1
|
Howden N, Branch K, Douglas P, Gray M, Budoff M, Dewey M, Newby DE, Nicholls SJ, Blankstein R, Fathieh S, Grieve SM, Figtree GA. Computed tomographic angiography measures of coronary plaque in clinical trials: opportunities and considerations to accelerate drug translation. Front Cardiovasc Med 2024; 11:1359500. [PMID: 38500753 PMCID: PMC10945423 DOI: 10.3389/fcvm.2024.1359500] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
Atherosclerotic coronary artery disease (CAD) is the causal pathological process driving most major adverse cardiovascular events (MACE) worldwide. The complex development of atherosclerosis manifests as intimal plaque which occurs in the presence or absence of traditional risk factors. There are numerous effective medications for modifying CAD but new pharmacologic therapies require increasingly large and expensive cardiovascular outcome trials to assess their potential impact on MACE and to obtain regulatory approval. For many disease areas, nearly a half of drugs are approved by the U.S. Food & Drug Administration based on beneficial effects on surrogate endpoints. For cardiovascular disease, only low-density lipoprotein cholesterol and blood pressure are approved as surrogates for cardiovascular disease. Valid surrogates of CAD are urgently needed to facilitate robust evaluation of novel, beneficial treatments and inspire investment. Fortunately, advances in non-invasive imaging offer new opportunity for accelerating CAD drug development. Coronary computed tomography angiography (CCTA) is the most advanced candidate, with the ability to measure accurately and reproducibly characterize the underlying causal disease itself. Indeed, favourable changes in plaque burden have been shown to be associated with improved outcomes, and CCTA may have a unique role as an effective surrogate endpoint for therapies that are designed to improve CAD outcomes. CCTA also has the potential to de-risk clinical endpoint-based trials both financially and by enrichment of participants at higher likelihood of MACE. Furthermore, total non-calcified, and high-risk plaque volume, and their change over time, provide a causally linked measure of coronary artery disease which is inextricably linked to MACE, and represents a robust surrogate imaging biomarker with potential to be endorsed by regulatory authorities. Global consensus on specific imaging endpoints and protocols for optimal clinical trial design is essential as we work towards a rigorous, sustainable and staged pathway for new CAD therapies.
Collapse
Affiliation(s)
- N. Howden
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia
- Department of Cardiology, Gosford Hospital, Gosford, NSW, Australia
| | - K. Branch
- Division of Cardiology, University of Washington, Seattle, WA, United States
| | - P. Douglas
- Duke Department of Medicine, The Duke University Medical Center, Durham, NC, United States
| | - M. Gray
- Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - M. Budoff
- Department of Cardiology, Lundquist Institute, Torrance, CA, United States
| | - M. Dewey
- Department of Radiology, Charité – Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, Campus Mitte, Charitéplatz 1, Berlin, Germany
| | - D. E. Newby
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - S. J. Nicholls
- Victorian Heart Institute, Monash University, Melbourne, VIC, Australia
| | - R. Blankstein
- Departments of Medicine (Cardiovascular Division), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - S. Fathieh
- Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - S. M. Grieve
- Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - G. A. Figtree
- Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia
- Kolling Institute, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
2
|
Rymer J, Takagi H, Koweek L, Ng N, Douglas P, Fairbairn T, Berman D, De Bruyne B, Bax JJ, Nieman K, Rogers C, Noorgaard BL, Patel MR, Leipsic J, Daubert M. Anatomic and functional discordance among patients with non-obstructive coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Non-obstructive coronary artery disease (CAD) is associated with increased adverse cardiovascular (CV) events. However, it is unclear if functional stenosis, as assessed by FFRCT <0.80, further stratifies risk among patients with non-obstructive CAD and which factors contribute to this anatomic-functional discordance (stenosis <50% and FFRCT <0.80).
Purpose
We hypothesized that patients with anatomically non-obstructive CAD by CTA and an abnormal FFRCT value of ≤0.80 have a phenomenon termed anatomic-functional discordance, and this discordance would be associated with increased adverse outcomes.
Methods
Patients in the ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) Registry who had exclusively non-obstructive CAD (anatomic stenosis <50%) were stratified by FFRCT >0.80 in all coronary vessels (concordant) vs. FFRCT <0.80 in at least one vessel (discordant). Baseline patient demographics, coronary computed tomography angiography findings, downstream testing and clinical outcomes were compared between groups. The primary composite endpoint included revascularization, CV hospitalization, heart failure, arrhythmia, non-fatal myocardial infarction, unplanned hospitalization for an acute coronary syndrome leading to urgent revascularization, and all-cause death.
Results
Among 1,261 patients with non-obstructive CAD, 543 (43.1%) had functional stenosis with FFRCT <0.80. Patients in the discordant group were older, more likely to have hypertension, hyperlipidemia, and had significantly higher indexed left ventricular (LV) mass and significantly lower coronary volume-to-mass ratios when compared with patients in the concordant group. Downstream non-invasive testing was more common among patients with discordance (35.9% vs 20.2%, p<0.0001) and more frequently resulted in a positive downstream test (10.3% vs. 3.3%, p<0.0001). Invasive angiography was also more common among patients with discordance (25.2% vs. 11.6%, p<0.0001). Anatomic-functional discordance was associated with higher rates of CV hospitalization and percutaneous coronary intervention (both p<0.0001), but no significant difference in all-cause death. After adjustment, anatomic-functional discordance was associated with a significantly higher risk of the composite endpoint (adjusted HR 2.79, 95% CI 1.67–4.65), Figure 1. As shown in Figure 2, the more vessels with anatomic-functional discordance, the higher the rate of adverse cardiac events.
Conclusion
Anatomic-functional discordance was present in nearly half of patients with exclusively non-obstructive CAD. The lower coronary volume: LV mass ratio may reflect abnormal coronary physiology at lower thresholds of anatomical stenosis among those with discordance. Compared to patients with concordance, patients with discordance had worse clinical outcomes suggesting that anatomic-functional discordance may stratify risk for adverse CV events among patients with non-obstructive CAD.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The analysis was an investigator-initiated analysis sponsored by Heart Flow.
Collapse
Affiliation(s)
- J Rymer
- Duke University , Durham , United States of America
| | - H Takagi
- University of British Columbia , Vancouver , Canada
| | - L Koweek
- Duke University , Durham , United States of America
| | - N Ng
- Heart Flow , Mountain View , United States of America
| | - P Douglas
- Duke University , Durham , United States of America
| | - T Fairbairn
- Liverpool Heart and Chest Hospital , Liverpool , United Kingdom
| | - D Berman
- William Beaumont Hospital , Royal Oak , United States of America
| | | | - J J Bax
- Leiden University Medical Center , Leiden , The Netherlands
| | - K Nieman
- Stanford University Medical Center , Stanford , United States of America
| | - C Rogers
- Heart Flow , Mountain View , United States of America
| | | | - M R Patel
- Duke University , Durham , United States of America
| | - J Leipsic
- University of British Columbia , Vancouver , Canada
| | - M Daubert
- Duke University , Durham , United States of America
| |
Collapse
|
3
|
Kolossváry M, deFilippi C, Lu M, Zanni M, Fulda E, Foldyna B, Ribaudo H, Mayrhofer T, Collier A, Bloomfield G, Fichtenbaum C, Overton E, Aberg J, Currier J, Fitch K, Douglas P, Grinspoon S. 463 Proteomic Signature Of Early Coronary Artery Disease In People With Hiv: Analysis Of The Reprieve Mechanistic Substudy. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
4
|
Díaz-Delgado J, Douglas P, Stoneburg S, Cirqueira C, Gomez G. Invasive mammary carcinoma in a black-handed spider monkey (Ateles geoffroyi). J Med Primatol 2021; 50:332-334. [PMID: 34585387 DOI: 10.1111/jmp.12543] [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: 05/27/2021] [Revised: 09/01/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2022]
Abstract
Mammary neoplasia is rare in nonhuman primates other than macaques; records in New World primates are exceedingly rare. We report the pathologic and immunohistochemical features of an invasive carcinoma no special type with neuroendocrine differentiation in a captive, black-handed spider monkey (Ateles geoffroyi).
Collapse
Affiliation(s)
- J Díaz-Delgado
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, Texas, USA
| | - P Douglas
- Little Rock Zoo, Little Rock, Arkansas, USA
| | | | - C Cirqueira
- Instituto Adolfo Lutz (IAL), Centro de Patologia, São Paulo, Brazil
| | - G Gomez
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, Texas, USA
| |
Collapse
|
5
|
Curzen N, Nicholas Z, Stuart B, Wilding S, Hill K, Shambrook J, Eminton Z, Ball D, Barrett C, Johnson L, Nuttall J, Fox K, Connolly D, O'Kane P, Hobson A, Chauhan A, Uren N, Mccann GP, Berry C, Carter J, Roobottom C, Mamas M, Rajani R, Ford I, Douglas P, Hlatky MA. Fractional flow reserve derived from computed tomography coronary angiography in the assessment and management of stable chest pain: the FORECAST randomized trial. Eur Heart J 2021; 42:3844-3852. [PMID: 34269376 PMCID: PMC8648068 DOI: 10.1093/eurheartj/ehab444] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/10/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022] Open
Abstract
Aims Fractional flow reserve (FFRCT) using computed tomography coronary angiography (CTCA) determines both the presence of coronary artery disease and vessel-specific ischaemia. We tested whether an evaluation strategy based on FFRCT would improve economic and clinical outcomes compared with standard care. Methods and results Overall, 1400 patients with stable chest pain in 11 centres were randomized to initial testing with CTCA with selective FFRCT (experimental group) or standard clinical care pathways (standard group). The primary endpoint was total cardiac costs at 9 months. Secondary endpoints were angina status, quality of life, major adverse cardiac and cerebrovascular events, and use of invasive coronary angiography. Randomized groups were similar at baseline. Most patients had an initial CTCA: 439 (63%) in the standard group vs. 674 (96%) in the experimental group, 254 of whom (38%) underwent FFRCT. Mean total cardiac costs were higher by £114 (+8%) in the experimental group, with a 95% confidence interval from −£112 (−8%) to +£337 (+23%), though the difference was not significant (P = 0.10). Major adverse cardiac and cerebrovascular events did not differ significantly (10.2% in the experimental group vs. 10.6% in the standard group) and angina and quality of life improved to a similar degree over follow-up in both randomized groups. Invasive angiography was reduced significantly in the experimental group (19% vs. 25%, P = 0.01). Conclusion A strategy of CTCA with selective FFRCT in patients with stable angina did not differ significantly from standard clinical care pathways in cost or clinical outcomes, but did reduce the use of invasive coronary angiography.
Collapse
Affiliation(s)
- N Curzen
- Faculty of Medicine, University of Southampton.,Coronary Research Group, University Hospital Southampton
| | - Z Nicholas
- Coronary Research Group, University Hospital Southampton
| | - B Stuart
- Clinical Trials Unit, University of Southampton
| | - S Wilding
- Clinical Trials Unit, University of Southampton
| | - K Hill
- Clinical Trials Unit, University of Southampton
| | - J Shambrook
- Cardiothoracic Radiology, University Hospital Southampton
| | - Z Eminton
- Clinical Trials Unit, University of Southampton
| | - D Ball
- Clinical Trials Unit, University of Southampton
| | - C Barrett
- Clinical Trials Unit, University of Southampton
| | - L Johnson
- Clinical Trials Unit, University of Southampton
| | - J Nuttall
- Clinical Trials Unit, University of Southampton
| | - K Fox
- Imperial College, London, UK
| | | | - P O'Kane
- Dorset Heart Centre, University Hospitals Dorset, Bournemouth
| | - A Hobson
- Queen Alexandra Hospital, Portsmouth
| | | | - N Uren
- Royal Infirmary, Edinburgh
| | - G P Mccann
- Department of Cardiovascular Sciences, University of Leicester & NIHR Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - C Berry
- British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow
| | - J Carter
- University Hospital of North Tees, Stockton on Tees
| | | | - M Mamas
- Royal Stoke University Hospital, Stoke-on-Trent
| | - R Rajani
- Guy's & St Thomas' Hospital, London
| | - I Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow
| | | | | | | |
Collapse
|
6
|
Douglas P, Rice C, Runswick-Cole K, Easton A, Gibson MF, Gruson-Wood J, Klar E, Shields R. Re-storying autism: a body becoming disability studies in education approach. International Journal of Inclusive Education 2021; 25:605-622. [DOI: 10.1080/13603116.2018.1563835] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/22/2018] [Indexed: 08/30/2023]
Affiliation(s)
- P. Douglas
- Faculty of Education, Brandon University, Brandon, Canada
| | - C. Rice
- College of Social and Applied Human Sciences, University of Guelph, Guelph, Canada
| | | | - A. Easton
- Independent Artist and Writer, Hamilton, Canada
| | - M. F. Gibson
- School of Social Work, York University, Toronto, Canada
| | - J. Gruson-Wood
- Department of Science and Technology Studies, York University, Toronto, Canada
| | - E. Klar
- Critical Disability Studies, York University, Toronto, Canada
| | - R. Shields
- Critical Disability Studies, York University, Toronto, Canada
| |
Collapse
|
7
|
Ohkado A, Douglas P, Zenner D, Kawatsu L. Pre-migration TB screening-the first step is always the hardest. Int J Tuberc Lung Dis 2020; 24:1261-1264. [PMID: 33317669 DOI: 10.5588/ijtld.20.0102] [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: 11/10/2022] Open
Abstract
As the proportion of foreign-born persons among TB notifications continues to rise, Japan is preparing to introduce pre-migration TB screening for those coming from selected countries, who are intending to stay for more than 90 days. It has announced that the programme will commence in 2020. In this review, the authors examine the experiences from two countries which already have years of experience in operating pre-migration TB screening, namely the United Kingdom and Australia. The authors point out that both countries have developed strong health information system not only to collect and analyse screening results, but also to use the data to effectively monitor and evaluate the screening programme itself. The critical role which health information system plays within pre-migration screening is often overlooked. Here we argue that Japan, as with any other countries planning to introduce pre-migration screening for TB, must also plan for data management.
Collapse
Affiliation(s)
- A Ohkado
- Department of Epidemiology and Clinical Research, Research Institute of Tuberculosis, Japan Anti-tuberculosis Association (RIT/JATA), Kiyose, Japan
| | - P Douglas
- Migration Health Division, International Organization for Migration (IOM), Geneva, Switzerland
| | - D Zenner
- Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University, London, UK
| | - L Kawatsu
- Department of Epidemiology and Clinical Research, Research Institute of Tuberculosis, Japan Anti-tuberculosis Association (RIT/JATA), Kiyose, Japan
| |
Collapse
|
8
|
Greenaway C, Hargreaves S, Barkati S, Coyle CM, Gobbi F, Veizis A, Douglas P. COVID-19: Exposing and addressing health disparities among ethnic minorities and migrants. J Travel Med 2020; 27:5875716. [PMID: 32706375 PMCID: PMC7454797 DOI: 10.1093/jtm/taaa113] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 11/12/2022]
Abstract
COVID-19 disproportionately affects vulnerable and marginalized populations such as ethnic minorities and migrant groups. In this perspective we review the complex interaction of the many factors driving these inequities and suggest several possible solutions to mitigate the negative impact of COVID-19 on these populations.
Collapse
Affiliation(s)
- Christina Greenaway
- Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- JD MacLean Centre for Tropical Diseases, McGill University Health Centre, McGill University, Montreal, Canada
- To whom correspondence should be addressed. Division of Infectious Diseases, Jewish General Hospital, Room G-200, 3755 Cote St. Catherine Road, Montreal, PQ H3T 1E2, Canada; Tel: (514) 340-8222 Ext. 22933; Fax: (514) 340-7546;
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George’s University of London, London, UK
| | - Sapha Barkati
- JD MacLean Centre for Tropical Diseases, McGill University Health Centre, McGill University, Montreal, Canada
- Department of Medicine, Division of Infectious Diseases, McGill University Health Center, McGill University, Montreal, Canada
| | - Christina M Coyle
- Department of Medicine, Division of Infectious Disease, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | | | - Paul Douglas
- Migration Health Division, International Organization for Migration, Geneva, Switzerland
| |
Collapse
|
9
|
Scandurra G, Degeling C, Douglas P, Dobler CC, Marais B. Tuberculosis in migrants - screening, surveillance and ethics. Pneumonia (Nathan) 2020; 12:9. [PMID: 32923311 PMCID: PMC7473829 DOI: 10.1186/s41479-020-00072-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/28/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022] Open
Abstract
Tuberculosis (TB) is the leading infectious cause of human mortality and is responsible for nearly 2 million deaths every year. It is often regarded as a ‘silent killer’ because it predominantly affects the poor and marginalized, and disease outbreaks occur in ‘slow motion’ compared to Ebola or coronavirus 2 (COVID-19). In low incidence countries, TB is predominantly an imported disease and TB control in migrants is pivotal for countries to progress towards TB elimination in accordance with the World Health Organisations (WHO’s) End TB strategy. This review provides a brief overview of the different screening approaches and surveillance processes that are in place in low TB incidence countries. It also includes a detailed discussion of the ethical issues related to TB screening of migrants in these settings and the different interests that need to be balanced. Given recognition that a holistic approach that recognizes and respects basic human rights is required to end TB, the review considers the complexities that require consideration in low-incidence countries that are aiming for TB elimination.
Collapse
Affiliation(s)
- Gabriella Scandurra
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement Evidence and Values, University of Wollongong, Wollongong, Australia
| | - Paul Douglas
- International Organization for Migration (IOM), Geneva, Switzerland
| | - Claudia C Dobler
- Institute for Evidenced-Based Healthcare, Bond University, Gold Coast, Australia
| | - Ben Marais
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| |
Collapse
|
10
|
Ferencik M, Mayrhofer T, Lu M, Bittner D, Emami H, Puchner S, Meyersohn N, Ivanov A, Adami E, Foldyna B, Voora D, Ginsburg G, Januzzi J, Douglas P, Hoffmann U. Relationship Of Myocardial Necrosis, Inflammation And Coronary Atherosclerosis To Cardiovascular Outcomes In Patients With Stable Chest Pain: Results From The Promise Trial. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.169] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
11
|
Kiage LM, Douglas P. Linkages between land cover change, lake shrinkage, and sublacustrine influence determined from remote sensing of select Rift Valley Lakes in Kenya. Sci Total Environ 2020; 709:136022. [PMID: 31884292 DOI: 10.1016/j.scitotenv.2019.136022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/06/2019] [Accepted: 12/07/2019] [Indexed: 06/10/2023]
Abstract
The Great Rift Valley system is home to many volcanic and tectonic lakes including some of the world's oldest and deepest lakes. These lakes host a rich heritage of biodiversity that is endangered by recent drastic hydrologic changes due to multiple natural and anthropogenic stressors in the catchment areas of some of the lakes. This study utilized Landsat TM, ETM+, and OLI data to conduct a systematic investigation of the relationship between hydrological dynamics in the basins of four Rift Valley lakes (Nakuru, Baringo, Bogoria, and Elementaita) and recent land cover and land-use change. The Modified Normalized Difference Water Index (MNDWI) proved to be more accurate and robust for delineating water surface areas when compared to the output of Normalized Difference Vegetation Index (NDVI) and classification algorithms. NDVI was successful when delineating water surface at Lake Baringo but not in Lakes Bogoria, Nakuru, and Elementaita, whose surfaces were dominated by algae. All the lakes expanded substantially after 2010 submerging surrounding areas leading to disruption of livelihoods, property damage, and displacement of thousands of people. The recent drastic hydrologic changes have multiple causations including land cover and land use change, increase in rainfall, and possible change in geogenic water input due to tectonic activity. The rapid rise in water levels appears to have altered the biogeochemical balance of the hypersaline lakes with severe ramifications on the rich biodiversity that is supported by the lakes.
Collapse
Affiliation(s)
- Lawrence M Kiage
- Department of Geosciences, Georgia State University, Atlanta, GA 30303, USA.
| | - Paul Douglas
- Department of Geosciences, Georgia State University, Atlanta, GA 30303, USA
| |
Collapse
|
12
|
Williams B, Douglas P, Roca Barcelo A, Hansell AL, Hayes E. Estimating Aspergillus fumigatus exposure from outdoor composting activities in England between 2005 and 14. Waste Manag 2019; 84:235-244. [PMID: 30691898 DOI: 10.1016/j.wasman.2018.11.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 09/27/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
Bioaerosols, ubiquitous in ambient air, are released in elevated concentrations from composting facilities with open-air processing areas. However, spatial and temporal variability of bioaerosols, particularly in relation to meteorology, is not well understood. Here we model relative concentrations of Aspergillus fumigatus at each postcode-weighted centroid within 4 km of 217 composting facilities in England between 2005 and 2014. Facilities were geocoded with the aid of satellite imagery. Data from existing bioaerosol modelling literature were used to build emission profiles in ADMS. Variation in input parameters between each modelled facility was reduced to a minimum. Meteorological data for each composting facility was derived from the nearest SCAIL-Agriculture validated meteorological station. According to our results, modelled exposure risk was driven primarily by wind speed, direction and time-varying emissions factors incorporating seasonal fluctuations in compostable waste. Modelled A.fumigatus concentrations decreased rapidly from the facility boundary and plateaued beyond 1.5-2.0 km. Where multiple composting facilities were within 4 km of each other, complex exposure risk patterns were evident. More long-term bioaerosol monitoring near facilities is needed to help improve exposure estimation and therefore assessment of any health risks to local populations.
Collapse
Affiliation(s)
- B Williams
- Air Quality Management Resource Centre, University of the West of England, Faculty of Environment and Technology, Coldharbour Lane, Bristol BS16 1QY, UK.
| | - P Douglas
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London W2 1PG, UK; Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London SW3 6LR, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - A Roca Barcelo
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London W2 1PG, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - A L Hansell
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London W2 1PG, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London W2 1NY, UK; Centre for Environmental Health and Sustainability, George Davies Centre University of Leicester, University Road, Leicester LE1 7RH, UK
| | - E Hayes
- Air Quality Management Resource Centre, University of the West of England, Faculty of Environment and Technology, Coldharbour Lane, Bristol BS16 1QY, UK
| |
Collapse
|
13
|
Douglas P, Cetron M, Spiegel P. Definitions matter: migrants, immigrants, asylum seekers and refugees. J Travel Med 2019; 26:5315619. [PMID: 30753575 DOI: 10.1093/jtm/taz005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 02/08/2019] [Indexed: 11/14/2022]
Affiliation(s)
- P Douglas
- Migration Health Division, International Organization for Migration, 17 Route des Morillons, PO Box 17, CH 1211, Geneva 19, Switzerland
| | - M Cetron
- Center for Disease Control and Prevention, Atlanta, GA, USA
| | - P Spiegel
- Johns Hopkins Bloomberg School of Public Health, Center for Humanitarian Health, Baltimore, MD, USA
| |
Collapse
|
14
|
Bittner D, Mayrhofer T, Budoff M, Szilveszter B, Hallett T, Ivanov A, Janjua S, Meyersohn N, Staziaki P, Achenbach S, Ferencik M, Douglas P, Hoffmann U, Lu M. 1184Prognostic value of coronary CT angiography beyond coronary artery calcium in stable chest pain: comparison between conventional stenosis severity and CAD-RADS stenosis categories in the PROMISE trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Bittner
- University of Erlangen-Nuremberg, Department of Cardiology, Erlangen, Germany
| | - T Mayrhofer
- Harvard Medical School, Boston, United States of America
| | - M Budoff
- University of California Los Angeles, Los Angeles, United States of America
| | - B Szilveszter
- Harvard Medical School, Boston, United States of America
| | - T Hallett
- Harvard Medical School, Boston, United States of America
| | - A Ivanov
- Harvard Medical School, Boston, United States of America
| | - S Janjua
- Harvard Medical School, Boston, United States of America
| | - N Meyersohn
- Harvard Medical School, Boston, United States of America
| | - P Staziaki
- Harvard Medical School, Boston, United States of America
| | - S Achenbach
- University of Erlangen-Nuremberg, Department of Cardiology, Erlangen, Germany
| | - M Ferencik
- Oregon Health & Science University, Portland, United States of America
| | - P Douglas
- Duke Clinical Research Institute, Durham, United States of America
| | - U Hoffmann
- Harvard Medical School, Boston, United States of America
| | - M Lu
- Harvard Medical School, Boston, United States of America
| |
Collapse
|
15
|
Adamson P, Newby D, Hill L, Coles A, Douglas P, Fordyce C. P4208Impact of international guidelines' differing approaches to the risk stratification of patients with suspected stable angina: Insights form PROMISE and SCOT-HEART. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- P Adamson
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - D Newby
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - L Hill
- Duke Clinical Research Institute, Durham, United States of America
| | - A Coles
- Duke Clinical Research Institute, Durham, United States of America
| | - P Douglas
- Duke Clinical Research Institute, Durham, United States of America
| | - C Fordyce
- University of British Columbia, Division of Cardiology, Vancouver, Canada
| |
Collapse
|
16
|
Dobler CC, Fox GJ, Douglas P, Viney KA, Ahmad Khan F, Temesgen Z, Marais BJ. Screening for tuberculosis in migrants and visitors from high-incidence settings: present and future perspectives. Eur Respir J 2018; 52:13993003.00591-2018. [PMID: 29794133 DOI: 10.1183/13993003.00591-2018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/17/2018] [Indexed: 12/26/2022]
Abstract
In most settings with a low incidence of tuberculosis (TB), foreign-born people make up the majority of TB cases, but the distribution of the TB risk among different migrant populations is often poorly quantified. In addition, screening practices for TB disease and latent TB infection (LTBI) vary widely. Addressing the risk of TB in international migrants is an essential component of TB prevention and care efforts in low-incidence countries, and strategies to systematically screen for, diagnose, treat and prevent TB among this group contribute to national and global TB elimination goals.This review provides an overview and critical assessment of TB screening practices that are focused on migrants and visitors from high to low TB incidence countries, including pre-migration screening and post-migration follow-up of those deemed to be at an increased risk of developing TB. We focus mainly on migrants who enter the destination country via application for a long-stay visa, as well as asylum seekers and refugees, but briefly consider issues related to short-term visitors and those with long-duration multiple-entry visas. Issues related to the screening of children and screening for LTBI are also explored.
Collapse
Affiliation(s)
- Claudia C Dobler
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.,Mayo Clinic Center for Tuberculosis, Rochester, MN, USA
| | - Greg J Fox
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.,Central Clinical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, Australia
| | - Paul Douglas
- International Organization for Migration (IOM), Geneva, Switzerland
| | - Kerri A Viney
- Dept of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Faiz Ahmad Khan
- Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Depts of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | | | - Ben J Marais
- The Children's Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia
| |
Collapse
|
17
|
Williams B, Laemmle-Ruff I, Hellard M, Douglas P, Horyniak D. 4.10-P20Pre-migration screening rates of HIV, tuberculosis and viral hepatitis among offshore permanent visa applicants (including offshore humanitarian entrants), Australia, 2014-2017. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.159] [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: 11/14/2022] Open
Affiliation(s)
| | | | - M Hellard
- Burnet Institute, Australia
- School of Public Health and Preventative Medicine, Monash University, Australia
| | - P Douglas
- Department of Immigration and Border Protection, Australia
| | | |
Collapse
|
18
|
Dara M, Sulis G, Centis R, D'Ambrosio L, de Vries G, Douglas P, Garcia D, Jansen N, Zuroweste E, Migliori GB. Cross-border collaboration for improved tuberculosis prevention and care: policies, tools and experiences. Int J Tuberc Lung Dis 2018. [PMID: 28633696 DOI: 10.5588/ijtld.16.0940] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
As tuberculosis (TB) spreads beyond borders with people movements, several interventions ensuring the continuity of care are essential, although difficult to put in place in the absence of well-defined agreements allowing data sharing and easy referral of patients to appropriate health facilities. This article first sets out general principles for cross-border collaboration and continuity of care. It then presents a series of case studies. Policies and practices on cross-border collaboration in selected low-incidence countries (Australia, Italy, Norway, The Netherlands, the United Kingdom and the United States) are described and critically appraised. Details of the World Health Organization's (WHO's) European Respiratory Society TB Consilium for transborder migration and those of the Health Network's TBNet activities are described. With increasing population movement, including migrants and travellers, it is time to build on good practices and existing tools and to remove legal, financial and social barriers to ensure early diagnosis, full treatment and continuity of care across our world. Data sharing between the sending and the receiving countries is of utmost importance and must be conducted in line with privacy protection rules. Successful implementation of these interventions is key to being on track with the WHO's End TB strategy targets for 2030.
Collapse
Affiliation(s)
- M Dara
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - G Sulis
- University Division of Infectious and Tropical Diseases, Spedali Civili Hospital, Brescia
| | - R Centis
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy
| | - L D'Ambrosio
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy, Public Health Consulting Group, Lugano, Switzerland
| | - G de Vries
- KNCV Tuberculosis Foundation, The Hague, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - P Douglas
- Health Services and Policy Division, Department of Immigration and Border Protection, Sydney, New South Wales, Australia
| | - D Garcia
- Johns Hopkins School of Medicine; Migrant Clinicians Network, New York, New York, USA
| | - N Jansen
- KNCV Tuberculosis Foundation, The Hague
| | - E Zuroweste
- Johns Hopkins School of Medicine; Migrant Clinicians Network, New York, New York, USA
| | - G B Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy
| |
Collapse
|
19
|
Martin B, Douglas P. Intergovernmental collaboration for the health and wellbeing of refugees settling in Australia. Public Health Res Pract 2018; 28:2811807. [DOI: 10.17061/phrp2811807] [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] Open
|
20
|
Douglas P, Hayes ET, Williams WB, Tyrrel SF, Kinnersley RP, Walsh K, O'Driscoll M, Longhurst PJ, Pollard SJT, Drew GH. Use of dispersion modelling for Environmental Impact Assessment of biological air pollution from composting: Progress, problems and prospects. Waste Manag 2017; 70:22-29. [PMID: 28889991 DOI: 10.1016/j.wasman.2017.08.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 08/08/2017] [Accepted: 08/09/2017] [Indexed: 06/07/2023]
Abstract
With the increase in composting asa sustainable waste management option, biological air pollution (bioaerosols) from composting facilities have become a cause of increasing concern due to their potential health impacts. Estimating community exposure to bioaerosols is problematic due to limitations in current monitoring methods. Atmospheric dispersion modelling can be used to estimate exposure concentrations, however several issues arise from the lack of appropriate bioaerosol data to use as inputs into models, and the complexity of the emission sources at composting facilities. This paper analyses current progress in using dispersion models for bioaerosols, examines the remaining problems and provides recommendations for future prospects in this area. A key finding is the urgent need for guidance for model users to ensure consistent bioaerosol modelling practices.
Collapse
Affiliation(s)
- P Douglas
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom; School of Water, Energy and Environment, Cranfield University, Cranfield, Bedfordshire MK43 0AL, UK.
| | - E T Hayes
- Air Quality Management Resource Centre, University of the West of England, Faculty of Environment and Technology, Coldharbour Lane, Bristol BS16 1QY, UK.
| | - W B Williams
- Air Quality Management Resource Centre, University of the West of England, Faculty of Environment and Technology, Coldharbour Lane, Bristol BS16 1QY, UK.
| | - S F Tyrrel
- School of Water, Energy and Environment, Cranfield University, Cranfield, Bedfordshire MK43 0AL, UK.
| | - R P Kinnersley
- Environment Agency, Environment and Business Directorate, Deanery Road, Bristol BS1 5AH, UK.
| | - K Walsh
- Environment Agency, Environment and Business Directorate, Deanery Road, Bristol BS1 5AH, UK.
| | - M O'Driscoll
- Environment Agency, Air Quality Modelling Assessment Unit, Deanery Road, Bristol BS1 5AH, United Kingdom.
| | - P J Longhurst
- School of Water, Energy and Environment, Cranfield University, Cranfield, Bedfordshire MK43 0AL, UK.
| | - S J T Pollard
- School of Water, Energy and Environment, Cranfield University, Cranfield, Bedfordshire MK43 0AL, UK.
| | - G H Drew
- School of Water, Energy and Environment, Cranfield University, Cranfield, Bedfordshire MK43 0AL, UK.
| |
Collapse
|
21
|
Zhang C, Han X, Douglas P, Dai Y, Wang G. Bipolar Radiofrequency Ablation of Spinal Tumors: The Effect of the Posterior Vertebral Cortex Defect on Temperature Distribution in the Spinal Canal. AJNR Am J Neuroradiol 2017; 39:E1-E2. [PMID: 29146717 DOI: 10.3174/ajnr.a5393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- C Zhang
- Department of Bone and Soft Tissue Tumors Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin's Clinical Research Center for Cancer Tianjin, China
| | - X Han
- Department of Bone and Soft Tissue Tumors Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin's Clinical Research Center for Cancer Tianjin, China
| | - P Douglas
- Tianjin Medical University Tianjin, China
| | - Y Dai
- Institute of Robotics and Automatic Information System Tianjin Key Laboratory of Intelligent Robotics College of Computer and Control Engineering, Nankai University Tianjin, China
| | - G Wang
- Department of Bone and Soft Tissue Tumors Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin's Clinical Research Center for Cancer Tianjin, China
| |
Collapse
|
22
|
Borisov SE, Dheda K, Enwerem M, Romero Leyet R, D’Ambrosio L, Centis R, Sotgiu G, Tiberi S, Alffenaar JW, Maryandyshev A, Belilowski E, Ganatra S, Skrahina A, Akkerman O, Aleksa A, Amale R, Artsukevich J, Bruchfeld J, Caminero JA, Carpena Martinez I, Codecasa L, Dalcolmo M, Denholm J, Douglas P, Duarte R, Esmail A, Fadul M, Filippov A, Davies Forsman L, Gaga M, Garcia-Fuertes JA, Garcia-Garcia JM, Gualano G, Jonsson J, Kunst H, Lau JS, Lazaro Mastrapa B, Lazaro Teran Troya J, Manga S, Manika K, González Montaner P, Mullerpattan J, Oelofse S, Ortelli M, Palmero DJ, Palmieri F, Papalia A, Papavasileiou A, Payen MC, Pontali E, Robalo Cordeiro C, Sadutshang TD, Sanukevich T, Solodovnikova V, Spanevello A, Topgyal S, Toscanini F, Tramontana A, Udwadia ZF, Viggiani P, White V, Zumla A, Migliori GB. Bedaquiline (BQ)-containing regimen at the programmatic level for MDR-TB: preliminary results. Tuberculosis (Edinb) 2017. [DOI: 10.1183/1393003.congress-2017.oa4852] [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: 11/05/2022]
|
23
|
Toms C, Stapledon R, Coulter C, Douglas P. Tuberculosis notifications in Australia, 2014. Commun Dis Intell (2018) 2017; 41:E247-E263. [PMID: 29720074] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In 2014, the National Notifiable Diseases Surveillance System received 1,339 tuberculosis (TB) notifications, representing a rate of 5.7 per 100,000 population. Australia has achieved and maintained good tuberculosis (TB) control since the mid-1980s, sustaining a low annual TB incidence rate of approximately 5 to 6 cases per 100,000 population. The number of multi-drug resistant TB (MDR-TB) cases diagnosed in Australia is low by international standards, with approximately 1-2% of notifications per year being classified as MDR-TB. Australia's overseas-born population continued to represent the majority (86%) of TB notifications and Australia's Aboriginal and Torres Strait Islander population continue to record TB rates around 6 times higher than the Australian born non Indigenous population. Whilst Australia has achieved excellent and sustained control of TB in Australia, sustained effort is still required to reduce rates further and contribute to the achievement of the World Health Organization's goal to end the global TB epidemic by 2035.
Collapse
Affiliation(s)
- Cindy Toms
- Office of Health Protection, Department of Health, Canberra, ACT
| | - Richard Stapledon
- South Australian Tuberculosis Services, Royal Adelaide Hospital, Adelaide, SA
| | - Chris Coulter
- Queensland Mycobacterium Reference Laboratory, Pathology Queensland, Brisbane, Qld
| | - Paul Douglas
- Immigration Health Branch, Australian Government Department of Immigration and Border Protection, Sydney, NSW
| |
Collapse
|
24
|
Ferencik M, Mayrhofer T, Bittner D, Emami H, Puchner S, Lu M, Meyersohn N, Ivanov A, Adami E, Patel M, Mark D, Udelson J, Lee K, Douglas P, Hoffmann U. 3209High-risk coronary plaque is an independent predictor of major adverse cardiovascular events in patients with stable chest pain: Results from PROMISE. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3209] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Douglas P, Posey DL, Zenner D, Robson J, Abubakar I, Giovinazzo G. Capacity strengthening through pre-migration tuberculosis screening programmes: IRHWG experiences. Int J Tuberc Lung Dis 2017; 21:737-745. [PMID: 28633697 PMCID: PMC10461077 DOI: 10.5588/ijtld.17.0019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Effective tuberculosis (TB) prevention and care for migrants requires population health-based approaches that treat the relationship between migration and health as a progressive, interactive process influenced by many variables and addressed as far upstream in the process as possible. By including capacity building in source countries, pre-migration medical screening has the potential to become an integral component of public health promotion, as well as infection and disease prevention, in migrant-receiving nations, while simultaneously increasing capabilities in countries of origin. This article describes the collaborative experiences of five countries (Australia, Canada, New Zealand, United Kingdom and the United States of America, members of the Immigration and Refugee Health Working Group [IRHWG]), with similar pre-migration screening programmes for TB that are mandated. Qualitative examples of capacity building through IRHWG programmes are provided. Combined, the IRHWG member countries screen approximately 2 million persons overseas every year. Large-scale pre-entry screening programmes undertaken by IRHWG countries require building additional capacity for health care providers, radiology facilities and laboratories. This has resulted in significant improvements in laboratory and treatment capacity, providing availability of these facilities for national public health programmes. As long as global health disparities and disease prevalence differentials exist, national public health programmes and policies in migrant-receiving nations will continue to be challenged to manage the diseases prevalent in these migrating populations. National TB programmes and regulatory systems alone will not be able to achieve TB elimination. The management of health issues resulting from population mobility will require integration of national and global health initiatives which, as demonstrated here, can be supported through the capacity-building endeavours of pre-migration screening programmes.
Collapse
Affiliation(s)
- P Douglas
- Health Services and Policy Division, Department of Immigration and Border Protection, Sydney, New South Wales, Australia
| | - D L Posey
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - D Zenner
- Centre of Infectious Disease Surveillance and Control, Public Health England and Institute of Global Health University College, London, UK
| | - J Robson
- Service Design and Performance, Immigration New Zealand, Wellington, New Zealand
| | - I Abubakar
- Institute for Global Health, University College London, London, UK
| | - G Giovinazzo
- Immigration, Refugees and Citizenship Canada, Migration Health Branch, Ottawa, Ontario, Canada
| |
Collapse
|
26
|
Borisov SE, Dheda K, Enwerem M, Romero Leyet R, D'Ambrosio L, Centis R, Sotgiu G, Tiberi S, Alffenaar JW, Maryandyshev A, Belilovski E, Ganatra S, Skrahina A, Akkerman O, Aleksa A, Amale R, Artsukevich J, Bruchfeld J, Caminero JA, Carpena Martinez I, Codecasa L, Dalcolmo M, Denholm J, Douglas P, Duarte R, Esmail A, Fadul M, Filippov A, Davies Forsman L, Gaga M, Garcia-Fuertes JA, García-García JM, Gualano G, Jonsson J, Kunst H, Lau JS, Lazaro Mastrapa B, Teran Troya JL, Manga S, Manika K, González Montaner P, Mullerpattan J, Oelofse S, Ortelli M, Palmero DJ, Palmieri F, Papalia A, Papavasileiou A, Payen MC, Pontali E, Robalo Cordeiro C, Saderi L, Sadutshang TD, Sanukevich T, Solodovnikova V, Spanevello A, Topgyal S, Toscanini F, Tramontana AR, Udwadia ZF, Viggiani P, White V, Zumla A, Migliori GB. Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study. Eur Respir J 2017; 49:49/5/1700387. [PMID: 28529205 DOI: 10.1183/13993003.00387-2017] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/16/2017] [Indexed: 11/05/2022]
Abstract
Large studies on bedaquiline used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) are lacking. This study aimed to evaluate the safety and effectiveness of bedaquiline-containing regimens in a large, retrospective, observational study conducted in 25 centres and 15 countries in five continents.428 culture-confirmed MDR-TB cases were analysed (61.5% male; 22.1% HIV-positive, 45.6% XDR-TB). MDR-TB cases were admitted to hospital for a median (interquartile range (IQR)) 179 (92-280) days and exposed to bedaquiline for 168 (86-180) days. Treatment regimens included, among others, linezolid, moxifloxacin, clofazimine and carbapenems (82.0%, 58.4%, 52.6% and 15.3% of cases, respectively).Sputum smear and culture conversion rates in MDR-TB cases were 63.6% and 30.1%, respectively at 30 days, 81.1% and 56.7%, respectively at 60 days; 85.5% and 80.5%, respectively at 90 days and 88.7% and 91.2%, respectively at the end of treatment. The median (IQR) time to smear and culture conversion was 34 (30-60) days and 60 (33-90) days. Out of 247 culture-confirmed MDR-TB cases completing treatment, 71.3% achieved success (62.4% cured; 8.9% completed treatment), 13.4% died, 7.3% defaulted and 7.7% failed. Bedaquiline was interrupted due to adverse events in 5.8% of cases. A single case died, having electrocardiographic abnormalities that were probably non-bedaquiline related.Bedaquiline-containing regimens achieved high conversion and success rates under different nonexperimental conditions.
Collapse
Affiliation(s)
- Sergey E Borisov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation.,These authors contributed equally
| | - Keertan Dheda
- UCT Lung Institute, Division of Pulmonology, University of Cape Town, Cape Town, South Africa.,These authors contributed equally
| | - Martin Enwerem
- Amity Health Consortium, Country Club Estate, Johannesburg, South Africa.,These authors contributed equally
| | - Rodolfo Romero Leyet
- Clinical Unit, District Clinical Specialist Team, Springbok, South Africa.,These authors contributed equally
| | - Lia D'Ambrosio
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,Public Health Consulting Group, Lugano, Switzerland.,These authors contributed equally
| | - Rosella Centis
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,These authors contributed equally
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Sassari, Italy.,These authors contributed equally
| | - Simon Tiberi
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK.,Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,These authors contributed equally
| | - Jan-Willem Alffenaar
- University of Groningen, University Medical Center Groningen, Dept of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.,These authors contributed equally
| | - Andrey Maryandyshev
- Northern State Medical University, Arkhangelsk, Russian Federation.,These authors contributed equally
| | - Evgeny Belilovski
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation.,These authors contributed equally
| | - Shashank Ganatra
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India.,These authors contributed equally
| | - Alena Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.,These authors contributed equally
| | - Onno Akkerman
- University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands.,University of Groningen, University Medical Center Groningen, Dept of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands
| | - Alena Aleksa
- Dept of Phthisiology, Grodno State Medical University, GRCC "Phthisiology", Grodno, Belarus
| | - Rohit Amale
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - Janina Artsukevich
- Dept of Phthisiology, Grodno State Medical University, GRCC "Phthisiology", Grodno, Belarus
| | - Judith Bruchfeld
- Unit of Infectious Diseases, Dept of Medicine, Solna, Karolinska Institute, Dept of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Jose A Caminero
- Pneumology Dept, Hospital General de Gran Canaria "Dr Negrin", Las Palmas de Gran Canaria, Spain.,MDR-TB Unit, Tuberculosis Division, International Union against Tuberculosis and Lung Disease (The Union), Paris, France
| | | | - Luigi Codecasa
- TB Reference Centre, Villa Marelli Institute/Niguarda Hospital, Milan, Italy
| | | | - Justin Denholm
- Victorian Tuberculosis Program, Melbourne Health, Dept of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Paul Douglas
- Health Policy and Performance Branch, Health Services and Policy Division, Dept of Immigration and Border Protection, Sydney, Australia
| | - Raquel Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Dept of Pneumology, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Aliasgar Esmail
- UCT Lung Institute, Lung Infection and Immunity Unit, Division of Pulmonology, Dept of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Mohammed Fadul
- UCT Lung Institute, Lung Infection and Immunity Unit, Division of Pulmonology, Dept of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Alexey Filippov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - Lina Davies Forsman
- Unit of Infectious Diseases, Dept of Medicine, Solna, Karolinska Institute, Dept of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Mina Gaga
- 7th Respiratory Medicine Dept, Athens Chest Hospital, Athens, Greece
| | | | | | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy
| | - Jerker Jonsson
- National TB Surveillance Unit, Public Health Agency, Stockholm, Sweden
| | - Heinke Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jillian S Lau
- Dept of Infectious Diseases, Box Hill Hospital, Victoria, Australia
| | | | | | - Selene Manga
- Dept of Infectious Diseases, University National San Antonio Abad Cusco, Cusco, Perù
| | - Katerina Manika
- Pulmonary Dept, 'G. Papanikolaou' Hospital, Aristotle University, Thessaloniki, Greece
| | | | - Jai Mullerpattan
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - Suzette Oelofse
- UCT Lung Institute, Lung Infection and Immunity Unit, Division of Pulmonology, Dept of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | | | | | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy
| | - Antonella Papalia
- AOVV Eugenio Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy
| | | | - Marie-Christine Payen
- Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Tatsiana Sanukevich
- Dept of Phthisiology, Grodno State Medical University, GRCC "Phthisiology", Grodno, Belarus
| | - Varvara Solodovnikova
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Antonio Spanevello
- Pneumology Dept, Maugeri Care and Research Institute, Tradate, Italy.,Dept of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | | | - Federica Toscanini
- University Hospital San Martino, Care and Research Institute, National Institute for Cancer Research, Genoa, Italy
| | | | - Zarir Farokh Udwadia
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - Pietro Viggiani
- AOVV Eugenio Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy
| | - Veronica White
- Dept of Respiratory Medicine, Barts Healthcare NHS Trust, London, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Giovanni Battista Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy .,These authors contributed equally
| |
Collapse
|
27
|
Douglas P, Tyrrel SF, Kinnersley RP, Whelan M, Longhurst PJ, Walsh K, Pollard SJT, Drew GH. Sensitivity of predicted bioaerosol exposure from open windrow composting facilities to ADMS dispersion model parameters. J Environ Manage 2016; 184:448-455. [PMID: 27743831 DOI: 10.1016/j.jenvman.2016.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/28/2016] [Accepted: 10/01/2016] [Indexed: 06/06/2023]
Abstract
Bioaerosols are released in elevated quantities from composting facilities and are associated with negative health effects, although dose-response relationships are not well understood, and require improved exposure classification. Dispersion modelling has great potential to improve exposure classification, but has not yet been extensively used or validated in this context. We present a sensitivity analysis of the ADMS dispersion model specific to input parameter ranges relevant to bioaerosol emissions from open windrow composting. This analysis provides an aid for model calibration by prioritising parameter adjustment and targeting independent parameter estimation. Results showed that predicted exposure was most sensitive to the wet and dry deposition modules and the majority of parameters relating to emission source characteristics, including pollutant emission velocity, source geometry and source height. This research improves understanding of the accuracy of model input data required to provide more reliable exposure predictions.
Collapse
Affiliation(s)
- P Douglas
- School of Energy, Environment and Agrifood, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom; Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, W2 1PG, United Kingdom.
| | - S F Tyrrel
- School of Energy, Environment and Agrifood, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom.
| | - R P Kinnersley
- Environment Agency, Evidence Directorate, Deanery Road, Bristol, BS1 5AH, United Kingdom.
| | - M Whelan
- School of Energy, Environment and Agrifood, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom; Department of Geography, Leicester University, Leicestershire, LE1 7RH, United Kingdom.
| | - P J Longhurst
- School of Energy, Environment and Agrifood, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom.
| | - K Walsh
- Environment Agency, Evidence Directorate, Deanery Road, Bristol, BS1 5AH, United Kingdom.
| | - S J T Pollard
- School of Energy, Environment and Agrifood, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom.
| | - G H Drew
- School of Energy, Environment and Agrifood, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom.
| |
Collapse
|
28
|
McCotter L, Douglas P, Laur C, Gandy J, Fitzpatrick L, Rajput-Ray M, Ray S. Hydration education: developing, piloting and evaluating a hydration education package for general practitioners. BMJ Open 2016; 6:e012004. [PMID: 27927656 PMCID: PMC5168638 DOI: 10.1136/bmjopen-2016-012004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To (1) assess the hydration knowledge, attitudes and practices (KAP) of doctors; (2) develop an evidence-based training package; and (3) evaluate the impact of the training package. DESIGN Educational intervention with impact evaluation. SETTING Cambridgeshire, UK. PARTICIPANTS General practitioners (GPs (primary care physicians)). INTERVENTIONS Hydration and healthcare training. MAIN OUTCOME MEASURES Hydration KAP score before and immediately after the training session. RESULTS Knowledge gaps of doctors identified before the teaching were the definition of dehydration, European Food Safety Authority water intake recommendations, water content of the human body and proportion of water from food and drink. A face-to-face teaching package was developed on findings from the KAP survey and literature search. 54 questionnaires were completed before and immediately after two training sessions with GPs. Following the training, total hydration KAP scores increased significantly (p<0.001; median (25th, 75th centiles); 32 (29, 34)). Attendees rated the session as excellent or good (90%) and reported the training was likely to influence their professional practice (100%). CONCLUSIONS The training package will continue to be developed and adapted, with increased focus on follow-up strategies as well as integration into medical curricula and standards of practice. However, further research is required in the area of hydration care to allow policymakers to incorporate hydration awareness and care with greater precision in local and national policies.
Collapse
Affiliation(s)
- L McCotter
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - P Douglas
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - C Laur
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Department of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - J Gandy
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Nutrition and Dietetics, University of Hertfordshire, Hatfield Hertfordshire, UK
| | - L Fitzpatrick
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Cambridge University Hospitals and School of Clinical Medicine, Cambridge, UK
| | - M Rajput-Ray
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Cambridge University Hospitals and School of Clinical Medicine, Cambridge, UK
| | - S Ray
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Cambridge University Hospitals and School of Clinical Medicine, Cambridge, UK
| |
Collapse
|
29
|
Laur C, Ball L, Ahankari AS, Avdagovska M, Crowley J, Deen D, Douglas P, Hark L, Kohlmeier M, Luzi L, McCotter L, Martyn K, Nowson C, Wall C, Ray S. Proceedings of the inaugural International Summit for Medical Nutrition Education and Research. Public Health 2016; 140:59-67. [PMID: 27726865 DOI: 10.1016/j.puhe.2016.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/22/2016] [Accepted: 08/25/2016] [Indexed: 10/20/2022]
Abstract
Medical Nutrition Education (MNE) has been identified as an area with potential public health impact. Despite countries having distinctive education systems, barriers and facilitators to effective MNE are consistent across borders, demanding a common platform to initiate global programmes. A shared approach to supporting greater MNE is ideal to support countries to work together. In an effort to initiate this process, the Need for Nutrition Education/Innovation Programme group, in association with their strategic partners, hosted the inaugural International Summit on Medical Nutrition Education and Research on August 8, 2015 in Cambridge, UK. Speakers from the UK, the USA, Canada, Australia, New Zealand, Italy, and India provided insights into their respective countries including their education systems, inherent challenges, and potential solutions across two main themes: (1) Medical Nutrition Education, focused on best practice examples in competencies and assessment; and (2) Medical Nutrition Research, discussing how to translate nutrition research into education opportunities. The Summit identified shared needs across regions, showcased examples of transferrable strategies and identified opportunities for collaboration in nutrition education for healthcare (including medical) professionals. These proceedings highlight the key messages presented at the Summit and showcase opportunities for working together towards a common goal of improvement in MNE to improve public health at large.
Collapse
Affiliation(s)
- C Laur
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; Faculty of Applied Health Sciences, School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada.
| | - L Ball
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; Menzies Health Institute Queensland, G02.05A, Griffith University, Gold Coast, Australia.
| | - A S Ahankari
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; University of Nottingham, UK; Halo Medical Foundation, India.
| | - M Avdagovska
- Faculty of Medicine and Dentistry, University of Alberta, 3-285 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB T6G 1C9, Canada.
| | - J Crowley
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; Discipline of Nutrition and Dietetics, Faculty of Medical Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - D Deen
- Office of Academic Affairs; Sophie Davis School of Biomedical Education, City College of New York, New York, NY, 10031, USA.
| | - P Douglas
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, UK.
| | - L Hark
- Wills Eye Hospital, Professor of Medicine, Sidney Kimmel Medical College, 840 Walnut Street, Suite 800, Philadelphia, PA, 19107, USA.
| | - M Kohlmeier
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; University of North Carolina, School of Medicine and Gillings School of Global Public Health, and UNC Nutrition Research Institute, 500 Laureate Way, Kannapolis, NC, 28081, USA.
| | - L Luzi
- Endocrinology and Metabolism, Policlinico San Donato IRCCS, Università degli Studi di Milano, Italy.
| | - L McCotter
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK; Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, UK.
| | - K Martyn
- Brighton and Sussex Medical School University of Brighton, Westlain House, Village Way, Falmer, BN21 9PH, UK.
| | - C Nowson
- School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 20000, Geelong, Victoria, 3220, Australia; Institute for Physical Activity and Nutrition, Australia.
| | - C Wall
- Discipline of Nutrition and Dietetics, Faculty of Medical Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - S Ray
- The Need for Nutrition Education/Innovation Programme (University of Cambridge), C/O MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK.
| |
Collapse
|
30
|
Dingley J, Williams D, Douglas P, Douglas M, Douglas JO. The development and evaluation of a non-pressurised, chemical oxygen reaction generation vessel and breathing system providing emergency oxygen for an extended duration. Anaesthesia 2016; 71:1464-1470. [DOI: 10.1111/anae.13595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- J. Dingley
- Swansea University College of Medicine; Swansea UK
- ABM University Health Board; Swansea UK
| | - D. Williams
- Swansea University College of Medicine; Swansea UK
- Welsh Centre for Burns; ABM University Health Board; Swansea UK
| | - P. Douglas
- Chemistry Group; College of Engineering; Swansea University; Swansea UK
- School of Chemistry and Physics; University of KwaZulu-Natal; Durban South Africa
| | - M. Douglas
- Chemistry Group; College of Engineering; Swansea University; Swansea UK
| | - J. O. Douglas
- College of Engineering; Swansea University; Swansea UK
| |
Collapse
|
31
|
|
32
|
Teo SS, Tay EL, Douglas P, Krause VL, Graham SM. The epidemiology of tuberculosis in children in Australia, 2003-2012. Med J Aust 2016; 203:440. [PMID: 26654612 DOI: 10.5694/mja15.00717] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/09/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the burden of and trends in paediatric tuberculosis (TB) in Australia between 2003 and 2012. DESIGN A retrospective analysis of TB data from the National Notifiable Diseases Surveillance System (NNDSS) on TB in children (under 15 years of age) during the 10-year period, 2003-2012. RESULTS TB notifications in Australia during the study period included 538 children (range, 37-66 cases per year), representing 4.6% of the total TB case load during the period (range, 3.8%-5.8% each year). Place of birth was recorded for 524 patients (97.4%); of these, 230 (43.9%) were born in Australia, 294 (56.1%) overseas. The average annual notification rate was 1.31 (95% CI, 1.20-1.43) cases per 100 000 child population. The rate was higher for overseas-born than for Australian-born children (9.57 [95% CI, 8.51-10.73] v 0.61 [95% CI, 0.53-0.69] cases per 100 000 children. The overall rate was highest among those aged 0-4 years. The annual notification rate was three times higher for Indigenous children than for non-Indigenous Australian-born children. Of 427 patients (79.4% of total) for whom the method of case detection was recorded, 37.0% were detected by contact screening, 8.7% by post-arrival immigration screening, and 54.3% by passive case detection. Pulmonary TB was the most common diagnostic classification (64.7% of patients). The most common risk factors were close contact with a TB case and recent residence in a country with a high incidence of TB. Treatment outcomes were satisfactory; 89.4% of children had completed treatment or were cured. CONCLUSIONS The burden of paediatric TB in Australia is low but has not changed over the past decade. The highest rates are among children born overseas, emphasising the important role of immigration screening as Australia aspires to eliminate TB.
Collapse
Affiliation(s)
| | - Ee Laine Tay
- Department of Health and Human Services, Melbourne, VIC
| | - Paul Douglas
- Department of Immigration and Border Protection, Sydney, NSW
| | - Vicki L Krause
- Centre for Disease Control, Department of Health, Darwin, NT
| | | |
Collapse
|
33
|
Douglas P, Kuhs M, Sajjia M, Khraisheh M, Walker G, Collins MN, Albadarin AB. Bioactive PCL matrices with a range of structural & rheological properties. REACT FUNCT POLYM 2016. [DOI: 10.1016/j.reactfunctpolym.2016.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Douglas P, Albadarin AB, Sajjia M, Mangwandi C, Kuhs M, Collins MN, Walker GM. Effect of poly ethylene glycol on the mechanical and thermal properties of bioactive poly(ε-caprolactone) melt extrudates for pharmaceutical applications. Int J Pharm 2016; 500:179-86. [DOI: 10.1016/j.ijpharm.2016.01.036] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 10/22/2022]
|
35
|
Cooray G, Sengupta B, Douglas P, Englund M, Wickstrom R, Friston K. ID 202 – Characterising seizures in anti-NMDA-receptor encephalitis with Dynamic Causal Modelling. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.374] [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]
|
36
|
Toms C, Stapledon R, Waring J, Douglas P. Tuberculosis notifications in Australia, 2012 and 2013. Commun Dis Intell (2018) 2015; 39:E217-E235. [PMID: 26234258] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The National Notifiable Diseases Surveillance System received 1,317 tuberculosis (TB) notifications in 2012 and 1,263 notifications in 2013. This represents a rate of 5.8 per 100,000 population in 2012 and 5.5 per 100,000 population in 2013 and a reversal of the upward trend in TB incidence reported since 2007. In 2012 and 2013, Australia's overseas-born population continued to represent the majority of TB notifications with an incidence rate of 19.5 per 100,000 and 18.4 per 100,000 respectively. The incidence of TB in the Australian-born Indigenous population has fluctuated over the last decade; however, it remained reasonably steady in 2012 and 2013 with an incidence rate of 4.5 per 100,000 and 4.6 per 100,000 respectively. The incidence of TB in the Australian-born non-Indigenous population has continued to remain low at 0.7 per 100,000 in 2012 and 0.8 per 100,000 in 2013. Australia continued to record only a small number of multi-drug resistant TB cases nationally (2012: n=20; 2013: n=22) of which nearly all were identified in the overseas-born population. This report demonstrates excellent and sustained control of TB in Australia and reflects Australia's commitment to reducing the global burden of TB.
Collapse
Affiliation(s)
- Cindy Toms
- Vaccine Preventable Diseases Surveillance Section, Health Emergency Management Branch, Office of Health Protection, Department of Health, Canberra, Australian Capital Territory
| | - Richard Stapledon
- South Australian Tuberculosis Services, Royal Adelaide Hospital, Adelaide, South Australia
| | - Justin Waring
- Western Australian Tuberculosis Control Program, Department of Health, Perth, Western Australia
| | - Paul Douglas
- Immigration Health Branch, Australian Government Department of Immigration and Border Protection, Sydney, New South Wales
| |
Collapse
|
37
|
Núñez B, Miao L, Carrozza J, Ross J, Douglas P, Gordon P, Katz SE, Kuntz R, Morgan JP. Cocaine-induced transmural myocardial infarction in a Yorkshire swine with normal coronary arteries: Evidence for microvascular and/or epicardial coronary artery spasm. Cardiovasc Pathol 2015; 3:93-7. [PMID: 25990854 DOI: 10.1016/1054-8807(94)90039-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 01/05/1993] [Accepted: 11/12/1993] [Indexed: 11/28/2022] Open
Abstract
Cocaine-induced myocardial infarction with normal coronary arteries is well documented in humans. The exact mechanism of action remains speculative. We report one case of cocaine-induced myocardial infarction with normal coronaries in one swine. Systemic hemodynamics and angiographic, electrocardiographic, echocardiographic, and histopathologic data are presented. Intravenous cocaine (1, 3, 10 mg/kg) produced significant decreases in mean arterial pressure, heart rate, stroke volume, coronary blood flow, and coronary reserve, whereas pulmonary artery diastolic pressure and coronary vascular resistances increased. Left anterior descending and left circumflex coronary artery cross-sectional area decreased by 31% and 64%, respectively, without localized vasospasm. Electrocardiographic changes occurred (3 mm ST elevation in leads II, III, AVF). Peak creatine phosphokinase was 17,220 IU/L. The echocardiogram revealed severe hypokinesis of the inferior wall and normal ventricular function. The animal survived the acute phase of the infarction and the swine was restudied 12 weeks later. Upon rechallenge, systemic and coronary hemodynamics shoved changes similar to those in the previous study. The swine developed ventricular fibrillation and expired after the 10 mg/kg cocaine dose. Macroscopic examination of the external surface of the heart revealed marked diffuse fibrosis in the posteroinferior and lateral left ventricular wall. Our data suggest that the infarct induced by cocaine may have resulted from severe vasoconstriction or spasm at the level of the microcirculation, and/or the epicardial coronary arteries, which shoved slight but significant narrowing throughout their lengths.
Collapse
Affiliation(s)
- B Núñez
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - L Miao
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - J Carrozza
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - J Ross
- Tufts University School of Veterinary Medicine, North Grafton, Massachusetts, USA
| | - P Douglas
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - P Gordon
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - S E Katz
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - R Kuntz
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - J P Morgan
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, USA; Cardiovascular Division, Department of Medicine, Beth Israel Hospital, USA; Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
38
|
Douglas P, Albadarin AB, Al-Muhtaseb AH, Mangwandi C, Walker G. Thermo-mechanical properties of poly ε-caprolactone/poly l -lactic acid blends: Addition of nalidixic acid and polyethylene glycol additives. J Mech Behav Biomed Mater 2015; 45:154-65. [DOI: 10.1016/j.jmbbm.2015.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/27/2015] [Accepted: 01/29/2015] [Indexed: 10/24/2022]
|
39
|
Lönnroth K, Migliori GB, Abubakar I, D'Ambrosio L, de Vries G, Diel R, Douglas P, Falzon D, Gaudreau MA, Goletti D, González Ochoa ER, LoBue P, Matteelli A, Njoo H, Solovic I, Story A, Tayeb T, van der Werf MJ, Weil D, Zellweger JP, Abdel Aziz M, Al Lawati MR, Aliberti S, Arrazola de Oñate W, Barreira D, Bhatia V, Blasi F, Bloom A, Bruchfeld J, Castelli F, Centis R, Chemtob D, Cirillo DM, Colorado A, Dadu A, Dahle UR, De Paoli L, Dias HM, Duarte R, Fattorini L, Gaga M, Getahun H, Glaziou P, Goguadze L, del Granado M, Haas W, Järvinen A, Kwon GY, Mosca D, Nahid P, Nishikiori N, Noguer I, O'Donnell J, Pace-Asciak A, Pompa MG, Popescu GG, Robalo Cordeiro C, Rønning K, Ruhwald M, Sculier JP, Simunović A, Smith-Palmer A, Sotgiu G, Sulis G, Torres-Duque CA, Umeki K, Uplekar M, van Weezenbeek C, Vasankari T, Vitillo RJ, Voniatis C, Wanlin M, Raviglione MC. Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J 2015; 45:928-52. [PMID: 25792630 PMCID: PMC4391660 DOI: 10.1183/09031936.00214014] [Citation(s) in RCA: 528] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 01/02/2015] [Indexed: 12/31/2022]
Abstract
This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.
Collapse
Affiliation(s)
- Knut Lönnroth
- Global TB Programme, World Health Organization, Geneva, Switzerland
- Both authors contributed equally
| | - Giovanni Battista Migliori
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
- Both authors contributed equally
| | - Ibrahim Abubakar
- TB Section, University College London and Public Health England, London, UK
| | - Lia D'Ambrosio
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | - Roland Diel
- University Hospital Schleswig Holstein, Institute for Epidemiology, Kiel, Germany
| | - Paul Douglas
- Global Health Borders Refugee and Onshore Services, Dept of Immigration and Border Protection, Sydney, Australia
| | - Dennis Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Marc-Andre Gaudreau
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Delia Goletti
- National Institute for Infectious Diseases, Rome, Italy
| | - Edilberto R. González Ochoa
- Research and Surveillance Group on TB, Leprosy and ARI, Epidemiology Board, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Philip LoBue
- Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Howard Njoo
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Ivan Solovic
- TB Dept, National Institute for TB, Respiratory Diseases and Thoracic Surgery, Vysne Hagy, Catholic University, Ružomberok, Slovakia
| | | | - Tamara Tayeb
- National TB Control Programme, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Diana Weil
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | - Stefano Aliberti
- Università degli Studi di Milano – Bicocca, UO Clinica Pneumologica, AO San Gerardo, Monza, Italy
| | | | | | - Vineet Bhatia
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Francesco Blasi
- Dipartimento Fisiopatologia Medico-Chirurgica e dei Trapianti, University of Milan, IRCCS Fondazione Cà Granda, Milan, Italy
| | - Amy Bloom
- US Agency for International Development, Washington, DC, USA
| | - Judith Bruchfeld
- Unit of Infectious Diseases, Institution of Medicine, Karolinska Institute Solna and Karolinska University Hospital, Stockholm, Sweden
| | | | - Rosella Centis
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | | | | | - Andrei Dadu
- TB and M/XDR-TB Control Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ulf R. Dahle
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Hannah M. Dias
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Mina Gaga
- National Referral Centre for Mycobacteria, Athens Chest Hospital, Ministry of Health, Athens, Greece
| | | | - Philippe Glaziou
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Lasha Goguadze
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | | | - Walter Haas
- Dept of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Asko Järvinen
- Finnish Lung Health Association, Helsinki, Finland
- Helsinki University Central Hospital, Division of Infectious Diseases, Helsinki, Finland
| | - Geun-Yong Kwon
- Korea Centers for Disease Control and Prevention (KCDC), Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Davide Mosca
- International Organization for Migration, Geneva, Switzerland
| | - Payam Nahid
- University of California, San Francisco, CA, USA
- American Thoracic Society (ATS), New York, NY, USA
| | - Nobuyuki Nishikiori
- Stop TB and Leprosy Elimination, WHO Regional Office for the Western Pacific, Manila, Philippines
| | | | - Joan O'Donnell
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | | | | | | | | | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Giorgia Sulis
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Carlos A. Torres-Duque
- Asociacion Latinoamericana de Torax (ALAT) - Fundacion Neumologica Colombiana, Bogota, Colombia
| | | | - Mukund Uplekar
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Maryse Wanlin
- Fonds des Affections Respiratoires (FARES), Brussels, Belgium
| | | |
Collapse
|
40
|
Bareja C, Waring J, Stapledon R, Toms C, Douglas P. Tuberculosis notifications in Australia, 2011. Commun Dis Intell (2018) 2014; 38:E356-E368. [PMID: 25631599] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The National Notifiable Diseases Surveillance System received 1,385 tuberculosis (TB) notifications in 2011, representing a rate of 6.2 cases per 100,000 population. While Australia has maintained a rate of 5 to 6 cases per 100,000 for TB since the mid-1980s, there has been a steady increase in incidence over the past decade. In 2011, Australia's overseas-born population continued to represent the majority of TB notifications (88%) with a notification rate of 20.2 per 100,000. The incidence of TB in the Australian-born Indigenous population has fluctuated over the last decade and showed no clear trend; however, in 2011 the notification rate was 4.9 per 100,000, which is a notable decrease from the 7.5 per 100,000 recorded in 2010. The incidence of TB in the Australian-born non-Indigenous population has continued to remain low at 0.9 per 100,000. Australia continued to record only a small number of multi-drug-resistant TB (MDR-TB) cases nationally (n=25), all of which were identified in the overseas-born population. To ensure that Australia can retain its low TB rate and work toward reducing rates further, it is essential that Australia maintains good centralised national TB reporting to monitor trends and identify at-risk populations, and continues to contribute to global TB control initiatives.
Collapse
Affiliation(s)
- Christina Bareja
- Vaccine Preventable Diseases Surveillance Section, Health Emergency Management Branch, Office of Health Protection, Department of Health, Canberra, Australian Capital Territory
| | - Justin Waring
- Western Australian Tuberculosis Control Program, Department of Health, Perth, Western Australia
| | - Richard Stapledon
- South Australian Tuberculosis Services, Royal Adelaide Hospital, Adelaide, South Australia
| | - Cindy Toms
- Vaccine Preventable Diseases Surveillance Section, Health Emergency Management Branch, Office of Health Protection, Department of Health, Canberra, Australian Capital Territory
| | - Paul Douglas
- Global Health Branch, Australian Government Department of Immigration and Border Protection, Sydney, New South Wales
| |
Collapse
|
41
|
Davies ML, Carnie M, Holliman PJ, Connell A, Douglas P, Watson T, Charbonneau C, Troughton J, Worsley D. Compositions, colours and efficiencies of organic–inorganic lead iodide/bromide perovskites for solar cells. ACTA ACUST UNITED AC 2014. [DOI: 10.1179/1433075x14y.0000000252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- M. L. Davies
- School of ChemistryBangor University, Gwynedd LL57 2UW, UK
- SPECIFICCollege of Engineering, Swansea University, Baglan Bay Innovation Centre, Baglan Energy Park, Baglan, Port Talbot SA12 7AZ, UK
| | - M. Carnie
- SPECIFICCollege of Engineering, Swansea University, Baglan Bay Innovation Centre, Baglan Energy Park, Baglan, Port Talbot SA12 7AZ, UK
| | - P. J. Holliman
- School of ChemistryBangor University, Gwynedd LL57 2UW, UK
| | - A. Connell
- School of ChemistryBangor University, Gwynedd LL57 2UW, UK
| | - P. Douglas
- Chemistry GroupCollege of Engineering, Swansea University, Singleton Park, Swansea SA2 8PP, UK
- School of Chemistry and PhysicsUniversity of KwaZulu-Natal, Westville Campus, Durban 4000, South Africa
| | - T. Watson
- SPECIFICCollege of Engineering, Swansea University, Baglan Bay Innovation Centre, Baglan Energy Park, Baglan, Port Talbot SA12 7AZ, UK
| | - C. Charbonneau
- SPECIFICCollege of Engineering, Swansea University, Baglan Bay Innovation Centre, Baglan Energy Park, Baglan, Port Talbot SA12 7AZ, UK
| | - J. Troughton
- SPECIFICCollege of Engineering, Swansea University, Baglan Bay Innovation Centre, Baglan Energy Park, Baglan, Port Talbot SA12 7AZ, UK
| | - D. Worsley
- SPECIFICCollege of Engineering, Swansea University, Baglan Bay Innovation Centre, Baglan Energy Park, Baglan, Port Talbot SA12 7AZ, UK
| |
Collapse
|
42
|
Kodali S, Hahn R, Williams M, Thourani V, Tuzcu EM, Svensson L, Douglas P, Alu M, Mcandrew T, Leon M. Impact of paravalvular leak following transcatheter aortic valve replacement on one-year mortality: analysis of the combined PARTNER cohorts. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.2584] [Citation(s) in RCA: 2] [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] [Indexed: 11/13/2022] Open
|
43
|
King DL, Gradisar M, Drummond A, Lovato N, Wessel J, Micic G, Douglas P, Delfabbro P. The impact of prolonged violent video-gaming on adolescent sleep: an experimental study. J Sleep Res 2012; 22:137-43. [PMID: 23137332 DOI: 10.1111/j.1365-2869.2012.01060.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 09/12/2012] [Indexed: 11/29/2022]
Abstract
Video-gaming is an increasingly prevalent activity among children and adolescents that is known to influence several areas of emotional, cognitive and behavioural functioning. Currently there is insufficient experimental evidence about how extended video-game play may affect adolescents' sleep. The aim of this study was to investigate the short-term impact of adolescents' prolonged exposure to violent video-gaming on sleep. Seventeen male adolescents (mean age = 16 ± 1 years) with no current sleep difficulties played a novel, fast-paced, violent video-game (50 or 150 min) before their usual bedtime on two different testing nights in a sleep laboratory. Objective (polysomnography-measured sleep and heart rate) and subjective (single-night sleep diary) measures were obtained to assess the arousing effects of prolonged gaming. Compared with regular gaming, prolonged gaming produced decreases in objective sleep efficiency (by 7 ± 2%, falling below 85%) and total sleep time (by 27 ± 12 min) that was contributed by a near-moderate reduction in rapid eye movement sleep (Cohen's d = 0.48). Subjective sleep-onset latency significantly increased by 17 ± 8 min, and there was a moderate reduction in self-reported sleep quality after prolonged gaming (Cohen's d = 0.53). Heart rate did not differ significantly between video-gaming conditions during pre-sleep game-play or the sleep-onset phase. Results provide evidence that prolonged video-gaming may cause clinically significant disruption to adolescent sleep, even when sleep after video-gaming is initiated at normal bedtime. However, physiological arousal may not necessarily be the mechanism by which technology use affects sleep.
Collapse
Affiliation(s)
- Daniel L King
- School of Psychology, Flinders University, Adelaide, SA, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Douglas P, Maher-McWilliams C, Barker PF. Frequency stabilization of an external-cavity diode laser to metastable argon atoms in a discharge. Rev Sci Instrum 2012; 83:063107. [PMID: 22755615 DOI: 10.1063/1.4729793] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A laser stabilization scheme using magnetic dichroism in a RF plasma discharge is presented. This method has been used to provide a frequency stable external-cavity diode laser that is locked to the 4s[3/2](2) → 4p[5/2](3) argon laser cooling transition at 811.53 nm. Using saturated absorption spectroscopy, we lock the laser to a Doppler free peak which gave a locking range of 20 MHz when the slope of the error signal was maximized. The stability of the laser was characterized by determining the square root Allan variance of laser frequency fluctuations when the laser was locked. A stability of 129 kHz was measured at 1 s averaging time for data acquired over 6000 s.
Collapse
Affiliation(s)
- P Douglas
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | | | | |
Collapse
|
45
|
Alvarez GG, Gushulak B, Abu Rumman K, Altpeter E, Chemtob D, Douglas P, Erkens C, Helbling P, Hamilton I, Jones J, Matteelli A, Paty MC, Posey DL, Sagebiel D, Slump E, Tegnell A, Valín ER, Winje BA, Ellis E. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates. BMC Infect Dis 2011; 11:3. [PMID: 21205318 PMCID: PMC3022715 DOI: 10.1186/1471-2334-11-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 01/04/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. METHODS Descriptive study of immigration TB screening programs. RESULTS 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. CONCLUSIONS In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should facilitate the development of improved screening programs.
Collapse
Affiliation(s)
- Gonzalo G Alvarez
- Divisions of Respirology and Infectious Diseases, University of Ottawa at The Ottawa Hospital, The Ottawa Health Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Alvarez GG, Clark M, Altpeter E, Douglas P, Jones J, Paty MC, Posey DL, Chemtob D. Pediatric tuberculosis immigration screening in high-immigration, low-incidence countries. Int J Tuberc Lung Dis 2010; 14:1530-1537. [PMID: 21144237] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) screening in migrant children, including immigrants, refugees and asylum seekers, is an ongoing challenge in low TB incidence countries. Many children from high TB incidence countries harbor latent TB infection (LTBI), and some have active TB disease at the point of immigration into host nations. Young children who harbor LTBI have a high risk of progression to TB disease and are at a higher risk than adults of developing disseminated severe forms of TB with significant morbidity and mortality. Many countries have developed immigration TB screening programs to suit the needs of adults, but have not focused much attention on migrant children. OBJECTIVE To compare the TB immigration medical examination requirements in children in selected countries with high immigration and low TB incidence rates. DESIGN Descriptive study of TB immigration screening programs for systematically selected countries. RESULTS Of 18 eligible countries, 16 responded to the written survey and telephone interview. CONCLUSION No two countries had the same approach to TB screening among migrant children. The optimal evidenced-based manner in which to screen migrant children requires further research.
Collapse
Affiliation(s)
- G G Alvarez
- Division of Respirology, The Ottawa Hospital Research Institute, University of Ottawa at The Ottawa Hospital, Ottawa, Ontario, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Douglas P, Yunger S, Maroun JA, Zabransky J, Byrne M, Ruzic M, Blair L, Georget G, Shum D, Milliken D. Timeliness of private access to intravenous (IV) cancer drugs: A Canadian analysis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e16533] [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: 11/20/2022] Open
|
48
|
Weaver E, Gradisar M, Dohnt H, Lovato N, Douglas P. The effect of presleep video-game playing on adolescent sleep. J Clin Sleep Med 2010; 6:184-189. [PMID: 20411697 PMCID: PMC2854707] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
STUDY OBJECTIVES Video-game use before bedtime has been linked with poor sleep outcomes for adolescents; however, experimental evidence to support this link is sparse. The present study investigated the capacity of presleep video-game playing to extend sleep latency and reduce subjective feelings of sleepiness in adolescents. The arousing psychophysiologic mechanisms involved and the impact of presleep video-game playing on sleep architecture were also explored. METHOD Thirteen male adolescent "evening types" (mean age = 16.6 years, SD = 1.1) participated in a counterbalanced, within-subjects design with experimental (active video gaming) and control (passive DVD watching) conditions. The experiment was conducted in the Flinders University Sleep Research Laboratory. RESULTS Relative to the control condition, presleep video-game playing increased sleep-onset latency (Z= 2.45, p= .01) and reduced subjective sleepiness (Z = 2.36, p = .02)-but only slightly. Video gaming was related to changes in cognitive alertness (as measured by a power: p < 0.01) but not physiologic arousal (as measured by heart rate: p > 0.05). Contrary to previous findings, sleep architecture was unaffected (both rapid eye movement and slow wave sleep: p > 0.05). CONCLUSIONS Results suggest the direct effect of presleep video-game playing on adolescent sleep may be more modest than previously thought, suggesting that surveys linking stimulating presleep activities to poor sleep need substantiating with empirical evidence.
Collapse
Affiliation(s)
- Edward Weaver
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Michael Gradisar
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Hayley Dohnt
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Nicole Lovato
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Paul Douglas
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
49
|
Affiliation(s)
- Edward Weaver
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Michael Gradisar
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Hayley Dohnt
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Nicole Lovato
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Paul Douglas
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
50
|
Thomas S, Douglas P, Smith M. Refugee health. N S W Public Health Bull 2010; 21:101-102. [PMID: 20556910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Susan Thomas
- NSW Public Health Officer Training Program, NSW Department of Health
| | | | | |
Collapse
|