1
|
Jensen MB, Pedersen CB, Misiakou MA, Talman MLM, Gibson L, Tange UB, Kledal H, Vejborg I, Kroman N, Nielsen FC, Ejlertsen B, Rossing M. Multigene profiles to guide the use of neoadjuvant chemotherapy for breast cancer: a Copenhagen Breast Cancer Genomics Study. NPJ Breast Cancer 2023; 9:47. [PMID: 37258527 DOI: 10.1038/s41523-023-00551-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
Estrogen receptor (ER) and human epidermal growth factor 2 (HER2) expression guide the use of neoadjuvant chemotherapy (NACT) in patients with early breast cancer. We evaluate the independent predictive value of adding a multigene profile (CIT256 and PAM50) to immunohistochemical (IHC) profile regarding pathological complete response (pCR) and conversion of positive to negative axillary lymph node status. The cohort includes 458 patients who had genomic profiling performed as standard of care. Using logistic regression, higher pCR and node conversion rates among patients with Non-luminal subtypes are shown, and importantly the predictive value is independent of IHC profile. In patients with ER-positive and HER2-negative breast cancer an odds ratio of 9.78 (95% CI 2.60;36.8), P < 0.001 is found for pCR among CIT256 Non-luminal vs. Luminal subtypes. The results suggest a role for integrated use of up-front multigene subtyping for selection of a neoadjuvant approach in ER-positive HER2-negative breast cancer.
Collapse
Affiliation(s)
- M-B Jensen
- Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - C B Pedersen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Section for Bioinformatics, DTU Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - M-A Misiakou
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - M-L M Talman
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - L Gibson
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - U B Tange
- Department of Clinical Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - H Kledal
- Department of Breast Examinations, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
| | - I Vejborg
- Department of Breast Examinations, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
| | - N Kroman
- Department of Breast Surgery, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - F C Nielsen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - B Ejlertsen
- Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - M Rossing
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Omodara DA, Gibson L, Bowpitt G. Exploring the impact of cultural beliefs in the self-management of type 2 diabetes among Black sub-Saharan Africans in the UK - a qualitative study informed by the PEN-3 cultural model. Ethn Health 2022; 27:1358-1376. [PMID: 33546564 DOI: 10.1080/13557858.2021.1881764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The purpose of this study was to examine cultural beliefs, attitudes, and practices of Black sub-Saharan Africans (BsSAs) in the UK regarding their type 2 diabetes (T2D) self-management using the concepts of the PEN-3 cultural model. METHOD A qualitative study involved 36 semi-structured interviews with BsSAs living with T2D in the UK to examine relevant cultural practices and beliefs that have contributed to the uneven burden of self-management behaviours. A narrative thematic analysis of the data was then conducted for the study using NVivo software and guided by the PEN-3 cultural model, which moves beyond individualistic health behaviour models of diabetes but centralises culture in understanding health behaviours. RESULTS Cultural perceptions and self-management behaviours of T2D varied among the BsSAs. Systems of self-management and treatment practices that were congruent with their cultural beliefs and personal priorities were seen as essential in the positive response to self-managing T2D. Knowledge and perceptions of non-conventional and alternative remedies linked to cultural beliefs reflected the existential health-seeking behaviours, and the significance attached to BsSAs negotiated cultural identities and collective practices within the communities. Social network supports were seen as enablers while advice and regimens from healthcare professionals (HCPs) were presented as medicalised and devoid of cultural sensitivities to respondents. CONCLUSION The study findings highlight the need to be not only aware of the negative impact of diabetes perceptions and health behaviours among the BsSA communities, but also be aware of the enabling factors and collective practices within the communities that are equally critical in influencing the self-management and health-seeking decisions of BsSAs living with T2D. PEN-3 model was significant with exploring not only how cultural context shapes health beliefs and practices, but also how social networks and systems play a critical role in enabling or nurturing positive health behaviours and health outcomes.
Collapse
Affiliation(s)
- D A Omodara
- Sociology, Nottingham Trent University, Nottingham, UK
| | - L Gibson
- Sociology, Nottingham Trent University, Nottingham, UK
| | - G Bowpitt
- Social Work and Health, Nottingham Trent University, Nottingham, UK
| |
Collapse
|
3
|
Gibson L, Mittal A, Qureshi F, Neerumpa S, Hamidpour S, Mateescu V, Salzman G, Molteni A, Monaghan NP, Poisner A. Distinct Responses in the Brain Compared to Lung in a Rat Model of Fat Embolism Syndrome. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lilian Gibson
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - A. Mittal
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - F. Qureshi
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - S. Neerumpa
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - S. Hamidpour
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - V. Mateescu
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - G. Salzman
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | - A. Molteni
- Biomedical sciencesUniversity of MissouriKansas CityMO
| | | | - A. Poisner
- University of Kansas Medical CenterKansas CityKS
| |
Collapse
|
4
|
Mcgaffin S, Taggart M, Smyth D, O"doherty D, Brown J, Teague S, Slevin C, Montgomery L, Coll M, Lindsay C, Crumley B, Gibson L, Elliott H, Hughes S, Connolly S. Transitioning a cardiovascular health and rehabilitation programme to a virtual platform during covid 19. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Our Hearts Our Minds
Purpose
Can a virtual cardiovascular prevention and rehabilitation programme be as effective as face-to-face programme.
Background
The Our Hearts Our Minds (OHOM) prevention and rehabilitation programme rapidly transitioned to a virtual platform in the covid era. Here we compare if a virtual programme potentially could offer the same standard of the nursing intervention (education, smoking cessation, medical risk factor management and psychosocial health) as the previous face to face programme
Methods
Both the initial assessment (IA) and end of programme (EOP) assessments were conducted via telephone/video as per patient preference. The following measures were recorded at both time points (home blood pressure (BP) monitors were provided)
Smoking (self report) BP/Heart rate, Lipids/HbA1c (facilitated by phlebotomy hub), cardio protective drugs (doses, adherence), Hospital Anxiety and Depression score, EuroQoL
Nursing Intervention Smoking cessation counselling and pharmacotherapy where appropriate
Weekly meeting with cardiologist to optimise BP and lipid management and up titration cardio protective drugs
Bimonthly virtual coaching consultation for monitoring/goal resetting
Bimonthly group video education sessions
Results
From April to November 2020, of the 432 referrals received 400 were eligible with 377 accepting the offer of an IA (94% response rate). 262 have had an IA with the remaining 115 awaiting an assessment date. Of the completed IA’s 257 were willing to attend the programme (98% uptake). 120 had been offered an end of programme assessment with 114 attending (96% of those offered). The results for the virtual programme were then compared to the same period one year previously when the programme was fully face to face and are outlined in the table below.
The comparison of results delivered via remote delivery are remarkably similar to those achieved in the previous year delivered via face to face.
Conclusion
Initial data has shown that virtual delivery of the nursing component of the OHOM prevention/rehabilitation programme was highly acceptable to patients and was as effective as that of the traditional face to face service.
Table 1 below exhibits the clinical and patient-reported outcomes.
Collapse
Affiliation(s)
- S Mcgaffin
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - M Taggart
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - D Smyth
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - D O"doherty
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - J Brown
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - S Teague
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - C Slevin
- South West Acute Hospital, Our Hearts Our Minds, Enniskillen, United Kingdom of Great Britain & Northern Ireland
| | - L Montgomery
- South West Acute Hospital, Our Hearts Our Minds, Enniskillen, United Kingdom of Great Britain & Northern Ireland
| | - M Coll
- South West Acute Hospital, Our Hearts Our Minds, Enniskillen, United Kingdom of Great Britain & Northern Ireland
| | - C Lindsay
- South West Acute Hospital, Our Hearts Our Minds, Enniskillen, United Kingdom of Great Britain & Northern Ireland
| | - B Crumley
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - L Gibson
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - H Elliott
- South West Acute Hospital, Our Hearts Our Minds, Enniskillen, United Kingdom of Great Britain & Northern Ireland
| | - S Hughes
- Altnagelvin Area Hospital, Our Hearts Our Minds, Londonderry, United Kingdom of Great Britain & Northern Ireland
| | - S Connolly
- South West Acute Hospital, Our Hearts Our Minds, Enniskillen, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
5
|
Andersson AA, Gibson L, Baker DM, Cybulski JD, Wang S, Leung B, Chu LM, Dingle C. Stable isotope analysis as a tool to detect illegal trade in critically endangered cockatoos. Anim Conserv 2021. [DOI: 10.1111/acv.12705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. A. Andersson
- Division of Ecology & Biodiversity School of Biological Sciences The University of Hong Kong Pokfulam Hong Kong SAR China
| | - L. Gibson
- School of Environmental Science and Engineering Southern University of Science and Technology Shenzhen China
| | - D. M. Baker
- Division of Ecology & Biodiversity School of Biological Sciences The University of Hong Kong Pokfulam Hong Kong SAR China
| | - J. D. Cybulski
- Division of Ecology & Biodiversity School of Biological Sciences The University of Hong Kong Pokfulam Hong Kong SAR China
| | - S. Wang
- School of Life Sciences The Chinese University of Hong Kong Shatin NT, Hong Kong SAR China
| | - B. Leung
- School of Life Sciences The Chinese University of Hong Kong Shatin NT, Hong Kong SAR China
| | - L. M. Chu
- School of Life Sciences The Chinese University of Hong Kong Shatin NT, Hong Kong SAR China
| | - C. Dingle
- Division of Ecology & Biodiversity School of Biological Sciences The University of Hong Kong Pokfulam Hong Kong SAR China
| |
Collapse
|
6
|
Law KH, Dimmock JA, Guelfi KJ, Nguyen T, Bennett E, Gibson L, Tan XH, Jackson B. A peer support intervention for first-time mothers: Feasibility and preliminary efficacy of the mummy buddy program. Women Birth 2020; 34:593-605. [PMID: 33160896 DOI: 10.1016/j.wombi.2020.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/15/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The transition to motherhood, although joyous, can be highly stressful, and the availability of professional postpartum support for mothers is often limited. Peer volunteer support programs may offer a viable and cost-effective method to provide community-based support for new mothers. AIM To determine the feasibility of a peer volunteer support program-The Mummy Buddy Program-in which experienced volunteer mothers are paired with, and trained to offer social support to, first-time mothers. METHODS Using a single-group non-randomised feasibility trial, a total of 56 experienced mothers participated in the Mummy Buddy training program, which was focused on education and practical exercises relating to the provision of various forms of social support. Experienced mothers ('Mummy Buddies') were subsequently paired with expectant first-time mothers (n=47 pairs), and were encouraged to provide support until 24-weeks postpartum. FINDINGS In terms of key feasibility considerations, 95.1% of Mummy Buddies felt that they were trained sufficiently to perform their role, and 85.8% of New Mothers were satisfied with the support provided by their Buddy. Analyses of preliminary efficacy (i.e., program outcomes) revealed that the first-time mothers maintained normal levels of stress and depressive symptomology, and possessed relatively strong maternal functioning, across the program duration. CONCLUSION The Mummy Buddy Program appears to be a feasible and potentially valuable peer volunteer support program for first-time mothers. This study provides a foundation for program expansion and for work designed to examine program outcomes-for first-time mothers, Mummy Buddies, and entire family units-within a sufficiently-powered randomised controlled trial.
Collapse
Affiliation(s)
- K H Law
- Department of Psychology, College of Healthcare Sciences, James Cook University, Australia, @BrianLaw_Psych.
| | - J A Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Australia, @BrianLaw_Psych
| | - K J Guelfi
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western, Australia
| | - T Nguyen
- Division of Psychiatry, School of Medicine, The University of Western, Australia; Peel and Rockingham, Kwinana Mental Health Service, Western Australia, Australia
| | | | - L Gibson
- Telethon Kids Institute, Western Australia, Australia
| | - X H Tan
- Cairnmillar Institute, Victoria, Australia
| | - B Jackson
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western, Australia
| |
Collapse
|
7
|
Gaudreau P, Peng D, Rodriguez B, Fradette J, Gibson L, Della Corte C, Sen T, Kundu S, Chen L, Wargo J, Gibbons D. P1.04-26 EMT-Associated Response and Resistance to MEK Inhibitor and Immune Checkpoint Blockade Combinations in KRAS-Mutant NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Sommer I, Kien C, Faustmann A, Gibson L, Schneider M, Krczal E, Jank R, Gartlehner G. Prevalence of Mental Disorders in Young Refugees and Asylum-Seekers in European Countries. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- I Sommer
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - C Kien
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - A Faustmann
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - L Gibson
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - M Schneider
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - E Krczal
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - R Jank
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| | - G Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
| |
Collapse
|
9
|
Verhey R, Gibson L, Brakarsh J, Chibanda D, Seedat S. Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe. Eur J Psychotraumatol 2018; 9:1536286. [PMID: 30397426 PMCID: PMC6211317 DOI: 10.1080/20008198.2018.1536286] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/02/2018] [Accepted: 09/23/2018] [Indexed: 11/18/2022] Open
Abstract
Background: We investigated the prevalence of and factors associated with post-traumatic stress disorder (PTSD) and common mental disorders (CMDs), which include depression and anxiety disorders, in a setting with a prevalence of high human immunodeficiency virus (HIV) within a primary care clinic, using the PTSD Checklist for DSM-5 and the 14-item Shona Symptom Questionnaire, both locally validated screening tools. Methods: A cross-sectional survey was carried out with adult patients (n = 204) from the largest primary care clinic facility in Harare, Zimbabwe, in June 2016. Results: A total of 83 patients (40.7%) met the criteria for probable PTSD, of whom 57 (69.5%) had comorbid CMDs. Among people living with HIV, 42 (55.3%) had PTSD. Probable PTSD was associated with having experienced a negative life event in the past 6 months [adjusted odds ratio (OR) 3.73, 95% confidence interval (CI) 1.49-9.34] or screening positive for one or more CMD (adjusted OR 6.48, 95% CI 3.35-2.54). Conclusion: People living with HIV showed a high prevalence of PTSD and CMD comorbidity. PTSD screening should be considered when the CMD screen is positive and there is a history of negative life events.
Collapse
Affiliation(s)
- R. Verhey
- Research Support Center, University of Zimbabwe, Harare, Zimbabwe
| | - L. Gibson
- Department of Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - J. Brakarsh
- Say and Play Therapy Centre, Harare, Zimbabwe
| | - D. Chibanda
- Research Support Center, University of Zimbabwe, Harare, Zimbabwe
| | - S. Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
10
|
Menjak IB, Trudeau ME, Mehta R, McCullock F, Bristow B, Wright F, Rice K, Gibson L, Pasetka M, Szumacher EF. Abstract P4-10-14: Pilot data from the development of the Senior Women's Breast Cancer Clinic at Sunnybrook Odette Cancer Centre. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-10-14] [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: 11/16/2022]
Abstract
Abstract
Introduction: Women over 70 are a growing demographic of breast cancer patients with specific needs requiring individualized care plans. We developed the interdisciplinary Senior Women's Breast Cancer Clinic (SWBCC) to improve access to a comprehensive geriatric assessment (CGA) and allied health services such as social work, occupational therapy, and pharmacy assistance. After initiation of the SWBCC, we conducted a pilot study using the VES-13 (vulnerable elders survey-13) tool to screen all patients over 70 with the goal of focusing referrals for patients who may benefit most from a CGA. The VES-13 was developed for community-dwelling elders and is validated in oncology patients. The objective of this study is to examine the outcomes of VES-13 screening, determine the medical issues identified by the CGA, and describe the development of this clinic.
Methods: A retrospective review of the clinic from May 2015 - May 2017 was performed using the electronic medical records and paper screening forms. We separately describe the impact of the VES-13 to manage CGA referrals. A score of 3 or greater is a positive screen, and indicates the patient is at risk for death or decline. Non-parametric descriptive statistics were used for statistical analyses.
Results: A total of 25 patients have been seen in the SWBCC for CGA to date. Median age was 83, (range 67-97). A median of two (range 1-4) new medical issues were identified from the CGA for each patient. The most common new diagnoses or issues identified were cognitive impairment (15/25), falls (6/25), neuropathy (4/25), and pain (4/25). The geriatric day program and falls prevention program were common referrals. After the introduction of VES-13 screening, a total of 54 patients were screened. Median age in that group was 78.5 years (range 70-95). The median VES-13 score was 1 (range 0-10). Of the 21 patients screened positive on VES-13, 7 went on to have a CGA. Of the remaining screen-positive patients, 3/21 patients declined SWBCC referral, and the others were not referred at the discretion of the physician. None of the patients with negative VES-13 were referred for CGA. The SWBCC structure was developed to utilize breast cancer-specific resources, whereby geriatricians provide consultation within the oncology space, and the allied health providers were affiliated with the breast centre. Oncology and geriatric administrative staff organized bookings to better coordinate schedules between the two disciplines. The geriatricians supervised trainees for the CGA, and follow-ups took place at SWBCC or in the geriatric outpatient clinic. Clinic coordinators affixed the VES-13 tool to all new patient charts for those aged ≥70. Nursing resources were dedicated to assist patients with VES-13 if needed, and document scores in the electronic medical record.
Conclusions: A dedicated clinic for seniors with breast cancer providing geriatric assessment can identify important undiagnosed medical issues that warrant intervention or monitoring during breast cancer treatment. The VES-13 screening tool provides useful information to help manage resources for geriatrics referral. A prospective trial examining the role of CGA in decision-making for adjuvant chemotherapy is underway in this clinic.
Citation Format: Menjak IB, Trudeau ME, Mehta R, McCullock F, Bristow B, Wright F, Rice K, Gibson L, Pasetka M, Szumacher EF. Pilot data from the development of the Senior Women's Breast Cancer Clinic at Sunnybrook Odette Cancer Centre [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-14.
Collapse
Affiliation(s)
- IB Menjak
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - ME Trudeau
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - R Mehta
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - F McCullock
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - B Bristow
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - F Wright
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - K Rice
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - L Gibson
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - M Pasetka
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - EF Szumacher
- University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| |
Collapse
|
11
|
Smith A, O'Connor A, Hennessy S, O'Sullivan PG, Gibson L. Permanent Childhood Hearing Impairment: Aetiological Evaluation of Infants identified through the Irish Newborn Hearing Screening Programme. Ir Med J 2017; 110:651. [PMID: 29465841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Newborn Hearing Screening Programme (NHSP) was established in Cork University Maternity Hospital (CUMH) in April 2011. Between April 2011 and July 2014, 42 infants were identified with a Permanent Childhood Hearing Impairment (PCHI). Following this diagnosis, infants underwent a paediatric assessment according to recognised guidelines with the intention of identifying the underlying aetiology of the PCHI. The aim of this study was to assess the findings of this aetiological workup via retrospective chart review. PCHI data was obtained from the eSP database. This is a web based information system (eSP) used to track each baby through the screening and referral process A retrospective chart review of these patients was performed. Sixteen (38%) infants were diagnosed with a bilateral sensorineural hearing loss. Two infants had congenital CMV infection. A Connexin 26 gene mutation was detected in one infant. Two infants were diagnosed with Waardenburg syndrome, One with Pendred syndrome and one with Pfeiffer syndrome. Five babies underwent cochlear implantation. Through adherence to the recommended protocol a possible cause of PCHI may be determined. This study has identified areas of future improvement for this service in Ireland.
Collapse
Affiliation(s)
- A Smith
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| | - A O'Connor
- Department of Otolaryngology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - S Hennessy
- Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - P G O'Sullivan
- Department of Otolaryngology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - L Gibson
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| |
Collapse
|
12
|
O'Kane D, Gibson L, du Plessis J, Davidson A, Bolton D, Lawrentschuk N. Delivery of intracavernosal therapies using needle-free injection devices. Int J Impot Res 2017; 29:225-228. [DOI: 10.1038/ijir.2017.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 06/08/2017] [Accepted: 06/26/2017] [Indexed: 11/09/2022]
|
13
|
Przybylak K, Madden J, Covey-Crump E, Gibson L, Barber C, Patel M, Cronin M. Characterisation of data resources for in silico modelling: benchmark datasets for ADME properties. Expert Opin Drug Metab Toxicol 2017; 14:169-181. [DOI: 10.1080/17425255.2017.1316449] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- K.R. Przybylak
- School of Pharmacy and Chemistry, Liverpool John Moores University, Liverpool, UK
| | - J.C. Madden
- School of Pharmacy and Chemistry, Liverpool John Moores University, Liverpool, UK
| | | | - L. Gibson
- Lhasa Limited, Granary Wharf House, Leeds, UK
| | - C. Barber
- Lhasa Limited, Granary Wharf House, Leeds, UK
| | - M. Patel
- Lhasa Limited, Granary Wharf House, Leeds, UK
| | - M.T.D. Cronin
- School of Pharmacy and Chemistry, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
14
|
Reed MJ, Gibson L, Black P, Dewar A, Clegg G, Short S. THE PARAMEDIC ULTRASOUND IN CARDIAC ARREST STUDY. Arch Emerg Med 2016. [DOI: 10.1136/emermed-2016-206402.27] [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]
|
15
|
Black KI, Geary R, French R, Leefe N, Mercer CH, Glasier A, Macdowall W, Gibson L, Datta J, Palmer M, Wellings K. Trends in the use of emergency contraception in Britain: evidence from the second and third National Surveys of Sexual Attitudes and Lifestyles. BJOG 2016; 123:1600-7. [PMID: 27245637 PMCID: PMC4995725 DOI: 10.1111/1471-0528.14131] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the changes in the prevalence of, and the factors associated with, the use of emergency contraception (EC) in Britain between 2000 and 2010, spanning the period of deregulation and increase in pharmacy supply. DESIGN Cross-sectional probability sample surveys. SETTING AND POPULATION British general population. METHODS Data were analysed from the second and third British National Surveys of Sexual Attitudes and Lifestyles (Natsal), undertaken in 1999-2001 and 2010-12. Univariate and logistic regression analyses were used to measure change in EC use amongst sexually active women aged 16-44 years not intending pregnancy. MAIN OUTCOME MEASURES Prevalence of EC use and factors associated with use. RESULTS Of the 5430 women surveyed in 1999-2001 and the 4825 women surveyed in 2010-12, 2.3 and 3.6%, respectively, reported using EC in the year prior to interview (P = 0.0019 for change over time). The prevalence of EC use increased amongst single women and those with higher educational attainment (adjusted odds ratio, aOR 1.51; 95% confidence interval, 95% CI 1.04-2.20; P = 0.0308). Increases in EC use were generally greater among women without behavioural risk factors, such as those with no history of abortion within 5 years (aOR 1.57; 95% CI 1.17-2.12; P = 0.0029), or those whose first heterosexual intercourse occurred after the age of 16 years (aOR 1.68; 95% CI 1.21-2.35; P = 0.0021). The increase in EC use was also more marked among women usually accessing contraception from retail sources than among those doing so from healthcare sources, which may reflect a use of condoms amongst EC users. CONCLUSION The increase in EC use among women in Britain in the first decade of the 21st century was associated with some, but not all, risk factors for unplanned pregnancy. Advice and provision may need to be targeted at those at highest risk of unplanned pregnancy. TWEETABLE ABSTRACT Despite pharmacy access, only a small rise in emergency contraception use has been seen in Britain over 10 years.
Collapse
Affiliation(s)
- KI Black
- University of SydneySydneyNSWAustralia
| | - R Geary
- London School of Hygiene and Tropical MedicineLondonUK
| | - R French
- London School of Hygiene and Tropical MedicineLondonUK
| | - N Leefe
- University College LondonLondonUK
| | | | - A Glasier
- London School of Hygiene and Tropical MedicineLondonUK
| | - W Macdowall
- London School of Hygiene and Tropical MedicineLondonUK
| | - L Gibson
- London School of Hygiene and Tropical MedicineLondonUK
| | - J Datta
- London School of Hygiene and Tropical MedicineLondonUK
- University of EdinburghEdinburghUK
| | - M Palmer
- London School of Hygiene and Tropical MedicineLondonUK
| | - K Wellings
- London School of Hygiene and Tropical MedicineLondonUK
| |
Collapse
|
16
|
Cousens C, Gibson L, Finlayson J, Pritchard I, Dagleish MP. Prevalence of ovine pulmonary adenocarcinoma (Jaagsiekte) in a UK slaughterhouse sheep study. Vet Rec 2015; 176:413. [PMID: 25721510 DOI: 10.1136/vr.102880] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 12/22/2022]
Affiliation(s)
- C Cousens
- Moredun Research Institute, Edinburgh EH26 0PZ, UK
| | - L Gibson
- SAC Consulting Veterinary Services, Allan Watt Building, Bush Estate, Penicuik EH26 0QE, UK
| | - J Finlayson
- Moredun Research Institute, Edinburgh EH26 0PZ, UK
| | - I Pritchard
- SAC Consulting Veterinary Services, Allan Watt Building, Bush Estate, Penicuik EH26 0QE, UK
| | - M P Dagleish
- Moredun Research Institute, Edinburgh EH26 0PZ, UK
| |
Collapse
|
17
|
Adams C, Gibson L, Behbakht K, Spillman M, Bradford A. Identification of a gene expression signature to distinguish uterine leiomyosarcomas from leiomyomas. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
18
|
Abstract
OBJECTIVES This study evaluated the implementation of recommendations from a prior review of functional capacity evaluation practice in a regionalised rehabilitation service. The evaluation considered the acceptance of the recommendations and the current level of consistency of approach in practice. STUDY DESIGN The study was qualitative in nature, using a descriptive survey and a focus group. Participants were occupational therapists of a major rehabilitation provider in Queensland, Australia. Eighteen of 48 therapists (38%) responded to the questionnaire. Eight therapists participated in the focus group. RESULTS The results indicated some acceptance of the recommendations for functional capacity evaluation in areas such as procedure, reporting, equipment and model of evaluation. Further research into the reliability and validity of functional capacity evaluation was indicated. DISCUSSION The low response rate did not allow conclusive results. However, the findings provided some evidence of consistency in functional capacity evaluation practice. The results are discussed in relation to current issues in functional capacity evaluation practice.
Collapse
Affiliation(s)
- L Gibson
- Department of Occupational Therapy, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - J Strong
- Department of Occupational Therapy, The University of Queensland, Brisbane, Queensland 4072, Australia
| |
Collapse
|
19
|
Parvanta S, Gibson L, Moldovan-Johnson M, Mallya G, Hornik RC. Race and gender moderation of the relationship between cessation beliefs and intentions: is race or gender message segmentation necessary in anti-smoking campaigns? Health Educ Res 2013; 28:857-868. [PMID: 23720493 PMCID: PMC3772333 DOI: 10.1093/her/cyt067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 04/25/2013] [Indexed: 05/28/2023]
Abstract
Debate persists over whether different message strategies in anti-smoking campaigns are needed for audiences of different races or genders. This study considers the need for 'message segmentation', which is the process of differentiating the beliefs that might be the focus of messages for population subgroups. We have two aims: (i) lay out an approach that yields evidence about the necessity for message segmentation and (ii) demonstrate and assess findings from this approach using the formative evaluation for the Philadelphia Anti-Smoking Campaign. We examine whether associations between beliefs about quitting smoking and intention to quit are moderated by race (black/white) or gender. Data came from a representative sample of 501 adult smokers (46% black; 56% female) surveyed in July 2010 for the campaign's formative evaluation. Out of 26 beliefs about cessation, 8 were significantly related to cessation intention regardless of subgroup affiliation, suggesting that these would be promising beliefs for messages in a unified campaign. Four beliefs were significant for white smokers only, and three beliefs were significant for female smokers only. The evidence justified a unified message approach because subgroups shared enough beliefs that could become message strategies to increase cessation across smokers without the added costs associated with message segmentation.
Collapse
Affiliation(s)
- S. Parvanta
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA, Nebraska Department of Health and Human Services, Lincoln, NE 68508, USA and Philadelphia Department of Public Health, Philadelphia, PA 19102, USA
| | - L. Gibson
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA, Nebraska Department of Health and Human Services, Lincoln, NE 68508, USA and Philadelphia Department of Public Health, Philadelphia, PA 19102, USA
| | - M. Moldovan-Johnson
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA, Nebraska Department of Health and Human Services, Lincoln, NE 68508, USA and Philadelphia Department of Public Health, Philadelphia, PA 19102, USA
| | - G. Mallya
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA, Nebraska Department of Health and Human Services, Lincoln, NE 68508, USA and Philadelphia Department of Public Health, Philadelphia, PA 19102, USA
| | - R. C. Hornik
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA, Nebraska Department of Health and Human Services, Lincoln, NE 68508, USA and Philadelphia Department of Public Health, Philadelphia, PA 19102, USA
| |
Collapse
|
20
|
Gibson L, Lynam AJ, Bradshaw CJA, He F, Bickford DP, Woodruff DS, Bumrungsri S, Laurance WF. Near-Complete Extinction of Native Small Mammal Fauna 25 Years After Forest Fragmentation. Science 2013; 341:1508-10. [DOI: 10.1126/science.1240495] [Citation(s) in RCA: 264] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
21
|
Ross GM, Johnson N, Orr N, Walker K, Gibson L, Folkerd E, Haynes B, Palles C, Coupland B, Shoemaker M, Jones M, Broderick P, Sawyer E, Kerin M, Tomlinson I, Zvelebil M, Chilcott-Burns S, Tomczyk K, Simpson G, Willianson J, Hillier S, Houlston R, Swerdlow A, Ashworth A, Dowsett M, Peto J, dos Santos I, Fletcher O. Abstract P3-08-04: Impact of CYP3A variation on estrone levels and breast cancer risk. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-08-04] [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: 11/16/2022]
Abstract
Abstract
Background: Epidemiological studies provide strong evidence for a role of endogenous sex steroids in the etiology of breast cancer. Our aim was to identify common variants in genes involved in sex steroid synthesis or metabolism that were associated with premenopausal hormone levels and breast cancer risk.
Methods: We measured urinary estrone glucuronide (E1G) and pregnanediol glucuronide (PG) using a protocol specifically developed to account for cyclic variation in hormone levels during the menstrual cycle, plasma sex hormone-binding globulin (SHBG) and androgenic precursors in up to 763 healthy premenopausal women. We genotyped 642 single nucleotide polymorphisms (SNPs) in these women; a single SNP was further tested for association with breast cancer risk in data from 10,551 breast cancer case patients and 17,535 control subjects. All statistical tests were two-sided.
Results: rs10273424 mapping approximately 50kb centromeric to the cytochrome P450 3A (CYP3A) cluster (7q22.1) was associated with a 21.8% reduction in E1G levels (P = 2.7 × 10−9) and a modest reduction in breast cancer risk in cases diagnosed at or before age 50 (OR = 0.91; P = 0.03) but not older cases (odds ratio (OR) = 1.01; P = 0.82). A rare non-synonymous SHBG SNP was associated with reduced plasma SHBG levels.
Conclusions: Genetic variation in non-coding sequences flanking the CYP3A locus contributes to variance in premenopausal E1G levels and breast cancer risk in younger cases. Since CYP3A4, the most predominantly expressed CYP3A gene, is responsible for metabolism of endogenous and exogenous hormones and hormonal agents such as tamoxifen, used in the treatment of breast cancer this association may have wider implications.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-08-04.
Collapse
Affiliation(s)
- GM Ross
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - N Johnson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - N Orr
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - K Walker
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - L Gibson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - E Folkerd
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - B Haynes
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - C Palles
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - B Coupland
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Shoemaker
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Jones
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - P Broderick
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - E Sawyer
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Kerin
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - I Tomlinson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Zvelebil
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - S Chilcott-Burns
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - K Tomczyk
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - G Simpson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - J Willianson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - S Hillier
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - R Houlston
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - A Swerdlow
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - A Ashworth
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Dowsett
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - J Peto
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - I dos Santos
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - O Fletcher
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| |
Collapse
|
22
|
Awan FT, Osman S, Kochuparambil ST, Gibson L, Remick SC, Abraham J, Craig M, Jillella A, Hamadani M. Impact of response to thalidomide-, lenalidomide- or bortezomib- containing induction therapy on the outcomes of multiple myeloma patients undergoing autologous transplantation. Bone Marrow Transplant 2011; 47:146-8. [DOI: 10.1038/bmt.2011.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
23
|
|
24
|
Rooney KD, Sundaram R, Gibson L, Price RJ. Safety programme reduces ICU mortality. Crit Care 2011. [PMCID: PMC3068422 DOI: 10.1186/cc9913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
25
|
Kanate A, Chaudhary L, Cumpston A, Leadmon S, Bunner P, Bulian D, Gibson L, Tse W, Abraham J, Remick S, Craig M, Hamadani M. High Rates of Non-Relapse Mortality and Graft-Versus-Host Disease in Patient Undergoing Allogeneic Stem Cell Transplantation (ASCT) Following Non-Myeloablative (NMA) Conditioning With TLI/ATG. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.476] [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]
|
26
|
Kanate A, Osman S, Cumpston A, Hobbs G, Leadmon S, Bunner P, Gibson L, Tse W, Abraham J, Remick S, Craig M, Hamadani M. In Vivo T-Cell Depletion (TCD) Does Not Improve Rates of Graft-Versus-Host Disease (GVHD) and Transplantation Outcomes in Patients Undergoing Peripheral Blood Allogeneic Hematopoietic Cell Transplant (AHCT). Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.465] [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]
|
27
|
Altaha R, Almubarak M, Newton MD, Torres-Trejo A, Marano G, Hobbs G, Gibson L, Petros WP, Remick SC. A pilot study of fosbretabulin with bevacizumab in recurrent high-grade gliomas. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
28
|
Walker K, Fletcher O, Johnson N, Palles C, Folkerd E, Hillier SG, Moss S, Gibson L, Dowsett M, Peto J, dos santos Silva I. Polymorphisms, endogenous hormone levels and familial breast cancer risk in premenopausal women. Breast Cancer Res 2010. [PMCID: PMC2875587 DOI: 10.1186/bcr2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
|
29
|
Abstract
AIM To determine the prevalence and associations of self-reported and parent-reported pain in children with cerebral palsy (CP) of all severities. METHOD Cross-sectional design using a questionnaire; analysis using ordinal regression. Children aged 8-12 years were randomly selected from population-based registers of children with CP in eight European regions; a further region recruited 75 children from multiple sources. Outcome measures were pain in the previous week among children who could self-report and parents' perception of their child's pain in the previous 4 weeks. RESULTS Data on pain were available from 490 children who could self-report and parents of 806 children (those who could and could not self-report). The estimated population prevalence of self-reported pain in the previous week was 60% (95% CI: 54-65%) and that of parent-reported pain in the previous 4 weeks was 73% (95% CI: 69-76%). In self-reporting children, older children reported more pain but pain was not significantly associated with severity of impairment. In parent reports, severity of child impairment, seizures and parental unemployment were associated with more frequent and severe pain. CONCLUSION Pain in children with CP is common. Clinicians should enquire about pain and consider appropriate physical, therapeutic or psychological management.
Collapse
Affiliation(s)
- K N Parkinson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
| | | | | | | |
Collapse
|
30
|
Lokaj P, Krivan L, Kozak M, Sepsi M, Trcka P, Vlasinova J, Spinar J, Ferraro A, Rordorf R, Belvito C, Vicentini A, Savastano S, Petracci B, Sanzo A, Landolina M, Greenberg S, Goldman D, Deering T, Epstein A, Burke J, Dalal Y, Hurley J, Robinson B, Melton C, Patel M, Saporito J, Charlton S, Sims JJ, Van Casteren L, Heidbuchel H, Rossenbacker T, Gopal R, Vanhaecke J, Van Cleemput J, Droogne W, Willems R, Rocha Costa S, Silva J, Almeida S, Reis Santos K, Cavaco D, Morgado F, Adragao P, Silva A, Kanoupakis EM, Mavrakis HE, Kallergis EM, Koutalas EP, Saloustros IG, Milathianaki M, Manios EG, Vardas PE, Richey M, Malkin RA, Masson SC, Ransbury T, Urtz M, Ideker RE, Sanders WE, Greenberg S, Deering T, Goldman D, Epstein A, Burke J, Dalal Y, Brembilla-Perrot B, Azman B, Terrier De La Chaise A, Blangy H, Sadoul N, Claudon O, Louis P, Selton O, Braunschweig F, Ekman M, Maschio M, Linde C, Cowie MR, Pignalberi C, Lavalle C, Morichelli L, Porfili A, Quarta L, Sassi A, Ricci RP, Santini M, Deering TF, Goldman DS, Greenberg S, Epstein A, Gupta M, Gall SA, Kelland NF, Tynan M, Lord SW, Plummer CJ, Mccomb JM, Treguer F, Mabo P, Tassin A, Prunier F, Furber A, Daubert JC, Leclercq C, Dupuis JM, Bertini M, Ng ACT, Borleffs CJW, Delgado V, Boriani G, Leung DY, Schalij MJ, Bax JJ, Cabrera Bueno F, Alzueta J, Pena-Hernandez J, Molina-Mora MJ, Fernandez-Pastor J, Barrera A, De Teresa E, Stockburger M, Krebs A, Rauchhaus M, Celebi O, Nitardy A, Habedank D, Knaus T, Dietz R, Varma N, Epstein A, Irimpen A, Gibson L, Love C, Hindricks G, Elsner C, Geller J, Kautzner J, Moertel HB, Piorkowski C, Schumacher B, Taborsky M, Vest R, Blanco R, Valadri R, Shukrullah I, London B, Dudley S, Zafari M, Bloom H, Caliskan K, Theuns DF, Hoedemakers YM, Ten Cate FJ, Jordaens L, Szili Torok T, Biscione F, Di Grazia A, Pandolfo L, Porzio A, Deneke T, Lemke B, Horlitz M, Reinecke J, Lawo T, Muegge A, Grewe P, Borleffs CJW, Van Rees JB, Van Welsenes GH, Van Bommel RJ, Van Der Velde ET, Van Erven L, Bax JJ, Schalij MJ, Bhavnani S, Coleman C, Guertin D, White CM, Yarlagadda R, Clyne C, Kluger J. Poster Session 2: Primary prevention. Europace 2009. [DOI: 10.1093/europace/euq203] [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
|
31
|
Kesarcodi-Watson A, Kaspar H, Lategan MJ, Gibson L. Two pathogens of Greenshell mussel larvae, Perna canaliculus: Vibrio splendidus and a V. coralliilyticus/neptunius-like isolate. J Fish Dis 2009; 32:499-507. [PMID: 19538643 DOI: 10.1111/j.1365-2761.2009.01006.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Bacterial pathogens of Greenshell mussel (GSM) larvae can cause batch losses during hatchery production. Twenty-two isolates were screened using a larval bioassay. Two strains were identified as potential pathogens. Phenotypic identification of these strains revealed two non-reactive Gram-negative, oxidase positive rods. Sequencing of the 16S rRNA gene identified Vibrio splendidus and a V. coralliilyticus/neptunius-like isolate as pathogens of GSM larvae, with an ability to cause 83% and 75% larval mortality in vitro, respectively, at a concentration of 10(2) CFU mL(-1). Histopathology indicated that the route of infection was via the digestive system. Using healthy larvae as target hosts, Koch's postulates were confirmed for the two isolates. This is the first report on pathogens of GSM larvae.
Collapse
|
32
|
Gibson L, Crawley V, Simpson F, Everett A, Hickey G, Baajens S. Improving compliance to appropriate nutritional planning and intervention in ICU. Safer systems - saving lives. Nutrition 2008. [DOI: 10.1016/j.nut.2008.01.049] [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]
|
33
|
Brodaty H, Sachdev P, Berman K, Gibson L, Kemp NM, Cullen B, Burns A. Do extrapyramidal features in Alzheimer patients treated with acetylcholinesterase inhibitors predict disease progression? Aging Ment Health 2007; 11:451-6. [PMID: 17612809 DOI: 10.1080/13607860601086439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of the study is to explore the longitudinal course of patients with Alzheimer's disease (AD) with and without extrapyramidal signs (EPS) taking donepezil. A cohort of 106 community-dwelling patients with probable AD receiving donepezil in Sydney, Australia (n = 52) and Manchester, UK (n = 54) was followed over 12 months. Cognition was measured by the Mini-Mental State Exam (MMSE) and the Alzheimer Disease Assessment Scale-Cognitive test (ADAS-Cog) and function by the Alzheimer Disease Cooperative Study-Activities of Daily Living Scale (ADCS-ADL). A further follow-up at five years was conducted to examine mortality and institutionalisation. At baseline, EPS were correlated with MMSE (r = -0.467, p < 0.01), ADAS-Cog (r = 0.485, p < 0.01) and ADCS-ADL (r = -0.526, p < 0.01) scores. Patients with EPS had lower MMSE (F = 9.95, df = 1, p = 0.002) and ADCS-ADL (F = 9.41, df = 1, p = 0.003) scores than patients without EPS. Over one year no time main effects or time x group interaction effects were observed for either dependent variable. At five years patients with EPS were found to have a hazard of institution or death 2.2 times higher than those without EPS (p = 0.018; 95% CI: 1.2, 4.4). There was a positive association between EPS and cognitive and functional impairment. However, EPS did not predict more rapid cognitive or functional decline of patients taking donepezil or response to donepezil. The presence of EPS was a risk factor both for institutionalisation and for death.
Collapse
Affiliation(s)
- H Brodaty
- School of Psychiatry, University of New South Wales, Kensington, Australia
| | | | | | | | | | | | | |
Collapse
|
34
|
Jassem J, Hall E, Coombes R, Bliss J, Gibson L. Surgical approaches to early breast cancer in the intergroup exemestane study: large differences by country and geographical region. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)90965-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
35
|
Gibson L. Medicines agency introduces greater transparency. West J Med 2003. [DOI: 10.1136/bmj.327.7428.1368-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Abstract
There is increasing evidence that endocrine therapy has an important role in patients with oestrogen receptor positive breast cancer. Several large meta-analyses have reinforced the value of both ovarian ablation and tamoxifen in improving survival. Over the past decade, aromatase inhibitors have become the treatment of choice for second-line therapy of metastatic breast cancer, and the third generation inhibitors have now an established reputation for good patient tolerability. Early studies indicated that aminoglutethimide/hydrocortisone could benefit postmenopausal patients with primary breast cancer, and in 2001, the ATAC study showed that the third generation aromatase inhibitor, anastrozole, seemed superior to tamoxifen in that anastrozole-treated patients had a longer disease-free survival. Other studies will report on the relative merits of the steroidal inhibitor exemestane as well as non-steroidal letrozole. The exact duration and sequencing of treatment, together with the long-term effects on bone are at present, unknown.
Collapse
Affiliation(s)
- R Charles Coombes
- CR(UK) Department of Cancer Medicine, Imperial College, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK.
| | | | | | | | | |
Collapse
|
37
|
Sharp A, Gibson L, Norton M, Ryan B, Marks A, Semeraro L. The breeding season diet of wedge-tailed eagles (Aquila audax) in western New South Wales and the influence of Rabbit Calicivirus Disease. Wildl Res 2002. [DOI: 10.1071/wr00077] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A total of 2071 individual prey items were identified from 34 active and 55 inactive wedge-tailed eagle nests following the 1995, 1996 and 1997 breeding seasons. Overall, the eagle's diet was comparable to that reported in other studies within semi-arid regions, with rabbits, reptiles and macropods accounting for 47.8, 22.6 and 13.7% of prey items, respectively. In spring 1996 rabbit calicivirus moved into the study area, resulting in a 44-78% reduction in rabbit abundance (Sharp et al. 2001). An index was developed to enable the time since death for individual prey items to be approximated and a historical perspective of the eagle's diet to be constructed. Rabbits constituted 56-69% of dietary items collected during the pre-rabbit calicivirus disease (RCD) samples, but declined to 31% and 16% in the two post-RCD samples. A reciprocal trend was observed for the proportion of reptiles in the diet, which increased from 8-21% of pre-RCD dietary items to 49-54% after the advent of RCD. Similarly, the proportion of avian prey items was observed to increase in the post-RCD samples. These data suggested that prey switching may have occurred following the RCD epizootic. However, a lack of data on the relative abundances of reptiles and birds prevented an understanding of the eagle's functional responses to be developed and definitive conclusions to be drawn. Nevertheless, the eagles were observed to modify their diet to the change in rabbit densities by consuming larger quantities of native prey species.
Collapse
|
38
|
|
39
|
Abstract
This article aims to examine the prevention of pressure ulcers in the community. Pressure ulcers continue to cause needless distress and anxiety for patients, carers and their families. Health professionals in the community often face extreme challenges when caring for patients who are at risk of developing pressure ulcers. This could be due to lack of appropriate assessment skills and having insufficient time to conduct an appropriate assessment. Having an understanding and awareness of the function of the skin and the aetiology of pressure ulcer development can assist the health professional in attempting to take a proactive approach to prevent pressure ulcer formation in the community setting.
Collapse
Affiliation(s)
- L Gibson
- Nursing, Florence Nightingale School of Nursing and Midwifery, King's College London
| |
Collapse
|
40
|
Gibson L, Poulain N. Clinical governance and tissue viability. Nurs Times 2001; 97:54. [PMID: 11954460] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
|
41
|
Estrada CA, Unterborn JN, Price J, Thompson D, Gibson L. Judging the effectiveness of clinical pathways for pneumonia: the role of risk adjustment. Eff Clin Pract 2000; 3:221-8. [PMID: 11185327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
CONTEXT Although observational studies suggest that clinical pathways may decrease costs and improve quality in hospitalized patients with community-acquired pneumonia, inferences from these studies are limited by potential selection bias and inadequate case-mix adjustment. OBJECTIVE To compare the assessment of a clinical pathway for community-acquired pneumonia with and without adjusting for patient characteristics and disease severity. DESIGN Retrospective cohort study. PATIENTS AND SETTING Consecutive series of adult patients admitted with clinical diagnosis of community-acquired pneumonia, treated with either a clinical pathway (which included guidelines for antibiotics, tests, and ancillary care) or usual care. MAIN OUTCOME MEASURES Total hospital charges, length of stay, clinical deterioration (requiring mechanical ventilation or intensive care unit transfer), and in-hospital mortality. We used multiple linear and logistic regression to adjust for patient case mix. RESULTS Compared with patients receiving usual care (n = 275), patients in the pathway group (n = 97) were more likely to be treated by family physicians than specialists and had lower pneumonia severity scores. In the unadjusted analysis, total hospital charges were lower among pathway patients ($2456; 95% CI, $175 to $4737; P = 0.04); in the adjusted analysis, the difference in total charges was smaller (average reduction $1807; CI, $4164 lower to $549 higher; P = 0.13). In the unadjusted analysis, length of stay was lower among pathway patients (1.8 days lower; CI, 3.9 lower to 0.4 higher; P = 0.12); in the adjusted analysis, the difference in length of stay was smaller (0.9 days lower; CI, 3.2 lower to 1.3 higher; P = 0.4). Although unadjusted analysis showed significantly lower in-hospital mortality in pathway patients, this difference was not confirmed in the adjusted analysis. CONCLUSIONS Clinical pathways may reduce costs and improve quality of care in community-acquired pneumonia. In nonrandomized studies, however, selection bias and case-mix differences may explain some of the apparent effectiveness.
Collapse
Affiliation(s)
- C A Estrada
- East Carolina University School of Medicine, Greenville, NC, USA.
| | | | | | | | | |
Collapse
|
42
|
Boppart MD, Aronson D, Gibson L, Roubenoff R, Abad LW, Bean J, Goodyear LJ, Fielding RA. Eccentric exercise markedly increases c-Jun NH(2)-terminal kinase activity in human skeletal muscle. J Appl Physiol (1985) 1999; 87:1668-73. [PMID: 10562607 DOI: 10.1152/jappl.1999.87.5.1668] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Eccentric contractions require the lengthening of skeletal muscle during force production and result in acute and prolonged muscle injury. Because a variety of stressors, including physical exercise and injury, can result in the activation of the c-Jun NH(2)-terminal kinase (JNK) intracellular signaling cascade in skeletal muscle, we investigated the effects of eccentric exercise on the activation of this stress-activated protein kinase in human skeletal muscle. Twelve healthy subjects (7 men, 5 women) completed maximal concentric or eccentric knee extensions on a KinCom isokinetic dynamometer (10 sets, 10 repetitions). Percutaneous needle biopsies were obtained from the vastus lateralis muscle 24 h before exercise (basal), immediately postexercise, and 6 h postexercise. Whereas both forms of exercise increased JNK activity immediately postexercise, eccentric contractions resulted in a much higher activation (15.4 +/- 4.5 vs. 3.5 +/- 1.4-fold increase above basal, eccentric vs. concentric). By 6 h after exercise, JNK activity decreased back to baseline values. In contrast to the greater activation of JNK with eccentric exercise, the mitogen-activated protein kinase kinase 4, the immediate upstream regulator of JNK, was similarly activated by concentric and eccentric exercise. Because the activation of JNK promotes the phosphorylation of a variety of transcription factors, including c-Jun, the results from this study suggest that JNK may be involved in the molecular and cellular adaptations that occur in response to injury-producing exercise in human skeletal muscle.
Collapse
Affiliation(s)
- M D Boppart
- Research Division, Joslin Diabetes Center, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Massachusetts 02111, USA
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Ogilvy S, Metcalf D, Gibson L, Bath ML, Harris AW, Adams JM. Promoter elements of vav drive transgene expression in vivo throughout the hematopoietic compartment. Blood 1999; 94:1855-63. [PMID: 10477714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
To develop a method for targeting expression of genes to the full hematopoietic system, we have used transgenic mice to explore the transcriptional regulation of the vav gene, which is expressed throughout this compartment but rarely outside it. Previously, we showed that a cluster of elements surrounding its promoter could drive hematopoietic-specific expression of a bacterial lacZ reporter gene, but the expression was confined to lymphocytes and was sporadically silenced. Those limitations are ascribed here to the prokaryotic reporter gene. With a human CD4 (hCD4) cell surface reporter, the vav promoter elements drove expression efficiently and stably in virtually all nucleated cells of adult hematopoietic tissues but not notably in nonhematopoietic cell types. In multiple lines, hCD4 appeared on most, if not all, B and T lymphocytes, granulocytes, monocytes, megakaryocytes, eosinophils, and nucleated erythroid cells. Moreover, high levels appeared on both lineage-committed progenitors and the more primitive preprogenitors. In the fetus, expression was evident in erythroid cells of the definitive but not the primitive type. These results indicate that a prokaryotic sequence can inactivate a transcription unit and that the vav promoter region constitutes a potent transgenic vector for the entire definitive hematopoietic compartment.
Collapse
Affiliation(s)
- S Ogilvy
- The Walter and Eliza Hall Institute of Medical Research, Royal Melbourne Hospital, Victoria, Australia
| | | | | | | | | | | |
Collapse
|
44
|
Gibson L. Amenities. Valet with a vision. Hosp Health Netw 1999; 73:14, 16. [PMID: 10224956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
45
|
Yan SD, Shi Y, Zhu A, Fu J, Zhu H, Zhu Y, Gibson L, Stern E, Collison K, Al-Mohanna F, Ogawa S, Roher A, Clarke SG, Stern DM. Role of ERAB/L-3-hydroxyacyl-coenzyme A dehydrogenase type II activity in Abeta-induced cytotoxicity. J Biol Chem 1999; 274:2145-56. [PMID: 9890977 DOI: 10.1074/jbc.274.4.2145] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Endoplasmic reticulum-associated amyloid beta-peptide (Abeta)-binding protein (ERAB)/L-3-hydroxyacyl-CoA dehydrogenase type II (HADH II) is expressed at high levels in Alzheimer's disease (AD)-affected brain, binds Abeta, and contributes to Abeta-induced cytotoxicity. Purified recombinant ERAB/HADH II catalyzed the NADH-dependent reduction of S-acetoacetyl-CoA with a Km of approximately 68 microM and a Vmax of approximately 430 micromol/min/mg. The contribution of ERAB/HADH II enzymatic activity to Abeta-mediated cellular dysfunction was studied by site-directed mutagenesis in the catalytic domain (Y168G/K172G). Although COS cells cotransfected to overexpress wild-type ERAB/HADH II and variant beta-amyloid precursor protein (betaAPP(V717G)) showed DNA fragmentation, cotransfection with Y168G/K172G-altered ERAB and betaAPP(V717G) was without effect. We thus asked whether the enzyme might recognize alcohol substrates of which the aldehyde products could be cytotoxic; ERAB/HADH II catalyzed oxidation of a variety of simple alcohols (C2-C10) to their respective aldehydes in the presence of NAD+ and NAD-dependent oxidation of 17beta-estradiol. Addition of micromolar levels of synthetic Abeta(1-40) to purified ERAB/HADH II inhibited, in parallel, reduction of S-acetoacetyl-CoA (Ki approximately 1.6 microM), as well as oxidation of 17beta-estradiol (Ki approximately 3.2 microM) and (-)-2-octanol (Ki approximately 2.6 microM). Because micromolar levels of Abeta were required to inhibit ERAB/HADH II activity, whereas Abeta binding to ERAB/HADH II occurred at much lower concentrations (Km approximately 40-70 nM), the latter more closely simulating Abeta levels within cells, Abeta perturbation of ERAB/HADH II was likely to result from mechanisms other than the direct modulation of enzymatic activity. Cells cotransfected to overexpress ERAB/HADH II and betaAPP(V717G) generated malondialdehyde-protein and 4-hydroxynonenal-protein epitopes, which were detectable only at the lowest levels in cells overexpressing either ERAB/HADH II or betaAPP(V717G) alone. Generation of such toxic aldehydes was not observed in cells contransfected to overexpress Y168G/K172G-altered ERAB and betaAPP(V717G). We conclude that the generalized alcohol dehydrogenase activity of ERAB/HADH II is central to the cytotoxicity observed in an Abeta-rich environment.
Collapse
Affiliation(s)
- S D Yan
- Departments of Pathology, Physiology and Surgery, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Innes KM, Szilvassy SJ, Davidson HE, Gibson L, Adams JM, Cory S. Retroviral transduction of enriched hematopoietic stem cells allows lifelong Bcl-2 expression in multiple lineages but does not perturb hematopoiesis. Exp Hematol 1999; 27:75-87. [PMID: 9923446 DOI: 10.1016/s0301-472x(98)00015-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Transduction of hematopoietic stem cells with a novel retrovirus has allowed long-term expression of human Bcl-2 in multiple hematopoietic lineages. Thy-1.2lo Sca-1+ H-2Khi stem cells enriched from the bone marrow of 5-fluorouracil-treated (Ly5-2) mice were infected with the bcl-2 retrovirus and injected into (Ly5-1) irradiated recipients. Analysis at 5 months indicated that reconstitution of hematopoiesis occurred predominantly from donor-derived (Ly5-2+) stem cells and that, in half the mice (18 of 35), most blood cells derived from virally transduced stem cells. The level of Bcl-2 expression achieved with the retroviral vector approached that of a well-characterized transgenic vector and could be sustained for life in several blood cell lineages. In the 25 mice assessed at 10 months, human Bcl-2 was readily detectable in 62+/-22% of Ly5-2+ peripheral blood leukocytes. More detailed analysis of a cohort killed between 14 and 20 months established that human Bcl-2 protein could be detected in B and T lymphocytes, granulocytes, macrophages, and some immature erythroid cells. Furthermore, hematopoietic stem cells from the bone marrow of these mice maintained Bcl-2 expression in hematopoietic tissues of secondary recipients for at least another 19 months. These data provide clear evidence for efficient infection of primitive hematopoietic stem cells and for maintenance of proviral expression for over 2.5 years, the lifespan of mice. The level of exogenous Bcl-2 was sufficient to enhance survival of B and T lymphoid cells, granulocytes, and myeloid colony-forming cells cultured under suboptimal conditions, but hematopoiesis in the mice was not notably perturbed.
Collapse
Affiliation(s)
- K M Innes
- The Walter and Eliza Hall Institute of Medical Research, Victoria, Australia
| | | | | | | | | | | |
Collapse
|
47
|
Berkowitz RD, Alexander S, Bare C, Linquist-Stepps V, Bogan M, Moreno ME, Gibson L, Wieder ED, Kosek J, Stoddart CA, McCune JM. CCR5- and CXCR4-utilizing strains of human immunodeficiency virus type 1 exhibit differential tropism and pathogenesis in vivo. J Virol 1998; 72:10108-17. [PMID: 9811751 PMCID: PMC110545 DOI: 10.1128/jvi.72.12.10108-10117.1998] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/1998] [Accepted: 08/26/1998] [Indexed: 11/20/2022] Open
Abstract
CCR5-utilizing (R5) and CXCR4-utilizing (X4) strains of human immunodeficiency virus type 1 (HIV-1) have been studied intensively in vitro, but the pathologic correlates of such differential tropism in vivo remain incompletely defined. In this study, X4 and R5 strains of HIV-1 were compared for tropism and pathogenesis in SCID-hu Thy/Liv mice, an in vivo model of human thymopoiesis. The X4 strain NL4-3 replicates quickly and extensively in thymocytes in the cortex and medulla, causing significant depletion. In contrast, the R5 strain Ba-L initially infects stromal cells including macrophages in the thymic medulla, without any obvious pathologic consequence. After a period of 3 to 4 weeks, Ba-L infection slowly spreads through the thymocyte populations, occasionally culminating in thymocyte depletion after week 6 of infection. During the entire time of infection, Ba-L did not mutate into variants capable of utilizing CXCR4. Therefore, X4 strains are highly cytopathic after infection of the human thymus. In contrast, infection with R5 strains of HIV-1 can result in a two-phase process in vivo, involving apparently nonpathogenic replication in medullary stromal cells followed by cytopathic replication in thymocytes.
Collapse
Affiliation(s)
- R D Berkowitz
- Gladstone Institute of Virology and Immunology, San Francisco, Stanford University, Stanford, and Veterans Hospital, Palo Alto, California, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Gibson L. Hospital sales. A deal behind every door. Hosp Health Netw 1998; 72:47-8. [PMID: 9842366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
|
49
|
Gibson L, Lawrence JC, Nelson EA, Vowden K. From the Journals. J Wound Care 1998; 7:549-550. [PMID: 27957894 DOI: 10.12968/jowc.1998.7.10.549] [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: 11/11/2022]
Abstract
PRESSURE ULCER RISK ASSESSMENT IN INTENSIVE CARE SETTINGS MRSA IN BURN PATIENTS LONG-STRETCH AND SHORT- STRETCH BANDAGING HEALING RATES AND TREATMENT COSTS IN COMPRESSION BANDAGING.
Collapse
Affiliation(s)
- L Gibson
- Lecturer, Post Registration Nursing, University of Hertfordshire, Hatfield, Herts, UK
| | | | - E A Nelson
- Research Fellow, Centre for Evidence-based Nursing, University of York, York, UK
| | - K Vowden
- Clinical Nurse Specialist, Bradford Royal Infirmary, Bradford, UK
| |
Collapse
|
50
|
Gibson L. Disaster planning. Fire escape. Hosp Health Netw 1998; 72:36-8. [PMID: 9823293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
|