1
|
Unda SR, Pomeranz LE, Marongiu R, Yu X, Kelly L, Hassanzadeh G, Molina H, Vaisey G, Wang P, Dyke JP, Fung EK, Grosenick L, Zirkel R, Antoniazzi AM, Norman S, Liston CM, Schaffer C, Nishimura N, Stanley SA, Friedman JM, Kaplitt MG. Bidirectional Regulation of Motor Circuits Using Magnetogenetic Gene Therapy. bioRxiv 2024:2023.07.13.548699. [PMID: 37503198 PMCID: PMC10369996 DOI: 10.1101/2023.07.13.548699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Here we report a novel suite of magnetogenetic tools, based on a single anti-ferritin nanobody-TRPV1 receptor fusion protein, which regulated neuronal activity when exposed to magnetic fields. AAV-mediated delivery of a floxed nanobody-TRPV1 into the striatum of adenosine 2a receptor-cre driver mice resulted in motor freezing when placed in an MRI or adjacent to a transcranial magnetic stimulation (TMS) device. Functional imaging and fiber photometry both confirmed activation of the target region in response to the magnetic fields. Expression of the same construct in the striatum of wild-type mice along with a second injection of an AAVretro expressing cre into the globus pallidus led to similar circuit specificity and motor responses. Finally, a mutation was generated to gate chloride and inhibit neuronal activity. Expression of this variant in subthalamic nucleus in PitX2-cre parkinsonian mice resulted in reduced local c-fos expression and motor rotational behavior. These data demonstrate that magnetogenetic constructs can bidirectionally regulate activity of specific neuronal circuits non-invasively in-vivo using clinically available devices. Teaser A novel magnetogenetics toolbox to regulate neural circuits in-vivo .
Collapse
|
2
|
Pomeranz L, Li R, Yu X, Kelly L, Hassanzadeh G, Molina H, Gross D, Brier M, Vaisey G, Wang P, Jimenez-Gonzalez M, Garcia-Ocana A, Dordick J, Friedman J, Stanley S. Magnetogenetic cell activation using endogenous ferritin. bioRxiv 2024:2023.06.20.545120. [PMID: 37786709 PMCID: PMC10541561 DOI: 10.1101/2023.06.20.545120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The ability to precisely control the activity of defined cell populations enables studies of their physiological roles and may provide therapeutic applications. While prior studies have shown that magnetic activation of ferritin-tagged ion channels allows cell-specific modulation of cellular activity, the large size of the constructs made the use of adeno-associated virus, AAV, the vector of choice for gene therapy, impractical. In addition, simple means for generating magnetic fields of sufficient strength have been lacking. Toward these ends, we first generated a novel anti-ferritin nanobody that when fused to transient receptor potential cation channel subfamily V member 1, TRPV1, enables direct binding of the channel to endogenous ferritin in mouse and human cells. This smaller construct can be delivered in a single AAV and we validated that it robustly enables magnetically induced cell activation in vitro . In parallel, we developed a simple benchtop electromagnet capable of gating the nanobody-tagged channel in vivo . Finally, we showed that delivering these new constructs by AAV to pancreatic beta cells in combination with the benchtop magnetic field delivery stimulates glucose-stimulated insulin release to improve glucose tolerance in mice in vivo . Together, the novel anti-ferritin nanobody, nanobody-TRPV1 construct and new hardware advance the utility of magnetogenetics in animals and potentially humans.
Collapse
|
3
|
Kelly L, Koopmans MPG, Horigan V, Papa A, Sikkema RS, Koren LGH, Snary EL. Assessing the quality of data for drivers of disease emergence. REV SCI TECH OIE 2023; 42:90-102. [PMID: 37232315 DOI: 10.20506/rst.42.3352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Drivers are factors that have the potential to directly or indirectly influence the likelihood of infectious diseases emerging or re-emerging. It is likely that an emerging infectious disease (EID) rarely occurs as the result of only one driver; rather, a network of sub-drivers (factors that can influence a driver) are likely to provide conditions that allow a pathogen to (re-)emerge and become established. Data on sub-drivers have therefore been used by modellers to identify hotspots where EIDs may next occur, or to estimate which sub-drivers have the greatest influence on the likelihood of their occurrence. To minimise error and bias when modelling how sub-drivers interact, and thus aid in predicting the likelihood of infectious disease emergence, researchers need good-quality data to describe these sub-drivers. This study assesses the quality of the available data on sub-drivers of West Nile virus against various criteria as a case study. The data were found to be of varying quality with regard to fulfilling the criteria. The characteristic with the lowest score was completeness, i.e. where sufficient data are available to fulfil all the requirements for the model. This is an important characteristic as an incomplete data set could lead to erroneous conclusions being drawn from modelling studies. Thus, the availability of good-quality data is essential to reduce uncertainty when estimating the likelihood of where EID outbreaks may occur and identifying the points on the risk pathway where preventive measures may be taken.
Collapse
|
4
|
Ulanova M, Tsang RSW, Nix EB, Kelly L, Shuel M, Lance B. Epidemiology of invasive Haemophilus influenzae disease in northwestern Ontario: comparison of invasive and noninvasive H. influenzae clinical isolates. Can J Microbiol 2023. [PMID: 36753721 DOI: 10.1139/cjm-2022-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
In the post-Haemophilus influenzae type b (Hib) vaccine era, invasive H. influenzae type a (Hia) disease emerged in North American Indigenous populations. The role of Hia in noninvasive disease is uncertain; it is unknown whether noninvasive Hia infections are prevalent in populations with a high incidence of invasive disease, and whether invasive and noninvasive Hia isolates have different characteristics. We analyzed all invasive and noninvasive clinical H. influenzae isolates collected in a northwestern Ontario hospital serving 82% Indigenous population over 5.5 years. Serotyping, clonal analysis, and antimicrobial sensitivity testing were conducted on 233 noninvasive and 20 invasive isolates. Among noninvasive isolates, 91% were nontypeable (NTHi) and 3% were Hia; Hia was the most frequent invasive isolate (60%). Incidence rates of invasive H. influenzae disease (12.5/100 000/year) greatly exceeded average provincial data, with the highest found in <6-year-old children (63.9/100 000/year); the proportion of Hia among invasive isolates was seven times larger than in Ontario. No difference in clonal characteristics between invasive and noninvasive Hia isolates was found. Antibiotic resistance was more common among NTHi than among encapsulated isolates, without differences between invasive and noninvasive isolates. Considering the significance of Hia in Indigenous populations, pediatric immunization against Hia will be useful to prevent serious infections in young Indigenous children.
Collapse
Affiliation(s)
| | - R S W Tsang
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - E B Nix
- NOSM University, Thunder Bay, ON, Canada
| | - L Kelly
- Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, ON, Canada
| | - M Shuel
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - B Lance
- Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, ON, Canada
| | | |
Collapse
|
5
|
O'Leary BD, Kelly L, Fitzpatrick M, Keane DP. Underdiagnosis of internal anal sphincter trauma following vaginal delivery. Ultrasound Obstet Gynecol 2023; 61:251-256. [PMID: 36722430 PMCID: PMC10108077 DOI: 10.1002/uog.26049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Damage to the anal sphincter during childbirth remains the leading cause of fecal incontinence in women. Defects in the internal (IAS) or external anal sphincter, alongside symptoms and sphincter tone, will generally dictate the suggested mode of delivery in any successive pregnancy. This study aimed to examine using endoanal ultrasonography the prevalence of IAS damage in women referred with Grade-3a or -3b obstetric anal sphincter injury (OASI) in a tertiary-referral perineal clinic. METHODS This was a retrospective observational study of all women referred to a tertiary-referral perineal clinic after primary repair of OASI (Grade 3a-c, 4) diagnosed for the first time following vaginal delivery between January 2016 and December 2019, inclusive. Women were assessed using the Wexner bowel continence questionnaire, digital examination of sphincter tone and endoanal ultrasound. Injuries in each sphincter were classified as a scar (≤ 30°) or defect (> 30-90° or > 90°) on endoanal imaging in the axial plane. RESULTS In total, 615 women were referred following primary repair of OASI. Sonographic evidence of damage to the IAS was seen in 9.1% (46/506) of women diagnosed with a Grade-3a/3b injury. In women referred with a Grade-3a/3b tear, symptom scores were statistically higher (P = 0.025) in those with an IAS defect > 30° compared to those with an intact or scarred IAS, although the median score was zero in both groups. The proportion of women in each group with severe symptoms (score > 9) was similar (2.6% vs 6.5%; P = 0.148). Among women referred with a Grade-3a/3b tear, sphincter tone was reduced more frequently in those with a defect of the IAS than in those with an intact or scarred IAS (52.2% vs 11.7%; odds ratio, 8.14 (95% CI, 4.26-15.67); P < 0.001). Regardless of the reason for referral, women with reduced sphincter tone on rectal examination were four times as likely to have had an IAS defect > 30° than were those with normal resting tone (risk ratio, 4.58 (95% CI, 3.25-6.45); P < 0.001). CONCLUSIONS One in 11 women diagnosed with a Grade-3a or -3b tear have evidence of damage to their IAS on endoanal ultrasound. Damage to this muscle is linked to fecal incontinence in women and can have a significant impact on the planning of any future deliveries. This study highlights the importance of established perineal clinics with access to ultrasound. Nonetheless, if reduced sphincter tone is felt on rectal examination, a clinician should have a high index of suspicion for an occult IAS injury. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- B. D. O'Leary
- Perineal ClinicNational Maternity HospitalDublinIreland
- UCD Perinatal Research CentreNational Maternity HospitalDublinIreland
| | - L. Kelly
- Perineal ClinicNational Maternity HospitalDublinIreland
| | | | - D. P. Keane
- UCD Perinatal Research CentreNational Maternity HospitalDublinIreland
- Royal College of Surgeons IrelandNational Maternity HospitalDublinIreland
| |
Collapse
|
6
|
Boyle O, Kelly L, Whelan C, Murtagh E, O'Dwyer A, Ryan M, Hill F, McCabe A, Hayden D. 251 PREVALENCE AND CHARACTERISTICS OF SWALLOWING/COMMUNICATION IMPAIRMENTS IN FRAIL OLDER ADULTS ATTENDING THE EMERGENCY DEPARTMENT: A RETROSPECTIVE COHORT STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
The presentation of frail older adults to the Emergency Department (ED) may be complicated by swallowing and/or communication impairment. Adults with communication impairment may experience difficulty accessing healthcare. Dysphagia is associated with frailty irrespective of age and/or number of chronic diseases [1]. This study aims to determine the prevalence and characteristics of swallowing and/or communication impairments among frail older adults attending the ED.
Methods
A retrospective cohort study of consecutive ED attendees aged ≥ 75 years assessed by an interdisciplinary Gerontological ED team between October 2021 – February 2022 was conducted. A swallow/communication screening tool determined requirement for Speech and Language Therapy (SLT) referral. Data related to demographics and SLT interventions was extracted. Data analysis was completed using STATA Version 12. Ethical approval was obtained.
Results
Among 518 patients, 118 (23%) (mean age 82.4 (+/-6.4) years, 54% male) required SLT assessment. These patients had high rates of frailty (Median CFS= 6 (IQR 5-7), suspected delirium (4AT ≥ 4 in 45%), suspected malnutrition (MNA score 0-11 in 75%), and probable sarcopenia (SARC-F= ≥ 4 in 75%). Therapy Outcome Measurement Scales and the Functional Oral Intake Scale were used in this first episode of SLT care. Oropharyngeal dysphagia was identified for 43% (27% mild, 10% moderate, 3% moderate-severe, 3% severe), with 6% presenting with signs/symptoms of oesophageal dysphagia. Changes in baseline communication was identified for 57%; cognitive communication difficulties (38%), dysarthria (11%), dysphonia (8%). SLT intervention and management approaches were initiated in the ED.
Conclusion
Findings indicate a high prevalence of swallowing/communication impairment in frail older adults attending the ED. Future research should explore SLT outcomes at point of discharge to refine these swallowing/communication presentations.
Reference
1. Bahat G et al. Association between dysphagia and frailty in community-dwelling older adults. The Journal of Nutrition, Health & Ageing. 2019:23, 571–577.
Collapse
Affiliation(s)
- O Boyle
- Tallaght University Hospital Department of Speech and Language Therapy, , Tallaght, Dublin 24, Ireland
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| | - L Kelly
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| | - C Whelan
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| | - E Murtagh
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| | - A O'Dwyer
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| | - M Ryan
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| | - F Hill
- Tallaght University Hospital Department of Speech and Language Therapy, , Tallaght, Dublin 24, Ireland
| | - A McCabe
- Tallaght University Hospital Department of Emergency Medicine, , Tallaght, Dublin 24, Ireland
| | - D Hayden
- Tallaght University Hospital Department of Age-Related Healthcare, , Tallaght, Dublin 24, Ireland
| |
Collapse
|
7
|
Woods C, Kelly L, Volf K, Gelius P, Messing S, Forberger S, Lakerveld J, den Braver N, Zukowska J. The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Insufficient physical activity (PA) is a global issue for health. A multifaceted response, including government action, is essential to improve population levels of PA. The purpose of this study was to develop the ‘Physical Activity Environment Policy Index’ (PA-EPI) monitoring framework to assess government policies and actions for creating a healthy PA environment.
Methods
An iterative process was undertaken. This involved a review of policy documents from authoritative organisations, a policy audit of four European countries, and systematic reviews of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops where quantitative and qualitative data alongside theoretical and pragmatic considerations were used to inform PA-EPI development.
Results
The PA-EPI is conceptualised as a two-component ‘policy’ and ‘infrastructure support’ framework. The two components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development, and health-in-all-policies. Forty-five ‘good practice statements’ (GPS) or indicators of ideal good practice within each domain concludes the PA-EPI. A potential eight-step process for conducting the PA-EPI is described.
Conclusions
Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI GPS will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.
Collapse
Affiliation(s)
- C Woods
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - L Kelly
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - K Volf
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen- Nürnberg , Erlangen, Germany
| | - S Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen- Nürnberg , Erlangen, Germany
| | - S Forberger
- Leibniz Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam , Amsterdam, Netherlands
- Upstream Team, VU University Amsterdam , Amsterdam, Netherlands
| | - N den Braver
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam , Amsterdam, Netherlands
- Upstream Team, VU University Amsterdam , Amsterdam, Netherlands
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Gdansk, Poland
| | | |
Collapse
|
8
|
Josephy P, Elder R, Allen-Vercoe E, Kelly L, Ryan A, Harvey J, Ackerley D, Keyzers R. S-32-02 Characterization and toxicology of azo dye metabolites. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Kelly L, Slungaard D. Delayed rehabilitation in non-freezing cold injury results in increased pain and reduced quality of life in military personnel. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.320] [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: 10/19/2022]
|
10
|
Browne S, Kelly L, Geraghty A, Reynolds C, McCallum K, McBean L, Clyne B, Bury G, Bradley C, McCullagh L, Finnigan K, Bardon L, Murrin C, Perrotta C, Gibney E, Kennelly S, Castro PD, Corish C. Healthcare professionals’ perceptions of malnutrition management and oral nutritional supplement prescription in the community: a qualitative study. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Upadhyay P, Narayanan S, Khera T, Kelly L, Mathur PA, Shanker A, Novack L, Sadhasivam S, Hoffman KA, Pérez-Robles R, Subramaniam B. Perceived stress, resilience, well-being, and COVID 19 response in Isha yoga practitioners compared to matched controls: A research protocol. Contemp Clin Trials Commun 2021; 22:100788. [PMID: 34056143 PMCID: PMC8139364 DOI: 10.1016/j.conctc.2021.100788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/26/2021] [Revised: 04/21/2021] [Accepted: 05/16/2021] [Indexed: 01/11/2023] Open
Abstract
Objectives The COVID-19 pandemic has been a significant stressor worldwide and reports of psychological distress, depression, sedentary lifestyles, and overall decreased wellbeing are increasing. Yoga practices have been found to improve mental and physical health. The purpose of this randomized controlled trial is to compare Isha yoga practitioners to controls on perceived stress, resilience, wellbeing, and protection and recovery from COVID-19. Trial Design. In this prospective randomized control trial, the effects of yoga practices are being compared between seasoned yoga practitioners with two controls who are age (±3 years), gender matched, and living in the same neighborhood. Methods Participants will be asked to complete a series of web-based surveys at baseline, six weeks, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess stress, mood states, resilience, and overall wellbeing. Questionnaires, weekly activity diaries, and medical history, will be collected using REDCap. Results We hypothesize that routine yoga practice during the COVID-19 pandemic will reduce stress, enhance well-being, and provide protective effects against COVID-19. Conclusion With the growing concern about the physical and mental impacts of COVID-19 and increased interest in alternative practices such as yogic practices, this study will contribute to the growing body of evidence about the safety and efficacy of yoga for emotional, mental, and physical health conditions.
Collapse
Affiliation(s)
- P Upadhyay
- Oregon Health & Science University, United States
| | - S Narayanan
- Oregon Health & Science University, United States
| | - T Khera
- Oregon Health & Science University, United States
| | - L Kelly
- Oregon Health & Science University, United States
| | - P A Mathur
- Oregon Health & Science University, United States
| | - A Shanker
- Oregon Health & Science University, United States
| | - L Novack
- Oregon Health & Science University, United States
| | - S Sadhasivam
- Oregon Health & Science University, United States
| | - K A Hoffman
- Oregon Health & Science University, United States
| | | | | |
Collapse
|
12
|
Walsh S, O'Mahony M, Lehane E, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin AM, Tabirca S, Corrigan MA, Hegarty J. Cancer and breast cancer awareness interventions in an intellectual disability context: A review of the literature. J Intellect Disabil 2021; 25:131-145. [PMID: 31104540 DOI: 10.1177/1744629519850999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Women with an intellectual disability (ID) have a similar risk of developing breast cancer as women in the general population yet present with later stage breast cancers, which have poorer outcomes. AIM To identify whether there is a need to develop a breast cancer awareness intervention for women with an ID. METHODS Interventions aimed at increasing cancer awareness and breast cancer awareness for people with an ID were identified and critically appraised. RESULTS Five interventions to increase cancer awareness or breast cancer awareness in people with an ID were identified. CONCLUSION The review highlighted the paucity of theoretically underpinned breast cancer awareness interventions specifically aimed at women with an ID. Facilitating breast cancer awareness for women with an ID could potentially lead to earlier presentation of potential symptoms of breast cancer, earlier treatment, better prognosis and ultimately, improved survival. This article establishes that there is a need for an intervention underpinned by theory to increase breast cancer awareness in women with an ID.
Collapse
Affiliation(s)
- S Walsh
- 8795University College Cork, Ireland
| | | | - E Lehane
- 8795University College Cork, Ireland
| | - D Farrell
- 8813Institute of Technology Tralee, Ireland
| | - L Taggart
- 2596Ulster University, Northern Ireland
| | - L Kelly
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - L Sahm
- 8795University College Cork, Ireland
| | - A Byrne
- 63976Cope Foundation, Ireland
| | - M Corrigan
- St. John of God Hospitaller Ministries, Ireland
| | - M Caples
- 8795University College Cork, Ireland
| | | | - S Tabirca
- 8795University College Cork, Ireland
| | - M A Corrigan
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - J Hegarty
- 8795University College Cork, Ireland
| |
Collapse
|
13
|
Kelly L, Bougouin A, Kebreab E. Maintenance energy requirement and efficiency of utilisation of metabolisable energy for milk production of Bos taurus × Bos indicus crossbred tropical dairy cows: a meta-analysis. Anim Prod Sci 2021. [DOI: 10.1071/an20470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ContextDairy consumption has the ability to provide nutrient dense food in low-income countries. However, cows in the tropics may not be able to reach their full potential due to poor nutrition. In tropical regions, milk is mostly produced by Bos taurus × Bos indicus crossbred cattle for which no nutrient requirement tables have been fully developed. Although many novel feeds and feed additives have been tested, nutrient requirements specifically targeting energy and protein for these livestock need to be estimated accurately for milk production to increase sustainably.
AimsTo determine the net energy for lactation (NEL) requirement for maintenance and efficiency of utilisation of metabolisable energy intake (MEI) for milk production (kL) of Bos taurus × Bos indicus crossbred dairy cows in the tropics.
MethodsA meta-analysis using 141 observations from 38 independent studies in tropical regions with crossbred dairy cows was conducted. The energy produced in milk corrected for zero energy balance (EL0) was regressed by MEI including other covariates. This meta-regression analysis was conducted by frequentist inference via optimisation in RStan.
Key resultsThe best-fit model contained only MEI as a covariate. This model predicted a net energy for lactation value at maintenance of 0.323 MJ/kg BW0.75.day (s.e. = 0.0004) with variations for each specific study. The efficiency with which MEI is used for milk production was estimated to be 0.554 (s.e. = 0.00008), which was common for all studies.
ConclusionThe key energy parameters estimated in this study should replace commonly used values derived from Bos taurus breeds when formulating diets for crossbred tropical cattle.
ImplicationsNutritional requirement tables need to be estimated specifically for Bos taurus × Bos indicus crossbred dairy cows as their requirements differ from Western breeds. Using appropriate nutritional requirements of crossbred cattle would lead to better nutrition and increased production as determined by their genetic merit.
Collapse
|
14
|
Cullinane C, Khawaja F, O’Leary D, Kelly L, O’Sullivan M, Corrigan M, Redmond H. Circulating tumour DNA as a prognostic biomarker in predicting breast cancer outcomes: Systematic review and meta-analysis. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30792-9] [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: 11/29/2022]
|
15
|
Volf K, Kelly L, García Bengoechea E, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Systematic review examining the evidence for impact of school policies on physical activity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Epidemiological evidence has demonstrated that physical activity can have substantive health benefits for children and young people. The 'Policy Evaluation Network' is a multi-disciplinary research network across 7 European countries and New Zealand aimed at building capacity and evaluating the level of impact of policy interventions for promoting healthy lifestyles. The Toronto Charter identified 'whole-of-school' programmes as one of seven key investments for promotion of PA. This paper presents results of a SLR, designed to assess the level of evidence for policies within the school setting that contribute directly or indirectly to increasing PA.
Methods
Researchers searched six online databases for scientific literature regarding PA policy interventions in the school setting using key concepts of policy, school, PA and evaluation. Risk of bias will be assessed with tools appropriate to the design of the studies considered. Evidence of actual or potential positive PA outcomes arising directly or indirectly from policy actions will be catalogued.
Results
Preliminary searches identified 2327 unique scientific articles. 1938 (83.3%) were excluded on first reading and 189 (8.8%) were included for full text analysis. Initial findings suggest that organisational policies, for example avoiding overcrowding in playgrounds during school breaks, may be a promising policy action. Detailed analysis revealing other potential policy actions supported by evidence will be presented (SLR in progress).
Conclusions
Preliminary findings suggest that few studies link policy actions in the school setting to PA outcomes. However, studies that have investigated the effects of changes to the school environment on PA levels may provide evidence for policy actions. Preliminary recommendations include strengthening the evidence base for school-based PA policy by supporting studies into the effects of particular policy or legislative changes on PA outcomes.
Key messages
School physical activity policies are an underappreciated public health intervention. More studies should link policy changes to physical activity outcomes.
Collapse
Affiliation(s)
- K Volf
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - L Kelly
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - E García Bengoechea
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - A Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - J Lakerveld
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - P Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - C Woods
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| |
Collapse
|
16
|
Forberger S, Gelius P, Messing S, Volf K, Kelly L, Taylor S, Zukowska J, Lakerveld J, Woods C. Sub-national structures matter when evaluating physical activity promotion: Lessons from Germany. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Public policies are increasingly acknowledged as important part of promoting physical activity (PA). However, especially in states with sub-national administrative structures such as Germany, national and sub-national approaches differ considerably. In Germany, sport for all (SfA) promotion is mostly organized at sub-national level, which is usually not covered in national evaluations. Knowledge of these structures helps to understand national outcomes, enables comparisons and learning within and between countries, and assists in identifying support structures for effective PA promotion.
Methods
Data were collected in the PEN Policy Evaluation Network project. In addition to the WHO HEPA PAT, a questionnaire was sent to the sports representatives of the 16 federal states. Responses of 11 state representatives were included and overarching issues were identified using inductive thematic analysis.
Results
PA promotion in Germany is organized in three areas: SfA, professional sports and school sports. SfA promotion at sub-national level is assigned to different administrative bodies (ministries, senate administration, state chancellery) and policy areas: culture, health and care, home affairs with various aspects, education, social affairs and family. The priorities of the federal states are more diverse and specific compared to the national level. There is an overlap in the topics: urban planning, cycling, health prevention and targeting children. Cooperation mechanisms and partners vary between federal states, but some partners are active at sub-national and national level.
Conclusions
The results provide an insight into the complexity of PA and especially SfA promotion at sub-national level in Germany. Our results suggest that a broader range of approaches is used in the 16 German states than national overviews would suggest. These particularities must be taken into account when assessing and comparing the results from different countries.
Key messages
The promotion of SfA at German sub-national level is much more diverse than represented at national level evaluations. Knowledge of sub-national structures enables the understanding of national outcomes, the promotion of cross-national learning and the identification of supportive structures for effective PA promotion.
Collapse
Affiliation(s)
- S Forberger
- BIPS, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - P Gelius
- FAU, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Messing
- FAU, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - K Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - L Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - S Taylor
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - J Lakerveld
- VUmc, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - C Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| |
Collapse
|
17
|
Gluncic V, Moric M, Chu Y, Hanko V, Li J, Lukić IK, Lukić A, Edassery SL, Kroin JS, Persons AL, Perry P, Kelly L, Shiveley TJ, Nice K, Napier TC, Kordower JH, Tuman KJ. Corrigendum to: In Utero Exposure to Anesthetics Alters Neuronal Migration Pattern in Developing Cerebral Cortex and Causes Postnatal Behavioral Deficits in Rats. Cereb Cortex 2020; 30:5190. [DOI: 10.1093/cercor/bhz234] [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] [Received: 07/27/2018] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 11/12/2022] Open
|
18
|
Cullinane CM, Creavin B, O'Connell EP, Kelly L, O'Sullivan MJ, Corrigan MA, Redmond HP. Risk of colorectal cancer associated with BRCA1 and/or BRCA2 mutation carriers: systematic review and meta-analysis. Br J Surg 2020; 107:951-959. [PMID: 32297664 DOI: 10.1002/bjs.11603] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Carriers of the BRCA1 and/or BRCA2 mutation incur a lifetime risk of up to 85 per cent for breast cancer, and between 20 and 40 per cent for ovarian cancer. Efforts to estimate the lifetime risk of developing colorectal cancer for BRCA mutation carriers have produced conflicting results. Consequently, there are no formal guidelines regarding the need for bowel screening for individuals with BRCA1 and/or BRCA2 mutations. This systematic review and meta-analysis determined the risk of colorectal cancer associated with BRCA carrier mutations. METHODS The primary outcome was incidence of colorectal cancer in BRCA mutation carriers. Secondary outcomes were the incidence in BRCA1 and BRCA2 carriers, Ashkenazi Jews, and age- and sex-matched cohorts. RESULTS Eleven studies were included in the review, with an overall population of 14 252 and 4831 colorectal cancers identified. Nine studies were included in the meta-analysis. There was no increase in colorectal cancer among patients carrying a BRCA mutation (odds ratio 1·03, 95 per cent c.i. 0·80 to 1·32; P = 0·82). After adjustment for Ashkenazi heritage, and age and sex estimates, there was no increased odds of developing colorectal cancer (with no heterogeneity, I2 = 0 per cent). CONCLUSION BRCA1 and/or BRCA2 mutation carriers are not at a higher risk of colorectal cancer.
Collapse
Affiliation(s)
- C M Cullinane
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - B Creavin
- Department of General Surgery, University Hospital Kerry, Tralee, Ireland
| | - E P O'Connell
- Department of General Surgery, University Hospital Kerry, Tralee, Ireland
| | - L Kelly
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - M J O'Sullivan
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - M A Corrigan
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - H P Redmond
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| |
Collapse
|
19
|
Silbernagel K, Jechorek R, Carver C, Barbour WM, Mrozinski P, Albert A, Andaloro B, Anderson G, Beacorn F, Brooks R, Carson M, Crossfield D, Eliasberg S, Farmer D, Frantzeskakis C, Gasses T, Gatesy T, Hall G, Hanson P, Heddaeus K, Hermann K, Hutchins J, Jenkins J, Johnson F, Johnson J, Kawalek M, Kelly L, Koschmann C, Lannon P, Lester D, Manner K, Martin J, Maselli M, McGovern B, Mohnke F, Moon B, Murray L, Pace R, Richards J, Robeson S, Rodgers D, Rosario G, Saunders C, Shaw C, Dana Shell J, Sloan E, Thompson S, Vialpando M, Voermans R, Watts K, Wieczorek K, Wilson K, Yeh H, Zamora D. Evaluation of the BAX® System for Detection of Salmonella in Selected Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.6.1149] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare the automated BAX® System to the standard cultural methods for detection of Salmonella in selected foods. Five food types—frankfurters, raw ground beef, mozzarella cheese, raw frozen tilapia fish, and orange juice—at 3 inoculation levels, were analyzed by each method. A sixth food type, raw ground chicken, was tested using 3 naturally contaminated lots. A total of 16 laboratories representing government and industry participated. In this study, 1386 samples were analyzed, of which 1188 were paired samples and 198 were unpaired samples. Of the 1188 paired samples, 461 were positive by both methods and 404 were negative by both methods. Thirty-seven samples were positive by the BAX System but negative by the standard reference method, and 11 samples were positive by standard cultural method and negative by the BAX System. Of the 198 unpaired samples, 106 were positive by the BAX System and 60 were positive by the standard cultural method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, the BAX System demonstrated results comparable to those of the standard reference methods based on the Chi square results.
Collapse
Affiliation(s)
| | | | - Charles Carver
- rtech laboratories, PO Box 64101, St. Paul, MN 55164-0101
| | - W Mark Barbour
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
| | - Peter Mrozinski
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Vimalesvaran K, Kelly L, Vazir A, Smith R. P5572Percutaneous edge-to-edge repair for the treatment of acute decompensated severe mitral regurgitation: a single-centre experience. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with acute, decompensated severe mitral regurgitation (MR) are poorly served by surgical or medical treatments and is associated with high mortality. Percutaneous edge-to-edge mitral valve repair (PMVR) with the MitraClip system is potentially a less-invasive life-saving procedure. While PMVR has demonstrated efficacy in stable patients with severe MR, there is limited evidence for its use in patients suffering from prolonged cardiogenic shock, recurrent or persistent pulmonary oedema, and haemodynamic instability.
Purpose
The aim of this study was to evaluate the effectiveness of emergency PMVR in haemodynamically unstable patients with decompensated MR who were unsuitable for surgical intervention.
Methods
We performed a retrospective review of all patients who underwent emergency PMVR from January 2015 to January 2019 in a single centre. Inclusion criteria were patients with acute decompensated severe MR and shock (defined at the time of procedure as dependence on one or more of: intravenous (IV) inotropes; afterload reduction for persistent pulmonary oedema; mechanical circulatory support; and invasive respiratory support). Outcome measures were pre- and post-procedural MR severity grade, mortality at six months, and incidence of further mitral valve intervention.
Results
Of 183 consecutive patients undergoing PMVR, 14 (8%) patients fulfilled the inclusion criteria. Median age was 70 (range 55–88, IQR 23), and 8 were female. At the time of admission, 7 (50%) were in cardiogenic shock and 7 were in persistent pulmonary oedema. MR was functional in 7 (50%) patients and degenerative in 7, of which 4 were secondary to acute papillary muscle rupture. All patients had Grade 4 MR at presentation and were considered too high-risk for surgery by the Heart Team. Median Euroscore II was 14.4 (8.1–54.6, IQR 9.1). Post-procedure, 13 patients (93%) of patients had Grade 3 MR or less. Eleven (79%) patients were successfully weaned from mechanical support and intravenous drugs. The remaining three patients died of persistent arrhythmia, stroke or heart failure within 4 weeks. At six-months, 9 out of 12 patients (75%) were alive and 2 were lost to follow-up. No patients underwent further mitral valve intervention.
Conclusions
This small case-series suggests that PMVR may be a feasible and life-saving procedure in patients presenting with acute, decompensated severe MR who were unsuitable for surgery. It was associated with reversal of cardiogenic shock and good short-term survival in the majority of patients. These patients are typically considered critically unwell with very high mortality. These promising results may inform larger, prospective studies to manage this otherwise under-served patient cohort.
Collapse
Affiliation(s)
- K Vimalesvaran
- Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - L Kelly
- Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - A Vazir
- Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - R Smith
- Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
21
|
Mawer D, Byrne F, Drake S, Brown C, Prescott A, Warne B, Bousfield R, Skittrall JP, Ramsay I, Somasunderam D, Bevan M, Coslett J, Rao J, Stanley P, Kennedy A, Dobson R, Long S, Obisanya T, Esmailji T, Petridou C, Saeed K, Brechany K, Davis-Blue K, O'Horan H, Wake B, Martin J, Featherstone J, Hall C, Allen J, Johnson G, Hornigold C, Amir N, Henderson K, McClements C, Liew I, Deshpande A, Vink E, Trigg D, Guilfoyle J, Scarborough M, Scarborough C, Wong THN, Walker T, Fawcett N, Morris G, Tomlin K, Grix C, O'Cofaigh E, McCaffrey D, Cooper M, Corbett K, French K, Harper S, Hayward C, Reid M, Whatley V, Winfield J, Hoque S, Kelly L, King I, Bradley A, McCullagh B, Hibberd C, Merron M, McCabe C, Horridge S, Taylor J, Koo S, Elsanousi F, Saunders R, Lim F, Bond A, Stone S, Milligan ID, Mack DJF, Nagar A, West RM, Wilcox MH, Kirby A, Sandoe JAT. Cross-sectional study of the prevalence, causes and management of hospital-onset diarrhoea. J Hosp Infect 2019; 103:200-209. [PMID: 31077777 DOI: 10.1016/j.jhin.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 05/01/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The National Health Service in England advises hospitals collect data on hospital-onset diarrhoea (HOD). Contemporaneous data on HOD are lacking. AIM To investigate prevalence, aetiology and management of HOD on medical, surgical and elderly-care wards. METHODS A cross-sectional study in a volunteer sample of UK hospitals, which collected data on one winter and one summer day in 2016. Patients admitted ≥72 h were screened for HOD (definition: ≥2 episodes of Bristol Stool Type 5-7 the day before the study, with diarrhoea onset >48 h after admission). Data on HOD aetiology and management were collected prospectively. FINDINGS Data were collected on 141 wards in 32 hospitals (16 acute, 16 teaching). Point-prevalence of HOD was 4.5% (230/5142 patients; 95% confidence interval (CI) 3.9-5.0%). Teaching hospital HOD prevalence (5.9%, 95% CI 5.1-6.9%) was twice that of acute hospitals (2.8%, 95% CI 2.1-3.5%; odds ratio 2.2, 95% CI 1.7-3.0). At least one potential cause was identified in 222/230 patients (97%): 107 (47%) had a relevant underlying condition, 125 (54%) were taking antimicrobials, and 195 (85%) other medication known to cause diarrhoea. Nine of 75 tested patients were Clostridium difficile toxin positive (4%). Eighty (35%) patients had a documented medical assessment of diarrhoea. Documentation of HOD in medical notes correlated with testing for C. difficile (78% of those tested vs 38% not tested, P<0.001). One-hundred and forty-four (63%) patients were not isolated following diarrhoea onset. CONCLUSION HOD is a prevalent symptom affecting thousands of patients across the UK health system each day. Most patients had multiple potential causes of HOD, mainly iatrogenic, but only a third had medical assessment. Most were not tested for C. difficile and were not isolated.
Collapse
Affiliation(s)
- D Mawer
- Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK.
| | - F Byrne
- Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - S Drake
- Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - C Brown
- Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - A Prescott
- Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - B Warne
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - R Bousfield
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - J P Skittrall
- Royal Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE, UK
| | - I Ramsay
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - D Somasunderam
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - M Bevan
- Department of Infection Prevention, Royal Gwent Hospital, Newport, NP20 2UB, UK
| | - J Coslett
- Department of Infection Prevention, Royal Gwent Hospital, Newport, NP20 2UB, UK
| | - J Rao
- Department of Microbiology, Barnsley Hospital NHS Foundation Trust, Barnsley, S75 2EP, UK
| | - P Stanley
- Infection Prevention and Control, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - A Kennedy
- Infection Prevention and Control, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - R Dobson
- Infection Prevention and Control, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - S Long
- Department of Microbiology, East Lancashire Hospitals NHS Trust, Blackburn, BB2 3HH, UK
| | - T Obisanya
- Department of Microbiology, East Lancashire Hospitals NHS Trust, Blackburn, BB2 3HH, UK
| | - T Esmailji
- Department of Microbiology, East Lancashire Hospitals NHS Trust, Blackburn, BB2 3HH, UK
| | - C Petridou
- Department of Microbiology, Hampshire Hospitals NHS Foundation Trust, Winchester, SO22 5DG, UK
| | - K Saeed
- Department of Microbiology, Hampshire Hospitals NHS Foundation Trust, Winchester, SO22 5DG, UK
| | - K Brechany
- Department of Microbiology, Hampshire Hospitals NHS Foundation Trust, Winchester, SO22 5DG, UK
| | - K Davis-Blue
- Department of Microbiology, Hampshire Hospitals NHS Foundation Trust, Winchester, SO22 5DG, UK
| | - H O'Horan
- Department of Microbiology, Hampshire Hospitals NHS Foundation Trust, Winchester, SO22 5DG, UK
| | - B Wake
- Department of Microbiology, Hampshire Hospitals NHS Foundation Trust, Winchester, SO22 5DG, UK
| | - J Martin
- Department of Microbiology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - J Featherstone
- Department of Microbiology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - C Hall
- Department of Infectious Diseases, Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
| | - J Allen
- Department of Infectious Diseases, Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
| | - G Johnson
- Department of Infectious Diseases, Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
| | - C Hornigold
- Department of Infectious Diseases, Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
| | - N Amir
- Department of Microbiology, Mid Yorkshire Hospitals NHS Trust, Wakefield, WF1 4DG, UK
| | - K Henderson
- Inverclyde Royal Hospital, Greenock, PA16 0XN, UK
| | - C McClements
- Inverclyde Royal Hospital, Greenock, PA16 0XN, UK
| | - I Liew
- Inverclyde Royal Hospital, Greenock, PA16 0XN, UK
| | - A Deshpande
- Department of Microbiology, Inverclyde Royal Hospital, Greenock, PA16 0XN, UK
| | - E Vink
- Department of Microbiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK
| | - D Trigg
- Department of Infection Prevention & Control, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - J Guilfoyle
- Department of Infection Prevention & Control, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - M Scarborough
- Department of Infectious Diseases, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK
| | - C Scarborough
- Nuffield Department of Medicine, University of Oxford, OX3 7FZ, UK
| | - T H N Wong
- Department of Infectious Diseases, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK
| | - T Walker
- Department of Infectious Diseases, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK
| | - N Fawcett
- Department of Medicine, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK
| | - G Morris
- Department of Microbiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, UK
| | - K Tomlin
- Department of Infection Prevention & Control, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, UK
| | - C Grix
- Department of Infection Prevention & Control, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, UK
| | - E O'Cofaigh
- Department of Medicine, Friarage Hospital, South Tees Hospital NHS Foundation Trust, Northallerton, DL6 1JG, UK
| | - D McCaffrey
- Department of Infection Prevention & Control, James Cook University Hospital, South Tees Hospital NHS Foundation Trust, Middlesborough, TS4 3BW, UK
| | - M Cooper
- Department of Microbiology, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - K Corbett
- Department of Infection Prevention & Control, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - K French
- Department of Microbiology, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - S Harper
- Department of Infection Prevention & Control, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - C Hayward
- Department of Infection Prevention & Control, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - M Reid
- Department of Infection Prevention & Control, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - V Whatley
- Corporate Support Services, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - J Winfield
- Department of Infection Prevention & Control, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - S Hoque
- Department of Microbiology, Torbay and South Devon Healthcare NHS Foundation Trust, Torquay, TQ2 7AA, UK
| | - L Kelly
- Department of Infection Prevention & Control, Torbay and South Devon Healthcare NHS Foundation Trust, Torquay, TQ2 7AA, UK
| | - I King
- Department of Infection Prevention & Control, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, BT16 1RH, UK
| | - A Bradley
- Department of Infection Prevention & Control, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, BT16 1RH, UK
| | - B McCullagh
- Pharmacy Department, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, BT16 1RH, UK
| | - C Hibberd
- Pharmacy Department, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, BT16 1RH, UK
| | - M Merron
- Department of Infection Prevention & Control, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, BT16 1RH, UK
| | - C McCabe
- Department of Infection Prevention & Control, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, BT16 1RH, UK
| | - S Horridge
- Department of Microbiology, University Hospital Coventry, University Hospitals of Coventry and Warwickshire, Warwick, CV2 2DX, UK
| | - J Taylor
- Department of Virology and Molecular Pathology, University Hospital Coventry, University Hospitals of Coventry and Warwickshire, Warwick, CV2 2DX, UK
| | - S Koo
- Department of Microbiology, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - F Elsanousi
- Department of Microbiology, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - R Saunders
- Department of Microbiology, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - F Lim
- Department of Microbiology, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - A Bond
- Department of Microbiology, York Teaching Hospital NHS Foundation Trust, York, YO31 8HE, UK
| | - S Stone
- Royal Free Campus, University College Medical School, London, NW3 2QG, UK
| | - I D Milligan
- Department of Microbiology, Royal Free Hospital, University College London Hospitals NHS Foundation Trust, London, NW3 2QG, UK
| | - D J F Mack
- Department of Microbiology, Royal Free Hospital, University College London Hospitals NHS Foundation Trust, London, NW3 2QG, UK
| | - A Nagar
- Department of Microbiology, Antrim Area Hospital, Northern Health and Social Care Trust, Bush Road, Antrim, BT41 2RL, UK
| | - R M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - M H Wilcox
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - A Kirby
- Leeds Institute of Medical Research, University of Leeds, Leeds, LS2 9JT, UK
| | - J A T Sandoe
- Leeds Institute of Medical Research, University of Leeds, Leeds, LS2 9JT, UK
| |
Collapse
|
22
|
Wali GN, Gibbons E, Kelly L, Reed JR, Matin RN. Use of the Skin Cancer Quality of Life Impact Tool (SCQOLIT) - a feasibility study in non-melanoma skin cancer. J Eur Acad Dermatol Venereol 2019; 34:491-501. [PMID: 31419362 DOI: 10.1111/jdv.15887] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 07/08/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Incidence of non-melanoma skin cancers (NMSCs) is increasing and can significantly impact on quality of life (QOL), yet there are few studies evaluating patient-reported outcome measures (PROMs) in NMSC populations. We undertook a prospective feasibility study to evaluate a skin cancer-specific PROM, the Skin Cancer Quality of Life Impact Tool (SCQOLIT), in patients with a new diagnosis of NMSC. OBJECTIVES (i) To establish acceptability of SCQOLIT in dermatology clinics, (ii) a descriptive analysis of SCQOLIT scores in NMSC. METHODS Patients with histologically confirmed NMSC completed SCQOLIT, EQ-5D and a transition item. Questionnaires were completed at baseline and 3 months for group 1 ('low-risk' NMSC) and group 2 ('high-risk' NMSC) with additional questionnaires at 6-9 months for group 2. Patients participated in structured interviews. Clinician experience was captured through staff evaluation forms and a focus group. Acceptability and psychometric properties of SCQOLIT were assessed. RESULTS Overall, 318 patients consented to participate. Mean SCQOLIT score at baseline was 5.33, with 2.6% of patients scoring ≥20. No ceiling effects were observed, whilst 13.9% scored 0. Validity was demonstrated against EQ-5D. Cronbach's alpha 0.84 demonstrated internal consistency. Thirteen patients were interviewed and thought SCQOLIT was comprehensive, captured impact on health-related QOL and helped express their needs to clinicians. Most clinicians found SCQOLIT 'very useful' or 'useful to some extent' in facilitating discussions. CONCLUSIONS This feasibility study demonstrates that SCQOLIT is acceptable to patients and staff in dermatology skin cancer clinics. The psychometric properties of SCQOLIT confirm its utility in NMSC populations.
Collapse
Affiliation(s)
- G N Wali
- Dermatology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - E Gibbons
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - L Kelly
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - J R Reed
- Dermatology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R N Matin
- Dermatology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
23
|
Horigan V, Gale P, Adkin A, Brown I, Clark J, Kelly L. A qualitative risk assessment of cleansing and disinfection requirements after an avian influenza outbreak in commercial poultry. Br Poult Sci 2019; 60:691-699. [PMID: 31474117 DOI: 10.1080/00071668.2019.1655707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
1. During an avian influenza (AI) outbreak in the United Kingdom, the joint aim of the poultry industry and the Government is to eliminate and prevent the spread of infection, through control measures based on the current European Union (EU) Council Directive (2005/94/EC). An essential part of these measures is the cleansing and disinfection (C&D) of infected premises.2. This risk assessment assessed the differences in re-infection in a repopulated flock if the EU Directive is interpreted to permit secondary C&D to be undertaken either with or without dismantling complex equipment. The assessment estimated the probability of virus survival on different types of equipment in a depopulated contaminated poultry house before and after preliminary and secondary C&D procedures. A risk matrix spreadsheet tool was used to carry out the assessment and concluded that, provided secondary C&D is carried out with due diligence (i.e. carried out to a defined code of practice as agreed by both industry and policymakers), the risk of re-infection from equipment is negligible, both with and without dismantling complex equipment in all farm types considered.3. By considering the equipment types individually, the assessment identified those areas of the house which may still contain viable virus post-preliminary C&D and on which attention should be focussed during secondary C&D. The generic risk pathway and matrix spreadsheet tool have the potential to be used for other pathogens and species, given appropriate data.
Collapse
Affiliation(s)
- V Horigan
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK
| | - P Gale
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK
| | - A Adkin
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK
| | - I Brown
- Department of Virology, Animal and Plant Health Agency, Surrey, UK
| | - J Clark
- Department of Virology, Animal and Plant Health Agency, Surrey, UK
| | - L Kelly
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK.,Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| |
Collapse
|
24
|
Gluncic V, Moric M, Chu Y, Hanko V, Li J, Lukić IK, Lukić A, Edassery SL, Kroin JS, Persons AL, Perry P, Kelly L, Shiveley TJ, Nice K, Napier CT, Kordower JH, Tuman KJ. In utero Exposure to Anesthetics Alters Neuronal Migration Pattern in Developing Cerebral Cortex and Causes Postnatal Behavioral Deficits in Rats. Cereb Cortex 2019; 29:5285-5301. [DOI: 10.1093/cercor/bhz065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Abstract
During fetal development, cerebral cortical neurons are generated in the proliferative zone along the ventricles and then migrate to their final positions. To examine the impact of in utero exposure to anesthetics on neuronal migration, we injected pregnant rats with bromodeoxyuridine to label fetal neurons generated at embryonic Day (E) 17 and then randomized these rats to 9 different groups receiving 3 different means of anesthesia (oxygen/control, propofol, isoflurane) for 3 exposure durations (20, 50, 120 min). Histological analysis of brains from 54 pups revealed that significant number of neurons in anesthetized animals failed to acquire their correct cortical position and remained dispersed within inappropriate cortical layers and/or adjacent white matter. Behavioral testing of 86 littermates pointed to abnormalities that correspond to the aberrations in the brain areas that are specifically developing during the E17. In the second set of experiments, fetal brains exposed to isoflurane at E16 had diminished expression of the reelin and glutamic acid decarboxylase 67, proteins critical for neuronal migration. Together, these results call for cautious use of anesthetics during the neuronal migration period in pregnancy and more comprehensive investigation of neurodevelopmental consequences for the fetus and possible consequences later in life.
Collapse
Affiliation(s)
- V Gluncic
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago IL, USA
| | - M Moric
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - Y Chu
- Department of Neurological Sciences, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - V Hanko
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - J Li
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - I K Lukić
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - A Lukić
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - S L Edassery
- Department of Pharmacology, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - J S Kroin
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - A L Persons
- Department of Pharmacology, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
- The Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL, USA
| | - P Perry
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - L Kelly
- Department of Neurological Sciences, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - T J Shiveley
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - K Nice
- Department of Neurological Sciences, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - C T Napier
- Department of Pharmacology, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
- The Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - J H Kordower
- Department of Neurological Sciences, Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - K J Tuman
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
25
|
Dynes MM, Bernstein E, Morof D, Kelly L, Ruiz A, Mongo W, Chaote P, Bujari RN, Serbanescu F. Client and provider factors associated with integration of family planning services among maternal and reproductive health clients in Kigoma Region, Tanzania: a cross-sectional study, April-July 2016. Reprod Health 2018; 15:152. [PMID: 30208913 PMCID: PMC6134585 DOI: 10.1186/s12978-018-0593-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 04/15/2018] [Accepted: 08/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integration of family planning (FP) services into non-FP care visits is an essential strategy for reducing maternal and neonatal mortality through reduction of short birth intervals and unplanned pregnancies. METHODS Cross-sectional surveys were conducted across 61 facilities in Kigoma Region, Tanzania, April-July 2016. Multilevel, mixed effects logistic regression analyses were conducted on matched data from providers (n = 330) and clients seeking delivery (n = 935), well-baby (n = 272), pregnancy loss (PL; n = 229), and other routine (postnatal, HIV/STI, other; n = 69) services. Outcomes of interest included receipt of FP information and a modern FP method (significance level p < 0.05). RESULTS Clients had significantly greater odds of receiving FP information if the primary reason for seeking care was for PL versus (vs) any other types of care (aOR 1.97), had four or more pregnancies vs fewer (aOR 1.78), and had had a FP discussion with their partner vs no FP discussion (aOR 1.73). Clients had lower odds of receiving FP information if they were aged 40-49 vs 15-19 (aOR 0.50) and reported attending religious services at least weekly vs less frequently (aOR 0.61). Clients of providers who perceived that in-service training had helped vs had not helped job performance (aOR 2.27), and clients of providers having high vs low recent FP training index scores (aOR 1.58) had greater odds of receiving FP information. Clients had greater odds of receiving a modern method when they received information on two or more vs fewer methods (aOR 7.13), had had a FP discussion with their partner vs no discussion (aOR 5.87), if the primary reason for seeking care was for PL vs any other types of care (aOR 4.08), had zero vs one or more live births (aOR 3.92), made their own FP decisions vs not made own FP decisions (aOR 3.17), received FP information from two or more vs fewer sources (aOR 3.12), and were in the middle or high vs the low wealth tercile (aOR 1.99 and 2.30, respectively). Well-baby care clients, Other routine services clients, and married clients had significantly lower odds of receiving a method (aOR 0.14; aOR 0.08; and aOR 0.41, respectively) compared to their counterparts. CONCLUSIONS Strategies that better integrate FP into routine care visits, encourage women to have FP discussions with their partners and providers, increase FP training among providers, and expand FP options and sources of information may help reduce the unmet need for FP, and ultimately lower maternal and neonatal mortality.
Collapse
Affiliation(s)
- M M Dynes
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, USA.
| | - E Bernstein
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, USA
| | - D Morof
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, USA
| | - L Kelly
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, USA
| | - A Ruiz
- Centers for Disease Control and Prevention, Division of Reproductive Health (CDCF Contractor), Atlanta, USA
| | - W Mongo
- EngenderHealth, Washington, DC, USA
| | - P Chaote
- Regional Medical Officer, Kigoma, Kigoma Region, Tanzania
| | - R N Bujari
- AMCA Inter Consult, Dar es Salaam, Tanzania
| | - F Serbanescu
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, USA
| |
Collapse
|
26
|
Gibbons J, Jordan B, McLymont V, Kelly L, Symonette D, Stella C, Li V, Anselmo C. Where can I go from here? Implementation of a Clinical Career Ladder. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Rajakulasingam R, Jayaratne N, Zuhair M, Cantor E, Halim K, Kelly L, Conway M, Seraphim A, Rahman Haley S, Meier P, Di Mario C, Smith R, Vazir A. P6035Prognostic importance of intraprocedural transmitral mean pressure gradient during mitraclip implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - N Jayaratne
- Harefield Hospital, Cardiology, London, United Kingdom
| | - M Zuhair
- Royal Brompton Hospital, London, United Kingdom
| | - E Cantor
- Harefield Hospital, Cardiology, London, United Kingdom
| | - K Halim
- Harefield Hospital, Cardiology, London, United Kingdom
| | - L Kelly
- Royal Brompton Hospital, London, United Kingdom
| | - M Conway
- Royal Brompton Hospital, London, United Kingdom
| | - A Seraphim
- Royal Brompton Hospital, London, United Kingdom
| | | | - P Meier
- Royal Brompton Hospital, London, United Kingdom
| | - C Di Mario
- Royal Brompton Hospital, London, United Kingdom
| | - R Smith
- Royal Brompton Hospital, London, United Kingdom
| | - A Vazir
- Royal Brompton Hospital, London, United Kingdom
| | | |
Collapse
|
28
|
Walravens A, Peck K, Smolgovsky S, Kelly L, Benhaghnazar R, Marban L, de Couto G, Rodriguez-Borlado L. Extracellular vesicles from cardiosphere-derived cells and from mesenchymal stem cells show different immunomodulatory capabilities and distinct RNA Cargo. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.057] [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: 10/17/2022]
|
29
|
Walsh S, Lehane E, Hegarty J, O’mahony M, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin A, Tabirca S, Corrigan M. Breast awareness amongst women with a mild/moderate intellectual disability: Linking theory to practice. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
30
|
Dynes MM, Twentyman E, Kelly L, Maro G, Msuya AA, Dominico S, Chaote P, Rusibamayila R, Serbanescu F. Patient and provider determinants for receipt of three dimensions of respectful maternity care in Kigoma Region, Tanzania-April-July, 2016. Reprod Health 2018; 15:41. [PMID: 29506559 PMCID: PMC5838967 DOI: 10.1186/s12978-018-0486-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of respectful maternity care (RMC) is increasingly recognized as a human rights issue and a key deterrent to women seeking facility-based deliveries. Ensuring facility-based RMC is essential for improving maternal and neonatal health, especially in sub-Saharan African countries where mortality and non-skilled delivery care remain high. Few studies have attempted to quantitatively identify patient and delivery factors associated with RMC, and none has modeled the influence of provider characteristics on RMC. This study aims to help fill these gaps through collection and analysis of interviews linked between clients and providers, allowing for description of both patient and provider characteristics and their association with receipt of RMC. METHODS We conducted cross-sectional surveys across 61 facilities in Kigoma Region, Tanzania, from April to July 2016. Measures of RMC were developed using 21-items in a Principal Components Analysis (PCA). We conducted multilevel, mixed effects generalized linear regression analyses on matched data from 249 providers and 935 post-delivery clients. The outcomes of interest included three dimensions of RMC-Friendliness/Comfort/Attention; Information/Consent; and Non-abuse/Kindness-developed from the first three components of PCA. Significance level was set at p < 0.05. RESULTS Significant client-level determinants for perceived Friendliness/Comfort/Attention RMC included age (30-39 versus 15-19 years: Coefficient [Coef] 0.63; 40-49 versus 15-19 years: Coef 0.79) and self-reported complications (reported complications versus did not: Coef - 0.41). Significant provider-level determinants included perception of fair pay (Perceives fair pay versus unfair pay: Coef 0.46), cadre (Nurses/midwives versus Clinicians: Coef - 0.46), and number of deliveries in the last month (11-20 versus < 11 deliveries: Coef - 0.35). Significant client-level determinants for Information/Consent RMC included labor companionship (Companion versus none: Coef 0.37) and religiosity (Attends services at least weekly versus less often: Coef - 0.31). Significant provider-level determinants included perception of fair pay (Perceives fair pay versus unfair: Coef 0.37), weekly work hours (Coef 0.01), and age (30-39 versus 20-29 years: Coef - 0.34; 40-49 versus 20-29 years: Coef - 0.58). Significant provider-level determinants for Non-abuse/Kindness RMC included the predictors of age (age 50+ versus 20-29 years: Coef 0.34) and access to electronic mentoring (Access to two mentoring types versus none: Coef 0.37). CONCLUSIONS These findings illustrate the value of including both client and provider information in the analysis of RMC. Strategies that address provider-level determinants of RMC (such as equitable pay, work environment, access to mentoring platforms) may improve RMC and subsequently address uptake of facility delivery.
Collapse
Affiliation(s)
- M. M. Dynes
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia
| | - E. Twentyman
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia
| | - L. Kelly
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia
| | - G. Maro
- Bloomberg Philanthropies Tanzania, Kigoma, Tanzania
| | | | | | - P. Chaote
- Kigoma Region Ministry of Health, Kigoma, Tanzania
| | - R. Rusibamayila
- Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania
| | - F. Serbanescu
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia
| |
Collapse
|
31
|
Wilcock M, Kelly L, Hill A. Letter to the editor: Hospitalization Drug Regimen Changes in Geriatric Patients and Adherence to Modifications by General Practioners in Primary Care. J Nutr Health Aging 2018; 22:1021. [PMID: 30272110 DOI: 10.1007/s12603-018-1040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Wilcock
- M. Wilcock, Royal Cornwall Hospital, United Kingdom,
| | | | | |
Collapse
|
32
|
Richardson N, Carroll P, Harrison M, Donohoe A, Keohane A, Robertson S, Kelly L. An investigation of a community based physical activity intervention for adult men, ‘Men on the Move’. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Richardson
- The National Centre for Men’s Health, Institute of Technology Carlow, Carlow, Ireland
| | - P Carroll
- Department of Health Sport and Exercise Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - M Harrison
- Department of Health Sport and Exercise Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - A Donohoe
- Department of Health Sport and Exercise Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - A Keohane
- Department of Health Sport and Exercise Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - S Robertson
- School of Health & Wellbeing, Leeds Beckett University, Leeds, UK
| | - L Kelly
- The National Centre for Men’s Health, Institute of Technology Carlow, Carlow, Ireland
| |
Collapse
|
33
|
Laux DW, Kelly L, Bravo IR, Ramezani T, Feng Y. Live imaging the earliest host innate immune response to preneoplastic cells using a zebrafish inducible KalTA4-ER T2/UAS system. Methods Cell Biol 2016; 138:137-150. [PMID: 28129841 DOI: 10.1016/bs.mcb.2016.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
As cancers develop, transformed cells hijack various host mechanisms and manipulate them to create a dynamic tumor microenvironment, which supports tumor growth. This protumorigenic microenvironment is made up of many different cell types, including transformed cells, fibroblasts, inflammatory cells, and endothelial cells, the interactions of which have been shown to play a role in sustaining tumor growth. Multiple reports implicate the inflammatory cells of the tumor microenvironment as having both pro- and antitumorigenic roles, the balance of which is vital for the progression of the tumor, and while our understanding of established cancers has vastly increased since the turn of the 21st Century, our knowledge of these cellular interactions at the earliest stages of cancer initiation and development remains relatively limited. This is largely due to difficulties in monitoring these processes in vivo and in real time. Since the late nineties, the zebrafish (Danio rerio) has emerged as a vital model organism, allowing studies of previously unattainable stages of tumor initiation in a vertebrate model system. Using genetic and live-imaging approaches, this model system can be used both independently to monitor stages of tumor progression from the earliest initiation stages and incorporated into previously established systems to investigate the interactions between cancer cells and the various cell types of the tumor microenvironment, including inflammatory cells. Here, we describe the use of an inducible KalTA4-ERT2/UAS expression system in zebrafish, which allows spatial and temporal control of preneoplastic cell (PNC) growth and monitoring of innate immune cells in response to the developing PNC microenvironment.
Collapse
Affiliation(s)
- D W Laux
- University of Edinburgh, Edinburgh, United Kingdom
| | - L Kelly
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - T Ramezani
- University of Edinburgh, Edinburgh, United Kingdom
| | - Y Feng
- University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
34
|
Abstract
This paper introduces a new estimation technique for discretely observed diffusion processes. Transform functions are applied to transform the data to obtain good and easily calculated estimators of both the drift and diffusion coefficients. Consistency and asymptotic normality of the resulting estimators is investigated. Power transforms are used to estimate the parameters of affine diffusions, for which explicit estimators are obtained.
Collapse
|
35
|
O'Brien C, Kelly J, Lehane EA, Livingstone V, Cotter B, Butt A, Kelly L, Corrigan MA. Validation and Assessment of a Technology Familiarity Score in Patients Attending a Symptomatic Breast Clinic. World J Surg 2016; 39:2441-9. [PMID: 26178658 DOI: 10.1007/s00268-015-3134-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION New media technologies (computers, mobile phones and the internet) have the potential to transform the healthcare information needs of patients with breast disease (Ferlay et al. in Eur J Cancer 49:1374-1403, 2013). However, patients' current level of use and their willingness to accept new media for education and communication remain unknown. METHODS This was a single-centre clinic-based prospective cross-sectional study. A previously developed instrument was modified, validated and tested on patients attending a symptomatic breast clinic. RESULTS The instrument was evaluated on 200 symptomatic breast patients. The commonest outlets for education were staff (95 %), leaflets (69 %) and websites (59 %). Websites are more likely to be consulted by younger patients (<47 years), and patients who were working, students or homemakers (p < 0.05). Patients rated usefulness of information media in this order: (1) print, (2) phone, (3) website, (4) email, (5) text and (6) apps. Patients who were new to the clinic were more likely to find text messaging and emailing useful (n < 0.05). Younger patients (<47 years) are more likely to find text messages, apps, websites and email useful (p < 0.05). Urban patients are more likely to find websites and email useful (p < 0.05). Patients with higher education were more likely to favour apps, websites and email (p < 0.05). Smartphone owners were significantly more likely to rate text messaging, apps, websites and email as useful media (p < 0.05). CONCLUSION This study demonstrates that new media technology use among breast patients is expanding as expected along generational trends. As such its' further integration into healthcare systems can potentially ameliorate patient education and communication.
Collapse
Affiliation(s)
- C O'Brien
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Simons RRL, Hill AA, Swart A, Kelly L, Snary EL. A Transport and Lairage Model for Salmonella Transmission Between Pigs Applicable to EU Member States. Risk Anal 2016; 36:482-497. [PMID: 25965672 DOI: 10.1111/risa.12390] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A model for the transmission of Salmonella between finisher pigs during transport to the abattoir and subsequent lairage has been developed, including novel factors such as environmental contamination and the effect of stress, and is designed to be adaptable for any EU Member State (MS). The model forms part of a generic farm-to-consumption model for Salmonella in pigs, designed to model potentially important risk factors and assess the effectiveness of interventions. In this article, we discuss the parameterization of the model for two case study MSs. For both MSs, the model predicted an increase in the average MS-level prevalence of Salmonella-positive pigs during both transport and lairage, accounting for a large amount of the variation between reported on-farm prevalence and reported lymph-node prevalence at the slaughterhouse. Sensitivity analysis suggested that stress is the most important factor during transport, while a number of factors, including environmental contamination and the dose-response parameters, are important during lairage. There was wide variation in the model-predicted change in prevalence in individual batches; while the majority of batches (80-90%) had no increase, in some batches the increase in prevalence was over 70% and in some cases infection was introduced into previously uninfected batches of pigs. Thus, the model suggests that while the transport and lairage stages of the farm-to-consumption exposure pathway are unlikely to be responsible for a large increase in average prevalence at the MS level, they can have a large effect on prevalence at an individual-batch level.
Collapse
Affiliation(s)
- R R L Simons
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Addlestone, Surrey, KT15 3NB, UK
| | - A A Hill
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Addlestone, Surrey, KT15 3NB, UK
| | - A Swart
- RIVM - Centre for Infectious Disease Control, P.O. Box 1, 3720, BA, Bilthoven, The Netherlands
| | - L Kelly
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Addlestone, Surrey, KT15 3NB, UK
| | - E L Snary
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Addlestone, Surrey, KT15 3NB, UK
| |
Collapse
|
37
|
Davies A, Popplewell M, Kelly L, Bate G, Darvall K, Bradbury A. Impact of UK National Institute of Health and Care Excellent (NICE) Clinical Guidelines (CG 168) on the Referral and Management of Leg Ulcers. J Vasc Surg Venous Lymphat Disord 2016. [DOI: 10.1016/j.jvsv.2015.10.028] [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: 10/22/2022]
|
38
|
Adkin A, Brouwer A, Downs SH, Kelly L. Assessing the impact of a cattle risk-based trading scheme on the movement of bovine tuberculosis infected animals in England and Wales. Prev Vet Med 2015; 123:23-31. [PMID: 26687761 DOI: 10.1016/j.prevetmed.2015.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 11/18/2015] [Accepted: 11/30/2015] [Indexed: 11/25/2022]
Abstract
The adoption of bovine tuberculosis (bTB) risk-based trading (RBT) schemes has the potential to reduce the risk of bTB spread. However, any scheme will have cost implications that need to be balanced against its likely success in reducing bTB. This paper describes the first stochastic quantitative model assessing the impact of the implementation of a cattle risk-based trading scheme to inform policy makers and contribute to cost-benefit analyses. A risk assessment for England and Wales was developed to estimate the number of infected cattle traded using historic movement data recorded between July 2010 and June 2011. Three scenarios were implemented: cattle traded with no RBT scheme in place, voluntary provision of the score and a compulsory, statutory scheme applying a bTB risk score to each farm. For each scenario, changes in trade were estimated due to provision of the risk score to potential purchasers. An estimated mean of 3981 bTB infected animals were sold to purchasers with no RBT scheme in place in one year, with 90% confidence the true value was between 2775 and 5288. This result is dependent on the estimated between herd prevalence used in the risk assessment which is uncertain. With the voluntary provision of the risk score by farmers, on average, 17% of movements was affected (purchaser did not wish to buy once the risk score was available), with a reduction of 23% in infected animals being purchased initially. The compulsory provision of the risk score in a statutory scheme resulted in an estimated mean change to 26% of movements, with a reduction of 37% in infected animals being purchased initially, increasing to a 53% reduction in infected movements from higher risk sellers (score 4 and 5). The estimated mean reduction in infected animals being purchased could be improved to 45% given a 10% reduction in risky purchase behaviour by farmers which may be achieved through education programmes, or to an estimated mean of 49% if a rule was implemented preventing farmers from the purchase of animals of higher risk than their own herd. Given voluntary trials currently taking place of a trading scheme, recommendations for future work include the monitoring of initial uptake and changes in the purchase patterns of farmers. Such data could be used to update the risk assessment to reduce uncertainty associated with model estimates.
Collapse
Affiliation(s)
- A Adkin
- Department for Epidemiological Sciences, Animal & Plant Health Agency, Woodham Lane, Weybridge, UK.
| | - A Brouwer
- Department for Epidemiological Sciences, Animal & Plant Health Agency, Woodham Lane, Weybridge, UK.
| | - S H Downs
- Department for Epidemiological Sciences, Animal & Plant Health Agency, Woodham Lane, Weybridge, UK.
| | - L Kelly
- Department of Mathematics and Statistics, University of Strathclyde, Richmond Street, Glasgow G1 1XH, UK.
| |
Collapse
|
39
|
Gwilliam B, Keeley V, Todd C, Gittens M, Roberts C, Kelly L, Barclay S, Stone P. Comparison of clinicians' and advanced cancer patients' estimates of survival. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2011-000020.53rep] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
40
|
Kelly L, Dummett S, Dawson J, Fitzpatrick R, Jenkinson C, Morley D. Psychometric evaluation of the Oxford participation & activities questionnaire (Ox-PAQ). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.959] [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]
|
41
|
Hill AA, Dewé T, Kosmider R, Von Dobschuetz S, Munoz O, Hanna A, Fusaro A, De Nardi M, Howard W, Stevens K, Kelly L, Havelaar A, Stärk K. Modelling the species jump: towards assessing the risk of human infection from novel avian influenzas. R Soc Open Sci 2015; 2:150173. [PMID: 26473042 PMCID: PMC4593676 DOI: 10.1098/rsos.150173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/12/2015] [Indexed: 05/06/2023]
Abstract
The scientific understanding of the driving factors behind zoonotic and pandemic influenzas is hampered by complex interactions between viruses, animal hosts and humans. This complexity makes identifying influenza viruses of high zoonotic or pandemic risk, before they emerge from animal populations, extremely difficult and uncertain. As a first step towards assessing zoonotic risk of influenza, we demonstrate a risk assessment framework to assess the relative likelihood of influenza A viruses, circulating in animal populations, making the species jump into humans. The intention is that such a risk assessment framework could assist decision-makers to compare multiple influenza viruses for zoonotic potential and hence to develop appropriate strain-specific control measures. It also provides a first step towards showing proof of principle for an eventual pandemic risk model. We show that the spatial and temporal epidemiology is as important in assessing the risk of an influenza A species jump as understanding the innate molecular capability of the virus. We also demonstrate data deficiencies that need to be addressed in order to consistently combine both epidemiological and molecular virology data into a risk assessment framework.
Collapse
Affiliation(s)
- A. A. Hill
- Royal Veterinary College, London, UK
- Animal and Plant Health Agency, New Haw, Surrey, UK
- Author for correspondence: A. A. Hill e-mail:
| | - T. Dewé
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - R. Kosmider
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - S. Von Dobschuetz
- Royal Veterinary College, London, UK
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - O. Munoz
- Instituto Zooprofilattico Sperimentale delle Venizie, Padua, Italy
| | - A. Hanna
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - A. Fusaro
- Instituto Zooprofilattico Sperimentale delle Venizie, Padua, Italy
| | - M. De Nardi
- Instituto Zooprofilattico Sperimentale delle Venizie, Padua, Italy
| | - W. Howard
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | | | - L. Kelly
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | | | - K. Stärk
- Royal Veterinary College, London, UK
| |
Collapse
|
42
|
Kelly L, Offringa M. 139: Standards for Creating a Paediatric Drug Monograph. Paediatr Child Health 2015. [DOI: 10.1093/pch/20.5.e84b] [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
|
43
|
|
44
|
Gale P, Kelly L, Mearns R, Duggan J, Snary E. Q fever through consumption of unpasteurised milk and milk products - a risk profile and exposure assessment. J Appl Microbiol 2015; 118:1083-95. [DOI: 10.1111/jam.12778] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/28/2015] [Accepted: 02/15/2015] [Indexed: 01/03/2023]
Affiliation(s)
- P. Gale
- Department of Epidemiological Sciences; Animal and Plant Health Agency (APHA); Weybridge UK
| | - L. Kelly
- Department of Epidemiological Sciences; Animal and Plant Health Agency (APHA); Weybridge UK
| | - R. Mearns
- Animal and Plant Health Agency (APHA); Penrith UK
| | - J. Duggan
- Public Health England (PHE); Porton Down UK
| | - E.L. Snary
- Department of Epidemiological Sciences; Animal and Plant Health Agency (APHA); Weybridge UK
| |
Collapse
|
45
|
Baber M, Chaudhry S, Kelly L, Ross C, Carleton B, Berger H, Koren G. The pharmacogenetics of codeine pain relief in the postpartum period. Pharmacogenomics J 2015; 15:430-5. [DOI: 10.1038/tpj.2015.3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 11/16/2014] [Accepted: 12/02/2014] [Indexed: 11/10/2022]
|
46
|
Joyce DP, Lowery AJ, McGrath-Soo LB, Downey E, Kelly L, O’Donoghue GT, Barry M, Hill ADK. Management of the axilla: has Z0011 had an impact? Ir J Med Sci 2015; 185:145-9. [DOI: 10.1007/s11845-015-1246-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 12/31/2014] [Indexed: 11/28/2022]
|
47
|
Gale P, Kelly L, Snary EL. Pathways for Entry of Livestock Arboviruses into Great Britain: Assessing the Strength of Evidence. Transbound Emerg Dis 2015; 62:115-23. [DOI: 10.1111/tbed.12317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- P. Gale
- Department of Epidemiological Sciences; Animal Health and Veterinary Laboratories Agency; Addlestone UK
| | - L. Kelly
- Department of Epidemiological Sciences; Animal Health and Veterinary Laboratories Agency; Addlestone UK
- Department of Mathematics and Statistics; University of Strathclyde; Glasgow UK
| | - E. L. Snary
- Department of Epidemiological Sciences; Animal Health and Veterinary Laboratories Agency; Addlestone UK
| |
Collapse
|
48
|
Rivero R, Verdes J, Matto C, Kelly L, Guerrero F, Gimeno E. Inherited α-mannosidosis in crossbred calves. J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.011] [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: 10/24/2022]
|
49
|
Abstract
The role of regulatory drug submission evaluators in Canada is to critically assess both the data submitted and the sponsor's interpretation of the data in order to reach an evidence-, and context- based recommendation as to the potential benefits and potential harms (i.e., risks) associated with taking the drug under the proposed conditions of use. The purpose of this document is to outline the regulatory framework in which this assessment occurs, including: defining what “authorization to market a drug in Canada” means, in terms of the role of the sponsor, the responsibility of Health Canada in applying the Food and Drugs Act prior to and after marketing authorization, and the distinction between regulatory authorization versus physician authorization; highlighting organizational, process and legal factors within Health Canada related to authorization of clinical trials and authorization to market a drug; considerations during the review process, such as regulatory and scientific issues related to the drug, patient populations and trial designs; application of international guidelines, and decisions from other jurisdictions; regulatory realities regarding drug authorization, including the requirement for wording in the Product Monograph to accurately reflect the information currently available on the safe and effective use of a drug, and that hypothesis-confirming studies are essential to regulatory endorsement; current issues related to the review of therapies for dementia, such as assessing preventative treatments, and therapies that have symptomatic versus disease-modifying effects, statistical issues regarding missing data, and trial design issues.
Collapse
Affiliation(s)
- L Kelly
- CNSD, BCANS, Therapeutic Products Directorate, Tunney's Pasture, Ottawa, ON, Canada
| | | | | |
Collapse
|
50
|
Lichtwark G, Farris D, Kelly L, Brown N. Lower limb biomechanics and muscle function. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.106] [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: 11/17/2022]
|