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Lambe K, Guerra S, Salazar de Pablo G, Ayis S, Cameron ID, Foster NE, Godfrey E, Gregson CL, Martin FC, Sackley C, Walsh N, Sheehan KJ. Effect of inpatient rehabilitation treatment ingredients on functioning, quality of life, length of stay, discharge destination, and mortality among older adults with unplanned admission: an overview review. BMC Geriatr 2022; 22:501. [PMID: 35689181 PMCID: PMC9188066 DOI: 10.1186/s12877-022-03169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To synthesise the evidence for the effectiveness of inpatient rehabilitation treatment ingredients (versus any comparison) on functioning, quality of life, length of stay, discharge destination, and mortality among older adults with an unplanned hospital admission. METHODS A systematic search of Cochrane Library, MEDLINE, Embase, PsychInfo, PEDro, BASE, and OpenGrey for published and unpublished systematic reviews of inpatient rehabilitation interventions for older adults following an unplanned admission to hospital from database inception to December 2020. Duplicate screening for eligibility, quality assessment, and data extraction including extraction of treatment components and their respective ingredients employing the Treatment Theory framework. Random effects meta-analyses were completed overall and by treatment ingredient. Statistical heterogeneity was assessed with the inconsistency-value (I2). RESULTS Systematic reviews (n = 12) of moderate to low quality, including 44 non-overlapping relevant RCTs were included. When incorporated in a rehabilitation intervention, there was a large effect of endurance exercise, early intervention and shaping knowledge on walking endurance after the inpatient stay versus comparison. Early intervention, repeated practice activities, goals and planning, increased medical care and/or discharge planning increased the likelihood of discharge home versus comparison. The evidence for activities of daily living (ADL) was conflicting. Rehabilitation interventions were not effective for functional mobility, strength, or quality of life, or reduce length of stay or mortality. Therefore, we did not explore the potential role of treatment ingredients for these outcomes. CONCLUSION Benefits observed were often for subgroups of the older adult population e.g., endurance exercise was effective for endurance in older adults with chronic obstructive pulmonary disease, and early intervention was effective for endurance for those with hip fracture. Future research should determine whether the effectiveness of these treatment ingredients observed in subgroups, are generalisable to older adults more broadly. There is a need for more transparent reporting of intervention components and ingredients according to established frameworks to enable future synthesis and/or replication. TRIAL REGISTRATION PROSPERO Registration CRD42018114323 .
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Affiliation(s)
- K Lambe
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK
| | - S Guerra
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK
| | - G Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Ayis
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK
| | - I D Cameron
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District and University of Sydney, Sydney, Australia
| | - N E Foster
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - E Godfrey
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C L Gregson
- Musculoskeletal Research Unit, Translation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - F C Martin
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK
| | - C Sackley
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK
| | - N Walsh
- Centre for Health and Clinical Research, University of the West of England Bristol, Bristol, UK
| | - K J Sheehan
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK.
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Bennett SE, Gooberman-Hill R, Clark E, Paskins Z, Walsh N, Drew S. POS1514-HPR UNDERSTANDING AND CHARACTERISING PATIENT PATHWAYS TO TREATMENT FOR VERTEBRAL FRACTURES: A QUALITATIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.346] [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: 11/04/2022]
Abstract
BackgroundOsteoporosis involves thinning of the bones, making them more prone to break. The most common osteoporotic fracture is a vertebral fracture (OVF). People with OVFs are at high risk of further fractures. To reduce this risk, guidelines recommend prescription of bone protection therapies to people who have experienced a fracture. However, many patients do not receive diagnosis. Understanding patient pathways to treatment for OVFs will provide information to improve practice and aid in effective identification and management.ObjectivesTo understand and characterise patient pathways to treatment for OVFs.MethodsTwenty-three semi-structured qualitative interviews were conducted with patients aged ≥50 years with diagnosis of OVF. Patients were recruited through two hospitals in England and were purposively sampled to capture variation in pathways to diagnosis, sex, age, comorbidities and other relevant characteristics. Interviews were audio-recorded, transcribed and analysed thematically, with themes transposed onto key stages of the patient pathway.ResultsSeveral factors influenced patient pathways to treatment:Patient appraisal and self-management: Characteristics and attitudes towards back pain impacted treatment-seeking behaviour. Patients who appraised their pain as ‘different’, severe or disruptive, or associated with an injury such as a fall, were more likely to seek help. Limited availability of information about OVFs and risk factors meant most patients did not associate symptoms with a potential OVF. Factors contributing to delayed consultation included the normalisation of back pain and prioritisation of comorbid conditions. Several misappraised their symptoms as a “pulled muscle” or other minor injury. Many adopted strategies to manage pain, including use of painkillers, lying flat or resting. For some, a lack of improvement in symptoms over time, combined with worsening pain, created a ‘tipping point’ in seeking care. There was a moral dimension for some patients who did not want to “bother” healthcare professionals.Healthcare professional appraisal: Differential diagnosis was a barrier to treatment and healthcare professionals interpreted OVF pain as broken ribs, muscular pain, kidney pain or sciatica. GPs tended to instigate watchful waiting, in which patients were asked to re-consult if pain did not improve. Feeling disbelieved caused some patients to become disillusioned and reluctant to re-consult and a small number of patients presented at Accident and Emergency. Those already having treatment for musculoskeletal conditions with access to specialist care, were more likely to receive timely diagnosis.Communication of diagnosis: Patients discussed multiple methods of communication, including written communication and clinical conversations. Several expressed confusion around the use of unfamiliar medical terminology, the implications of OVFs, how many OVFs they had experienced and how they had been identified.Treatment initiation: Bone protection therapies were not consistently prescribed after diagnosis. Patients who were familiar with these therapies were unsure whether treatment should be initiated in primary or secondary care. Patients described how they felt a need to be proactive by arranging appointments and asking for treatment.ConclusionThe study provides novel findings about patient pathways to treatment and will be used to identify targeted solutions to improve management of OVFs. This work addresses stages of the Model of Pathways to Treatment[1] and provides detailed understanding of patients’ experiences of these stages. Further work with healthcare professionals in primary care is underway to identify additional system-level factors that may impact patients’ journeys to treatment.References[1]Scott, S.E., et al., The model of pathways to treatment: conceptualization and integration with existing theory. Br J Health Psychol, 2013. 18(1): p. 45-65.AcknowledgementsThis study is funded by the National Institute for Health Research (NIHR) Research for Patient Benefit (RfPB) programme NIHR201523. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.Disclosure of InterestsNone declared
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Berry A, McClellan C, Wanless B, Walsh N. Evidencing the behaviour change model underpinning a personalised and tailored app for low back pain. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Howard M, Peppard S, O'Dwyer E, McLoughlin K, McLoughlin L, Carolan N, Walsh N, Chukwureh W, Russell E, Wilson L, Kottackal LM, Kelly M, Sheeran G, Maeri C. 147 ‘CHAMPIONING CONTINENCE’—ESTABLISHMENT OF A MULTIDISCIPLINARY CONTINENCE PROMOTION WORKING GROUP IN AN ACUTE TEACHING HOSPITAL. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.147] [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: 02/25/2023] Open
Abstract
Abstract
Background
In line with the National Frailty Programme1, patients over the age of 75 admitted to hospital should have a comprehensive geriatric assessment including the assessment of current continence status and any history of incontinence. Up to 39% of adults are reported to develop new onset urinary incontinence during admission to hospital2,3, however studies show that is it a problem not always identified by staff members,4. In response to these observations within an acute teaching hospital, a continence working party was formed involving members of nursing, physiotherapy and occupational therapy colleagues to explore the current practice and culture relating to continence management.
Methods
The group established key objectives which were broken into four strands;
1. Audit of documentation of baseline continence on admission (therapy and nursing).
2. Obtaining access to additional types of continence wear.
3. Staff education.
4. Pre and post education survey.
Results
1. Audit of documentation demonstrated poor standards of documentation of baseline continence. This led to an amendment to questioning prompts on therapy initial assessment forms and a plan to further evaluate the nursing documentation.
2. A wider array of continence wear has been made available on the wards providing greater options for patients.
3. Staff education session was compiled by a specialist physiotherapist and is widely available for staff to access on the hospitals online training portal.
4. Pre-education surveys have been completed with a view to re-administering following education roll-out.
Conclusion
The aim of this multidisciplinary working group is to equip staff with the correct resources, knowledge, and confidence to ensure best practice promotion of continence on the targeted wards. This project is the first strand of a wider culture changed that is needed around continence promotion for older adults in the acute setting.
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Affiliation(s)
- M Howard
- Beaumont Hospital , Dublin, Ireland
| | | | | | | | | | | | - N Walsh
- Beaumont Hospital , Dublin, Ireland
| | | | | | - L Wilson
- Beaumont Hospital , Dublin, Ireland
| | | | - M Kelly
- Beaumont Hospital , Dublin, Ireland
| | | | - C Maeri
- Beaumont Hospital , Dublin, Ireland
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King S, Woodley J, Walsh N. A systematic review of non-pharmacologic interventions to reduce anxiety in adults in advance of diagnostic imaging procedures. Radiography (Lond) 2020; 27:688-697. [PMID: 33028496 DOI: 10.1016/j.radi.2020.09.018] [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: 07/29/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Anticipation of a diagnostic imaging (DI) procedure, particularly one involving advanced technology, can provoke feelings of anxiety in patients. Anxiolytics (anxiety reducing drugs) can be used to reduce pre-procedural anxiety in patients, however there are several known disadvantages to this approach. The aim of this systematic review was to identify and evaluate any preparatory non-pharmacological interventions used to reduce patient anxiety in advance of DI procedures. KEY FINDINGS Database searches revealed twelve studies met the eligibility criteria and were included in the review. A narrative synthesis identified three intervention categories: patient information/education, cognitive strategies (i.e. guided imagery, breathing techniques, imaginative visualisation) and music therapy. CONCLUSION The current review demonstrates that despite the existence of a number of studies providing some evidence for the effectiveness of a range of anxiety reducing interventions for patients prior to DI, the small number and overall low quality of studies identified makes it difficult to draw firm conclusions regarding the application of a specific intervention in clinical practice. IMPLICATIONS FOR PRACTICE The majority of interventions included in this review were shown to be practical for inclusion in the clinical setting and did have some positive effect on patient anxiety levels. As a result those professionals working with adults undergoing advanced technology DI procedures may consider implementing some of the strategies that have been discussed within their practice.
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Affiliation(s)
- S King
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
| | - J Woodley
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - N Walsh
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Bennett S, Walsh N, Moss T, Palmer S. AB1321-HPR DEVELOPING A SELF-MANAGEMENT INTERVENTION TO MANAGE JOINT HYPERMOBILITY SYNDROME AND EHLERS-DANLOS SYNDROME HYPERMOBILITY TYPE: AN ANALYSIS INFORMED BY BEHAVIOUR CHANGE THEORY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Joint Hypermobility Syndrome (JHS) and Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are heritable disorders of connective tissue that can cause joint instability and pain and are associated with increased anxiety and depression. There is currently little UK guidance for supporting patients with JHS/EDS-HT1. The analysis presented here used the Behaviour Change Wheel (made up of the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation and Behaviour (COM-B) model2) to identify possible intervention options to improve self-management in people with JHS/EDS-HT.Objectives:To determine recommendations for the components of a behaviour change intervention for people with JHS or EDS-HT.Methods:Data from: 1) A systematic review and thematic synthesis of the literature examining adults’ lived experiences of JHS/EDS3and 2) A thematic analysis of interview data where UK adults with JHS/EDS-HT (n=17, 14 women, 3 men) discussed the psychosocial impact of the condition on their lives4, were mapped onto the TDF and COM-B in a behavioural analysis. A modified Nominal Group Technique focus group (n=9, all women) explored which interventions identified by the TDF/COM-B mapping exercise were most important to them.Results:Participants prioritised a range of potential self-management interventions, including:Education: Participants wanted greater support to improve their knowledge of JHS/EDS-HT, including self-help strategies for coping with injury, fatigue and overexertion, and how to evaluate information about their condition.Training: In activity pacing, assertiveness and communication skills, and what to expect during pregnancy, when symptoms of JHS/EDS-HT can worsen.Environmental restructuring and enablement:Support from occupational therapists to maintain independence at home. Enablement of access to CBT, mindfulness and emotional support.Modelled behaviour:Positive first-person narratives that address how other patients with JHS/EDS-HT have coped with anxiety, depression, distress, fear, frustration and feelings of loss.Conclusion:This study is the first to apply theoretically-informed approaches to the management of JHS/EDS-HT. Through a modified nominal group technique, potential behaviour change interventions for addressing barriers to self-management have been prioritised. Discussion with participants indicated poor access to psychological support, occupational therapy and a lack of knowledge of JHS/EDS-HT. Future research with healthcare professional and patient stakeholder groups will further evaluate which intervention options would be most acceptable and feasible for the management of JHS/EDS-HT.References:[1]Palmer, S., Terry, R. Rimes, K.A., Clark, C., Simmonds, J. & Horwood, J. (2016). Physiotherapy management of joint hypermobility syndrome – a focus group study of patient and health professional perspectives. Physiotherapy,http://dx.doi.org/10.1016/j.physio.2015.05.001.[2]Michie, S., van Stralen, M.M. & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(42).[3]Bennett, S.E., Walsh, N., Moss, T. and Palmer, S. (2019a) “The lived experience of joint hypermobility and Ehlers-Danlos Syndromes: A systematic review and thematic synthesis.”Physical Therapy Reviews, 24 (1-2). pp. 12-28. ISSN 1083-3196[4]Bennett, S.E., Walsh, N., Moss, T. and Palmer, S. (2019b) “Understanding the psychosocial impact of Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome Hypermobility Type: A qualitative interview study.”Disability and Rehabilitation. ISSN 0963-8288Disclosure of Interests:None declared
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Kieley J, Walsh N, McCarthy J, Powell E, Garland SN. 1031 Exploring the Impact of Cognitive Behavioral Therapy for Insomnia (CBT-I) on Daytime Productivity in Survivors of Breast Cancer. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Post-treatment insomnia disorder and fatigue symptoms can impair work and daytime productivity in breast cancer survivors. Cognitive Behavioral Therapy for Insomnia (CBT-I) significantly improves insomnia and daytime fatigue. This feasibility study examined whether improving insomnia and fatigue using CBT-I is associated with improved work and activity productivity in breast cancer survivors.
Methods
10 survivors of early stage breast cancer participated in 7 weekly individual CBT-I sessions. The primary outcome was the Work Productivity and Activity Impairment Questionnaire-General Health (WPAIQ-GH) questionnaire. Secondary outcomes were the Insomnia Severity Index (ISI) and the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Assessments were conducted at baseline and post-treatment. Paired samples t-tests examined the impact of CBT-I on productivity and fatigue. Linear regression assessed whether change in fatigue was associated with change in productivity.
Results
Participants had a mean age of 50.8 (range 42-63) and the majority were diagnosed with stage II (60%) cancer. There was a significant reduction in fatigue [t(9)= 2.43, p =.04] and activity impairment due to insomnia [t(9)= 3.105, p <.05] following treatment. Insomnia affected 52% of work productivity at baseline with a non-significant decrease to 15% following treatment [t(3)= 2.25 p= .110]. Reductions in fatigue were significantly associated with reductions in activity impairment [F(1,8)= 7.25, p =.03], accounting for 47.5% of the variability.
Conclusion
Treating insomnia with CBT-I significantly improved daytime productivity, activity impairment, and fatigue. Controlled research with larger sample sizes is warranted to confirm these preliminary results.
Support
Nyissa Walsh is a trainee in the Cancer Research Training Program of the Beatrice Hunter Cancer Research Institute (BHCRI). Dr. Sheila Garland is supported by a Scotiabank New Investigator Award from BHCRI.
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Affiliation(s)
- J Kieley
- Department of Psychology, Memorial University, St. John’s, NL, CANADA
| | - N Walsh
- Department of Psychology, Memorial University, St. John’s, NL, CANADA
- Beatrice Hunter Cancer Research Institute, Halifax, NS, CANADA
| | - J McCarthy
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
| | - E Powell
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
| | - S N Garland
- Department of Psychology, Memorial University, St. John’s, NL, CANADA
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
- Beatrice Hunter Cancer Research Institute, Halifax, NS, CANADA
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Walsh N, Garland S, Lester R, McCarthy J, Laing K. 1030 An Exploration of the Impact of Cognitive Behavioural Therapy of Insomnia (CBT-I) on Perceived Cognitive Impairment in Breast Cancer Survivors. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Insomnia and cognitive impairment are prevalent and persistent symptoms in cancer survivors. Cognitive Behavior Therapy is effective for improving insomnia and comorbid symptoms in cancer survivors but there are very few empirically supported treatments that can improve cognitive impairment. This feasibility study explored the impact of CBT-I on perceived cognitive impairment in breast cancer survivors.
Methods
We enrolled 10 early stage breast cancer survivors with insomnia disorder and perceived cognitive impairment. Participants received 7 individual sessions of CBT-I over the course of 8 weeks and completed the Insomnia Severity Index (ISI), the Functional Assessment of Cancer Therapy - Cognitive Function (FACT-Cog) questionnaires and The Hospital Anxiety and Depression Scale (HADS) at baseline and post-treatment. Paired samples t-tests were used to assess change over time.
Results
The sample was predominantly diagnosed with stage II breast cancer (60%). Women were an average age of 50.8 (SD 6.84) and 18.2 (SD 3.62) years of education. CBT-I significantly reduced insomnia severity [19.4 to 7.1; t(9)= 6.56, p < .001] and improved perceived cognitive impairment [t(9)= -3.55, p < .01], perceived cognitive ability [t(9)= -2.87, p < .05], quality of life [t(9)= -3.14, p < .05], and overall subjective cognitive function [t(9)= -3.67, p < .01]. Although participants began treatment with low levels of mood disturbance, CBT-I further decreased symptoms of anxiety (baseline: M= 10.10, SD= 4.34; post-treatment M= 8.20, SD= 3.91) and depression (baseline: M= 7.90, SD= 3.45; post-treatment M= 5.30, SD= 2.83), although not statistically significant.
Conclusion
This study suggests CBT-I may improve perceived cognitive impairment in cancer survivors, in addition to insomnia and mood. Future randomized controlled trials with larger samples and objective measurements of cognition are needed.
Support
Nyissa Walsh is a trainee in the Cancer Research Training Program of the Beatrice Hunter Cancer Research Institute (BHCRI). Dr. Sheila Garland is supported by a Scotiabank New Investigator Award from BHCRI.
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Affiliation(s)
- N Walsh
- Department of Psychology, Memorial University, St. John’s, NL, CANADA
- Beatrice Hunter Cancer Research Institute, Halifax, NS, CANADA
| | - S Garland
- Department of Psychology, Memorial University, St. John’s, NL, CANADA
- Beatrice Hunter Cancer Research Institute, Halifax, NS, CANADA
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
| | - R Lester
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
| | - J McCarthy
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
| | - K Laing
- Discipline of Oncology, Memorial University, St. John’s, NL, CANADA
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Skrobo D, Walsh N, Quinn C, Walshe J, Smyth L, Gullo G, Crown J. 173P Clinical characteristics of long-term responders to anti-HER2 therapy in metastatic breast cancer: A review of the charactHER clinical data. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.273] [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] Open
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Walsh N, Furney S, Quinn C, Gullo G, Crown J. Genome copy number alteration burden represents predictor of response in long-term, never relapse exceptional responders of trastuzumab-treated HER2+ metastatic breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.008] [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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Bhandari B, Bian J, Bilton K, Callahan C, Chaves J, Chen H, Cline D, Cooper RL, Danielson D, Danielson J, Dokania N, Elliott S, Fernandes S, Gardiner S, Garvey G, Gehman V, Giuliani F, Glavin S, Gold M, Grant C, Guardincerri E, Haines T, Higuera A, Ji JY, Kadel R, Kamp N, Karlin A, Ketchum W, Koerner LW, Lee D, Lee K, Liu Q, Locke S, Louis WC, Manalaysay A, Maricic J, Martin E, Martinez MJ, Martynenko S, Mauger C, McGrew C, Medina J, Medina PJ, Mills A, Mills G, Mirabal-Martinez J, Olivier A, Pantic E, Philipbar B, Pitcher C, Radeka V, Ramsey J, Rielage K, Rosen M, Sanchez AR, Shin J, Sinnis G, Smy M, Sondheim W, Stancu I, Sterbenz C, Sun Y, Svoboda R, Taylor C, Teymourian A, Thorn C, Tull CE, Tzanov M, Van de Water RG, Walker D, Walsh N, Wang H, Wang Y, Yanagisawa C, Yarritu A, Yoo J. First Measurement of the Total Neutron Cross Section on Argon between 100 and 800 MeV. Phys Rev Lett 2019; 123:042502. [PMID: 31491269 DOI: 10.1103/physrevlett.123.042502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/23/2019] [Indexed: 06/10/2023]
Abstract
We report the first measurement of the neutron cross section on argon in the energy range of 100-800 MeV. The measurement was obtained with a 4.3-h exposure of the Mini-CAPTAIN detector to the WNR/LANSCE beam at LANL. The total cross section is measured from the attenuation coefficient of the neutron flux as it traverses the liquid argon volume. A set of 2631 candidate interactions is divided in bins of the neutron kinetic energy calculated from time-of-flight measurements. These interactions are reconstructed with custom-made algorithms specifically designed for the data in a time projection chamber the size of the Mini-CAPTAIN detector. The energy averaged cross section is 0.91±0.10(stat)±0.09(syst) b. A comparison of the measured cross section is made to the GEANT4 and FLUKA event generator packages, where the energy averaged cross sections in this range are 0.60 and 0.68 b, respectively.
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Affiliation(s)
- B Bhandari
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - J Bian
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - K Bilton
- Department of Physics, University of California, Davis, California 95616, USA
| | - C Callahan
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - J Chaves
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - H Chen
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - D Cline
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - R L Cooper
- Department of Physics, New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Danielson
- Department of Physics, University of California, Davis, California 95616, USA
| | - J Danielson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - N Dokania
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - S Elliott
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Fernandes
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - S Gardiner
- Department of Physics, University of California, Davis, California 95616, USA
| | - G Garvey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - V Gehman
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Giuliani
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - S Glavin
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - M Gold
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - C Grant
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - E Guardincerri
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - T Haines
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Higuera
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - J Y Ji
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - R Kadel
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N Kamp
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Karlin
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - W Ketchum
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - L W Koerner
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - D Lee
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Lee
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Q Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Locke
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - W C Louis
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Manalaysay
- Department of Physics, University of California, Davis, California 95616, USA
| | - J Maricic
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - E Martin
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - M J Martinez
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Martynenko
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - C Mauger
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - C McGrew
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - J Medina
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P J Medina
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Mills
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - G Mills
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | | | - A Olivier
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - E Pantic
- Department of Physics, University of California, Davis, California 95616, USA
| | - B Philipbar
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - C Pitcher
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - V Radeka
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J Ramsey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Rielage
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Rosen
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - A R Sanchez
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Shin
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - G Sinnis
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Smy
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - W Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - I Stancu
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - C Sterbenz
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Sun
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - R Svoboda
- Department of Physics, University of California, Davis, California 95616, USA
| | - C Taylor
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Teymourian
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - C Thorn
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C E Tull
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Tzanov
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - R G Van de Water
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Walker
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - N Walsh
- Department of Physics, University of California, Davis, California 95616, USA
| | - H Wang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Y Wang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - C Yanagisawa
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794, USA
| | - A Yarritu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Yoo
- Department of Physics, University of Houston, Houston, Texas 77204, USA
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Walsh N, Gullo G, Quinn C, Furney SJ, Crown J. Abstract P3-06-13: Whole exome sequencing of HER2+ metastatic breast cancer (MBC) patients (pts) with extraordinary durable complete responses (ExdCR) to trastuzumab (T). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-06-13] [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: Trastuzumab (T) has shown clinical efficacy in early-stage and MBC. However, within 1-year 40-50% develop resistance to T. The exact mechanism of the development of T resistance is not completely understood. Anecdotal observations suggest that a small fraction of patients with HER2+ MBC may be "extraordinary durable complete responders (ExdCR)". Indeed, we previously reported that 9% of MBC achieve dCR following T and chemotherapy. Understanding the genomic mechanisms underlying exceptional dCR to T may improve patient selection and treatment rationale to identify HER2+ MBC pts who are more likely to achieve dCR following T treatment.
Methods: Genomic DNA was extracted from paraffin embedded formalin fixed (FFPE) tissue. Whole exome sequencing (WES) on primary tumours from 9 MBC ExdCR > 60 mo (5 matched T:N) and 6 non-responders (NR) or PR < 6 mo (3 matched T:N). Tumours were analysed for single nucleotide variants (SNVs) point mutations, insertions/deletions (indels), copy number alterations (CNA), and tumour mutational burden. Detailed clinicopathologic data was collected for each patient and linked to the genomic information.
Results: WES of matched tumour:normal samples revealed differences in SNVs and indels between the ExdCR pts compared to NR. Mutations in TP53 were found in 2/5 ExdCR pts and in 0/3 NR. Initial analysis of CNA revealed that HER2 is significantly more amplified in ExdCR pts compared to NR, and this was also shown by IHC and FISH.
Conclusions: We present a genomic landscape of extraordinary durable complete responders compared to non-responders using WES. High variability exists in mutation profile of ExdCR pts with few overlapping genes. Further analysis into clinically relevant genomic and molecular alterations will be performed to potential aid in patient selection and choice of therapy, and novel drug targets.
Citation Format: Walsh N, Gullo G, Quinn C, Furney SJ, Crown J. Whole exome sequencing of HER2+ metastatic breast cancer (MBC) patients (pts) with extraordinary durable complete responses (ExdCR) to trastuzumab (T) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-06-13.
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Affiliation(s)
- N Walsh
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland; Genomic Oncology Research Group, Royal College of Surgeons Ireland, Dublin, Ireland
| | - G Gullo
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland; Genomic Oncology Research Group, Royal College of Surgeons Ireland, Dublin, Ireland
| | - C Quinn
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland; Genomic Oncology Research Group, Royal College of Surgeons Ireland, Dublin, Ireland
| | - SJ Furney
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland; Genomic Oncology Research Group, Royal College of Surgeons Ireland, Dublin, Ireland
| | - J Crown
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland; Genomic Oncology Research Group, Royal College of Surgeons Ireland, Dublin, Ireland
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Kydd AB, Smith S, King L, Gentleman M, Walsh N, Head K, Smart F. ENGAGING STUDENTS AS CO-RESEARCHERS TO CONDUCT FOCUS GROUPS WITH OLDER PEOPLE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.861] [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: 11/13/2022] Open
Affiliation(s)
- A B Kydd
- Edinburgh Napier University, Edinburgh, Scotland, United Kingdom
| | - S Smith
- Senior Lecturer, Edinburgh Napier University, Lothian, Edinburgh, Scotland, UK
| | - L King
- Lecturer, Edinburgh Napier University, Edinburgh, Lothian, Scotland, UK
| | - M Gentleman
- Edinburgh Napier University, Edinburgh, Lothian, Scotland, UK
| | - N Walsh
- Doctoral Student, Edinburgh Napier University, Edinburgh, Lothian, Scotland, UK
| | - K Head
- Pastoral Support Advisor, Edinburgh Napier University, Edinburgh, Lothian, Scotland, UK
| | - F Smart
- Senior Lecturer, Edinburgh Napier University, Edinburgh, Lothian, Scotland, UK:
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Walsh N, Breathnach C, El-Khuffash A, Franklin O, Corcoran JD. The utility of routine echocardiography in newborn infants with a persistent oxygen requirement. Ir Med J 2018; 111:755. [PMID: 30489051] [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: 06/09/2023]
Abstract
In the era of antenatal screening for congenital heart disease (CHD), infants presenting with an undiagnosed significant CHD are rare. However, term infants admitted with an initial diagnosis of TTN and a prolonged oxygen requirement often undergo an echocardiogram. We aimed to assess whether this practice yields any additional cases of undiagnosed CHD. We performed a retrospective chart review over a three year period [2013 – 2015] of term (> 36 weeks) infants admitted to the NICU for ≥ 5 days with a diagnosis of TTN and received an echocardiogram. The presence of CHD on the echocardiogram was assessed. Forty-seven infants were enrolled. The median age of echocardiogram was day four [2 – 8]. No infant had a diagnosis of significant CHD on the postnatal echocardiogram. A small muscular VSD was identified in two infants. Routine echocardiography for this cohort of infants to rule out major CHD appears to be unwarranted.
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Affiliation(s)
- N Walsh
- Department of Neonatology, the Rotunda Hospital, Dublin, Ireland
| | - C Breathnach
- Department of Neonatology, the Rotunda Hospital, Dublin, Ireland
| | - A El-Khuffash
- Department of Neonatology, the Rotunda Hospital, Dublin, Ireland
- School of Medicine (Department of Paediatrics), the Royal College of Surgeons in Ireland
| | - O Franklin
- Department of Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | - J D Corcoran
- Department of Neonatology, the Rotunda Hospital, Dublin, Ireland
- School of Medicine (Department of Paediatrics), the Royal College of Surgeons in Ireland
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Walsh N, Repa LM, Garland SN. 0654 Association Between Chronotype and Mental Health in Canadian University Students. Sleep 2018. [DOI: 10.1093/sleep/zsy061.653] [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: 11/12/2022] Open
Affiliation(s)
- N Walsh
- Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, CANADA
| | - L M Repa
- Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, CANADA
| | - S N Garland
- Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, CANADA
- Division of Oncology, Memorial University of Newfoundland, St. John’s, NL, CANADA
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Abstract
Malnutrition in hospital is often unrecognized. A nutrition team aims to teach simple methods of detecting malnutrition. On a single day all medical in-patients underwent a nutritional assessment. Eighty-four patients (43 men), median age 71 years (range 28–97), were assessed. The most common diagnoses were cardiac disease (26), stroke/dementia (12), non-malignant lung disease (9) and malignancy (6). A weight loss of more than 10% (%WL) was found in 17/65 (26%) and a body mass index (BMI) of less than 19kg/m2 in 13/69 (19%). A mid-arm muscle circumference (MAMC) less than the fifth percentile occurred in 16/83 (19%) patients. Percentage weight loss alone detected seven patients of whom four were overweight (BMI > 25 kg/m2), BMI alone detected three patients, and MAMC alone eight patients of whom three could not be weighed and three had fluid retention. There was fluid retention in 35/84 (42%) patients of whom nine were malnourished (six detected by BMI and/or %WL, and three by MAMC alone). All three measurements were made in 64 patients, six (9%) of whom were detected as malnourished by all three methods. Combining the three measurements 29/84 (35%) of patients were malnourished and only 28% of these patients had been assessed by a dietitian. BMI and %WL detect most patients but fluid retention may limit their accuracy. MAMC is useful in those who cannot be weighed or who have fluid retention.
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Gullo G, Walsh N, Fennelly D, Walshe J, O'Mahony K, Silva N, Ballot J, Calzaferri G, Quinn C, McDonnell D, Crown J. Abstract P5-20-05: Impact of type of (neo)adjuvant systemic therapy (AdjTx) and total exposure to trastuzumab (TET) on long-term outcome of HER2-positive (HER2+) early stage breast cancer (ESBrCa). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-20-05] [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
Trastuzumab (T) administered for 12 months (mos) as part of a taxane (Tax)– or Tax+anthracycline (Anthra)–based AdjTx is the standard of care as (neo)AdjTx of HER2+ ESBrCa. Several prospective randomized trials have investigated a shorter duration of Adj T (i.e. 9 weeks or 6 mos) compared to standard 12 mos of T. However, the results have not been conclusive so far. The impact of administering non-Tax/non-Anthra-based AdjTx and single-agent T on long-term outcome of HER2+ ESBrCa is not fully known.
Methods
We conducted a retrospective analysis on a prospectively maintained departmental database of all patients (pts) with Stage I-III HER2+ ESBrCa treated with at least one dose of (neo)Adj T. Pre-planned duration of T was 12 mos for all pts. TTE was defined as the interval in weeks between the first and the last dose of T. In order to ensure that most pts had a minimum FU of 3 yrs we included all pts who received 1st T before March 31st 2014. The database was locked for outcome analyses on March 31st 2017.
Results
506 pts treated between October 2001 and March 2014 were included in the study. Main pts characteristics: median age: 55 years (range: 26-85), oestrogen (ER) and/or progesterone (PR) receptors positive: 321 (63%), axillary lymph nodes positive: 266 (52%), Adj T: 386 (76%), neoAdj T: 120 (24%), Tax- and Tax/Anthra–based AdjTx: 457 (90%), non-Tax/non-Anthra AdjTx and single-agent T (without chemotherapy): 49 (10%). Median FU is 73.3 months (range: 1.4-176.3). In the overall population, DFS and OS rates are 83% and 91%, respectively. Pts treated with non-Tax/non-Anthra AdjTx had a significantly higher risk of BrCa relapse [DFS: HR 3.54 (95%CI:1.24 to 10.06, p=0.018)], and death [OS: HR 2.73 (95%CI:0.63 to 11.77 p=0.176)] compared to those treated with Tax–based AdjTx (e.g. TCH [docetaxel/carboplatin/T]). Pts who received single-agent T also had highly significantly worse DFS [HR 4.21 (95%CI:2.18 to 8.38, p<0.0001)] and OS [HR 6.75 (95%CI:3.13 to 14.6 p=<0.0001)] compared to those treated with Tax-based AdjTx. When adjusted for age (<55 vs >55 yrs), the detrimental impact of type of AdjTx remained highly statistically significant (p<0.0001). Patients with TTE<24 weeks had a highly significantly worse DFS [HR 4.7 (95%CI:2.34-9.47, p<0.0001)] and OS [HR 5.36 (95%CI:2.39-12.01, p<0.0001)] compared to pts with TTE>24weeks. In most cases, shorter duration of T was due to reduction in LVEF or patients refusal. In the multivariate model, positive lymph nodes, type of (neo)AdjTx and TET (<24 weeks vs >24 weeks) remained all significant and independent variables associated with worse DFS and OS.
Conclusions
Our mature results indicate that the administration of non-Tax/non-Anthra-based AdjTx and single-agent T is associated with a significant increase in the risk of disease relapse and death and should not be considered as therapeutic options for pts with HER2+ ESBrCa. The administration of T for <24weeks irrespective of the type of AdjTx is also associated with significantly worse outcome.
Citation Format: Gullo G, Walsh N, Fennelly D, Walshe J, O'Mahony K, Silva N, Ballot J, Calzaferri G, Quinn C, McDonnell D, Crown J. Impact of type of (neo)adjuvant systemic therapy (AdjTx) and total exposure to trastuzumab (TET) on long-term outcome of HER2-positive (HER2+) early stage breast cancer (ESBrCa) [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 P5-20-05.
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Affiliation(s)
- G Gullo
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - N Walsh
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - D Fennelly
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - J Walshe
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - K O'Mahony
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - N Silva
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - J Ballot
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - G Calzaferri
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - C Quinn
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - D McDonnell
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
| | - J Crown
- St Vincent's University Hospital, Dublin, Ireland; University College Dublin - School of Medicine, Dublin, Ireland; National Institute for Cellular Biotechnology, Dublin, Ireland; St Vincent's Private Hospital, Dublin, Ireland; Cancer Clinical Research Trust, Dublin, Ireland
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O'Halloran C, Walsh N, O'Grady MC, Barry L, Hooton C, Corcoran GD, Lucey B. Assessment of the comparability of CLSI, EUCAST and Stokes antimicrobial susceptibility profiles for Escherichia coli uropathogenic isolates. Br J Biomed Sci 2017; 75:24-29. [PMID: 29210602 DOI: 10.1080/09674845.2017.1392736] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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
BACKGROUND As many clinical laboratories convert between Stokes, Clinical and Laboratory Standards Institute (CLSI) and European Committee for Antimicrobial Susceptibility Testing (EUCAST) methods, the problem of comparing differently derived sets of antimicrobial susceptibility testing (AST) data with each other arises, owing to a scarcity of knowledge of inter-method comparability. The purpose of the current study was to determine the comparability of CLSI, EUCAST and Stokes AST methods for determining susceptibility of uropathogenic Escherichia coli to ampicillin, amoxicillin-clavulanate, trimethoprim, cephradine/cephalexin, ciprofloxacin and nitrofurantoin. METHODS A total of 100 E. coli isolates were obtained from boric acid urine samples from patients attending GP surgeries. For EUCAST and CLSI, the Kirby-Bauer disc diffusion method was used and results interpreted using the respective breakpoint guidelines. For the Stokes method, direct susceptibility testing was performed on the urine samples. RESULTS The lowest levels of agreement were for amoxicillin-clavulanate (60%) and ciprofloxacin (89%) between the three AST methods, when using 2017 interpretive guidelines for CLSI and EUCAST. A comparison of EUCAST and CLSI without Stokes showed 82% agreement for amoxicillin-clavulanate and 94% agreement for ciprofloxacin. Discrepancies were compounded by varying breakpoint susceptibility guidelines issued during the period 2011-2017, and through the inclusion of a definition of intermediate susceptibility in some cases. CONCLUSIONS Our data indicate that the discrepancies generated through using different AST methods and different interpretive guidelines may result in confusion and inaccuracy when prescribing treatment for urinary tract infection.
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Affiliation(s)
- C O'Halloran
- a Department of Biological Sciences , Cork Institute of Technology , Bishopstown , Cork , Ireland
| | - N Walsh
- a Department of Biological Sciences , Cork Institute of Technology , Bishopstown , Cork , Ireland
| | - M C O'Grady
- b Department of Clinical Microbiology , Cork University Hospital , Wilton , Cork , Ireland
| | - L Barry
- b Department of Clinical Microbiology , Cork University Hospital , Wilton , Cork , Ireland
| | - C Hooton
- b Department of Clinical Microbiology , Cork University Hospital , Wilton , Cork , Ireland
| | - G D Corcoran
- b Department of Clinical Microbiology , Cork University Hospital , Wilton , Cork , Ireland
| | - B Lucey
- a Department of Biological Sciences , Cork Institute of Technology , Bishopstown , Cork , Ireland
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Gullo G, Walsh N, Fennelly D, Tryphonopoulos D, Walshe J, O'Mahony K, Silva N, Hammond L, Ballot J, Quinn C, Buckley C, Crown J. Timing of initiation of trastuzumab (T) and long-term outcome of patients (pts) with early-stage (ES) HER2-positive (HER2+) breast cancer (BrCa): Impact of neo-adjuvant (NAdj) versus adjuvant (Adj) strategy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.029] [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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Walsh N, Gullo G, Maguire A, O'Donovan N, Quinn C, Crown J. Abstract P1-05-18: Genomic copy number alterations (CNA) associated with pCR in HER2-positive (HER2+) early-stage breast cancer (BrCa) patients receiving neoadjuvant trastuzumab (T). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-18] [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: Genetic alterations such as amplifications and deletions frequently contribute to tumorigenesis. These alterations can change gene expression which alters the normal cell growth and survival regulatory mechanisms. Characterisation of DNA copy number alterations (CNA) is important to understand cancer progression and response to therapy. The aim of this study is to determine patterns of CNAs in HER2+ early-stage BrCa patients achieving pathological complete response (pCR) to neoadjuvant T therapy.
Methods: Retrospective analysis of our database of 95 HER2+ BrCa (stages I-III) who received T neoadjuvantly revealed 46 % (44/95) achieved pCR compared with 53 % (51/95) who did not respond (NR). DNA from pre-treatment tumour biopsy specimens from neoadjuvant T therapy patients was extracted, and array-based comparative genomic hybridization (aCGH, n = 8; 6 pCR:2 NR) was used to identify CNAs, which correlated with pCR. Pathway analysis was then used to identify functionally relevant genes in aberrant regions.
Results: aCGH analysis of DNA from pCR and NR identified distinct patterns of CNAs. HER2 amplicon was confirmed by IHC and aCGH in all samples. Although there was no significant difference in the average CNAs between groups (20±17 vs 17±2), there was greater variation in the range of CNAs in pCR (8-56 CNA) compared to NR (15-19 CNA). More gains and amplifications were observed in pCR patients with more deletions in the NR group. The most common chromosomal amplification region included chr8q12.1-q24 with 87.5% of all cases displaying gains. Of the 6 patients who achieved pCR, 50% displayed a deletion in chr9 spanning p24.3-p21.3, consistent with a deletion of tumour suppressor CDKN2A. No aberrations in chr9 were observed in NR cohort. The deleted genomic region contained 65 common protein-coding genes, with the interferon biological pathway as the most significant (p=1.03E-36).
Conclusions: Distinct genomic CNAs were observed between patients achieving pCR compared to NR. However, of the 8 pts characterised here, none have relapsed. Follow-up data revealed a relapse rate of 6.8 % (3/44) vs 11.8 % (6/51) in the pCR and NR groups, respectively. To further elucidate the immunological response, we will present CNA data patterns on relapse and response and compare the impact of CNAs, immune-related proteins and pCR as surrogate predictors for outcome.
Citation Format: Walsh N, Gullo G, Maguire A, O'Donovan N, Quinn C, Crown J. Genomic copy number alterations (CNA) associated with pCR in HER2-positive (HER2+) early-stage breast cancer (BrCa) patients receiving neoadjuvant trastuzumab (T) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-05-18.
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Affiliation(s)
- N Walsh
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland
| | - G Gullo
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland
| | - A Maguire
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland
| | - N O'Donovan
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland
| | - C Quinn
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland
| | - J Crown
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland; St. Vincent's University Hospital, Dublin, Ireland
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Gullo G, Walsh N, Zacchia A, Hammond L, Fennelly D, Walshe J, O’Mahony K, Maltese M, Crown J. Clinical factors associated with overall survival (OS) for patients with HER2-positive (HER2+) metastatic breast cancer (MBC) treated with HER2-targeting systemic therapy (HER2Tx). Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gullo G, Bose R, Walsh N, Maltese M, Fennelly D, Walshe J, Ballot J, Crown J. Delayed initiation of HER2-targeted therapy (HER2Tx) is associated with a higher risk of relapse for early stage (ES) HER2-positive (HER2+) breast cancer (BrCa). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.64] [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
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Hurley M, Pearson J, Walsh N, Carter D. SAT0622 Co-Creating An Online Rehabilitation Programme for People with Chronic Knee/Hip Pain. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Walsh N, Wiesen E, Lo Y. WHO Western Pacific Regional Hepatitis Action Plan: Comprehensive action on viral hepatitis. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mahgoub T, Eustace AJ, Collins DM, Walsh N, O'Donovan N, Crown J. Kinase inhibitor screening identifies CDK4 as a potential therapeutic target for melanoma. Int J Oncol 2015. [PMID: 26201960 PMCID: PMC4532220 DOI: 10.3892/ijo.2015.3097] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Despite recent advances in targeted therapies and immunotherapies metastatic melanoma remains only rarely curable. The objective of the present study was to identify novel therapeutic targets for metastatic melanoma. A library of 160 well-characterised and potent protein kinase inhibitors was screened in the BRAF mutant cell line Sk-Mel-28, and the NRAS mutant Sk-Mel-2, using proliferation assays. Of the 160 inhibitors tested, 20 achieved >50% growth inhibition in both cell lines. Six of the 20 were cyclin dependent kinase (CDK) inhibitors, including two CDK4 inhibitors. Fascaplysin, a synthetic CDK4 inhibitor, was further tested in 8 melanoma cell lines. The concentration of fascaplysin required to inhibit growth by 50% (IC50 value) ranged from 0.03 to 0.22 μM. Fascaplysin also inhibited clonogenic growth and induced apoptosis. Sensitivity to PD0332991, a therapeutic CDK4/6 inhibitor was also evaluated in the melanoma cell lines. PD0332991 IC50 values ranged from 0.13 to 2.29 μM. Similar to fascaplysin, PD0332991 inhibited clonogenic growth of melanoma cells and induced apoptosis. Higher levels of CDK4 protein correlated with lower sensitivity to PD0332991 in the cell lines. Combined treatment with PD0332991 and the BRAF inhibitor PLX4032, showed additive anti-proliferative effects in the BRAF mutant cell line Malme-3M. In summary, targeting CDK4 inhibits growth and induces apoptosis in melanoma cells in vitro, suggesting that CDK4 may be a rational therapeutic target for metastatic melanoma.
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Affiliation(s)
- T Mahgoub
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - A J Eustace
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - D M Collins
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - N Walsh
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - N O'Donovan
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - J Crown
- Department of Medical Oncology, St. Vincent's University Hospital, Dublin, Ireland
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Grieve S, Jones L, Walsh N, McCabe C. What outcome measures are commonly used for Complex Regional Pain Syndrome clinical trials? A systematic review of the literature. Eur J Pain 2015; 20:331-40. [PMID: 26075938 DOI: 10.1002/ejp.733] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 11/10/2022]
Affiliation(s)
- S. Grieve
- Royal National Hospital for Rheumatic Diseases; Bath UK
- Faculty of Health and Applied Sciences; University of the West of England; Bristol UK
| | - L. Jones
- Faculty of Health and Applied Sciences; University of the West of England; Bristol UK
| | - N. Walsh
- Faculty of Health and Applied Sciences; University of the West of England; Bristol UK
| | - C. McCabe
- Royal National Hospital for Rheumatic Diseases; Bath UK
- Faculty of Health and Applied Sciences; University of the West of England; Bristol UK
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Walsh N, Phelan M. THU0634-HPR An Investigation of an Exercise Class Versus Individual Exercise Sessions in the Management of Rotator Cuff Impingement Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1025] [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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Salmon V, Hewlett S, Walsh N, Kirwan J, Morris M, Urban M, Cramp F. THU0639-HPR Acceptability of a Novel Physical Activity and Self-Management Intervention for Managing Fatigue in Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cramp F, Withall J, Haase A, Walsh N, Young A, Hewlett S. SAT0643-HPR Development of a Physical Activity Programme for People with Recently Diagnosed Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1647] [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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Simmons D, Deakin T, Walsh N, Turner B, Lawrence S, Priest L, George S, Vanterpool G, McArdle J, Rylance A, Terry G, Little P. Diabetes UK Position Statement. Competency frameworks in diabetes. Diabet Med 2015; 32:576-84. [PMID: 25611804 DOI: 10.1111/dme.12702] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 11/28/2022]
Abstract
The quality, skills and attitudes of staff working in the healthcare system are central to multidisciplinary learning and working, and to the delivery of the quality of care patients expect. Patients want to know that the staff supporting them have the right knowledge and attitudes to work in partnership, particularly for conditions such as diabetes where 95% of all care is delivered by the person with diabetes themselves. With the current changes in the NHS structures in England, and the potential for greater variation in the types of 'qualified provider', along with the recent scandal at Mid-Staffordshire Hospital, staff need to be shown to be competent and named/accredited or recognized as such. This will help to restore faith in an increasingly devolved delivery structure. The education and validation of competency needs to be consistently delivered and assured to ensure standards are maintained for different roles and disciplines across each UK nation. Diabetes UK recommends that all NHS organizations prioritize healthcare professional education, training and competency through the implementation of a National Diabetes Competency Framework and the phased approach to delivery to address this need.
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Affiliation(s)
- D Simmons
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Mazza T, Karamatskou A, Ilchen M, Bakhtiarzadeh S, Rafipoor AJ, O'Keeffe P, Kelly TJ, Walsh N, Costello JT, Meyer M, Santra R. Sensitivity of nonlinear photoionization to resonance substructure in collective excitation. Nat Commun 2015; 6:6799. [PMID: 25854939 PMCID: PMC4403373 DOI: 10.1038/ncomms7799] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 03/02/2015] [Indexed: 11/15/2022] Open
Abstract
Collective behaviour is a characteristic feature in many-body systems, important for developments in fields such as magnetism, superconductivity, photonics and electronics. Recently, there has been increasing interest in the optically nonlinear response of collective excitations. Here we demonstrate how the nonlinear interaction of a many-body system with intense XUV radiation can be used as an effective probe for characterizing otherwise unresolved features of its collective response. Resonant photoionization of atomic xenon was chosen as a case study. The excellent agreement between experiment and theory strongly supports the prediction that two distinct poles underlie the giant dipole resonance. Our results pave the way towards a deeper understanding of collective behaviour in atoms, molecules and solid-state systems using nonlinear spectroscopic techniques enabled by modern short-wavelength light sources. Electrons in atoms exhibit many-body collective behaviours that can be studied by highbrightness X-rays from FELs. Here, the authors examine two-photon above threshold ionization of xenon and find that nonlinearities in the response uncover that more than one state underpins the 4d giant resonance.
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Affiliation(s)
- T Mazza
- European XFEL GmbH, Albert-Einstein-Ring 19, 22761 Hamburg, Germany
| | - A Karamatskou
- 1] Center for Free-Electron Laser Science, DESY, Notkestrasse 85, 22607 Hamburg, Germany [2] Department of Physics, University of Hamburg, Jungiusstrasse 9, 20355 Hamburg, Germany
| | - M Ilchen
- 1] European XFEL GmbH, Albert-Einstein-Ring 19, 22761 Hamburg, Germany [2] Stanford PULSE Institute, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - S Bakhtiarzadeh
- 1] European XFEL GmbH, Albert-Einstein-Ring 19, 22761 Hamburg, Germany [2] Department of Physics, University of Hamburg, Jungiusstrasse 9, 20355 Hamburg, Germany
| | - A J Rafipoor
- 1] European XFEL GmbH, Albert-Einstein-Ring 19, 22761 Hamburg, Germany [2] Department of Physics, University of Hamburg, Jungiusstrasse 9, 20355 Hamburg, Germany
| | - P O'Keeffe
- CNR Istituto di Struttura della Materia, CP10, I-00016 Monterotondo Scalo, Italy
| | - T J Kelly
- School of Physical Sciences and NCPST, Dublin City University, Dublin 9, Ireland
| | - N Walsh
- School of Physical Sciences and NCPST, Dublin City University, Dublin 9, Ireland
| | - J T Costello
- School of Physical Sciences and NCPST, Dublin City University, Dublin 9, Ireland
| | - M Meyer
- European XFEL GmbH, Albert-Einstein-Ring 19, 22761 Hamburg, Germany
| | - R Santra
- 1] Center for Free-Electron Laser Science, DESY, Notkestrasse 85, 22607 Hamburg, Germany [2] Department of Physics, University of Hamburg, Jungiusstrasse 9, 20355 Hamburg, Germany
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Daffada PJ, Walsh N, McCabe CS, Palmer S. The impact of cortical remapping interventions on pain and disability in chronic low back pain: a systematic review. Physiotherapy 2014; 101:25-33. [PMID: 25442672 DOI: 10.1016/j.physio.2014.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 07/25/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cortical change, in the manner of cortical remapping is a common feature of and potential driver for chronic low back pain (CLBP). Novel interventions such as graded motor imagery (GMI) and mirror visual feedback (MVF) have been shown to facilitate correction of cortical changes and improve symptoms in other chronic pain states. However, little is known regarding the effectiveness of these treatment approaches in CLBP. OBJECTIVE To identify and assess the current evidence regarding the effectiveness of interventions which target cortical remapping in the management of CLBP. DATA SOURCES The electronic databases Medline, Embase, CINAHL, AMED, OVID, PEDro, BNI, PsycINFO, HMIC, and Cochrane library were systematically searched. STUDY SELECTION Of 11 potential citations identified, 5 articles were identified for inclusion and critiqued. These comprised 3 randomised controlled trials (RCTs), 1 randomised cross-over study, and 1 multiple case study design. RESULTS Visualisation of lumbar movement may significantly improve movement-related pain severity and duration. A combined sensorimotor retraining approach has been shown to produce short-term improvements in both pain and disability outcomes in CLBP. The relative effectiveness of individual interventions and their long-term efficacy have yet to be established. CONCLUSIONS There is a paucity of robust literature which has examined the application and efficacy of these novel treatments in the management of CLBP. Results from the few CLBP studies which are available are encouraging. Further, robust research is needed to optimise treatment protocols and establish their long-term effectiveness in CLBP.
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Affiliation(s)
- P J Daffada
- Department of Physiotherapy, St. David's Hospital, Cardiff and Vale University Health Board (UHB), United Kingdom; North Somerset Community Partnership (NSCP), United Kingdom.
| | - N Walsh
- Department of Allied Health Professions, Faculty of Health and Applied Sciences, University of West of England (UWE), United Kingdom
| | - C S McCabe
- Department of Allied Health Professions, Faculty of Health and Applied Sciences, University of West of England (UWE), United Kingdom
| | - S Palmer
- Department of Nursing and Midwifery, Faculty of Health and Applied Sciences, University of West of England (UWE), United Kingdom
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35
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Akerib DS, Araújo HM, Bai X, Bailey AJ, Balajthy J, Bedikian S, Bernard E, Bernstein A, Bolozdynya A, Bradley A, Byram D, Cahn SB, Carmona-Benitez MC, Chan C, Chapman JJ, Chiller AA, Chiller C, Clark K, Coffey T, Currie A, Curioni A, Dazeley S, de Viveiros L, Dobi A, Dobson J, Dragowsky EM, Druszkiewicz E, Edwards B, Faham CH, Fiorucci S, Flores C, Gaitskell RJ, Gehman VM, Ghag C, Gibson KR, Gilchriese MGD, Hall C, Hanhardt M, Hertel SA, Horn M, Huang DQ, Ihm M, Jacobsen RG, Kastens L, Kazkaz K, Knoche R, Kyre S, Lander R, Larsen NA, Lee C, Leonard DS, Lesko KT, Lindote A, Lopes MI, Lyashenko A, Malling DC, Mannino R, McKinsey DN, Mei DM, Mock J, Moongweluwan M, Morad J, Morii M, Murphy ASJ, Nehrkorn C, Nelson H, Neves F, Nikkel JA, Ott RA, Pangilinan M, Parker PD, Pease EK, Pech K, Phelps P, Reichhart L, Shutt T, Silva C, Skulski W, Sofka CJ, Solovov VN, Sorensen P, Stiegler T, O'Sullivan K, Sumner TJ, Svoboda R, Sweany M, Szydagis M, Taylor D, Tennyson B, Tiedt DR, Tripathi M, Uvarov S, Verbus JR, Walsh N, Webb R, White JT, White D, Witherell MS, Wlasenko M, Wolfs FLH, Woods M, Zhang C. First results from the LUX dark matter experiment at the Sanford underground research facility. Phys Rev Lett 2014; 112:091303. [PMID: 24655239 DOI: 10.1103/physrevlett.112.091303] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Indexed: 06/03/2023]
Abstract
The Large Underground Xenon (LUX) experiment is a dual-phase xenon time-projection chamber operating at the Sanford Underground Research Facility (Lead, South Dakota). The LUX cryostat was filled for the first time in the underground laboratory in February 2013. We report results of the first WIMP search data set, taken during the period from April to August 2013, presenting the analysis of 85.3 live days of data with a fiducial volume of 118 kg. A profile-likelihood analysis technique shows our data to be consistent with the background-only hypothesis, allowing 90% confidence limits to be set on spin-independent WIMP-nucleon elastic scattering with a minimum upper limit on the cross section of 7.6 × 10(-46) cm(2) at a WIMP mass of 33 GeV/c(2). We find that the LUX data are in disagreement with low-mass WIMP signal interpretations of the results from several recent direct detection experiments.
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Affiliation(s)
- D S Akerib
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - H M Araújo
- High Energy Physics, Imperial College London, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - X Bai
- South Dakota School of Mines and Technology, 501 East St Joseph Street, Rapid City, South Dakota 57701, USA
| | - A J Bailey
- High Energy Physics, Imperial College London, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J Balajthy
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - S Bedikian
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - E Bernard
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - A Bernstein
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - A Bolozdynya
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - A Bradley
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - D Byram
- Department of Physics, University of South Dakota, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - S B Cahn
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - M C Carmona-Benitez
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA and Department of Physics, University of California Santa Barbara, Santa Barbara, California 93106, USA
| | - C Chan
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - J J Chapman
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - A A Chiller
- Department of Physics, University of South Dakota, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - C Chiller
- Department of Physics, University of South Dakota, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - K Clark
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - T Coffey
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - A Currie
- High Energy Physics, Imperial College London, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - A Curioni
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - S Dazeley
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - L de Viveiros
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Dobi
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - J Dobson
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh, EH9 3JZ, United Kingdom
| | - E M Dragowsky
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - E Druszkiewicz
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - B Edwards
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C H Faham
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA and Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Fiorucci
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - C Flores
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - R J Gaitskell
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C Ghag
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - K R Gibson
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C Hall
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - M Hanhardt
- South Dakota School of Mines and Technology, 501 East St Joseph Street, Rapid City, South Dakota 57701, USA and South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S A Hertel
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - M Horn
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - D Q Huang
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - M Ihm
- Department of Physics, University of California Berkeley, Berkeley, California 94720, USA
| | - R G Jacobsen
- Department of Physics, University of California Berkeley, Berkeley, California 94720, USA
| | - L Kastens
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - K Kazkaz
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - R Knoche
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - S Kyre
- Department of Physics, University of California Santa Barbara, Santa Barbara, California 93106, USA
| | - R Lander
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - N A Larsen
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C Lee
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - D S Leonard
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - A Lindote
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M I Lopes
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Lyashenko
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - D C Malling
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - R Mannino
- Department of Physics, Texas A & M University, College Station, Texas 77843, USA
| | - D N McKinsey
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - D-M Mei
- Department of Physics, University of South Dakota, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - J Mock
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - M Moongweluwan
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - J Morad
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - M Morii
- Department of Physics, Harvard University, 17 Oxford Street, Cambridge, Massachusetts 02138, USA
| | - A St J Murphy
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh, EH9 3JZ, United Kingdom
| | - C Nehrkorn
- Department of Physics, University of California Santa Barbara, Santa Barbara, California 93106, USA
| | - H Nelson
- Department of Physics, University of California Santa Barbara, Santa Barbara, California 93106, USA
| | - F Neves
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - J A Nikkel
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - R A Ott
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - M Pangilinan
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - P D Parker
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - E K Pease
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - K Pech
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - P Phelps
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - L Reichhart
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - T Shutt
- Department of Physics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - C Silva
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - W Skulski
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - C J Sofka
- Department of Physics, Texas A & M University, College Station, Texas 77843, USA
| | - V N Solovov
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - T Stiegler
- Department of Physics, Texas A & M University, College Station, Texas 77843, USA
| | - K O'Sullivan
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - T J Sumner
- High Energy Physics, Imperial College London, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - R Svoboda
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - M Sweany
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - M Szydagis
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - D Taylor
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - B Tennyson
- Department of Physics, Yale University, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - D R Tiedt
- South Dakota School of Mines and Technology, 501 East St Joseph Street, Rapid City, South Dakota 57701, USA
| | - M Tripathi
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - S Uvarov
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - J R Verbus
- Department of Physics, Brown University, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - N Walsh
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - R Webb
- Department of Physics, Texas A & M University, College Station, Texas 77843, USA
| | - J T White
- Department of Physics, Texas A & M University, College Station, Texas 77843, USA
| | - D White
- Department of Physics, University of California Santa Barbara, Santa Barbara, California 93106, USA
| | - M S Witherell
- Department of Physics, University of California Santa Barbara, Santa Barbara, California 93106, USA
| | - M Wlasenko
- Department of Physics, Harvard University, 17 Oxford Street, Cambridge, Massachusetts 02138, USA
| | - F L H Wolfs
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - M Woods
- Department of Physics, University of California Davis, One Shields Avenue, Davis, California 95616, USA
| | - C Zhang
- Department of Physics, University of South Dakota, 414E Clark Street, Vermillion, South Dakota 57069, USA
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Howe K, Eustace A, Souahli S, Browne B, Aherne S, Barron N, Walsh N, Crown J, O'Donovan N. 143 MicroRNA-224 and −375 in Trastuzumab and Lapatinib Acquired and Innate Resistant HER2 Positive Breast Cancer Cells. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71941-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sloan D, Browne S, Meagher D, Lane A, Larkin C, Casey P, Walsh N, O'Callaghan E. Attitudes toward psychiatry among Irish final year medical students. Eur Psychiatry 2012; 11:407-11. [PMID: 19698492 DOI: 10.1016/s0924-9338(97)82579-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [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] [Received: 02/05/1996] [Accepted: 04/22/1996] [Indexed: 10/18/2022] Open
Abstract
This study investigated the attitudes of medical students towards psychiatry, both as a subject on the medical curriculum and as a career choice. Three separate questionnaires previously validated on medical student populations were administered prior to and immediately following an 8-week clinical training programme. The results indicate that the perception of psychiatry was positive prior to clerkship and became even more so on completion of training. On completion of the clerkship, there was a rise in the proportion of students who indicated that they might choose a career in psychiatry. Attitudes toward psychiatry correlated positively with the psychiatry examination results. Those that intended to specialise in psychiatry achieved significantly higher examination scores in the psychiatry examination.
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Affiliation(s)
- D Sloan
- Department of Psychiatry, University College Dublin, and St Vincent 's Hospital, Elm Park, Dublin 4, Ireland
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Howe K, Eustace A, Souahli S, Browne B, Aherne S, Barron N, Walsh N, Crown J, O'Donovan N. Microrna-9 and -224 In Trastuzumab Resistant HER2 Positive Breast Cancer Cells. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34197-1] [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: 11/26/2022] Open
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Lynn R, Walsh N, Lei M, Applegate K, Convery D, Guerrero-Urbano T. EP-1164 FIXED FIELD IMRT, VMAT AND TOMOTHERAPY TECHNIQUES FOR HNSCC: A DOSIMETRIC AND VOLUMETRIC COMPARISON. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71497-4] [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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Milesi N, Lynn R, Begum R, Walsh N, Dobson A, Donnelly R, Lei M, Convery D, James D, Guerrero Urbano T. PO-0898 ADAPTIVE PLANNING IN RESPONSE TO VARIATIONS IN PATIENT ANATOMY DURING IG-IMRT USING CBCT IN HEAD AND NECK CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71231-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vincent T, Van Vollenhoven R, Buch M, Bruce I, McCabe C, Hager C, Walsh N, Ehrenstein M, Helliwell P, Keat A, Pitzalis C, Nestle F, McHugh N, Helliwell P, Chinoy H, Isenberg D, Nanchahal J, Ball C, Bearne L, Manning V, Scott DL, Hurley M, Adams J, Deighton C, Nye A, Black DC, Gunneyon B, Walker D, Higginbottom A, Bowness P, van der Heijde D, Baeten D. Molecular mechanisms of disease: osteoarthritis * I68. Osteoarthritis. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes105] [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
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Walsh N, Dale J, McGraw KJ, Pointer MA, Mundy NI. Candidate genes for carotenoid coloration in vertebrates and their expression profiles in the carotenoid-containing plumage and bill of a wild bird. Proc Biol Sci 2012; 279:58-66. [PMID: 21593031 PMCID: PMC3223654 DOI: 10.1098/rspb.2011.0765] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 04/28/2011] [Indexed: 12/13/2022] Open
Abstract
Carotenoid-based coloration has attracted much attention in evolutionary biology owing to its role in honest, condition-dependent signalling. Knowledge of the genetic pathways that regulate carotenoid coloration is crucial for an understanding of any trade-offs involved. We identified genes with potential roles in carotenoid coloration in vertebrates via (i) carotenoid uptake (SR-BI, CD36), (ii) binding and deposition (StAR1, MLN64, StAR4, StAR5, APOD, PLIN, GSTA2), and (iii) breakdown (BCO2, BCMO1). We examined the expression of these candidate loci in carotenoid-coloured tissues and several control tissues of the red-billed quelea (Quelea quelea), a species that exhibits a male breeding plumage colour polymorphism and sexually dimorphic variation in bill colour. All of the candidate genes except StAR1 were expressed in both the plumage and bill of queleas, indicating a potential role in carotenoid coloration in the quelea. However, no differences in the relative expression of any of the genes were found among the quelea carotenoid phenotypes, suggesting that other genes control the polymorphic and sexually dimorphic variation in carotenoid coloration observed in this species. Our identification of a number of potential carotenoid genes in different functional categories provides a critical starting point for future work on carotenoid colour regulation in vertebrate taxa.
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Affiliation(s)
- N. Walsh
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 ITN, UK
| | - J. Dale
- Max Planck Institute for Ornithology, Eberhard-Gwinner Strasse, 82319 Seewiesen, Germany
| | - K. J. McGraw
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA
| | - M. A. Pointer
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 ITN, UK
| | - N. I. Mundy
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 ITN, UK
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Walsh N, George S, Priest L, Deakin T, Vanterpool G, Karet B, Simmons D. The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group. Diabet Med 2011; 28:1501-7. [PMID: 21838768 DOI: 10.1111/j.1464-5491.2011.03411.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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: 11/27/2022]
Abstract
Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service.
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Affiliation(s)
- N Walsh
- University of Nottingham, School of Nursing, Midwifery and Phyiotherapy, Grantham Education Centre, Nottingham, UK.
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Ndosi M, Vinall K, Hale C, Bird H, Hill J, Cornell P, Westlake S, Richards S, Sanderson T, Calnan M, Morris M, Richards P, Hewlett S, Richards A, Taylor S, Porcheret M, Grime J, Jordan K, Dziedzic K, Hewlett S, Ambler N, Knops B, Cliss A, Almeida C, Pope D, Hammond A, Swinkels A, Kitchen K, Pollock J, Hurley M, Walsh N, Mitchell H, Nicholas J, Day SH, Butt S, Deighton C, Gadsby K. Concurrent Oral 5 - BHPR Audit/Service Delivery and Research [OP32-OP39]: OP32. Is Nurse-Led Care Effective in Rheumatology? a Systematic Review. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Norton S, Done J, Sacker A, Young A, Cox N, Treharne GJ, McGavock ZC, Tonks A, Kafka SA, Hale ED, Kitas GD, Fletcher D, Sanderson T, Baker G, Street P, Hewlett S, Stynes S, Peat G, Myers H, Croft P, Bosworth AM, Crake D, Hurley M, Patel A, Walsh N, Mitchell H, Kumar K, Gordhan C, Situnayake D, Raza K, Bacon P, Hewlett S, Sanderson T, May J, Bingham CO, March L, Alten R, Pohl C, Woodworth T, Bartlett S, Stevenson K, Roddy E, Jordan K, Waldron N, Brown S, McCabe C, McHugh N, Hewlett S, Shelmerdine J, Ferenkeh-Koroma A, Breslin A, Sawyer S, Haas M, Elliott B, Law RJ, Breslin A, Oliver E, Mawn L, Markland D, Peter M, Thom J, Hewlett S, Sanderson T, May J, Bingham CO, March L, Alten R, Pohl C, Woodworth T, Bartlett S, Cliss A, Morris M, Ambler N, Knops B, Hammond A, Almeida C, Hewlett S. BHPR: Research [278-290]: 278. What does the Hospital Anxiety and Depression Scale Measure? Evidence of a Bifactor Structure and Item Bias. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq731] [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: 11/14/2022] Open
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Abstract
The production of aluminum cluster tetra-anions, and thus the first observation of a tetra-anionic metal cluster in the gas-phase, is reported. The aluminum cluster polyanions were generated by use of the "electron-bath technique." The smallest tetra-anion observed was Al(215) (4-), containing 14% fewer atoms than expected from classical estimates of the tetra-anion appearance size.
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Affiliation(s)
- N Walsh
- Institute for Physics, Ernst-Moritz-Arndt University, Greifswald 17489, Germany.
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Hurley M, Ratcliffe J, Jessep S, Walsh N. Authors’ response. Physiotherapy 2009. [DOI: 10.1016/j.physio.2009.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sheikh R, O'connor R, Walsh N, Clynes M, Mcdermott R. 6632 Characterisation of the response of pancreatic cancer cells to treatment with chemotherapeutic agents alone and in combination with tyrosine kinase inhibitors. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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O'Donnell H, Cooke K, Walsh N, Plowman PN. Early experience of tomotherapy-based intensity-modulated radiotherapy for breast cancer treatment. Clin Oncol (R Coll Radiol) 2009; 21:294-301. [PMID: 19249194 DOI: 10.1016/j.clon.2009.01.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 01/05/2009] [Accepted: 01/27/2009] [Indexed: 10/21/2022]
Abstract
AIMS New technology - specifically intensity-modulated radiotherapy (IMRT) - is now being applied to breast radiotherapy and a recent dosimetric analysis confirmed the advantages of IMRT over 'wedge-only' plans. Such application to everyday practice raises new issues and here we present the early experience of IMRT-based breast irradiation in a single centre. MATERIALS AND METHODS We present cases of breast cancer treated by Tomotherapy-based IMRT, where the perceived advantages of IMRT are considerable. Cases presented are bilateral disease, left breast irradiation, pectus excavatum, prominent contralateral prosthesis and internal mammary chain disease. We discuss the practicalities of such treatment and the advantages over standard breast irradiation techniques. RESULTS Advantages include better conformity of treatment with lowering of dosages to underlying organs at risk, for example ipsilateral lung and heart. There is improved coverage of the planning target volume, including regional nodes, without field junction problems. Planning, quality assurance and treatment delivery are more time consuming than for standard breast irradiation and the low dose 'bath' is increased. CONCLUSIONS The standard radiotherapy tangential technique for breast/chest wall treatments has not significantly changed over many decades, whereas across many other tumour sites there have been great advances in radiotherapy technology. The dosimetric advantages of IMRT are readily apparent from our early experience. The wider spread of the lower dose zone (the low dose 'bath' of radiation) is a potential concern regarding late oncogenesis and methods to minimise such risks should be considered.
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Affiliation(s)
- H O'Donnell
- Department of Radiotherapy, St Bartholomew's Hospital, London, UK
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Dwyer R, Topp L, Maher L, Power R, Hellard M, Walsh N, Jauncey M, Conroy A, Lewis J, Aitken C. Prevalences and correlates of non-viral injecting-related injuries and diseases in a convenience sample of Australian injecting drug users. Drug Alcohol Depend 2009; 100:9-16. [PMID: 19013725 DOI: 10.1016/j.drugalcdep.2008.08.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [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] [Received: 03/17/2008] [Revised: 08/25/2008] [Accepted: 08/25/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND The prevalences and correlates of non-viral injecting-related injuries and diseases (IRIDs) in Australian injecting drug users (IDUs) remain unknown. METHODS A cross-sectional survey of IDUs was conducted in six sites across Australia's eastern states to investigate IRID experience among Australian IDU. Correlates of IRIDs were explored using logistic and negative binomial regression analyses. RESULTS 393 IDUs were recruited. Lifetime experience of non-serious IRIDs was common (e.g., 'dirty hit' 68%); potentially serious and serious IRIDs were less commonly experienced (e.g., abscess 16%; gangrene <1%). Factors independently associated with potentially serious or serious IRIDs in the previous 12 months were: injecting in sites other than arms (Adjusted Odds Ratio 3.0, 95% confidence interval 1.7-5.4), injecting non-powder drug forms (5.0, 2.2-11.2), unstable accommodation (2.0, 1.1-3.5), being aged 25 years or older (4.3, 1.7-10.6) and not always washing hands before injection (9.3, 2.1-41.8). Factors independently associated with multiple IRIDs in the preceding 12 months were using three or more injecting sites (Adjusted Incidence Rate Ratio 1.5, 95% CI 1.1-2.0), injecting in sites other than arms (1.7, 1.3-2.2), using non-powder drug forms (1.9, 1.4-2.5), injecting daily or more often (1.7, 1.3-2.2), current pharmacotherapy experience (1.5, 1.1-1.9), and not always washing hands before injecting (1.9, 1.2-2.9). DISCUSSION Some IRIDs are widespread among Australian IDUs. Observed associations, particularly the protective effect of handwashing, have useful public health implications.
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Affiliation(s)
- R Dwyer
- Centre for Epidemiology and Population Health Research, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne 3001, Australia
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