The learning curve of pedicle screw placement: How many screws are enough?4.1.40 Preliminary report from the Ontario Inter-professional Spine Assessment and Education Clinics (ISAEC).4.1.41 A surrogate model of the spinal cord complex for simulating bony impingement.4.1.42 Clinical and surgical predictors of specific complications following surgery for the treatment of degenerative cervical myelopathy: results from the multicentre, prospective AOSpine international study on 479 patients.4.2.43 Outcomes of surgical management of cervical spondylotic myelopathy: results of the prospective, multicentre, AOSpine international study in 479 patients.4.2.44 A clinical prediction rule for clinical outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international AOSpine prospective multicentre data set of 757 subjects.4.2.45 The prevalence and impact of low back and leg pain among aging Canadians: a cross-sectional survey.4.3.46 Adjacent segment pathology: Progressive disease course or a product of iatrogenic fusion?4.3.47 Natural history of degenerative lumbar spondylolisthesis in patients with spinal stenosis.4.3.48 Changes in self-reported clinical status and health care utilization during wait time for surgical spine consultation: a prospective observational study.4.3.49 The Canadian surgical wait list for lumbar degenerative spinal stenosis has a detrimental effect on patient outcomes.4.3.50 Segmental lordosis is independent of interbody cage position in XLIF.4.3.51 Elevated patient BMI does not negatively affect self-reported outcomes of thoracolumbar surgery.1.5.52 The Spinal Stenosis Pedometer and Nutrition Lifestyle Intervention (SSPANLI): development and pilot.1.5.53 Study evaluating the variability of surgical strategy planning for patients with adult spinal deformity.1.5.54 Atlantoaxial instability in acute odontoid fractures is associated with nonunion and mortality.1.5.55 Peripheral hypersensitivity to subthreshold stimuli persists after resolution of acute experimental disc-herniation neuropathy.1.5.56 Radiation induced lumbar spinal osteonecrosis: case report and literature review.1.5.57 Comparative outcomes and cost-utility following surgical treatment of focal lumbar spinal stenosis compared with osteoarthritis of the hip or knee: Part 2 — estimated lifetime incremental cost-utility ratios.1.5.58 A predictive model of progression for adolescent idiopathic scoliosis based on 3D spine parameters at first visit.1.5.59 Development of a clinical prediction model for surgical decision making in patients with degenerative lumbar spine disease.2.5.60 Canadian spine surgery fellowship education: evaluating opportunity in developing a nationally based training curriculum.2.5.61 Pedicle subtraction osteotomy for severe proximal thoracic junctional kyphosis.2.5.62 A comparison of spine surgery referrals triaged through a multidisciplinary care pathway versus conventional referrals.2.5.63 Results and complications of posterior-based 3 column osteotomies in patients with previously fused spinal deformities.2.5.64 Orthopaedic Surgical AdVerse Event Severity (Ortho-SAVES) system: identifying opportunities for improved patient safety and resource utilization.2.5.65 Spontaneous spinal extra-axial haematomas — surgical experience in Otago and Southland 2011–2013.2.5.66 Obesity and spinal epidural lipomatosis in cauda equina syndrome.2.5.67 Factors affecting restoration of lumbar lordosis in adult degenerative scoliosis patients treated with lateral trans-psoas interbody fusion.3.6.68 Systematic review of complications in spinal surgery: a comparison of retrospective and prospective study design.3.6.69 Postsurgical rehabilitation patients have similar fear avoidance behaviour levels as those in nonoperative care.3.6.70 Outcomes of surgical treatment of adolescent spondyloptosis: a case series.3.6.71 Surgical success in primary versus revision thoracolumbar spine surgery.3.6.72 The effect of smoking on subjective patient outcomes in thoracolumbar surgery.3.6.73 Modelling patient recovery to predict outcomes following elective thoracolumbar surgery for degenerative pathologies.3.6.74 Outcomes from trans-psoas versus open approaches in the treatment of adult degenerative scoliosis.3.6.75 Lumbar spinal stenosis and presurgical assessment: the impact of walking induced strain on a performance-based outcome measure. Can J Surg 2014. [DOI: 10.1503/cjs.005614] [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: 11/01/2022] Open
|
30
|
|
31
|
Thompson C, Lee T, Stone L, McCarthy M, Burgman M. Inferring extinction risks from sighting records. J Theor Biol 2013; 338:16-22. [PMID: 23999285 DOI: 10.1016/j.jtbi.2013.08.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/28/2013] [Accepted: 08/20/2013] [Indexed: 11/26/2022]
|
32
|
Kalar D, Liston D, Adelstein B, Stone L. Shared positional noise in manual reaching and saccadic eye movements. J Vis 2013. [DOI: 10.1167/13.9.1223] [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: 11/24/2022] Open
|
33
|
Li L, Niehorster DC, Liston D, Siu WWF, Stone L. Shared neural sensory signals for eye-hand coordination in humans. J Vis 2013. [DOI: 10.1167/13.9.1205] [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: 11/24/2022] Open
|
34
|
Liston D, Stone L. Perceptual brightness decisions do not use a difference model. J Vis 2013. [DOI: 10.1167/13.9.516] [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: 11/24/2022] Open
|
35
|
Yaari R, Katriel G, Huppert A, Axelsen JB, Stone L. Modelling seasonal influenza: the role of weather and punctuated antigenic drift. J R Soc Interface 2013; 10:20130298. [PMID: 23676899 PMCID: PMC3673168 DOI: 10.1098/rsif.2013.0298] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 04/02/2013] [Accepted: 04/25/2013] [Indexed: 11/12/2022] Open
Abstract
Seasonal influenza appears as annual oscillations in temperate regions of the world, yet little is known as to what drives these annual outbreaks and what factors are responsible for their inter-annual variability. Recent studies suggest that weather variables, such as absolute humidity, are the key drivers of annual influenza outbreaks. The rapid, punctuated, antigenic evolution of the influenza virus is another major factor. We present a new framework for modelling seasonal influenza based on a discrete-time, age-of-infection, epidemic model, which allows the calculation of the model's likelihood function in closed form. This framework may be used to perform model inference and parameter estimation rigorously. The modelling approach allows us to fit 11 years of Israeli influenza data, with the best models fitting the data with unusually high correlations in which r > 0.9. We show that using actual weather to modulate influenza transmission rate gives better results than using the inter-annual means of the weather variables, providing strong support for the role of weather in shaping the dynamics of influenza. This conclusion remains valid even when incorporating a more realistic depiction of the decay of immunity at the population level, which allows for discrete changes in immunity from year to year.
Collapse
Affiliation(s)
- R. Yaari
- The Porter School of Environmental Studies, Tel Aviv University, 69978 Tel Aviv, Israel
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, 69978 Tel Aviv, Israel
| | - G. Katriel
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, 69978 Tel Aviv, Israel
- Department of Mathematics, ORT Braude College, Karmiel, Israel
| | - A. Huppert
- Bio-statistical Unit, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, 52621Israel
| | - J. B. Axelsen
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, 69978 Tel Aviv, Israel
| | - L. Stone
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, 69978 Tel Aviv, Israel
- School of Mathematical and Geospatial Sciences, RMIT University, Melbourne, 3000, Australia
| |
Collapse
|
36
|
Koenig KA, Lowe MJ, Lin J, Sakaie KE, Stone L, Bermel RA, Beall EB, Rao SM, Trapp BD, Phillips MD. Sex differences in resting-state functional connectivity in multiple sclerosis. AJNR Am J Neuroradiol 2013; 34:2304-11. [PMID: 23811974 DOI: 10.3174/ajnr.a3630] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Multiple studies have demonstrated evidence of sex differences in patients with MS, including differences in disease progression, cognitive decline, and biologic markers. This study used functional connectivity MRI to investigate sex differences in the strength of functional connectivity of the default mode network in patients with MS and healthy control subjects. MATERIALS AND METHODS A total of 16 men and 16 women with MS and 32 age- and sex-matched healthy control subjects underwent a whole-brain resting-state functional connectivity MRI scan. A group-based seed in the posterior cingulate was used to create whole-brain correlation maps. A 2 × 2 ANOVA was used to assess whether disease status and sex affected the strength of connectivity to the posterior cingulate. RESULTS Patients with MS showed significantly stronger connectivity from the posterior cingulate to the bilateral medial frontal gyri, the left ventral anterior cingulate, the right putamen, and the left middle temporal gyrus (P < .0005). In the left dorsal lateral prefrontal cortex, female patients showed significantly stronger connectivity to the posterior cingulate cortex compared with female control subjects (P = 3 × 10(4)), and male control subjects showed stronger posterior cingulate cortex-left dorsal lateral prefrontal cortex connectivity in comparison to female control subjects (P = .002). Male patients showed significantly weaker connectivity to the caudate compared with female patients (P = .004). CONCLUSIONS Disease status and sex interact to produce differences in the strength of functional connectivity from the posterior cingulate to the caudate and the left dorsal lateral prefrontal cortex.
Collapse
|
37
|
Affiliation(s)
- E Melinda Mahabee-Gittens
- Department of Pediatrics, Division of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH
| | | | | |
Collapse
|
38
|
Kinley J, Stone L, Hockley J. St Christopher's Hospice Clinical Guidelines: Anticipatory end-of-life care medication for the symptoms of terminal restlessness, pain and excessive secretions in frail older people in care homes. ACTA ACUST UNITED AC 2013. [DOI: 10.1136/eoljnl-03-03.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
39
|
Huang HP, Chen PH, Hwu WL, Chuang CY, Chien YH, Stone L, Chien CL, Li LT, Chiang SC, Chen HF, Ho HN, Chen CH, Kuo HC. Human Pompe disease-induced pluripotent stem cells for pathogenesis modeling, drug testing and disease marker identification. Hum Mol Genet 2012. [DOI: 10.1093/hmg/dds085] [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
|
40
|
Bhattacharyya P, Bermel R, Phillips M, Stone L, Mathew B, Lowe M. GABA-fMRI Activation Volume Correlation Suggests GABA Is a Marker of Cortical Adaptation in Multiple Sclerosis (P03.066). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
41
|
Liston D, Stone L. Deciphering the relationship between perceptual and motor variability. J Vis 2011. [DOI: 10.1167/11.11.548] [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: 11/24/2022] Open
|
42
|
Katriel G, Yaari R, Huppert A, Roll U, Stone L. Modelling the initial phase of an epidemic using incidence and infection network data: 2009 H1N1 pandemic in Israel as a case study. J R Soc Interface 2011; 8:856-67. [PMID: 21247949 PMCID: PMC3104348 DOI: 10.1098/rsif.2010.0515] [Citation(s) in RCA: 26] [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: 09/21/2010] [Accepted: 12/08/2010] [Indexed: 11/12/2022] Open
Abstract
This paper presents new computational and modelling tools for studying the dynamics of an epidemic in its initial stages that use both available incidence time series and data describing the population's infection network structure. The work is motivated by data collected at the beginning of the H1N1 pandemic outbreak in Israel in the summer of 2009. We formulated a new discrete-time stochastic epidemic SIR (susceptible-infected-recovered) model that explicitly takes into account the disease's specific generation-time distribution and the intrinsic demographic stochasticity inherent to the infection process. Moreover, in contrast with many other modelling approaches, the model allows direct analytical derivation of estimates for the effective reproductive number (R(e)) and of their credible intervals, by maximum likelihood and Bayesian methods. The basic model can be extended to include age-class structure, and a maximum likelihood methodology allows us to estimate the model's next-generation matrix by combining two types of data: (i) the incidence series of each age group, and (ii) infection network data that provide partial information of 'who-infected-who'. Unlike other approaches for estimating the next-generation matrix, the method developed here does not require making a priori assumptions about the structure of the next-generation matrix. We show, using a simulation study, that even a relatively small amount of information about the infection network greatly improves the accuracy of estimation of the next-generation matrix. The method is applied in practice to estimate the next-generation matrix from the Israeli H1N1 pandemic data. The tools developed here should be of practical importance for future investigations of epidemics during their initial stages. However, they require the availability of data which represent a random sample of the real epidemic process. We discuss the conditions under which reporting rates may or may not influence our estimated quantities and the effects of bias.
Collapse
Affiliation(s)
- G. Katriel
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - R. Yaari
- The Porter School of Environmental Studies, Tel Aviv University, Tel Aviv 69978, Israel
| | - A. Huppert
- Center for Risk Analysis, the Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - U. Roll
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - L. Stone
- Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| |
Collapse
|
43
|
Arnold D, Stone L. The clinical usefulness of routine MRI assessment. Int MS J 2011; 17:58-62. [PMID: 21689499] [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] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 03/30/2010] [Indexed: 05/30/2023]
Abstract
Although the diagnostic value of magnetic resonance imaging (MRI) in multiple sclerosis (MS) is widely accepted, the clinical usefulness of routine MRI for monitoring the evolution of patients with MS is less widely accepted. It is not uncommon for clinicians to say that they treat the patient, not the MRI. In this review, we highlight some of the evidence that routine MRI surveillance of patients with MS provides important information about disease activity that is not evident clinically, and that this information can help with prognosis and management decisions. Specific recommendations for MRI surveillance of MS patients are provided.
Collapse
Affiliation(s)
- Dl Arnold
- Douglas L Arnold Montreal Neurological Institute 3801 University Street Montreal Quebec Canada E-mail:
| | | |
Collapse
|
44
|
Liston D, Stone L. Shared effects of prior information and reward on motor and perceptual choices. J Vis 2010. [DOI: 10.1167/8.6.607] [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: 11/24/2022] Open
|
45
|
Liston D, Stone L. Coordinate system of visual motion signals driving pursuit initiation. J Vis 2010. [DOI: 10.1167/9.8.412] [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: 11/24/2022] Open
|
46
|
Li L, Stone L, Chan E. Visual control of steering toward a goal uses heading but not path information. J Vis 2010. [DOI: 10.1167/8.6.1162] [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: 11/24/2022] Open
|
47
|
Brooks K, Stone L. Monocular artifacts and the perception of stereomotion speed. J Vis 2010. [DOI: 10.1167/2.7.329] [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: 11/24/2022] Open
|
48
|
Mullins G, Jagne J, Stone L, Konings E, Howard-Grabman L, Hartman F, Fulton M. ‘One World One Health’ in practice: Integrating public health and veterinary curricula on emerging infectious diseases in Africa. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
49
|
Li M, Lin J, Sakaie K, Beall E, Stone L, Bermel R, Phillips M, Lowe M. An Evaluation of the Robustness of Tract-based Measures of White Matter Integrity. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
50
|
Wyckhuys KAG, Stone L, Desneux N, Hoelmer KA, Hopper KR, Heimpel GE. Parasitism of the soybean aphid, Aphis glycines by Binodoxys communis: the role of aphid defensive behaviour and parasitoid reproductive performance. Bull Entomol Res 2008; 98:361-70. [PMID: 18294416 PMCID: PMC2670187 DOI: 10.1017/s000748530800566x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The Asian parasitoid, Binodoxys communis (Gahan) (Hymenoptera: Braconidae), is a candidate for release against the exotic soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), in North America. In this study, we examined preferences by B. communis for the different developmental stages of A. glycines and investigated consequences of these preferences for parasitoid fitness. We also determined to what extent aphid defensive behaviours mediate such preferences. We found that B. communis readily attacks and successfully develops in the different A. glycines developmental stages. Binodoxys communis development time gradually increased with aphid developmental stage, and wasps took longest to develop in alates. An average (+/-SE) of 54.01+/-0.08% of parasitized A. glycines alatoid nymphs transformed into winged adult aphids prior to mummification. No-choice assays showed a higher proportion of successful attacks for immature apterous A. glycines nymphs compared to adults and alatoid nymphs. Also, choice trials indicated avoidance and lower attack and oviposition of adults and alatoid nymphs. The different aphid stages exhibited a range of defensive behaviours, including body raising, kicking and body rotation. These defenses were employed most effectively by larger aphids. We discuss implications for the potential establishment, spread and biological control efficacy of A. glycines by B. communis in the event that it is released in North America.
Collapse
Affiliation(s)
- K A G Wyckhuys
- Horticulture Research Center, Universidad Jorge Tadeo Lozano, Chia (Cundinamarca), Colombia.
| | | | | | | | | | | |
Collapse
|