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Johnstone C, Lomas JP, Dixson T, Walsh P, Yousaf A. Reassessing the numbers: discrepancies, implications and potential solutions for the NELA Risk Calculator. Anaesthesia 2023; 78:1414-1415. [PMID: 37551435 DOI: 10.1111/anae.16073] [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] [Accepted: 05/24/2023] [Indexed: 08/09/2023]
Affiliation(s)
- C Johnstone
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - J P Lomas
- Bolton NHS Foundation Trust, Bolton, UK
| | - T Dixson
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - P Walsh
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - A Yousaf
- King's College London, London, UK
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2
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Crossin R, Cleland L, Wilkins C, Rychert M, Adamson S, Potiki T, Pomerleau AC, MacDonald B, Faletanoai D, Hutton F, Noller G, Lambie I, Sheridan JL, George J, Mercier K, Maynard K, Leonard L, Walsh P, Ponton R, Bagshaw S, Muthukumaraswamy S, McIntosh T, Poot E, Gordon P, Sharry P, Nutt D, Boden J. The New Zealand drug harms ranking study: A multi-criteria decision analysis. J Psychopharmacol 2023; 37:891-903. [PMID: 37353972 PMCID: PMC10481626 DOI: 10.1177/02698811231182012] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
AIMS The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. METHODS Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12-17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. RESULTS When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. CONCLUSIONS The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Lana Cleland
- Department of Population Health, University of Otago, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Wilkins
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Marta Rychert
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Simon Adamson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Tuari Potiki
- Office of Māori Development, University of Otago, Dunedin, New Zealand
| | - Adam C Pomerleau
- National Poisons Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Blair MacDonald
- National Drug Intelligence Bureau, New Zealand Police, Wellington, New Zealand
| | - Dwaine Faletanoai
- Pacific Mental Health and Addictions Services (Takanga a Fohe), Waitemata District Health Board, Takapuna, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Wellington, New Zealand
| | - Geoff Noller
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Ian Lambie
- Department of Psychology, University of Auckland, Auckland, New Zealand
| | - Jane L Sheridan
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jason George
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Kali Mercier
- New Zealand Drug Foundation, Wellington, New Zealand
| | | | - Louise Leonard
- Community and Other Drug Service, Waikato District Health Board, Waikato, New Zealand
| | | | - Rhys Ponton
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Bagshaw
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Suresh Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Ministry of Social Development, Wellington, New Zealand
| | | | | | - Patrick Sharry
- People and Decisions, Sydney, Australia
- Australian Graduate School of Management, University of New South Wales, Sydney, Australia
| | - David Nutt
- Centre for Neuropsychopharmacology, Imperial College, London, UK
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Clore L, Jain V, Giménez-Arnau A, Lheritier K, Walsh P, Haemmerle S, Maurer M. REMIBRUTINIB TREATMENT IMPROVES SLEEP AND ACTIVITY IN CHRONIC SPONTANEOUS URTICARIA PATIENTS: PHASE 2B STUDY RESULTS. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.595] [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: 11/11/2022]
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4
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Rosenberg PB, Outen JD, Amjad H, Burhanullah H, Vandrey R, Agronin M, Castaneda R, Isesalaya M, Walsh P, Ash ET, Cohen L, Wilkins JM, Harper DG, Forester BP. Pilot trial of dronabinol adjunctive treatment of agitation in Alzheimer's disease (THC‐AD). Alzheimers Dement 2021. [DOI: 10.1002/alz.052594] [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: 11/05/2022]
Affiliation(s)
| | - John D. Outen
- Johns Hopkins University School of Medicine Baltimore MD USA
| | - Halima Amjad
- Johns Hopkins University School of Medicine Baltimore MD USA
| | | | - Ryan Vandrey
- Johns Hopkins University School of Medicine Baltimore MD USA
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Cohen LM, Ash E, Outen JD, Vandrey R, Amjad H, Agronin M, Burhanullah MH, Walsh P, Wilkins JM, Leoutsakos JM, Nowrangi MA, Harper D, Rosenberg PB, Forester BP. Study rationale and baseline data for pilot trial of dronabinol adjunctive treatment of agitation in Alzheimer's dementia (THC-AD). Int Psychogeriatr 2021:1-6. [PMID: 34629131 DOI: 10.1017/s1041610221001150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Agitation is a common complication of Alzheimer's dementia (Agit-AD) associated with substantial morbidity, high healthcare service utilization, and adverse emotional and physical impact on care partners. There are currently no FDA-approved pharmacological treatments for Agit-AD. We present the study design and baseline data for an ongoing multisite, three-week, double-blind, placebo-controlled, randomized clinical trial of dronabinol (synthetic tetrahydrocannabinol [THC]), titrated to a dose of 10 mg daily, in 80 participants to examine the safety and efficacy of dronabinol as an adjunctive treatment for Agit-AD. Preliminary findings for 44 participants enrolled thus far show a predominately female, white sample with advanced cognitive impairment (Mini Mental Status Examination mean 7.8) and agitation (Neuropsychiatric Inventory-Clinician Agitation subscale mean 14.1). Adjustments to study design in light of the COVID-19 pandemic are described. Findings from this study will provide guidance for the clinical utility of dronabinol for Agit-AD. ClinicalTrials.gov Identifier: NCT02792257.
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Affiliation(s)
- Leah M Cohen
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Eleanor Ash
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John D Outen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Halima Amjad
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marc Agronin
- Department of Mental Health and Clinical Research, Miami Jewish Health, Miami, FL, USA
| | - M Haroon Burhanullah
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patricia Walsh
- Department of Psychiatry, North Shore Medical Center, Salem, MA, USA
| | - James M Wilkins
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jeannie-Marie Leoutsakos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Harper
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Paul B Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brent P Forester
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
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Outen J, Rosenberg P, Vandrey R, Amjad H, Burhanullah H, Agronin M, Castaneda R, Isesalaya M, Walsh P, Ash E, Cohen L, Wilkins J, Harper D, Forester B. Pilot Trial of Dronabinol Adjunctive Treatment of Agitation in Alzheimer's Disease (THC-AD). The American Journal of Geriatric Psychiatry 2021. [DOI: 10.1016/j.jagp.2021.01.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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7
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Roy A, Courtenay K, Odiyoor M, Walsh P, Keane S, Biswas A, Marston G, Thirulokachandran S, Munir K. Setting priorities for people with intellectual disability/intellectual developmental disorders across the lifespan: a call to action by the World Psychiatric Association. BJPsych Int 2021; 18:54-57. [PMID: 34382957 PMCID: PMC8314992 DOI: 10.1192/bji.2021.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/14/2021] [Indexed: 11/23/2022] Open
Abstract
People with DSM-5 intellectual disability/intellectual developmental disorder (ID/IDD) or ICD-11 disorders of intellectual development (DID) have multiple healthcare needs, but in many countries these needs are neither recognised nor managed effectively. This paper discusses the negative impact that stigma, discrimination and social exclusion have on the identification and care of persons with ID/IDD in low- and middle-income countries (LMICs). It also reviews different models of care for children, adolescents and adults. In discussing some initiatives in LMICs the emphasis is on early diagnosis, with success in providing locally sourced care for affected people and their families. This is where the medical, social and rights-based models of care intersect and is a premise of the person-centred biopsychosocial framework of the World Psychiatric Association's Presidential Action Plan 2020–2023. The plan invites psychiatrists to take a lead in changing the culture of care, as well as medical education, clinical training and research, with a renewed emphasis on workforce integration and service development in terms of community-based rehabilitation strategies.
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Affiliation(s)
- Ashok Roy
- FRCPsych, Consultant Psychiatrist, Coventry and Warwickshire Partnership NHS Trust, UK.
| | - Ken Courtenay
- FRCPsych, Chair, Intellectual Disability Faculty, Royal College of Psychiatrists, London, UK
| | - Mahesh Odiyoor
- FRCPsych, Strategic Clinical Director, Centre for Autism, Neurodevelopmental Disorders and Intellectual Disabilities, Cheshire and Wirral Partnership NHS Foundation Trust, UK
| | - Patricia Walsh
- MRCPsych, Chair of the Faculty of Learning Disability, College of Psychiatrists of Ireland, Ireland
| | - Sarah Keane
- MRCPsych, Consultant Psychiatrist, HSE Dublin South Mental Health Services, Ireland
| | - Asit Biswas
- FRCPsych, Consultant Psychiatrist, Leicestershire Partnership NHS Trust, UK
| | - Geoff Marston
- FRCPsych, Consultant Psychiatrist, Coventry and Warwickshire Partnership NHS Trust, UK
| | | | - Kerim Munir
- DFAACAP, Director of Psychiatry, University Centre for Excellence in Developmental and Related Disabilities, Boston Children's Hospital, Harvard Medical School, Boston, Ma, USA
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8
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O Reilly D, Deady S, Walsh P, Lowery M. Impact of centralisation of national cancer services on patient outcomes for hepatobiliary cancers in Ireland 2000-2016. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Deek M, Yu C, Phillips R, Song D, Deville C, Greco S, DeWeese T, Antonarakis E, Markowski M, Paller C, Denmeade S, Carudcci M, Walsh P, Pienta K, Eisenberger M, Tran P. Radiotherapy In The Definitive Management Of Oligometastatic Prostate Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Killian M, Walsh P, Connor D, Murphy K, Bird B, Murphy C. Comparison of breast cancer outcomes in a private hospital with national outcomes in a country with a mixed public/private healthcare model. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz101.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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11
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Ryan L, Golparian D, Fennelly N, Rose L, Walsh P, Lawlor B, Mac Aogáin M, Unemo M, Crowley B. Antimicrobial resistance and molecular epidemiology using whole-genome sequencing of Neisseria gonorrhoeae in Ireland, 2014-2016: focus on extended-spectrum cephalosporins and azithromycin. Eur J Clin Microbiol Infect Dis 2018; 37:1661-1672. [PMID: 29882175 DOI: 10.1007/s10096-018-3296-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/02/2018] [Accepted: 05/31/2018] [Indexed: 12/21/2022]
Abstract
High-level resistance and treatment failures with ceftriaxone and azithromycin, the first-line agents for gonorrhoea treatment are reported and antimicrobial-resistant Neisseria gonorrhoeae is an urgent public health threat. Our aims were to determine antimicrobial resistance rates, resistance determinants and phylogeny of N. gonorrhoeae in Ireland, 2014-2016. Overall, 609 isolates from four University Hospitals were tested for susceptibility to extended-spectrum cephalosporins (ESCs) and azithromycin by the MIC Test Strips. Forty-three isolates were whole-genome sequenced based on elevated MICs. The resistance rate to ceftriaxone, cefixime, cefotaxime and azithromycin was 0, 1, 2.1 and 19%, respectively. Seven high-level azithromycin-resistant (HLAzi-R) isolates were identified, all susceptible to ceftriaxone. Mosaic penA alleles XXXIV, X and non-mosaic XIII, and G120K plus A121N/D/G (PorB1b), H105Y (MtrR) and A deletion (mtrR promoter) mutations, were associated with elevated ESC MICs. A2059G and C2611T mutations in 23S rRNA were associated with HLAzi-R and azithromycin MICs of 4-32 mg/L, respectively. The 43 whole-genome sequenced isolates belonged to 31 NG-MAST STs. All HLAzi-R isolates belonged to MLST ST1580 and some clonal clustering was observed; however, the isolates differed significantly from the published HLAzi-R isolates from the ongoing UK outbreak. There is good correlation between previously described genetic antimicrobial resistance determinants and phenotypic susceptibility categories for ESCs and azithromycin in N. gonorrhoeae. This work highlights the advantages and potential of whole-genome sequencing to be applied at scale in the surveillance of antibiotic resistant strains of N. gonorrhoeae, both locally and internationally.
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Affiliation(s)
- L Ryan
- Department of Clinical Microbiology, St James's Hospital, Dublin, Ireland.
| | - D Golparian
- WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - N Fennelly
- Department of Clinical Microbiology, St James's Hospital, Dublin, Ireland
| | - L Rose
- Department of Clinical Microbiology, St James's Hospital, Dublin, Ireland
| | - P Walsh
- Department of Computing, Cork Institute of Technology, Cork, Ireland
| | - B Lawlor
- Department of Computing, Cork Institute of Technology, Cork, Ireland
| | - M Mac Aogáin
- Department of Clinical Microbiology, Trinity Translational Medicine Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - B Crowley
- Department of Clinical Microbiology, St James's Hospital, Dublin, Ireland.,Department of Virology, St James's Hospital, Dublin, Ireland
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Kleinhenz MD, Van Engen NK, Gorden PJ, Ji J, Walsh P, Coetzee JF. Effects of transdermal flunixin meglumine on pain biomarkers at dehorning in calves. J Anim Sci 2018; 95:1993-2000. [PMID: 28726995 DOI: 10.2527/jas.2016.1138] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective of this study was to evaluate the analgesic properties of transdermal flunixin meglumine when given at the time of dehorning on pain biomarkers. Twenty-four weaned male Holstein calves, 6 to 8 wk of age were enrolled into the study. The calves were randomly assigned to 1 of 3 treatment groups: 1) transdermal flunixin and dehorn (DH-FLU); 2) transdermal flunixin and sham dehorn (SHAM-FLU); and 3) placebo and dehorn (DH-PLBO). Transdermal flunixin at a label dose of 3.33 mg/kg (or placebo at an equivalent volume) was administered as a pour-on along the top-line of the calves in each treatment group concurrently with electrocautery dehorning or sham dehorning. Biomarker parameters collected and analyzed included: infrared thermography (IRT), mechanical nociception threshold (MNT), plasma cortisol, and substance P (SP). There were no differences in maximal temperatures detected for the IRT measurements of the medial canthus of the eye for the DH groups. Mean control point MNT measurements at 48 h were 3.14 kgF, 3.46 kgF, and 1.43 kgF for the DH-FLU, Sham-FLU, and DH-PLBO groups, respectively (P = 0.0001). No other differences of MNT were detected between the dehorned groups for the other test sites and time points. Plasma cortisol reached peak concentration at 20 min postdehorning for the DH-FLU and DH-PLBO groups and 10 min for SHAM-FLU group. Peak plasma cortisol concentrations were 32.0 ng/mL, 12.7 ng/mL, and 28.8 ng/mL for the DH-FLU, SHAM-FLU, and DH-PLBO groups, respectively. Cortisol concentrations were lower for the DH-FLU group at 90 min postdehorning compared to the SHAM-FLU and DH-PLBO groups ( = 0.04). Area under the effect curve (AUEC) were similar for all groups ( = 0.93). No statistical differences in SP concentrations between groups were detected for any of the time points. In conclusion, transdermal flunixin meglumine given at the time of dehorning did not provide substantial analgesia based on the pain biomarkers investigated. Further investigation into its role as part of a multimodal analgesic plan is warranted.
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Perevezentsev A, Bell A, Brennan PD, Gibbons C, Hemmerich J, Knipe S, Miller A, Stead M, Walsh P, Yorkshades J. Dedicated Facility and Glovebox for Tritium Recovery from Carbon Flakes. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. Perevezentsev
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - A. Bell
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - P. D. Brennan
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - C. Gibbons
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | | | - S. Knipe
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - A. Miller
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - M. Stead
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - P. Walsh
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
| | - J. Yorkshades
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, 0X14 3DB, UK (01235)464484
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Lawson C, Pati S, Green J, Messina G, Strömberg A, Nante N, Golinelli D, Verzuri A, White S, Jaarsma T, Walsh P, Lonsdale P, Kadam UT. Development of an international comorbidity education framework. Nurse Educ Today 2017; 55:82-89. [PMID: 28535380 DOI: 10.1016/j.nedt.2017.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 04/27/2017] [Accepted: 05/08/2017] [Indexed: 06/07/2023]
Abstract
CONTEXT The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions. AIM Our aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education. METHODS We surveyed nursing, medical and pharmacy students from England, India, Italy and Sweden to evaluate their understanding of comorbidity care. A list of core comorbidity content was constructed by an international group of higher education academics and clinicians from the same disciplines, by searching current curricula and analysing clinical frameworks and the student survey data. This list was used to develop the International Comorbidity Education Framework. RESULTS The survey sample consisted of 917 students from England (42%), India (48%), Italy (8%) and Sweden (2%). The majority of students across all disciplines said that they lacked knowledge, training and confidence in comorbidity care and were unable to identify specific teaching on comorbidities. All student groups wanted further comorbidity training. The health education institution representatives found no specific references to comorbidity in current health education curricula. Current clinical frameworks were used to develop an agreed list of core comorbidity content and hence an International Comorbidity Education Framework. CONCLUSIONS Based on consultation with academics and clinicians and on student feedback we developed an International Comorbidity Education Framework to promote the integration of comorbidity concepts into current healthcare curricula.
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Affiliation(s)
- C Lawson
- Keele University, Keele Cardiovascular Research Group, Institute of Applied Clinical Sciences, UK.
| | - S Pati
- Public Health Foundation of India, Indian Institute of Public Health-Bhubaneswar, India
| | - J Green
- Keele University, Department of Nursing and Midwifery, UK
| | - G Messina
- University of Siena, Department of Public Health, Italy
| | - A Strömberg
- Linkoping University, Medical and Health Sciences, Sweden
| | - N Nante
- University of Siena, Department of Public Health, Italy
| | - D Golinelli
- University of Siena, Department of Public Health, Italy
| | - A Verzuri
- University of Siena, Department of Public Health, Italy
| | - S White
- Keele University, Department of Pharmacy, UK
| | - T Jaarsma
- Linkoping University, Social and Welfare Studies, Sweden
| | - P Walsh
- Keele University, Department of Nursing and Midwifery, UK
| | - P Lonsdale
- Keele University, Department of Nursing and Midwifery, UK
| | - U T Kadam
- Keele University, Keele Cardiovascular Research Group, Institute of Applied Clinical Sciences, UK
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Pigeon WR, Crean H, Cerulli C, Walsh P, Gallegos A, Bishop TM, Casey C, Gorman C, Bui A, Oleynk C, Heffner KL. 0339 DOES COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA ENHANCE THE EFFECTS OF COGNITIVE PROCESSING THERAPY FOR PTSD AMONG SURVIVORS OF INTERPERSONAL VIOLENCE? Sleep 2017. [DOI: 10.1093/sleepj/zsx050.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Kleinhenz MD, Van Engen NK, Gorden PJ, Ji J, Walsh P, Coetzee JF. Effects of transdermal flunixin meglumine on pain biomarkers at dehorning in calves. J Anim Sci 2017. [DOI: 10.2527/jas2016.1138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wake Z, Ramsay J, Walsh P, Murray C. Atypical Kawasaki Disease and Haemophagocytic Lymphohistiocytosis: An Unusual Association with Severe Consequences. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kleinhenz MD, Van Engen NK, Gorden PJ, KuKanich B, Rajewski SM, Walsh P, Coetzee JF. The pharmacokinetics of transdermal flunixin meglumine in Holstein calves. J Vet Pharmacol Ther 2016; 39:612-615. [PMID: 27121728 DOI: 10.1111/jvp.12314] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/23/2016] [Indexed: 11/30/2022]
Abstract
This study describes the pharmacokinetics of topical and intravenous (IV) flunixin meglumine in Holstein calves. Eight male Holsteins calves, aged 6 to 8 weeks, were administered flunixin at a dose of 2.2 mg/kg intravenously. Following a 10-day washout period, calves were dosed with flunixin at 3.33 mg/kg topically (transdermal). Blood samples were collected at predetermined times from 0 to 48 h for the intravenous portions and 0 to 72 h following topical dosing. Plasma drug concentrations were determined using liquid chromatography with mass spectroscopy. Pharmacokinetic analysis was completed using noncompartmental methods. The mean bioavailability of topical flunixin was calculated to be 48%. The mean AUC for flunixin was determined to be 13.9 h × ug/mL for IV administration and 10.1 h × ug/mL for topical administration. The mean half-life for topical flunixin was 6.42 h and 4.99 h for the intravenous route. The Cmax following topical application of flunixin was 1.17 μg/mL. The time to maximum concentration was 2.14 h. Mean residence time (MRT) following IV injection was 4.38 h and 8.36 h after topical administration. In conclusion, flunixin when administered as a topical preparation is rapidly absorbed and has longer half-life compared to IV administration.
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Affiliation(s)
- M D Kleinhenz
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - N K Van Engen
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - P J Gorden
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - B KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - S M Rajewski
- Pharmacology Analytical Support Team (PhAST), College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - P Walsh
- Orchard Veterinary Centre, Armagh, UK
| | - J F Coetzee
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA. .,Pharmacology Analytical Support Team (PhAST), College of Veterinary Medicine, Iowa State University, Ames, IA, USA.
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Walsh P, Carvallo Chaigneau FR, Anderson M, Behrens N, McEligot H, Gunnarson B, Gershwin LJ. Adverse effects of a 10-day course of ibuprofen in Holstein calves. J Vet Pharmacol Ther 2016; 39:518-21. [PMID: 26876241 DOI: 10.1111/jvp.12295] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 01/12/2016] [Indexed: 11/27/2022]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for various conditions in cattle. Ibuprofen is an inexpensive short-acting NSAID and is readily available in liquid formulation for administration to bottle-fed calves. We compared the adverse effects of a 10-day course of ibuprofen and placebo in 16 five- to six-week-old Holstein bull calves that were being treated for experimentally induced bovine respiratory syncytial virus infection. Ibuprofen was administered as a liquid in milk replacer at 30 mg/kg divided three times daily. We found an increased prevalence of abomasal ulceration 5 of 8 in the ibuprofen compared to placebo group 2 of 6 (P = NS). There was one (1 of 8) case of mild interstitial nephritis in the ibuprofen and none (0 of 8) in the placebo group (P = NS). Renal function as measured by serum BUN and creatinine levels was not different between groups; no animal demonstrated an increase in creatinine.
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Affiliation(s)
- P Walsh
- Pediatric Emergency Medicine, Sutter Medical Center, Sacramento, CA, USA.,Department of Emergency Medicine, University of California Davis, Sacramento, CA, USA.,Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - F R Carvallo Chaigneau
- San Bernardino Branch, California Animal Health and Food Safety Laboratory, San Bernardino, CA, USA
| | - M Anderson
- California Animal Health and Food Safety Laboratory, Davis, CA, USA
| | - N Behrens
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - H McEligot
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - B Gunnarson
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - L J Gershwin
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
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Derks M, Kiderlen M, Hilling D, Bastiaannet E, Boelens P, Siesling S, Van Eycken E, Walsh P, Borras J, Audisio R, Poortmans P, Van de Velde C. 1808 Treatment patterns for older patients with non-metastatic breast cancer in four European countries - preliminary data from a EURECCA international comparison. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30761-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Finucane C, O'Connell MDL, Fan CW, Soraghan C, Cronin H, Kenny RA, Shields L, McMurray M, Nolan H, Cronin H, Dunne L, Greene L, Walsh P, Kearney PM, Kenny RA, Finucane C, Romero-Ortuno R, Fouweather T, Jagger C. Epidemiology. Age Ageing 2013. [DOI: 10.1093/ageing/aft100] [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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Davison CM, Torunian M, Walsh P, Thompson W, McFaull S, Pickett W. Bicycle helmet use and bicycling-related injury among young Canadians: an equity analysis. Int J Equity Health 2013; 12:48. [PMID: 23819527 PMCID: PMC3702522 DOI: 10.1186/1475-9276-12-48] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/25/2013] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cycling is a major activity for adolescents in Canada and potential differences exist in bicycling-related risk and experience of injury by population subgroup. The overall aim of this study was to inform health equity interventions by profiling stratified analytic methods and identifying potential inequities associated with bicycle-related injury and the use of bicycle helmets among Canadian youth. The two objectives of this study were: (1) To examine national patterns in bicycle ridership and also bicycle helmet use among Canadian youth in a stratified analysis by potentially vulnerable population subgroups, and (2) To examine bicycling-related injury in the same population subgroups of Canadian youth in order to identify possible health inequities. METHODS Data for this study were obtained from the 6th cycle (2009/10) of the Health Behaviour in School-aged Children (HBSC) study, which is a general health survey that was completed by 26,078 students in grades 6-10 from 436 Canadian schools. Based on survey responses, we determined point prevalence for bicycle ridership, bicycle helmet use and relative risks for bicycling-related injury. RESULTS Three quarters of all respondents were bicycle riders (n=19,410). Independent factors associated with bicycle ridership among students include being male, being a younger student, being more affluent, and being a resident of a small town. Among bicycle riders, 43% (95%CI ± 0.6%) reported never wearing and 32% (± 0.6%) inconsistently wearing a helmet. Only 26% (± 0.5%) of students reported always wearing a bicycle helmet. Helmets were less frequently used among older students and there were also important patterns by sex, geographic location and socioeconomic status. Adjusting for all other demographic characteristics, boys reported 2.02-fold increase (95% CI: 1.61 to 1.90) and new immigrants a 1.35-fold increase (95%CI: 1.00 to1.82) in the relative risk of bicycling-related injury in the past 12 months, as compared to girls and students born in Canada. The relative risk of injury did not vary significantly by levels of socioeconomic status. CONCLUSIONS Troubling disparities exist in bicycle use, bicycle helmet use and bicycling-related injuries across specific population subgroups. Bicycle safety and injury prevention initiatives should be informed by disaggregated analyses and the context of bicycle-related health differences should be further examined.
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Affiliation(s)
- Colleen M Davison
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
- Kingston General Hospital, Kingston, Canada
- Department of Emergency Medicine, Queen’s University, Kingston, Canada
| | - Michael Torunian
- Youth Policy, Division of Children, Seniors and Healthy Development, Public Health Agency of Canada, Ottawa, Canada
| | - Patricia Walsh
- Youth Policy, Division of Children, Seniors and Healthy Development, Public Health Agency of Canada, Ottawa, Canada
| | - Wendy Thompson
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Canada
| | - Steve McFaull
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Canada
| | - William Pickett
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
- Kingston General Hospital, Kingston, Canada
- Department of Emergency Medicine, Queen’s University, Kingston, Canada
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Davison CM, Thompson W, Torunian M, Walsh P, McFaull S, Pickett W. Off-road vehicle ridership and associated helmet use in Canadian youth: an equity analysis. J Rural Health 2013; 29:39-45. [PMID: 23289653 DOI: 10.1111/j.1748-0361.2012.00441.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE In North America, the use of off-road vehicles by young people is increasing, as are related injuries and fatalities. We examined the prevalence of off-road ridership and off-road helmet use in different subgroups of Canadian youth in order to better understand possible inequities associated with these health risk behaviors. METHODS Data came from Cycle 6 (2009-2010) of the WHO Health Behavior in School-Aged Children Study (HBSC). Participants (n = 26,078) were young people from grades 6-10 in 436 Canadian schools. Students were asked, for a 12-mo recall period, how frequently they rode off-road vehicles and how often they wore a helmet while riding. Engagement in off-road ridership and helmet use were estimated by age group, gender, urban-rural geographic location, socioeconomic status, and how long participants had lived in Canada. FINDINGS About half of the sample reported riding off-road vehicles (12,750; 52%). Among riders, 5,691 (45%) always wore helmets. Riders were more often older students, male and born in Canada. Students in rural areas and small towns were much more likely to ride off-road vehicles than their urban peers (RR, 95% CI: 1.28 [1.23-1.33]). Helmet use was less common among females, new immigrants, older students, and those in lower socioeconomic groups. There was little reported difference in helmet use by urban-rural location. CONCLUSIONS Risks associated with the use of off-road vehicles and with nonhelmet use are not equitably distributed across Canadian youth. Factors characterizing off-road ridership (notably urban-rural location) are distinct from factors for helmet use. Preventive interventions should target population subgroups.
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Affiliation(s)
- Colleen M Davison
- Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.
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David B, Callahan D, Bair J, Walsh P, Norton S. Evaluation of the biocidal efficacy of multipurpose solutions in the presence of a contact lens. Cont Lens Anterior Eye 2012. [DOI: 10.1016/j.clae.2012.08.070] [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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Kava M, Walsh P, Berroya A, Halstead Y, Srinivasjois R, Lewis B, Cole C, Baker D, Nagarajan L. G.P.94 Incidence and severity of peripheral neuropathy in children on vincristine – Do vitamin E levels change during treatment? Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.224] [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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Watson MC, Errington G, Hamilton T, Mulvaney C, Smith S, Binley S, Coupland C, Kendrick D, Walsh P. EVALUATION OF A NATIONAL HOME SAFETY EQUIPMENT SCHEME. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580d.36] [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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Mulvaney C, Watson M, Errington G, Coupland C, Kendrick D, Walsh P. EVALUATION OF THE CHILD SAFETY EDUCATION COALITION IN ENGLAND. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580a.32] [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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Dai S, Bienek A, Walsh P, Wielgosz A, Morrison H. 182 The Burden of Hospitalized Stroke in Canada. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Witherick J, Kane N, Butler S, Walsh P, Blake K, Faulkner H, Burrows J, Inglis K, Cottrell D. 152 Are neurophysiological parameters an objective measure of disease status and progression in primary progressive multiple sclerosis? J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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LeMessurier J, O'Donnell S, Walsh P, McRae L, Bancej C. The development of national indicators for the surveillance of osteoporosis in Canada. Chronic Dis Inj Can 2012; 32:101-107. [PMID: 22414307 PMCID: PMC5104541] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION The Public Health Agency of Canada, in collaboration with bone health and osteoporosis experts from across Canada (n = 12), selected a core set of indicators for the public health surveillance of osteoporosis using a formal consensus process. METHODS A literature review identified candidate indicators that were subsequently categorized into an osteoporosis-specific indicator framework. A survey was then administered to obtain expert opinion on the indicators' public health importance. Indicators that scored less than 3 on a Likert scale of 1 (low) to 5 (high) were excluded from further consideration. Subsequently, a majority vote on the remaining indicators' level of public health importance was sought during a face-to-face meeting. RESULTS The literature yielded 111 indicators, and 88 were selected for further consideration via the survey. At the face-to-face meeting, more than half the experts considered 39 indicators to be important from the public health perspective. CONCLUSION This core set of indicators will serve to inform the development of new data sources and the integration, analysis and interpretation of existing data into surveillance products for the purpose of public health action.
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Affiliation(s)
- J LeMessurier
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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Martínez-Leal R, Salvador-Carulla L, Linehan C, Walsh P, Weber G, Van Hove G, Määttä T, Azema B, Haveman M, Buono S, Germanavicius A, van Schrojenstein Lantman-de Valk H, Tossebro J, Carmen-Câra A, Moravec Berger D, Perry J, Kerr M. The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe. J Intellect Disabil Res 2011; 55:858-872. [PMID: 21726319 PMCID: PMC3166640 DOI: 10.1111/j.1365-2788.2011.01439.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Despite progress in the process of deinstitutionalisation, very little is known about the health conditions of people with intellectual disability (PWID) who live in large institutions and PWID living in small residential services, family homes or independent living within the community. Furthermore, there are no international comparison studies at European level of the health status and health risk factors of PWID living in fully staffed residential services with formal support and care compared with those living in unstaffed family homes or independent houses with no formal support. METHODS A total of 1269 persons with ID and/or their proxy respondents were recruited and face-to-face interviewed in 14 EU countries with the P15, a multinational assessment battery for collecting data on health indicators relevant to PWID. Participants were grouped according to their living arrangements, availability of formal support and stage of deinstitutionalisation. RESULTS Obesity and sedentary lifestyle along with a number of illnesses such as epilepsy, mental disorders, allergies or constipation were highly prevalent among PWID. A significantly higher presence of myocardial infarctions, chronic bronchitis, osteoporosis and gastric or duodenal ulcers was found among participants in countries considered to be at the early stage of deinstitutionalisation. Regardless of deinstitutionalisation stage, important deficits in variables related to such medical health promotion measures as vaccinations, cancer screenings and medical checks were found in family homes and independent living arrangements. Age, number of people living in the same home or number of places in residential services, presence of affective symptoms and obesity require further attention as they seem to be related to an increase in the number of illnesses suffered by PWID. DISCUSSION Particular illnesses were found to be highly prevalent in PWID. There were important differences between different living arrangements depending on the level of formal support available and the stage of deinstitutionalisation. PWID are in need of tailored primary health programs that guarantee their access to quality health and health promotion and the preventative health actions of vaccination programs, systematic health checks, specific screenings and nutritional controls. Extensive national health surveys and epidemiological studies of PWID in the EC member states are urgently needed in order to reduce increased morbidity rates among this population.
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Affiliation(s)
- R Martínez-Leal
- UNIVIDD, Intellectual Disability and Developmental Disorders Research Unit, Fundación Villablanca, Grup Pere Mata, Reus, Spain Department of Psychiatry, University of Cádiz, Spain.
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Casserly B, Baram M, Walsh P, Sucov A, Ward NS, Levy MM. Implementing a collaborative protocol in a sepsis intervention program: lessons learned. Lung 2010; 189:11-9. [PMID: 21080182 DOI: 10.1007/s00408-010-9266-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 10/27/2010] [Indexed: 01/20/2023]
Abstract
The objective of this prospective cohort study was to see the effect of the implementation of a Sepsis Intervention Program on the standard processes of patient care using a collaborative approach between the Emergency Department (ED) and Medical Intensive Care Unit (MICU). This was performed in a large urban tertiary-care hospital, with no previous experience utilizing a specific intervention program as routine care for septic shock and which has services and resources commonly available in most hospitals. The study included 106 patients who presented to the ED with severe sepsis or septic shock. Eighty-seven of those patients met the inclusion criteria for complete data analysis. The ED and MICU staff underwent a 3-month training period followed by implementation of a protocol for sepsis intervention program over 6 months. In the first 6 months of the program's implementation, 106 patients were admitted to the ED with severe sepsis and septic shock. During this time, the ED attempted to initiate the sepsis intervention protocol in 76% of the 87 septic patients who met the inclusion criteria. This was assessed by documentation of a central venous catheter insertion for continuous SvO(2) monitoring in a patient with sepsis or septic shock. However, only 48% of the eligible patients completed the early goal-directed therapy (EGDT) protocol. Our data showed that the in-hospital mortality rate was 30.5% for the 87 septic shock patients with a mean APACHE II score of 29. This was very similar to a landmark study of EGDT (30.5% mortality with mean APACHE II of 21.5). Data collected on processes of care showed improvements in time to fluid administration, central venous access insertion, antibiotic administration, vasopressor administration, and time to MICU transfer from ED arrival in our patients enrolled in the protocol versus those who were not. Further review of our performance data showed that processes of care improved steadily the longer the protocol was in effect, although this was not statistically significant. There was no improvement in secondary outcomes, including total length of hospital stay, MICU days, and mortality. Implementation of a sepsis intervention program as a standard of care in a typical hospital protocol leads to improvements in processes of care. However, despite a collaborative approach, the sepsis intervention program was underutilized with only 48% of the patients completing the sepsis intervention protocol.
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Affiliation(s)
- Brian Casserly
- Memorial Hospital of Rhode Island, Brown University, 111 Brewster Street, Pawtucket, RI 02860, USA.
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Perry J, Linehan C, Kerr M, Salvador-Carulla L, Zeilinger E, Weber G, Walsh P, van Schrojenstein Lantman-de-Valk H, Haveman M, Azema B, Buono S, Câra AC, Germanavicius A, Van Hove G, Määttä T, Berger DM, Tossebro J. The P15 - a multinational assessment battery for collecting data on health indicators relevant to adults with intellectual disabilities. J Intellect Disabil Res 2010; 54:981-991. [PMID: 20825552 DOI: 10.1111/j.1365-2788.2010.01322.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Health disparities between adults with intellectual disabilities (ID) and the general population have been well documented but, to date, no dedicated assessment battery for measuring health disparity has been available. This paper reports on the development and testing of a multinational assessment battery for collecting data on a range of health indicators relevant to adults with ID. METHODS An assessment battery (the P15) was developed following piloting, and administered to samples of adults with ID, in 14 EU countries. Samples were neither random, nor representative of the countries from which they were drawn. However, within the local health administration areas selected in each country, efforts were made to ensure samples were broadly representative of the typical living circumstances, ages and ability levels of the administrative population of adults with ID. The total sample comprised 1269 adults with ID, of whom 49% were female. The mean age was 41 years (range 19 to 90). RESULTS Overall, feasibility, internal consistency and face validity of the P15 was acceptable. CONCLUSIONS With some refinement the P15 could be useful for collecting data on health indicators known to be particularly important for adults with ID. It is useable in a range of countries and has the potential to highlight health inequity for adults with ID at a national or local level. Larger scale epidemiological studies are needed to exploit the potential of the P15 to address health inequity in this group.
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Affiliation(s)
- J Perry
- Cardiff University, Psych Medical, Heath Park, Cardiff, UK.
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Shuhaibar M, Walsh C, Lindsay F, Lee N, Walsh P, O’Gorman P, Boran G, McLoughlin R, Qasim A, Breslin N, Ryan B, O’Connor H, O’Morain C. A comparative study of faecal occult blood kits in a colorectal cancer screening program in a cohort of healthy construction workers. Ir J Med Sci 2010; 180:103-8. [DOI: 10.1007/s11845-010-0605-0] [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] [Received: 04/12/2010] [Accepted: 09/30/2010] [Indexed: 12/22/2022]
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Walsh P, Columb M, Russell R. A comparison of a Neuropen monofilament and ethyl chloride for assessing loss of touch sensation during combined spinal–epidural anaesthesia for caesarean section. Int J Obstet Anesth 2010; 19:365-72. [DOI: 10.1016/j.ijoa.2010.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 03/25/2010] [Accepted: 06/25/2010] [Indexed: 11/26/2022]
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Leslie WD, O'Donnell S, Lagacé C, Walsh P, Bancej C, Jean S, Siminoski K, Kaiser S, Kendler DL, Jaglal S. Population-based Canadian hip fracture rates with international comparisons. Osteoporos Int 2010; 21:1317-22. [PMID: 19802507 PMCID: PMC5101056 DOI: 10.1007/s00198-009-1080-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 09/09/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY We identified hospitalizations throughout Canada during 2000-2005 in which the most responsible diagnosis was a proximal femoral fracture. Use of the US fracture risk assessment tool (FRAX) would be inappropriate for Canada as it would overestimate fracture risk in Canadian women and older men. INTRODUCTION It is recommended that the WHO fracture risk assessment tool should be calibrated to the target population. METHODS We identified hospitalizations for women and men throughout Canada during the study period 2000-2005 in which the most responsible diagnosis was a proximal femoral fracture (147,982 hip fractures). Age-standardized hip fracture rates were compared between Canadian provinces, and national rates were compared with those reported for the USA and Germany. RESULTS There were relatively small differences in hip fracture rates between provinces, and most did not differ appreciably from the Canadian average. Hip fracture rates for women in Canada in 2001 were substantially lower than in the USA (population-weighted rate ratio 0.70) and were also lower than in Germany for 2004 (population-weighted rate ratio 0.74). CONCLUSIONS Overall hip fracture rates for Canadian women were found to be substantially lower than those for the USA and Germany. This study underscores the importance of assessing country-specific fracture patterns prior to adopting an existing FRAX tool.
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Affiliation(s)
- W D Leslie
- Faculty of Medicine, Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, Canada.
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Rice CM, Mallam EA, Whone AL, Walsh P, Brooks DJ, Kane N, Butler SR, Marks DI, Scolding NJ. Safety and feasibility of autologous bone marrow cellular therapy in relapsing-progressive multiple sclerosis. Clin Pharmacol Ther 2010; 87:679-85. [PMID: 20445531 DOI: 10.1038/clpt.2010.44] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In this phase I study, we assessed the safety and feasibility of intravenous, autologous bone marrow (BM) cell therapy, without immunosuppressive preconditioning, in six patients with clinically definite, relapsing-progressive multiple sclerosis (MS). Assessment of efficacy was a secondary objective and employed clinical disability rating scales, multimodal evoked potential (MMEP) recordings, and magnetic resonance imaging (MRI) scans. Cells were harvested, filtered and infused intravenously in a day-case procedure that was well tolerated by patients and was not associated with any serious adverse events (AEs). Over a period of 12 months after the therapy, clinical disability scores showed either no change (Extended Disability Status Score, EDSS) or improvement (MS impact scale-29, MSIS-29), and MMEPs showed neurophysiological improvement. MRI scans did not show any significant changes over a post-therapy period of 3 months. The lack of serious adverse effects and the suggestion of a beneficial effect in this small sample of patients with progressive disease justify conducting a larger phase II/III study to make a fuller assessment of the efficacy of mobilization of autologous BM in patients with MS.
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Affiliation(s)
- C M Rice
- Institute of Clinical Neurosciences, University of Bristol, Frenchay Hospital, Bristol, UK
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39
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Ghose GM, Walsh P. Temporal kernels of motion perception are sharpened by training and attention. J Vis 2010. [DOI: 10.1167/5.8.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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40
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Biggs C, Walsh P, Overmyer CL, Gonzalez D, Feola M, Mordechai E, Adelson ME, Iacono KT. Performance of influenza rapid antigen testing in influenza in emergency department patients. Emerg Med J 2009; 27:5-7. [DOI: 10.1136/emj.2009.078683] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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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41
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Affiliation(s)
- S Dai
- Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada
| | - C Bancej
- Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada
| | - A Bienek
- Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada
| | - P Walsh
- Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada
| | - P Stewart
- Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada
| | - A Wielgosz
- Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada
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Lee HY, Manasseh RG, Edis RH, Page R, Keith-Rokosh J, Walsh P, Song S, Laycock A, Griffiths L, Fabian VA. Intraneural perineurioma. J Clin Neurosci 2009; 16:1633-6. [PMID: 19766004 DOI: 10.1016/j.jocn.2009.02.013] [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: 12/22/2008] [Accepted: 02/08/2009] [Indexed: 11/16/2022]
Abstract
Intraneural perineurioma is a rare tumour that affects peripheral nerves and, based on its histological features, may be confused with hereditary motor and sensory neuropathies. Detailed neuropathology, including immunoperoxidase stains and electron microscopy, is vital to distinguish these conditions. We report two patients with intraneural perineurioma that demonstrate salient features of this tumour. The first patient is the longest reported follow-up of an intraneural perineurioma; extension of the lesion was observed over 14years. The second patient is an 11-year-old female whose treatment highlights some of the controversy surrounding the management of these lesions, and the importance of thorough macroscopic and microscopic assessment by pathologists, including the status of surgical resection margins.
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Affiliation(s)
- H-Y Lee
- Department of Anatomical Pathology, Section of Neuropathology, Royal Perth Hospital, 2nd Floor North Block, Wellington Street Campus, Perth, Western Australia 6847, Australia
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44
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Walsh P. Salbutamol worth trying. Arch Emerg Med 2009; 26:684. [DOI: 10.1136/emj.2008.071290] [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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Vieth T, Lona N, Agha J, Walsh P. 414: Pacifier Use for SIDS Prevention: Extent of Caregiver Awareness and an Educational Intervention. Ann Emerg Med 2009. [DOI: 10.1016/j.annemergmed.2009.06.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Wood C, Walsh P. In one end of the shark and out the other: Events and consequences of feeding in the spiny dogfish, Squalus acanthias. Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.04.062] [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: 11/30/2022]
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47
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Dunne LE, Walsh P, Hermann S, Smyth B, Caulfield B. Wearable monitoring of seated spinal posture. IEEE Trans Biomed Circuits Syst 2008; 2:97-105. [PMID: 23852756 DOI: 10.1109/tbcas.2008.927246] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This work describes the evaluation of a wearable plastic optical fiber (POF) sensor for monitoring seated spinal posture, as compared to a conventional expert visual analysis, and the development of a field-deployable posture monitoring system. A garment-integrated POF sensor was developed and tested on nine healthy subjects. Data from the wearable sensor were compared to data taken simultaneously from a marker-based motion capture system, for accuracy and reliability. Peak analysis of the resulting data showed a mean time error of 0.53 plusmn 0.8 s, and a mean value error of 0.64 plusmn 3.1 deg, which represents 14.5% of the average range of motion. Expert determination of transitional (good to bad) posture showed a variation of 20.9% of range of motion. These results indicate that the wearable sensor approximates the accuracy of expert visual analysis, and provides sufficient accuracy of measurement to reliably monitor seated spinal posture.
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Chee C, Walsh P, Azimian K, Rothenberg S. 49: Prevalence of a Positive Emergency Department Septic Screen Differs Between RSV and Non-RSV Bronchiolitis. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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49
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Walsh P, Overmeyer C, Pham K, Michaelson S, Pusavat J, Tran T, Mordechai E, Adelson M. 116: Comparison of RSV-A RNA Recovery by PCR Using Different Methods of Specimen Preservation. Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Walsh P, Caldwell J, McQuillen KK, Rothenberg SJ. A Double Blind Randomized Controlled Trial Comparing Nebulized Epinephrine and Albuterol in the Emergency Department Treatment of Bronchiolitis. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.707] [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: 11/10/2022]
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