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Bellamy M, Chu B, Serencsits B, Quinn B, Prasad K, Altamirano J, Williamson M, Miodownik D, Abrahams N, Chen F, Bierman D, Wutkowski M, Carter L, Dauer L. Impact of shield location on staff and caregiver dose rates for I-131 radiopharmaceutical therapy patients. J Radiol Prot 2023; 43:033501. [PMID: 37413983 DOI: 10.1088/1361-6498/ace4d4] [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] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/06/2023] [Indexed: 07/08/2023]
Abstract
The goal of this study is to investigate the effect of the location and width of a single lead shield on the dose rate of staff and caregivers in a hospital room with an I-131 patient. The best orientation of the patient and caregiver relative to the shield was determined based on minimizing staff and caregiver radiation dose rates. Shielded and unshielded dose rates were simulated using a Monte Carlo computer simulation and validated using real-world ionisation chamber measurements. Based on a radiation transport analysis using an adult voxel phantom published by the International Commission on Radiological Protection, placing the shield near the caregiver yielded the lowest dose rates. However, this strategy reduced the dose rate in only a tiny area of the room. Furthermore, positioning the shield near the patient in the caudal direction provided a modest dose rate reduction while shielding a large room area. Finally, increased shield width was associated with decreasing dose rates, but only a four-fold dose-rate reduction was observed for standard width shields. The recommendations of this case study may be considered as potential candidate room configurations where radiation dose rates are minimized, however these findings must be weighed against additional clinical, safety, and comfort considerations.
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Affiliation(s)
- M Bellamy
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - B Chu
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - B Serencsits
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - B Quinn
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - K Prasad
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - J Altamirano
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - M Williamson
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - D Miodownik
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - N Abrahams
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - F Chen
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - D Bierman
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - M Wutkowski
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - L Carter
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
| | - L Dauer
- Memorial Sloan Kettering, 1275 York Avenue, New York, NY 10065, United States of America
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Angelakas A, Cook N, Graham D, Krebs M, Thistlethwaite F, Carter L. 124MO A single centre experience of patients with rare cancers referred for early phase clinical trials. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101070] [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: 04/05/2023] Open
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Hosseini S, Carter L, Thomson D, Howard M. EVALUATING THE EFFECTIVENESS OF AN ONLINE TRAINING COURSE FOR MEETING NEEDS ASSOCIATED WITH CAREGIVING BURDEN. Innov Aging 2022. [PMCID: PMC9766254 DOI: 10.1093/geroni/igac059.1720] [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: 12/24/2022] Open
Abstract
Informal caregivers make up a critical part of long-term support in the communities due to their important role in caring for older adults living at home. Modern-day caregivers are facing greater responsibility and burden for managing their care recipients. The present study aimed to explore the effect of a caregiving training program in alleviating caregiver burden. This program included four standalone online modules each with specific foci. Completion of activities across the modules allowed for the creation of a Caregiver Action Plan which offered a personal and practical resource to the informal caregivers. This evaluation study was qualitative and a used thematic analysis method of data analysis. Data stemmed from semi-structured interviews with the caregivers and their reflections on the program’s discussion board. Most caregivers provided care for persons with dementia. Interviews with the family caregivers were conducted, transcribed, and thematically analyzed. Themes were identified through constant comparison and in an iterative process. The family caregivers demonstrated consensus on the efficacy of the program in raising competence and confidence and contributing to ameliorating burden levels. Important themes were identified in association with areas for which the caregivers needed support: Early dementia education, planning for future care, learning about navigating healthcare systems, peer support, enhancing self-care, and coping with emotional burden and self-blame. The findings will be informative in shaping the program based on the caregiver’s identified needs through addressing those areas that they would need support. These findings may offer recommendations to other programs designed to support the family caregivers.
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Wicky BIM, Milles LF, Courbet A, Ragotte RJ, Dauparas J, Kinfu E, Tipps S, Kibler RD, Baek M, DiMaio F, Li X, Carter L, Kang A, Nguyen H, Bera AK, Baker D. Hallucinating symmetric protein assemblies. Science 2022; 378:56-61. [PMID: 36108048 PMCID: PMC9724707 DOI: 10.1126/science.add1964] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [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: 01/23/2023]
Abstract
Deep learning generative approaches provide an opportunity to broadly explore protein structure space beyond the sequences and structures of natural proteins. Here, we use deep network hallucination to generate a wide range of symmetric protein homo-oligomers given only a specification of the number of protomers and the protomer length. Crystal structures of seven designs are very similar to the computational models (median root mean square deviation: 0.6 angstroms), as are three cryo-electron microscopy structures of giant 10-nanometer rings with up to 1550 residues and C33 symmetry; all differ considerably from previously solved structures. Our results highlight the rich diversity of new protein structures that can be generated using deep learning and pave the way for the design of increasingly complex components for nanomachines and biomaterials.
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Affiliation(s)
- B. I. M. Wicky
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - L. F. Milles
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - A. Courbet
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| | - R. J. Ragotte
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - J. Dauparas
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - E. Kinfu
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - S. Tipps
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - R. D. Kibler
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - M. Baek
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - F. DiMaio
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - X. Li
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - L. Carter
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - A. Kang
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - H. Nguyen
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - A. K. Bera
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - D. Baker
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
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Hu X, Garcia E, Goossens A, Gozo M, Lee T, Liu X, Le B, Taylor Meadows K, Eto D, Yusuf I, Lu K, Michels T, Kasem M, Marby K, Rowbottom M, Osterhout R, Carter L. An orally bioavailable ENPP1-selective inhibitor demonstrates superior immune preservation effects over STING agonists and confers antitumor efficacy in combination with other therapies in syngeneic tumor models. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01133-9] [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: 11/27/2022]
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Kurtz K, Eibler L, Dacek M, Carter L, Cheal S, Veach D, Qureshy S, Han J, Reynaud E, Verma S, McDevitt M, Punzalan B, Vargas D, Santich B, Monette S, Kesner A, Cheung N, Larson S, Scheinberg D, Krebs S. A radiohapten capture system for CAR T cells that tracks them in vivo and improves efficacy. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Studts J, Carter L, Feldman J, Donaldson D, Pantelas J, Ostroff J, Stiles B, Scharnetzki E, Smith R, Kazernooni E, Rosenthal L, Durden K, Burn K, A. Campaign to End Lung Cancer Stigma. P2.08-07 The Campaign to End Lung Cancer Stigma: The ACS National Lung Cancer Roundtable Efforts to Confront and Extinguish Lung Cancer Stigma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Jittla P, Graham DM, Zhou C, Halliwell J, O'Reilly S, Aruketty S, Azizi A, Germetaki T, Lowe J, Little M, Punnett G, McMahon P, Benson L, Carter L, Krebs MG, Thistlethwaite FC, Darlington E, Yorke J, Cook N. EPIC: an evaluation of the psychological impact of early-phase clinical trials in cancer patients. ESMO Open 2022; 7:100550. [PMID: 35994790 PMCID: PMC9420347 DOI: 10.1016/j.esmoop.2022.100550] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Anxiety and depression in patients with cancer is associated with decreased quality of life and increased morbidity and mortality. However, these are often overlooked and untreated. Early-phase clinical trials (EPCTs) recruit patients with advanced cancers who frequently lack future treatment options, which may lead to increased anxiety and depression. Despite this, EPCTs do not routinely consider psychological screening for patients. Patients and methods This prospective observational study explored levels of anxiety and depression alongside impact of trial participation in the context of EPCTs. The Hospital Anxiety and Depression Scale and the Brief Illness Perceptions Questionnaire were completed at the point of EPCT consent, the end of screening and at pre-specified time points thereafter. Results Sixty-four patients (median age 56 years; median Eastern Cooperative Oncology Group performance status 1) were recruited. At consent, 57 patients returned questionnaires; 39% reported clinically relevant levels of anxiety whilst 18% reported clinically relevant levels of depression. Sixty-three percent of patients experiencing psychological distress had never previously reported this. Males were more likely to be depressed (P = 0.037) and females were more likely to be anxious (P = 0.011). Changes in anxiety or depression were observed after trial enrolment on an individual level, but not significant on a population level. Conclusions Patients on EPCTs are at an increased risk of anxiety and depression but may not seek relevant support. Sites offering EPCTs should consider including psychological screening to encourage a more holistic approach to cancer care and consider the sex of individuals when tailoring psychological support to meet specific needs. Early-phase cancer trial patients have an increased risk of anxiety and depression. Patients at risk were not seeking support for anxiety and depression. Male patients were more likely to be depressed; female patients were more likely to be anxious. This work highlights the need to screen for psychological symptoms in patients entering early-phase trials.
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Affiliation(s)
- P Jittla
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - D M Graham
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - C Zhou
- CRUK Manchester Institute Cancer Biomarker Centre, University of Manchester, Manchester, UK
| | - J Halliwell
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - S O'Reilly
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - S Aruketty
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - A Azizi
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - T Germetaki
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - J Lowe
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - M Little
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - G Punnett
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - P McMahon
- Medical Oncology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - L Benson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - L Carter
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - M G Krebs
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - F C Thistlethwaite
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - E Darlington
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - J Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - N Cook
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
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Carter L, Yadav A, O'Neill S, O'Shea E. Extended length of stay and related costs associated with dementia in acute care hospitals in Ireland. Aging Ment Health 2022; 27:911-920. [PMID: 35603799 DOI: 10.1080/13607863.2022.2068128] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To estimate the additional impact of dementia on in-patient length of stay (LOS) and related costs in Irish acute hospitals. Both principal and secondary diagnosis effects are estimated and valued. METHODS This is a cross-sectional study based on administrative data collected on all public hospital in-patient discharges in Ireland for people aged 65 years and older in 2019. Coarsened exact matching (CEM) was undertaken to account for observed confounders between dementia and non-dementia groups, while generalised linear modelling (GLM) was used to compare differences in LOS. RESULTS Patients with a principal diagnosis of dementia spent on average 17.5 (CI: 15.42, 19.56; p < .01) d longer in hospital than similar patients with no principal diagnosis of dementia. LOS was 6.7 (CI: 6.31, 7.14; p < .01) d longer for patients with a secondary diagnosis of dementia compared to similar patients with no secondary diagnosis of dementia. The additional annual cost of care for patients in hospitals with a secondary (principal) diagnosis of dementia was €62.0 million (€13.2 million). CONCLUSIONS This study highlights the economic impact of extended LOS for patients with dementia in Irish acute hospitals. Addressing specific dementia-related needs of people in hospital is likely to optimise resource use and decrease health care costs in acute care settings.
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Affiliation(s)
- L Carter
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
| | - A Yadav
- J.E. Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland
| | - S O'Neill
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - E O'Shea
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
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Lee E, Yap T, Fontana E, Rosen E, Spigel D, Lheureux S, Mettu N, Carter L, Plummer R, Patel S, McDougall R, Papp R, May S, Nejad P, Ulanet D, Wainszelbaum M, Manley P, Koehler M, Fretland A, Højgaard M. 9P Preliminary population pharmacokinetic (popPK) co-variates and exposure response (ER) assessment of QT for RP-3500, a highly potent and specific inhibitor of ataxia telangiectasia and Rad3-related (ATR) protein kinase. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.072] [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] Open
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Jefferies C, Long L, Twigg J, Carter L. 1521 Oral Foregut Duplication Cyst in A Neonate: A Case Report and Review of The Literature. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.385] [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]
Abstract
Abstract
A four-day-old neonate was referred to the Oral and Maxillofacial Surgery department by the Paediatric medical team regarding a cystic lesion associated with the child’s lingual frenulum. The lesion appeared to be affecting feeding causing a potential failure to thrive.
An MRI showed a 22 x 14 x 17 mm thin-walled oval cystic structure within the midline of the tongue/floor of the mouth. The decision was made with the family to surgically excise the lesion under a general anaesthetic. The histopathology results demonstrated the cyst to be lined with both gastric surface mucus cells and ciliated respiratory-type epithelium.
The patient was diagnosed with having an Oral Foregut Duplication Cyst (OFDC), also known as a lingual choristoma, enteric duplication cyst or heterotopic gastrointestinal cyst of the oral cavity. OFDCs are benign developmental anomalies that contain foregut derivatives. The cyst linings can contain gastrointestinal, respiratory, squamous or mixed cell types. There are only approximately 58 cases reported in the literature, demonstrating the rarity of these lesions.
OFDCs can be asymptomatic but in some neonates, they can present with difficulties feeding, swallowing and even has been shown to cause airway obstruction. If left in situ an OFDC can potentially go on to hinder speech development.
Although rare, OFDCs should be considered in a differential diagnosis of congenital oral lesions and in particular those of the anterior floor of mouth and tongue. With the use of pre-op imaging to help planning, surgical excision is both diagnostic and therapeutic.
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Affiliation(s)
- C Jefferies
- Leeds General Infirmary, Leeds, United Kingdom
| | - L Long
- Leeds General Infirmary, Leeds, United Kingdom
| | - J Twigg
- Leeds General Infirmary, Leeds, United Kingdom
| | - L Carter
- Leeds General Infirmary, Leeds, United Kingdom
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Ortega Franco A, Adamson-Raieste A, Rahman R, Pihlak R, Peters N, Scott JA, Aruketty S, Thomson C, Dransfield S, Henshaw A, Ward A, Cutts T, Carter L, Thistlethwaite F, Cook N, Graham D, Stevenson J, Krebs M. 44P Value of comprehensive genomic profiling in pre-screening patients for NTRK fusion in STARTRK2 trial: Single centre experience. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2040] [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] Open
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13
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Carter L, O'Neill S, Austin PC, Keogh F, Pierce M, O'Shea E. Admission to long-stay residential care and mortality among people with and without dementia living at home but on the boundary of residential care: a competing risks survival analysis. Aging Ment Health 2021; 25:1869-1876. [PMID: 33317328 DOI: 10.1080/13607863.2020.1857698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Health policy in many countries is underpinned by a commitment to support dependent older people to remain in their own home for as long as possible and practicable. This study explores factors affecting both admission to long-stay residential care (LSRC) and mortality among people with and without dementia who are currently living at home with intensive formal care support. METHODS This is a cross-sectional study based on administrative data collected on 429 dependent older people in Ireland, 269 of whom were people with dementia. A cause-specific hazard model was used to investigate the hazard of admission to LSRC, while accounting for mortality as a competing risk and vice versa. RESULTS Admission to LSRC was higher for people with dementia relative to people without and for those receiving lower amounts of informal care. The hazard of mortality was significantly higher for older people aged 85+, whereas it was lower for individuals with a medium level of dependency relative to those with high levels of dependency. The hazard of mortality was also influenced by the amount of informal care provision. CONCLUSION People with dementia are more likely to be admitted to LSRC than people without. Care for people with dementia needs to be more specialised and personal, and intensity of provision should not be equated to the number of care hours on offer. Informal care provision may help to prevent admission to LSRC. Advanced age, physical dependency and informal care provision affect mortality, raising interesting issues in relation to resource allocation.
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Affiliation(s)
- L Carter
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
| | - S O'Neill
- J.E. Cairnes School of Business and Economics, Upper Newcastle, National University of Ireland, Galway, Ireland
| | - Peter C Austin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Institute of Health Management, Policy and Evaluation, University of Toronto, Toronto, Canada
| | - F Keogh
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
| | - M Pierce
- Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - E O'Shea
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
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Jittla P, Graham D, Zhou C, Halliwell J, O'Reilly S, Aruketty S, Azizi A, Germetaki T, Lowe J, Little M, Punnett G, McMahon P, Benson L, Carter L, Krebs M, Thistlethwaite F, Yorke J, Cook N. 1493P An evaluation of the psychological impact of early phase clinical trials in cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.821] [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: 12/01/2022] Open
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Billy Graham Mariam N, Rahman R, Mistry H, Aruketty S, Adamson-Raieste A, Church M, Scott JA, Carter L, Thistlethwaite F, Krebs M, Cook N, Graham D. 1849P Ethnicity and socioeconomic deprivation in early phase clinical trials in a UK tertiary referral centre. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Carter L, Mankad A, Hobman EV, Porter NB. Playing God and tampering with nature: popular labels for real concerns in synthetic biology. Transgenic Res 2021; 30:155-167. [PMID: 33502671 DOI: 10.1007/s11248-021-00233-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/06/2021] [Indexed: 11/25/2022]
Abstract
Public engagement in science with diverse cross-sections of the community is considered a critical aspect of responsible biotechnological innovation. While the research community shows willingness to engage with both ambivalent and supportive audiences about potentially disruptive technological advances, there is less enthusiasm for engaging with groups who hold deeply opposing views to such advances. 'Playing God' and 'tampering with nature' are popular examples of intrinsic objections often made in opposition to the development or use of novel genetic technologies. Historically appearing in arguments against the pursuit of genetically modified organisms in agriculture and food industries, intrinsic objections have previously been labelled by the science community as inconsistent, non-scientific, and vague. Now found in a range of innovation contexts, the domain of synthetic biology appears to attract such objections consistently. We present the findings from a large Australian study (N = 4593) which suggests 'playing God' objections and their variants can be multilayered and, at times, accompanied by meaningful information about risk perceptions. We use qualitative analysis of open-ended responses from an online survey to show how these objections are articulated in response to selected synthetic biology applications across environmental and health domains. Our research invites a rethink of how the synthetic biology community perceives, and engages with, people who express intrinsic objections. These people may additionally hold extrinsic concerns that may be potentially addressed, or at least reasonably considered, through dialogue. We offer some concluding remarks for engaging with publics who employ these types of arguments to communicate unease with aspects of technology development and use.
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Affiliation(s)
- L Carter
- CSIRO Land and Water, Dutton Park, QLD, Australia.
| | - A Mankad
- CSIRO Land and Water, Dutton Park, QLD, Australia
| | - E V Hobman
- CSIRO Land and Water, Dutton Park, QLD, Australia
| | - N B Porter
- CSIRO Land and Water, Wembley, WA, Australia
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Berman R, Davies A, Cooksley T, Gralla R, Carter L, Darlington E, Scotté F, Higham C. Supportive Care: An Indispensable Component of Modern Oncology. Clin Oncol (R Coll Radiol) 2020; 32:781-788. [PMID: 32814649 PMCID: PMC7428722 DOI: 10.1016/j.clon.2020.07.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/14/2020] [Accepted: 07/29/2020] [Indexed: 12/15/2022]
Abstract
The advent of new cancer therapies, alongside expected growth and ageing of the population, better survival rates and associated costs of care, is uncovering a need to more clearly define and integrate supportive care services across the whole spectrum of the disease. The current focus of cancer care is on initial diagnosis and treatment, and end of life care. The Multinational Association of Supportive Care in Cancer defines supportive care as 'the prevention and management of the adverse effects of cancer and its treatment'. This encompasses the entire cancer journey, and necessitates involvement and integration of most clinical specialties. Optimal supportive care can assist in accurate diagnosis and management, and ultimately improve outcomes. A national strategy to implement supportive care is needed to acknowledge evolving oncology practice, changing disease patterns and the changing patient demographic.
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Affiliation(s)
- R Berman
- The Christie NHS Foundation Trust, Manchester, UK.
| | - A Davies
- Royal Surrey NHS Foundation Trust, Guildford, UK
| | - T Cooksley
- The Christie NHS Foundation Trust, Manchester, UK
| | - R Gralla
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - L Carter
- The Christie NHS Foundation Trust, Manchester, UK
| | - E Darlington
- The Christie NHS Foundation Trust, Manchester, UK
| | - F Scotté
- Gustave Roussy Cancer Institute, Interdisciplinary Cancer Course Department (DIOPP), Villejuif, France
| | - C Higham
- The Christie NHS Foundation Trust, Manchester, UK
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18
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Tuthill M, Cappuccini F, Carter L, Pollock E, Poulton I, Verrill C, Evans T, Gillessen S, Attard G, Protheroe A, Hamdy F, Hill A, Redchenko I. 682P Results from ADVANCE: A phase I/II open-label non-randomised safety and efficacy study of the viral vectored ChAdOx1-MVA 5T4 (VTP-800) vaccine in combination with PD-1 checkpoint blockade in metastatic prostate cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Strollo PJ, Malhotra A, Strohl K, Pepin J, Schweitzer P, Lammers G, Hedner J, Baladi M, Carter L, Bujanover S, Menno D, Dauvilliers Y. 0693 Effects Of Solriamfetol On 24-hour Blood Pressure Patterns In Participants With Excessive Daytime Sleepiness Associated With Obstructive Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.689] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Solriamfetol is a dopamine and norepinephrine reuptake inhibitor indicated to improve wakefulness in adult patients with excessive daytime sleepiness associated with obstructive sleep apnea (OSA; 37.5-150 mg/d) or narcolepsy (75-150 mg/d). Previous studies reported small mean increases in blood pressure (BP); however, the time course of these effects has not been evaluated. In addition, effects on BP dipping, which has been shown to be a risk factor for adverse cardiovascular outcomes have not been evaluated. These analyses evaluated the effects of solriamfetol treatment on BP using 24-hour ambulatory blood pressure monitoring (ABPM) and on the percentage of OSA patients with a non-dipping BP profile.
Methods
Twenty-four-hour ABPM was conducted at baseline and week 8 in a 12-week randomized controlled trial in participants with OSA (n=474).
Results
At week 8, increases in BP were apparent in the 75 and 300 mg dose groups from ~6 AM until 8 PM. At baseline, 58% (placebo) and 55% (combined solriamfetol) of participants were non-dippers (defined as <10% decrease in mean arterial pressure [MAP] during sleep). There was no increase in the percentage of non-dippers at week 8 relative to baseline (placebo, 56%; combined solriamfetol, 53%). Results were similar when dipping was defined by changes in systolic BP and diastolic BP.
Conclusion
The effects of solriamfetol on BP at the highest approved dose of 150 mg/d are transient across the day. Solriamfetol was not observed to have an increase in non-dipping classification in participants with OSA at any dose studied.
Support
Jazz Pharmaceuticals
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Affiliation(s)
- P J Strollo
- University of Pittsburgh/Veterans Administration Pittsburgh Health System, Pittsburgh, PA
| | - A Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, CA
| | - K Strohl
- Case Western Reserve University, Cleveland, OH
| | - J Pepin
- Grenoble Alpes University Hospital, Grenoble, FRANCE
| | - P Schweitzer
- Sleep Medicine and Research Center St. Luke’s Hospital, Chesterfield, MO
| | - G Lammers
- Sleep-Wake Centre SEIN, Zwolle, NETHERLANDS
| | - J Hedner
- Sahlgrenska University Hospital, Gothenburg, SWEDEN
| | - M Baladi
- Jazz Pharmaceuticals, Palo Alto, CA
| | - L Carter
- Jazz Pharmaceuticals, Palo Alto, CA
| | | | - D Menno
- Jazz Pharmaceuticals, Philadelphia, PA
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20
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Strollo PJ, Malhotra A, Strohl K, Pepin J, Schweitzer P, Lammers G, Hedner J, Baladi M, Carter L, Bujanover S, Menno D, Dauvilliers Y. 0772 Effects Of Solriamfetol On 24-hour Blood Pressure Patterns In Participants With Excessive Daytime Sleepiness Associated With Narcolepsy. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.768] [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
Introduction
Solriamfetol is a dopamine and norepinephrine reuptake inhibitor indicated to improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy (75-150 mg/d) or obstructive sleep apnea (37.5-150 mg/d). Previous studies reported small mean increases in blood pressure (BP); however, the time course of these effects has not been evaluated. In addition, effects on BP dipping, which has been shown to be a risk factor for adverse cardiovascular outcomes, have not been evaluated. These analyses evaluated the effects of solriamfetol treatment on BP using 24-hour ambulatory blood pressure monitoring (ABPM) and on the percentage of narcolepsy patients with a non-dipping BP profile.
Methods
Twenty-four-hour ABPM was conducted at baseline and week 8 in a 12-week randomized controlled trial in participants with narcolepsy (n=236).
Results
At week 8, increases in BP were apparent in the 150 and 300 mg dose groups from 8 AM until 4 PM and 6 PM, respectively. At baseline, 52% (placebo) and 48% (combined solriamfetol) of participants were non-dippers (defined as <10% decrease in mean arterial pressure [MAP] during sleep). There was no increase in the percentage of non-dippers at week 8 relative to baseline (placebo, 44%; combined solriamfetol, 39%). Results were similar when dipping was defined by changes in systolic BP and diastolic BP.
Conclusion
The effects of solriamfetol on BP at the highest approved dose of 150 mg/d are transient across the day. Solriamfetol was not observed to have an increase in non-dipping classification in participants with narcolepsy at any dose studied.
Support
Jazz Pharmaceuticals
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Affiliation(s)
- P J Strollo
- University of Pittsburgh/Veterans Administration Pittsburgh Health System, Pittsburgh, PA
| | - A Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, CA
| | - K Strohl
- Case Western Reserve University, Cleveland, OH
| | - J Pepin
- Grenoble Alpes University Hospital, Grenoble, FRANCE
| | - P Schweitzer
- Sleep Medicine and Research Center St. Luke’s Hospital, Chesterfield, MO
| | - G Lammers
- Sleep-Wake Centre SEIN, Zwolle, NETHERLANDS
| | - J Hedner
- Sahlgrenska University Hospital, Gothenburg, SWEDEN
| | - M Baladi
- Jazz Pharmaceuticals, Palo Alto, CA
| | - L Carter
- Jazz Pharmaceuticals, Palo Alto, CA
| | | | - D Menno
- Jazz Pharmaceuticals, Philadelphia, PA
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21
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Vinckenbosch F, Asin J, De Vries N, Vonk P, Donjacour C, Lammers G, Overeem S, Janssen H, Wang G, Chen D, Carter L, Zhou K, Vermeeren A, Ramaekers J. 0673 Effects Of Solriamfetol On Driving Performance In Participants With Excessive Daytime Sleepiness Associated With Obstructive Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.669] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA) is associated with an increased risk of driving accidents. Solriamfetol, a dopamine/norepinephrine reuptake inhibitor, is approved in the US (Sunosi®) for EDS associated with OSA (37.5-150 mg/day). This study evaluated solriamfetol’s effects on on-road driving performance in participants with EDS associated with OSA.
Methods
In each period of this randomized, double-blind, placebo-controlled, crossover study (NCT 02806895; EudraCT 2015-003930-28), driving performance during an on-road driving test was assessed at 2 hours and 6 hours postdose following 7 days of treatment with solriamfetol (150mg/day × 3, then 300mg/day × 4) or placebo. The primary endpoint—standard deviation of lateral position (SDLP), a measure of “weaving,” at 2 hours postdose—was compared between solriamfetol and placebo per time point using a repeated mixed-effects analysis of variance model.
Results
The study included 34 participants. Baseline characteristics reflected the broader OSA population (88% male; mean age=52 years; mean Epworth Sleepiness Scale score=14.4). SDLP at 2 hours postdose was statistically significantly lower following solriamfetol (least squares [LS] mean [standard error; SE], 18.83cm [0.63]) compared with placebo (19.92cm [0.63]): LS mean difference, -1.08cm; 95% confidence interval (CI), -1.85, -0.32; P=0.0062 (incomplete driving tests: solriamfetol, n=1; placebo, n=4), indicating better performance with solriamfetol. At 6 hours postdose, SDLP following solriamfetol (LS mean[SE], 19.24cm [0.63]) was statistically significantly lower compared with placebo (20.04cm [0.63]): LS mean difference, -0.80cm; 95% CI,
-1.58, -0.03; P=0.0432 (incomplete driving tests: solriamfetol, n=3; placebo, n=7). Common adverse events (≥5%) with solriamfetol were headache, nausea, insomnia, dizziness, and agitation.
Conclusion
Solriamfetol (300mg/day) improved SDLP, an important measure of driving performance, at 2 and 6 hours in participants with EDS associated with OSA.
Support
Jazz Pharmaceuticals
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Affiliation(s)
| | - J Asin
- Amphia Ziekenhuis, Breda, NETHERLANDS
| | - N De Vries
- Onze Lieve Vrouwe Gasthuis, Amsterdam, NETHERLANDS
| | - P Vonk
- Onze Lieve Vrouwe Gasthuis, Amsterdam, NETHERLANDS
| | | | - G Lammers
- Sleep-Wake Centre SEIN, Zwolle, NETHERLANDS
| | | | | | - G Wang
- Jazz Pharmaceuticals, Palo Alto, CA
| | - D Chen
- Jazz Pharmaceuticals, Palo Alto, CA
| | - L Carter
- Jazz Pharmaceuticals, Palo Alto, CA
| | - K Zhou
- Jazz Pharmaceuticals, Palo Alto, CA
| | - A Vermeeren
- Maastricht University, Maastricht, NETHERLANDS
| | - J Ramaekers
- Maastricht University, Maastricht, NETHERLANDS
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22
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Althawadi R, Shkurka E, Carter L, Woyda J, Shannon H. Cardiorespiratory physiotherapy for mechanically ventilated children following cardiac surgery: a prospective observational service evaluation. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.087] [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]
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23
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Donato E, Lightfoot N, MacEwan L, Carter L. Interprofessional Education in Four Canadian Undergraduate Nursing Programs: An Examination of the Supporting Data. DRHJ 2020. [DOI: 10.28984/drhj.v3i0.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Canadian nursing programs are required to provide Interprofessional Education (IPE) since formal inclusion in the undergraduate curricula in 2012. This multiple case study explored how four undergraduate university nursing programs in Northern Ontario integrated IPE into their curricula, including opportunities and challenges of meeting the new IPE requirements. Data collected and analyzed in the study were: interviews with program directors, focus groups and interviews with faculty members, program documentation and information on websites, and on-site program observations. This paper extends the findings of this study and the themes identified in it. These themes were as follows: 1) varied understandings of IPE, 2) diverse IPE learning activities within curricula, 3) the requirement for support and resources for IPE and research, 4) student participation and leadership in IPE, and 5) limited IPE evaluation (Author names removed for integrity of review process, 2019). In this paper, the themes are explored in further depth through extensive consideration of documentation provided by the involved universities. These resources complement the data derived through interviews and focus groups with faculty and directors. Exploration of these data is a valuable means of illuminating any congruencies and dissonances found in the director and faculty data.
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24
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Ware GM, Francis OJ, Carman AS, Kuan SS, Bennett G, Carter L, Gaba D, James T, Lyon S, Nowak G, Richelieu M, Routh J, Tarter E, Thorpe C. Gas Chromatographic Determination of Deoxynivalenol in Wheat with Electron Capture Detection: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/69.5.899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Ten laboratories participated in a collaborative study of a method for the determination of deoxynivalenol in wheat by gas chromatography with electron capture detection. Each laboratory analyzed 6 samples in duplicate. Each collaborator received samples spiked at the 100.3, 501.3, and 1002.6 ng/g levels; a control sample; and 2 naturally contaminated samples. The average recovery (outliers excluded) for the spiked samples was 92.2%. The mean repeatability and reproducibility, respectively, were 32.2 and 41.3% for the spiked samples and 30.9 and 47.6% for the naturally contaminated samples. The method was adopted official first action.
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Affiliation(s)
- George M Ware
- Food and Drug Administration, Natural Toxin Research Center, 4298 Elysian Fields Avenue, New Orleans, LA 70122
| | - Octave J Francis
- Food and Drug Administration, Natural Toxin Research Center, 4298 Elysian Fields Avenue, New Orleans, LA 70122
| | - Allen S Carman
- Food and Drug Administration, Natural Toxin Research Center, 4298 Elysian Fields Avenue, New Orleans, LA 70122
| | - Shia S Kuan
- Food and Drug Administration, Natural Toxin Research Center, 4298 Elysian Fields Avenue, New Orleans, LA 70122
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25
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Lowe J, Lauste R, Descamps T, Krebs M, Graham D, Thistlethwaite F, Carter L, Cook N. EVALUATION OF OLDER PATIENTS IN EARLY PHASE CLINICAL TRIALS. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31301-3] [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: 10/25/2022]
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26
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Tyler D, Wong JLY, Krishnan O, Carter L. Antimicrobial regimens used in the treatment of mandibular fractures in UK maxillofacial units: changes over 12 years. Br J Oral Maxillofac Surg 2019; 58:89-91. [PMID: 31519439 DOI: 10.1016/j.bjoms.2019.08.024] [Citation(s) in RCA: 5] [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: 12/14/2018] [Accepted: 08/28/2019] [Indexed: 11/25/2022]
Abstract
In the case of most mandibular fractures, the prescription of antimicrobials for more than 24 hours postoperatively confers no clinical benefit. To establish the prescribing patterns for mandibular fractures in UK OMFS units, and to compare them with those used 12 years ago, we did a telephone and email survey of OMFS units in the UK. Antimicrobials were prescribed for more than 24 hours postoperatively by 76 units (65%) (considerably fewer than the 82 (87%) in 2005). The most commonly prescribed first-line antimicrobial was co-amoxiclav (75%). Although there has been some improvement since 2005, most units still prescribe antimicrobials for periods longer than 24 hours. National collaboration may improve their appropriate prescription.
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Affiliation(s)
- D Tyler
- Maxillofacial Surgery, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX.
| | - J L Y Wong
- Maxillofacial Surgery, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX.
| | - O Krishnan
- Maxillofacial Surgery, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX.
| | - L Carter
- Maxillofacial Surgery, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX.
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27
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Krebs M, Carter L, Villa S, King A, Massey C, Lorens J, Darlington E, Fennell D. P2.06-09 MiST3: A Phase II Study of Oral Selective AXL Inhibitor Bemcentinib (BGB324) in Combination with Pembrolizumab in pts with Malignant Mesothelioma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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28
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Wang J, Liu S, Uronis H, Wu C, Mahalingam D, Spira A, Carter L, Hu X, Weems G, Wilkins H, Duska L, Kelly K. Novel small-molecule RORγ agonist immuno-oncology agent LYC-55716: Safety and efficacy in a phase IIA open-label, multicenter trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Vickers A, Carter L, Galvin M, Carter M, Franklin L, Morris K, Pierce J, Frese K, Blackhall F, Dive C. MA22.03 SCLC Circulating Tumour Cell Derived Explants: The Clinical Characteristics of Patients Whose Samples Generate CDX. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.503] [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]
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30
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Graham D, Jordan T, Tinsley N, Aruketty S, Vickers A, Kelly C, Kurup R, White A, Smith A, Walsh A, Thomson C, O'Reilly S, Norfolk M, Chang D, Blackhall F, Summers Y, Califano R, Taylor P, Thistlethwaite F, Cook N, Carter L, Krebs M. P1.01-26 Single-Centre Experience of Clinical Outcomes for Advanced Lung Cancer Patients in Phase I Clinical Trials. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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31
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Hu X, Liu X, Li H, Bogdan M, Gao Y, Fox B, Weems G, Wilkins H, Carter L. Novel immunooncology agent, small-molecule rorγ agonist lyc-55716: Tumor selection process for phase IIa expansion and rationale for clinical evaluation in ovarian cancer following phase I dose finding. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Affiliation(s)
- L Carter
- eMBED Health Consortium, United Kingdom
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33
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Rushworth B, Carter L. Tetanus after a penetrating injury to the right globe: a case report. Br J Oral Maxillofac Surg 2018; 56:425-426. [PMID: 29650473 DOI: 10.1016/j.bjoms.2018.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Abstract
A 24-year-old man attended the emergency department with a penetrating injury to the right globe after a road traffic accident. He later contracted tetanus for which he was given human tetanus immunoglobulin. Although it is rare, tetanus is life-threatening and a thorough immunisation history should be obtained before treatment of tetanus-prone injuries.
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Affiliation(s)
- B Rushworth
- Leeds Teaching Hospitals, Leeds Dental Institute and Leeds General Infirmary, LS1 3EX.
| | - L Carter
- Leeds Teaching Hospitals, Leeds Dental Institute and Leeds General Infirmary, LS1 3EX
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34
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Villeneuve P, Heale R, Rietze L, Carter L. Exploring Self-Perceptions of Anxiety among Nursing Students in the Clinical Setting and Select Demographics. Int J Nurs Educ Scholarsh 2018; 15:/j/ijnes.2018.15.issue-1/ijnes-2017-0042/ijnes-2017-0042.xml. [DOI: 10.1515/ijnes-2017-0042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 03/05/2018] [Indexed: 11/15/2022]
Abstract
AbstractClinical learning experiences are essential in nursing education but they are often anxiety provoking for learners. Understanding the factors associated with the anxiety levels of nursing students in clinical placements has become more complex over the years with increasing heterogeneity within the nursing population. A correlational study was conducted to examine the relationships between nursing students’ self-perceived anxiety levels, as measured by the State-Trait Anxiety Inventory (STAI), and the students’ age, gender, previous employment, and previous education. The findings revealed that nursing students have a higher than average level of anxiety and that male nursing students reported higher levels of anxiety compared to female nursing students. No significant correlations were found between age, previous education, previous employment, and self-perceived anxiety levels. Findings from this study provide an opportunity for discussion by nursing educators and identify a need for future research and practice.
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Affiliation(s)
- Pamela Villeneuve
- Health Sciences and Emergency Services, Northern College of Applied Arts and Technology, 4715 Highway 101 EastTimmins, Ontario, Canada
| | - Roberta Heale
- School of Nursing, Laurentian University, 935 Ramsey Lake Road,Sudbury, Ontario, Canada
| | - Lori Rietze
- School of Nursing, Laurentian University, 935 Ramsey Lake Road,Sudbury, Ontario, Canada
| | - Lorraine Carter
- Centre for Continuing Education, McMaster University, 1280 Main Street WestHamilton, Ontario, Canada
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35
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Wilson G, Mullamitha S, Bentley D, Bell J, Mullan D, Carter L, Chittalia A, Howell S, Laasch HU, Westwood T, Jeans S, Tipping J, Ryder D, Farquharson F, Arumugam P, Sheen A, Rajashanker B, Armstrong A, Misra V, Manoharan P, Lawrance J. Abstract P1-14-06: Selective internal radiation therapy (SIRT) with Yttrium-90 resin microspheres and FOLFOX/5FU chemotherapy in pre-treated breast cancer patients with liver metastases: A retrospective analysis of response rates, times to progression and survival of patients treated in Manchester UK between 2010 and 2016. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-14-06] [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:
SIRT is a globally licensed technique of Radio-Embolization (RE) of hepatic tumors via intra-arterial infusion of β-particle emitting Yttrium-90 (Y-90) radio-labelled microspheres. It increases response rates and hepatic time to progression in metastatic colorectal cancer when used in combination with 5FU/Oxaliplatin (FOLFOX) chemotherapy with acceptable toxicity profile. FOLFOX gives a radio-sensitizing effect and also controls disease outside the liver. Breast cancer liver metastases (BCLM) patients often have extra-hepatic disease and respond to multiple lines of systemic therapy and SIRT is infrequently used.
Methods and patients
Between 2010 and 2016 we treated 25 BCLM patients with Y-90 SIRT.
Receptor status: 20 ER+ve/HER-2 -ve, 3 ER-ve/HER-2 +ve, 2 triple -ve.
Eleven patients had liver only disease with 14 also having known extra-hepatic disease. Average number of previous lines of therapy in metastatic setting: chemotherapy = 2.4; endocrine = 1. Sixty-four % patients had prior Capecitabine (n=16); 12% platinum (n=3, all Carboplatin). Twenty patients received chemotherapy with SIRT: 17 had modified FOLFOX6 (Oxaliplatin/bolus 5FU day1, infusional 5FU day 1-3 (46 hrs); 3 patients had Modified de Gramont style 5FU alone. Five patients had no chemotherapy.
Sir-spheres were inserted on day 2 of FOLFOX with the 5FU infusion pump continuing to day 3. Further 2-weekly FOLFOX chemo cycles were at clinician's discretion: average number delivered 3.8. Four patients had the liver treated in two halves, approximately 6 weeks apart. One patient received SIRT only to half the liver. Patients were imaged with PET-CT/CT before and 2-3 months after SIRT. Retrospective case note review was performed and data correlated to evaluate tumor response (RR); hepatic and extra hepatic progression free survival (HPFS and EHPFS) and overall survival (OS). Accurate toxicity data was not recorded.
Results
Hepatic CT response rates: PR 56% (n=14), SD 28% (n=7) and PD 16% (n=4). Hepatic PET response rates: CR 32% (n=8), PR 40% (n=10), SD 12% (n=3), PD 16%(n=4). (Overall PET liver disease control rate = 84%).
Eight patients (32%) had extra-hepatic PD at first assessment. Of them, 4 had PR, 2 SD and 2 PD in the liver at that assessment. Two HER-2 +ve patients had brain metastases as first sign of PD within 75 days, an area not previously screened. Of 16 pre-treated with Capecitabine, liver CT response rates: 62.5% PR, 18.75% SD (n=10,3). Post SIRT/FOLFOX, average number of therapy lines: 2 for chemo and 0.75 for endocrine, with 8 patients still alive at time of censoring.
Median OS: 766 HPFS: 210 days (CI 140-286). Median EHPFS in patients with extra-hepatic disease: 152 days (CI 96-636).
Conclusions
SIRT with FOLFOX in previously treated BCLM patients produces high response rates, excellent tumor control and time to progression in the liver with good overall survival. It does not seem to decrease the ability to give further lines of chemotherapy and can be considered as an option for breast cancer patients with liver metastases.
Citation Format: Wilson G, Mullamitha S, Bentley D, Bell J, Mullan D, Carter L, Chittalia A, Howell S, Laasch H-U, Westwood T, Jeans S, Tipping J, Ryder D, Farquharson F, Arumugam P, Sheen A, Rajashanker B, Armstrong A, Misra V, Manoharan P, Lawrance J. Selective internal radiation therapy (SIRT) with Yttrium-90 resin microspheres and FOLFOX/5FU chemotherapy in pre-treated breast cancer patients with liver metastases: A retrospective analysis of response rates, times to progression and survival of patients treated in Manchester UK between 2010 and 2016 [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 P1-14-06.
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Affiliation(s)
- G Wilson
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - S Mullamitha
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - D Bentley
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - J Bell
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - D Mullan
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - L Carter
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - A Chittalia
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - S Howell
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - H-U Laasch
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - T Westwood
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - S Jeans
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - J Tipping
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - D Ryder
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - F Farquharson
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - P Arumugam
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - A Sheen
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - B Rajashanker
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - A Armstrong
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - V Misra
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - P Manoharan
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - J Lawrance
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
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Thompson DS, Abourbih J, Carter L, Adams-Carpino G, Berry S, Graves LE, Ranger NJ. Views from the field: Medical student experiences and perceptions of interprofessional learning and collaboration in rural settings. J Interprof Care 2017; 32:339-347. [PMID: 29236564 DOI: 10.1080/13561820.2017.1409703] [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: 10/18/2022]
Abstract
Exploring the perceived environment where students are educated, as well as where they practice, is particularly important for educators and practitioners working in situations of interprofessional rural and remote health. In this study, we explored the perceptions of undergraduate medical students regarding interprofessionalism across their four-year undergraduate program which focuses on rural health. A thematic content analysis of the text-data was conducted on a convenience sample of 47 student responses to essay questions across four cohorts of a four-year undergraduate medical program. The medical program has an explicit social accountability mandate for responsiveness to the needs of a rural population and thus students have multiple opportunities to experience interprofessional education and collaboration in rural contexts. Participants reported (a) blurring and flexibility of roles in a primarily positive manner, (b) participating in unstructured interprofessional learning and collaboration, (c) experiencing the importance of social connections to interprofessional collaboration and learning, and (d) realisations that interprofessional collaboration is a means of overcoming barriers in rural areas. We discuss our findings using the socio-material perspective of complexity theory. These findings may be used to inform undergraduate programs in re-defining, re-creating, developing, and fostering interprofessional learning opportunities for medical students in rural communities as well as to support clinical faculty through ongoing professional development.
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Affiliation(s)
- David S Thompson
- a School of Nursing , Lakehead University , Thunder Bay , Sudbury, Ontario , Canada
| | - Jacques Abourbih
- b Northern Ontario School of Medicine , Sudbury , Ontario , Canada
| | - Lorraine Carter
- c Centre for Continuing Education , McMaster University , West Hamilton , Ontario , Canada
| | - Gayle Adams-Carpino
- d Interprofessional Education , Laurentian University.,e Division of Clinical Sciences, Community Engagement , Northern Ontario School of Medicine , Sudbury , Ontario , Canada
| | - Sue Berry
- f Division of Clinical Sciences , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Lisa E Graves
- g Department of Family and Community Medicine , Western Michigan University Homer Stryker M.D. School of Medicine , Kalamazoo , Michigan , USA
| | - Nichole J Ranger
- h Family Medicine Rural Stream , Northern Ontario School of Medicine , Sudbury , Ontario , Canada
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Drake C, Bogan R, Benes H, Stern T, Villa K, Chen D, Carter L, Wang H, Black J, Weaver T. Function, work productivity, and quality of life measures in a phase 3, randomized, placebo-controlled, double-blind, multicenter, 12-week study of the safety and efficacy of solriamfetol (JZP-110) for the treatment of excessive sleepiness in patients with obstructive sleep apnea. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Saraswat M, Carter L, Sapp J, Gray C, Berrigan P, Fearon A, Gardner M, Parkash R. INTEGRATED MANAGEMENT APPROACH TO ATRIAL FIBRILLATION CARE: A COST UTILITY ANALYSIS. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Rack S, Darlington E, Odedra S, Owens R, Sarah D, Shah B, Cook N, Thistlethwaite F, Carter L, Hughes A, Homer J, Slevin N, Krebs M, Metcalf R. Molecular profiling of recurrent and metastatic salivary gland cancer to personalise cancer therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx511.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Power A, Bowden E, Adams A, Carter L. NHS dentistry: Slow the troubling trend. Br Dent J 2017; 223:308. [DOI: 10.1038/sj.bdj.2017.736] [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: 11/09/2022]
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Cook N, Carter L, Aruketty S, O'Brien C, Thistlethwaite F, Dean E, Krebs M, Warren M, Berman R. Enhanced supportive care in early phase clinical trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.045] [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: 11/12/2022] Open
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Gupta A, Ayub M, Miller C, Rothwell D, Wallace A, Jordan A, Cook N, Thistlethwaite F, Carter L, O’Brien C, Aruketty S, Dean E, Hudson A, Frese K, Dransfield J, Hughes A, Marais R, Dive C, Brady G, Krebs M. Development of the Manchester Cancer Research Centre Molecular Tumour Board for matching patients to clinical trials based on tumour and ctDNA genetic profiling. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- Behdin Nowrouzi-Kia
- School of Rural and Northern Health, Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada
| | - Carla Chidu
- Faculty of Science, McMaster University, Hamilton, Canada
| | - Lorraine Carter
- Center for Continuing Education, McMaster University, Hamilton, Canada
| | - Alicia McDougall
- Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Jennifer Casole
- Special Education Department, Loretto College, Toronto, Canada
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Nowrouzi B, Rukholm E, Lariviere M, Carter L, Koren I, Mian O, Giddens E. An examination of retention factors among registered nurses in Northeastern Ontario, Canada: Nurses intent to stay in their current position. Work 2017; 54:51-8. [PMID: 26967032 DOI: 10.3233/wor-162267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 11/15/2022] Open
Abstract
BACKGROUND The purpose of the study was to examine factors related to the retention of registered nurses in northeastern Ontario, Canada. OBJECTIVE/METHOD A cross-sectional survey of registered nurses working in northeastern Ontario, Canada was conducted. Logistic regression analyses were used to consider intent to stay in current employment in relation to the following: 1) demographic factors, and 2) occupation and career satisfaction factors. RESULTS A total of 459 (29.8% response rate) questionnaires were completed. The adjusted odds logistic regression analysis of RNs who intended to remain in their current position for the next five years, demonstrated that respondents in the 46 to 56 age group (OR: 2.65; 95% CI: 1.50 to 4.69), the importance of staff development in the organization (OR: 3.04; 95% CI: 1.13 to 8.13) northeastern Ontario lifestyle (OR: 2.61; 95% CI: 1.55 to 4.40), working in nursing for 14 to 22.5 years (OR: 2.55; 95% CI: 1.10 to 5.93), and working between 0 to 1 hour of overtime per week (OR: 1.20; 95% CI: 1.20 to 4.64) were significant factors in staying in their current position for the next five years. CONCLUSIONS This study shows that a further understanding of the work environment could assist with developing retention for rural nurses. Furthermore, employers may use such information to ameliorate the working conditions of nurses, while researchers may use such evidence to develop interventions that are applicable to improving the working conditions of nurses.
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Affiliation(s)
- Behdin Nowrouzi
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | - Ellen Rukholm
- Centre for Rural and Northern Health Research, Sudbury, ON, Canada
| | - Michel Lariviere
- School of Human Kinetics, Laurentian University, Sudbury, ON, Canada
| | - Lorraine Carter
- School of Nursing, Nipissing University, North Bay, ON, Canada
| | - Irene Koren
- Centre for Rural and Northern Health Research, Sudbury, ON, Canada
| | - Oxana Mian
- Centre for Rural and Northern Health Research, Sudbury, ON, Canada
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Nowrouzi B, Lightfoot N, Carter L, Larivière M, Rukholm E, Schinke R, Belanger-Gardner D. The relationship between quality of work life and location of cross-training among obstetric nurses in urban northeastern Ontario, Canada: A population-based cross sectional study. Int J Occup Med Environ Health 2016; 28:571-86. [PMID: 26190732 DOI: 10.13075/ijomeh.1896.00443] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES The purpose of this mixed methods study was to examine the quality of work life of registered nurses working in obstetrics at 4 hospitals in northeastern Ontario and explore demographic and occupational factors related to nurses' quality of work life (QWL). MATERIAL AND METHODS A stratified random sample of registered nurses (N = 111) selected from the 138 eligible registered nurses (80.4%) of staff in the labor, delivery, recovery, and postpartum areas at the 4 hospitals participated. Logistic regression analyses were used to consider QWL in relation to the following: 1) demographic factors, and 2) stress, employment status and educational attainment. RESULTS In the logistic regression model, the odds of a higher quality of work life for nurses who were cross trained (nurses who can work across all areas of obstetrical care) were estimated to be 3.82 (odds ratio = 3.82, 95% confidence interval: 1.01-14.5) times the odds of a higher quality of work life for nurses who were not cross trained. CONCLUSIONS This study highlights a relationship between quality of work life and associated factors including location of cross-training among obstetrical nurses in northeastern Ontario. These findings are supported by the qualitative interviews that examine in depth their relationship to QWL. Given the limited number of employment opportunities in the rural and remote regions, it is paramount that employers and employees work closely together in creating positive environments that promote nurses' QWL.
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Affiliation(s)
- Behdin Nowrouzi
- Laurentian University, Sudbury, Ontario, Canada (Interdisciplinary PhD Program).
| | - Nancy Lightfoot
- Laurentian University, Sudbury, Ontario, Canada (Centre for Research in Occupational Safety and Health)
| | - Lorraine Carter
- Nipissing University, North Bay, Ontario, Canada (Centres for Flexible Teaching and Learning)
| | - Michel Larivière
- Laurentian University, Sudbury, Ontario, Canada (Centre for Research in Occupational Safety and Health)
| | - Ellen Rukholm
- Laurentian University, Sudbury, Ontario, Canada (Centre for Rural and Northern and Health Research)
| | - Robert Schinke
- Laurentian University, Sudbury, Ontario, Canada (School of Human Kinetics and Northern Ontario School of Medicine)
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Yap T, Krebs M, Postel-Vinay S, Bang Y, El-Khoueiry A, Abida W, Harrington K, Sundar R, Carter L, Castanon-Alvarez E, Im S, Berges A, Khan M, Stephens C, Ross G, Soria J. Phase I modular study of AZD6738, a novel oral, potent and selective ataxia telangiectasia Rad3-related (ATR) inhibitor in combination (combo) with carboplatin, olaparib or durvalumab in patients (pts) with advanced cancers. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32607-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rothwell D, Mesquita B, Carter L, Smowton C, Leong H, Burt D, Miller C, Blackhall F, Dive C, Brady G. Molecular analysis of circulating tumour cells identifies distinct profiles in treatment naïve chemosensitive and chemorefractory small cell lung cancer patients. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Morrow CJ, Trapani F, Metcalf RL, Bertolini G, Hodgkinson CL, Khandelwal G, Kelly P, Galvin M, Carter L, Simpson KL, Williamson S, Wirth C, Simms N, Frankliln L, Frese KK, Rothwell DG, Nonaka D, Miller CJ, Brady G, Blackhall FH, Dive C. Tumourigenic non-small-cell lung cancer mesenchymal circulating tumour cells: a clinical case study. Ann Oncol 2016; 27:1155-1160. [PMID: 27013395 PMCID: PMC4880063 DOI: 10.1093/annonc/mdw122] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [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: 11/09/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Over the past decade, numerous reports describe the generation and increasing utility of non-small-cell lung cancer (NSCLC) patient-derived xenografts (PDX) from tissue biopsies. While PDX have proven useful for genetic profiling and preclinical drug testing, the requirement of a tissue biopsy limits the available patient population, particularly those with advanced oligometastatic disease. Conversely, 'liquid biopsies' such as circulating tumour cells (CTCs) are minimally invasive and easier to obtain. Here, we present a clinical case study of a NSCLC patient with advanced metastatic disease, a never smoker whose primary tumour was EGFR and ALK wild-type. We demonstrate for the first time, tumorigenicity of their CTCs to generate a patient CTC-derived eXplant (CDX). PATIENTS AND METHODS CTCs were enriched at diagnosis and again 2 months later during disease progression from 10 ml blood from a 48-year-old NSCLC patient and implanted into immunocompromised mice. Resultant tumours were morphologically, immunohistochemically, and genetically compared with the donor patient's diagnostic specimen. Mice were treated with cisplatin and pemetrexed to assess preclinical efficacy of the chemotherapy regimen given to the donor patient. RESULTS The NSCLC CDX expressed lung lineage markers TTF1 and CK7 and was unresponsive to cisplatin and pemetrexed. Examination of blood samples matched to that used for CDX generation revealed absence of CTCs using the CellSearch EpCAM-dependent platform, whereas size-based CTC enrichment revealed abundant heterogeneous CTCs of which ∼80% were mesenchymal marker vimentin positive. Molecular analysis of the CDX, mesenchymal and epithelial CTCs revealed a common somatic mutation confirming tumour origin and showed CDX RNA and protein profiles consistent with the predominantly mesenchymal phenotype. CONCLUSIONS This study shows that the absence of NSCLC CTCs detected by CellSearch (EpCAM(+)) does not preclude CDX generation, highlighting epithelial to mesenchymal transition and the functional importance of mesenchymal CTCs in dissemination of this disease.
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Affiliation(s)
- C J Morrow
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - F Trapani
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - R L Metcalf
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - G Bertolini
- Tumour Genomics Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C L Hodgkinson
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - G Khandelwal
- RNA Biology Group, University of Manchester, Manchester
| | - P Kelly
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - M Galvin
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - L Carter
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - K L Simpson
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - S Williamson
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - C Wirth
- Computational Biology Support Team, Cancer Research UK Manchester Institute, University of Manchester, Manchester
| | - N Simms
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - L Frankliln
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - K K Frese
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - D G Rothwell
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - D Nonaka
- The Christie NHS Foundation Trust, Manchester
| | - C J Miller
- RNA Biology Group, University of Manchester, Manchester
| | - G Brady
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK
| | - F H Blackhall
- The Christie NHS Foundation Trust, Manchester; Institute of Cancer Sciences, University of Manchester, Manchester; Cancer Research UK Lung Cancer Centre of Excellence, Manchester, UK
| | - C Dive
- Clinical and Experimental Pharmacology Group, University of Manchester, Manchester, UK; Cancer Research UK Lung Cancer Centre of Excellence, Manchester, UK.
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Donato E, Lightfoot N, Carter L, MacEwan L. Interprofessional Education in Canadian Nursing Programs and Implications for Continuing Education. ACTA ACUST UNITED AC 2016. [DOI: 10.18741/p9mw20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In 2010, the Canadian Association of Schools of Nursing, the accrediting body for nursing programs in Canada, became part of the Accreditation of Interprofessional Health Education initiative. In turn, interprofessional education (IPE) is now a requirement in nursing curricula. Although the requirement is formally in place, how it is achieved varies substantially. This paper explores how IPE has been integrated within Canadian nursing programs. Implications for the continuing education of nurses and other health professionals in order to achieve excellence in interprofessional practice are also considered.
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Nowrouzi B, Gohar B, Nowrouzi-Kia B, Garbaczewska M, Chapovalov O, Myette-Côté É, Carter L. Facilitators and barriers to occupational health and safety in small and medium-sized enterprises: a descriptive exploratory study in Ontario, Canada. Int J Occup Saf Ergon 2016; 22:360-6. [PMID: 26971744 DOI: 10.1080/10803548.2016.1158591] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 10/22/2022]
Abstract
PURPOSE The purpose of this particular study was to test a newly created instrument in describing the facilitators and barriers to occupational health and safety in small and medium-sized enterprises (SMEs) in Ontario, Canada. METHODS A cross-sectional design was used to identify the occupational health and safety culture of SMEs in public and private sectors in Ontario. RESULTS A total of 153 questionnaires were completed. The majority of respondents were female (84%) with a mean age of 49.8 years (SD 10.6). Seventy-four percent were supervisors. Seventy percent of respondents were from the private sector while 30% derived from the public sector including healthcare, community services, and non-profit organizations. Further, conducting regular external safety inspections of the workplace was found to be statistically associated with a safe work environment 2.88 95% CI [1.57, 5.27]. CONCLUSIONS Strategies and training opportunities that focus on how to adapt occupational health and safety legislation to the nature and diversity of SMEs are recommended. Furthermore, employers may use such information to improve safety in their SMEs, while researchers can hopefully use such evidence to develop interventions that are applicable to meeting the occupational health and safety needs of SMEs.
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Affiliation(s)
| | | | | | | | | | | | - Lorraine Carter
- a Laurentian University , Canada.,e Nipissing University , Canada
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