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Watts C, Spillane A, Henderson MA, Cust A, Braithwaite J, Gyorki DE, Hong AM, Kelly JW, Long GV, Mar VJ, Menzies AM, Morton RL, Rapport F, Saw RPM, Schmid H, Scolyer RA, Smith AL, Winder A, Mann GJ. Sentinel lymph node biopsy rates in Victoria, 2018 and 2019. Med J Aust 2022. [DOI: 10.5694/mja2.51424] [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: 11/17/2022]
Affiliation(s)
- Caroline Watts
- Daffodil Centre University of Sydney and Cancer Council NSW Sydney NSW
- The Kirby Institute UNSW Sydney NSW
| | - Andrew Spillane
- Melanoma Institute Australia University of Sydney Sydney NSW
- Sydney Medical School University of Sydney Sydney NSW
- Royal North Shore Hospital Sydney NSW
- Mater Hospital Sydney NSW
| | - Michael A Henderson
- Peter MacCallum Cancer Centre Melbourne VIC
- The University of Melbourne Melbourne VIC
| | - Anne Cust
- Daffodil Centre University of Sydney and Cancer Council NSW Sydney NSW
- Melanoma Institute Australia University of Sydney Sydney NSW
| | - J Braithwaite
- Australian Institute of Health Innovation Macquarie University Sydney NSW
| | - DE Gyorki
- Peter MacCallum Cancer Centre Melbourne VIC
| | - AM Hong
- Melanoma Institute Australia University of Sydney Sydney NSW
| | - JW Kelly
- Victorian Melanoma Service Alfred Hospital Melbourne VIC
| | - GV Long
- Melanoma Institute Australia University of Sydney Sydney NSW
- Sydney Medical School University of Sydney Sydney NSW
- Royal North Shore Hospital Sydney NSW
- Mater Hospital Sydney NSW
| | - VJ Mar
- Victorian Melanoma Service Alfred Hospital Melbourne VIC
| | - AM Menzies
- Melanoma Institute Australia University of Sydney Sydney NSW
- Sydney Medical School University of Sydney Sydney NSW
- Royal North Shore Hospital Sydney NSW
- Mater Hospital Sydney NSW
| | - RL Morton
- Melanoma Institute Australia University of Sydney Sydney NSW
- NHMRC Clinical Trials Centre University of Sydney Sydney NSW
| | - F Rapport
- Australian Institute of Health Innovation Macquarie University Sydney NSW
| | - RPM Saw
- Melanoma Institute Australia University of Sydney Sydney NSW
- Sydney Medical School University of Sydney Sydney NSW
- Mater Hospital Sydney NSW
| | - H Schmid
- Daffodil Centre University of Sydney and Cancer Council NSW Sydney NSW
| | - RA Scolyer
- Melanoma Institute Australia University of Sydney Sydney NSW
- Sydney Medical School University of Sydney Sydney NSW
- Royal Prince Alfred Hospital and New South Wales Health Pathology Sydney NSW
| | - AL Smith
- Daffodil Centre University of Sydney and Cancer Council NSW Sydney NSW
| | - A Winder
- Melanoma Institute Australia University of Sydney Sydney NSW
| | - GJ Mann
- Melanoma Institute Australia University of Sydney Sydney NSW
- The John Curtin School of Medical Research Australian National University Canberra ACT
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2
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Dennis M, Cheng E, Morton R, Addison D. Cost-effectiveness of Extracorporeal Cardiopulmonary Resuscitation (ECPR) for Out-of-Hospital Cardiac Arrest—A Systematic Review. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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3
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de Vries BS, Mcdonald S, Joseph FA, Morton R, Hyett JA, Phipps H, McGeechan K. Impact of analysis technique on our understanding of the natural history of labour: a simulation study. BJOG 2021; 128:1833-1842. [PMID: 33837643 DOI: 10.1111/1471-0528.16719] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the discrepancy between historical and more recent descriptions of the first stage of labour by testing whether the statistical techniques used recently (repeated-measures polynomial and interval-censored regression) were appropriate for detection of periods of rapid acceleration of cervical dilatation as might occur at the time of transition from a latent to an active phase of labour. DESIGN AND SETTING A simulation study using regression techniques. SAMPLE We created a simulated data set for 500 000 labours with clearly defined latent and active phases using the parameters described by Friedman. Additionally, we created a data set comprising 500 000 labours with a progressively increasing rate of cervical dilatation. METHODS Repeated-measures polynomial regression was used to create summary labour curves based on simulated cervical examinations. Interval-censored regression was used to create centimetre-by-centimetre estimates of rates of cervical dilatation and their 95th centiles. MAIN OUTCOME MEASURES Labour summary curves and rates of cervical dilatation. RESULTS Repeated-measures polynomial regression did not detect the rapid acceleration in cervical dilatation (i.e. acceleration phase) and overestimated lengths of labour, especially at smaller cervical dilatations. There was a two-fold overestimation in the mean rate of cervical dilatation from 4 to 6 cm. Interval-censored regression overestimated median transit times, at 4- to 5-cm cervical dilatation or when cervical examinations occurred less frequently than 0.5- to 1.5-hourly. CONCLUSION Repeated-measures polynomial regression and interval-censored regression should not be routinely used to define labour progress because they do not accurately reflect the underlying data. TWEETABLE ABSTRACT Repeated-measures polynomial and interval-censored regression techniques are not appropriate to model first stage of labour.
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Affiliation(s)
- B S de Vries
- Sydney Institute for Women, Children and their Families, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, NSW, Australia
| | - S Mcdonald
- Baymatob Operations Pty Ltd Sydney, Sydney, NSW, Australia
| | - F A Joseph
- RPA Women and Babies Camperdown, Camperdown, NSW, Australia
| | - R Morton
- RPA Women and Babies Camperdown, Camperdown, NSW, Australia
| | - J A Hyett
- Sydney Institute for Women, Children and their Families, Sydney, NSW, Australia
| | - H Phipps
- Sydney Institute for Women, Children and their Families, Sydney, NSW, Australia
| | - K McGeechan
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, NSW, Australia
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Doyle M, Watson D, Nguyen M, Wu J, Elder D, Ng M, Morton R, Keech A, Shah K, Harris J, Woldendorp K, Seco M. M19 Case Volume, Demographics and Surgical Risk Trends of Patients Undergoing Surgical and Transcatheter Aortic Valve Replacement. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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5
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Shah K, Woldendorp K, Harris J, Keech A, Morton R, Ng M, Elder D, Seco M, Nguyen M, Turner L, Wu J, Watson D, Doyle M. R29 Hospital Resource Use and Costs of Isolated Aortic Valve Replacement Procedures in Patients with aortic stenosis, by STS risk scores in New South Wales, Australia. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.187] [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: 11/25/2022]
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Grimison P, Mersiades A, Kirby A, Lintzeris N, Morton R, Haber P, Olver I, Walsh A, McGregor I, Cheung Y, Tognela A, Hahn C, Briscoe K, Aghmesheh M, Fox P, Abdi E, Clarke S, Della-Fiorentina S, Shannon J, Gedye C, Begbie S, Simes J, Stockler M. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Ann Oncol 2020; 31:1553-1560. [DOI: 10.1016/j.annonc.2020.07.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
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Shah K, Elder D, Nguyen M, Turner L, Doyle M, Woldendorp K, Seco M, Law C, Wilson M, Keech A, Ng M, Morton R. 628 Transcatheter Aortic Valve Implantation (TAVI) Versus Surgical Aortic Valve Replacement (SAVR) for Aortic Stenosis: A Cost-Comparison Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Bruning-Richardson A, Sanganee H, Barry S, Tams D, Brend T, King H, Morton R, Ward T, Steele L, Shaw G, Esteves F, Droop A, Lawler S, Short S. PL3.6 Targeting GSK-3 activity promotes mitotic catastrophe via centrosome destabilisation and enhances the effect of radiotherapy in glioma models. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Targeting kinases as regulators of cellular processes that drive cancer progression is a promising approach to improve patient outcome in GBM management. The glycogen synthase kinase 3 (GSK-3) plays a role in cancer progression and is known for its pro-proliferative activity in gliomas. The anti-proliferative and cytotoxic effects of the GSK-3 inhibitor AZD2858 were assessed in relevant in vitro and in vivo glioma models to confirm GSK-3 as a suitable target for improved single agent or combination treatments.
MATERIAL AND METHODS
The immortalised cell line U251 and the patient derived cell lines GBM1 and GBM4 were used in in vitro studies including MTT, clonogenic survival, live cell imaging, immunofluorescence microscopy and flow cytometry to assess the cytotoxic and anti-proliferative effects of AZD2858. Observed anti-proliferative effects were investigated by microarray technology for the identification of target genes with known roles in cell proliferation. Clinical relevance of targeting GSK-3 with the inhibitor either for single agent or combination treatment strategies was determined by subcutaneous and orthotopic in vivo modelling. Whole mount mass spectroscopy was used to confirm drug penetration in orthotopic tumour models.
RESULTS
AZD2858 was cytotoxic at low micromolar concentrations and at sub-micromolar concentrations (0.01 - 1.0 μM) induced mitotic defects in all cell lines examined. Prolonged mitosis, centrosome disruption/duplication and cytokinetic failure leading to cell death featured prominently among the cell lines concomitant with an observed S-phase arrest. No cytotoxic or anti-proliferative effect was observed in normal human astrocytes. Analysis of the RNA microarray screen of AZD2858 treated glioma cells revealed the dysregulation of mitosis-associated genes including ASPM and PRC1, encoding proteins with known roles in cytokinesis. The anti-proliferative and cytotoxic effect of AZD2858 was also confirmed in both subcutaneous and orthotopic in vivo models. In addition, combination treatment with AZD2858 enhanced clinically relevant radiation doses leading to reduced tumour volume and improved survival in orthotopic in vivo models.
CONCLUSION
GSK-3 inhibition with the small molecule inhibitor AZD2858 led to cell death in glioma stem cells preventing normal centrosome function and promoting mitotic failure. Normal human astrocytes were not affected by treatment with the inhibitor at submicromolar concentrations. Drug penetration was observed alongside an enhanced effect of clinical radiotherapy doses in vivo. The reported aberrant centrosomal duplication may be a direct consequence of failed cytokinesis suggesting a role of GSK-3 in regulation of mitosis in glioma. GSK-3 is a promising target for combination treatment with radiation in GBM management and plays a role in mitosis-associated events in glioma biology.
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Affiliation(s)
| | | | - S Barry
- Astra Zeneca, Cambridge, United Kingdom
| | - D Tams
- University of Leeds, Leeds, United Kingdom
| | - T Brend
- University of Leeds, Leeds, United Kingdom
| | - H King
- University of Leeds, Leeds, United Kingdom
| | - R Morton
- University of Leeds, Leeds, United Kingdom
| | - T Ward
- University of Leeds, Leeds, United Kingdom
| | - L Steele
- University of Leeds, Leeds, United Kingdom
| | - G Shaw
- University of Leeds, Leeds, United Kingdom
| | - F Esteves
- University of Leeds, Leeds, United Kingdom
| | - A Droop
- University of Leeds, Leeds, United Kingdom
| | - S Lawler
- Harvard University, Boston, MA, United States
| | - S Short
- University of Leeds, Leeds, United Kingdom
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Dieng M, Morton RL, Costa DSJ, Butow PN, Menzies SW, Lo S, Mann GJ, Cust AE, Kasparian NA. Benefits of a brief psychological intervention targeting fear of cancer recurrence in people at high risk of developing another melanoma: 12-month follow-up results of a randomized controlled trial. Br J Dermatol 2019; 182:860-868. [PMID: 30965384 DOI: 10.1111/bjd.17990] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with melanoma want and need effective interventions for living with fear of cancer recurrence (FCR). OBJECTIVES This study reports the 12-month outcomes of a brief, psychological intervention designed to reduce FCR in people at high risk of developing another primary melanoma compared with usual care. METHODS In this two-arm randomized controlled trial, adults previously diagnosed with stage 0, I or II melanoma were randomly allocated to the intervention (n = 80) or control (usual care) arm (n = 84). The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19 March 2013 (registration: ACTRN12613000304730). The intervention comprised a 76-page psychoeducational resource and three individually tailored, telephone-based sessions with a psychologist, scheduled at specific time points around participants' dermatological appointments. The primary outcome was the level of self-reported fear of new or recurrent melanoma assessed at 12 months postintervention using the severity subscale of the Fear of Cancer Recurrence Inventory. RESULTS Compared with the control arm, the intervention group reported significantly lower FCR at 12 months postintervention; the between-group mean difference was -1·41 for FCR severity [95% confidence interval (CI) -2·6 to -0·2; P = 0·02] and -1·32 for FCR triggers (95% CI -2·6 to -0·02; P = 0·04). The odds ratio for FCR severity scores ≥13 (54% intervention, 63% control) was 0·59 (95% CI 0·30-1·14, P = 0·12). There were no differences between groups in secondary outcomes, such as anxiety, depression or health-related quality of life. CONCLUSIONS The previously reported 6-month benefits of this brief, patient-centred psychological intervention in reducing FCR were found to continue 12 months postintervention, with no known adverse effects, supporting implementation as part of routine melanoma care.
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Affiliation(s)
- M Dieng
- NHMRC Clinical Trials Centre, The University of Sydney, NSW, Australia.,Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - R L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, NSW, Australia
| | - D S J Costa
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, NSW, Australia
| | - P N Butow
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, NSW, Australia
| | - S W Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney, NSW, Australia.,The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, NSW, Australia
| | - S Lo
- Melanoma Institute Australia, The University of Sydney, NSW, Australia.,Institute for Research and Medical Consultations, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - G J Mann
- Melanoma Institute Australia, The University of Sydney, NSW, Australia.,Centre for Cancer Research, Westmead Institute for Medical Research, University of Sydney, Australia
| | - A E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, NSW, Australia.,Melanoma Institute Australia, The University of Sydney, NSW, Australia
| | - N A Kasparian
- Melanoma Institute Australia, The University of Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, NSW, Australia.,Harvard Medical School, Boston, MA, U.S.A
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Morton R. SAT-037 STUDY PROTOCOL FOR THE SYMPTOM MONITORING WITH FEEDBACK TRIAL (SWIFT): A NOVEL REGISTRY-BASED CLUSTER RANDOMISED TRIAL AMONG ADULTS WITH END-STAGE KIDNEY DISEASE MANAGED ON HAEMODIALYSIS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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11
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TRAN A, Ying T, Webster A, Pilmore H, Kelly P, Gill J, Klarenbach S, Chadban S, Morton R. SUN-110 REGULAR SCREENING VERSUS NO SCREENING FOR ASYMPTOMATIC CORONARY ARTERY DISEASE IN WAIT-LISTED KIDNEY TRANSPLANT CANDIDATES: A MODELLED COST-EFFECTIVENESS ANALYSIS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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12
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Shah K, Nguyen M, Seco M, Elder D, Turner L, Wu J, Doyle M, Watson D, Woldendorp K, Keech A, Ng M, Morton R. Comparing Hospital Costs Of Trans-Catheter Aortic Valve Replacement and Isolated Surgical Aortic Valve Replacement in Patients with Aortic Stenosis Treated in New South Wales, Australia. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Elder D, Ng M, Morton R, Keech A, Seco M, Shah K, Turner L, Nguyen M, Woldendorp K, Doyle M, Wu J, Watson D. A Comparison of the Number and Demographics of Patients Undergoing Either Isolated Surgical or a Trans-Catheter Aortic Valve Replacement Following the Introduction of a TAVI Program. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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Pottie K, Menjivar-Ponce L, Rahman P, Morton R. 7.2-O8What are the values and preferences toward primary healthcare of newly arriving refugees and other migrants? A Discrete Choice Experiment. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.246] [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: 11/15/2022] Open
Affiliation(s)
- K Pottie
- University of Ottawa and Bruyere Research Institute, Canada
| | | | - P Rahman
- Bruyere Research Institute, Canada
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15
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Abstract
Background Care workers have an important social role which is set to expand with the increasing age of the UK population. However, the majority of care workers are employed on zero-hours contracts. Aims Firstly, to investigate the relationship between working conditions and employee outcomes such as engagement and general mental well-being in a sample of UK care workers and management. Secondly, to assess whether the use of zero-hours contracts affects employee well-being. Methods A cross-sectional survey of domiciliary care and care home employees, undertaken using the Management Standards Indicator Tool (MSIT), Utrecht Work Engagement Scale (UWES) and General Health Questionnaire (GHQ). T-tests and multivariate linear regression evaluated the differences in scoring between those with differing contractual conditions and job roles, and associations of MSIT scores with UWES and GHQ factors. Results Employee understanding of their role and job control were found to be priority areas for improvement in the sample. Similarly, care workers reported greater occupational demands and lower levels of control than management. However, while zero-hours contracts did not significantly influence employee well-being, these employees had greater levels of engagement in their jobs. Despite this, a greater proportion of individuals with zero-hours contracts had scores above accepted mental health cut-offs. Conclusions Individual understanding of their role as care workers appears to play an important part in determining engagement and general mental well-being. However, more research is needed on the influence of zero-hours contracts on well-being, particularly in groups with increased likelihood of developing mental health disorders.
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Affiliation(s)
| | - A R Fidalgo
- Department of Psychology, University of East London, London E162RD, UK
| | - R Morton
- School of Society, Enterprise and Environment, Bath Spa University, Bath BA29BN, UK
| | - L Russell
- School of Society, Enterprise and Environment, Bath Spa University, Bath BA29BN, UK
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16
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Wilson A, Vento M, Shah PS, Saugstad O, Finer N, Rich W, Morton RL, Rabi Y, Tarnow-Mordi W, Suzuki K, Wright IM, Oei JL. A review of international clinical practice guidelines for the use of oxygen in the delivery room resuscitation of preterm infants. Acta Paediatr 2018; 107:20-27. [PMID: 28792628 DOI: 10.1111/apa.14012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/05/2017] [Accepted: 08/03/2017] [Indexed: 01/20/2023]
Abstract
AIM To collate and assess international clinical practice guidelines (CPG) to determine current recommendations guiding oxygen management for respiratory stabilisation of preterm infants at delivery. METHODS A search of public databases using the terms 'clinical practice guidelines', 'preterm', 'oxygen' and 'resuscitation' was made and complemented by direct query to consensus groups, resuscitation expert committees and clinicians. Data were extracted to include the three criteria for assessment: country of origin, gestation and initial FiO2 and target SpO2 for the first 10 minutes of life. RESULTS A total of 45 CPGs were identified: 36 provided gestation specific recommendations (<28 to <37 weeks) while eight distinguished only between 'preterm' and 'term'. The most frequently recommended initial FiO2 were between 0.21 and 0.3 (n = 17). Most countries suggested altering FiO2 to meet SpO2 targets recommended by expert committees, However, specific five-minute SpO2 targets differed by up to 20% (70-90%) between guidelines. Five countries did not specify SpO2 targets. CONCLUSION CPG recommendations for delivery room oxygen management of preterm infants vary greatly, particularly in regard to gestational ages, initial FiO2 and SpO2 targets and most acknowledge the lack of evidence behind these recommendations. Sufficiently large and well-designed randomised studies are needed to inform on this important practice.
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Affiliation(s)
- A Wilson
- Department of Newborn Care; the Royal Hospital for Women; Randwick NSW Australia
| | - M Vento
- Division of Neonatology; University and Polytechnic Hospital La Fe; Valencia Spain
| | - PS Shah
- Department of Pediatrics; Mount Sinai Hospital and University of Toronto; Toronto ON Canada
| | - O Saugstad
- Department of Pediatric Research; the University of Oslo; Oslo University Hospital; Oslo Norway
| | - N Finer
- University of California; San Diego CA USA
| | - W Rich
- University of California; San Diego CA USA
| | - RL Morton
- NHMRC Clinical Trials Centre; University of Sydney; Camperdown NSW Australia
| | - Y Rabi
- University of Calgary; Calgary AB Canada
- Alberta Children's Hospital Research Institute; Calgary AB Canada
| | - W Tarnow-Mordi
- NHMRC Clinical Trials Centre; University of Sydney; Camperdown NSW Australia
| | - K Suzuki
- Department of Pediatrics; Tokai University School of Medicine; Isehara Kanagawa Japan
| | - IM Wright
- Illawarra Health and Medical Research Institute and Graduate Medicine; The University of Wollongong; Wollongong NSW Australia
| | - JL Oei
- Department of Newborn Care; the Royal Hospital for Women; Randwick NSW Australia
- NHMRC Clinical Trials Centre; University of Sydney; Camperdown NSW Australia
- School of Women's and Children's Health; the University of New South Wales; Kensington NSW Australia
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17
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Morton R, Doe S, Banya W, Simmonds N. EPS7.10 Clinical benefit of continuous nebulised Aztreonam Lysine for Inhalation (AZLI) in adults with cystic fibrosis – a retrospective cohort study. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30340-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Ricci JN, Morton R, Kulkarni G, Summers ML, Newman DK. Hopanoids play a role in stress tolerance and nutrient storage in the cyanobacterium Nostoc punctiforme. Geobiology 2017; 15:173-183. [PMID: 27527874 DOI: 10.1111/gbi.12204] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 07/15/2016] [Indexed: 06/06/2023]
Abstract
Hopanes are abundant in ancient sedimentary rocks at discrete intervals in Earth history, yet interpreting their significance in the geologic record is complicated by our incomplete knowledge of what their progenitors, hopanoids, do in modern cells. To date, few studies have addressed the breadth of diversity of physiological functions of these lipids and whether those functions are conserved across the hopanoid-producing bacterial phyla. Here, we generated mutants in the filamentous cyanobacterium, Nostoc punctiforme, that are unable to make all hopanoids (shc) or 2-methylhopanoids (hpnP). While the absence of hopanoids impedes growth of vegetative cells at high temperature, the shc mutant grows faster at low temperature. This finding is consistent with hopanoids acting as membrane rigidifiers, a function shared by other hopanoid-producing phyla. Apart from impacting fitness under temperature stress, hopanoids are dispensable for vegetative cells under other stress conditions. However, hopanoids are required for stress tolerance in akinetes, a resting survival cell type. While 2-methylated hopanoids do not appear to contribute to any stress phenotype, total hopanoids and to a lesser extent 2-methylhopanoids were found to promote the formation of cyanophycin granules in akinetes. Finally, although hopanoids support symbiotic interactions between Alphaproteobacteria and plants, they do not appear to facilitate symbiosis between N. punctiforme and the hornwort Anthoceros punctatus. Collectively, these findings support interpreting hopanes as general environmental stress biomarkers. If hopanoid-mediated enhancement of nitrogen-rich storage products turns out to be a conserved phenomenon in other organisms, a better understanding of this relationship may help us parse the enrichment of 2-methylhopanes in the rock record during episodes of disrupted nutrient cycling.
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Affiliation(s)
- J N Ricci
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - R Morton
- Department of Biology, California State University Northridge, Northridge, CA, USA
| | - G Kulkarni
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - M L Summers
- Department of Biology, California State University Northridge, Northridge, CA, USA
| | - D K Newman
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
- Howard Hughes Medical Institute, Pasadena, CA, USA
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19
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Dieng M, Cust AE, Kasparian NA, Butow P, Costa DSJ, Menzies SW, Mann GJ, Morton RL. Protocol for a within-trial economic evaluation of a psychoeducational intervention tailored to people at high risk of developing a second or subsequent melanoma. BMJ Open 2016; 6:e012153. [PMID: 27855094 PMCID: PMC5073649 DOI: 10.1136/bmjopen-2016-012153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 12/14/2022] Open
Abstract
INTRODUCTION Psychological support programmes are not currently funded for people with a history of melanoma. A major barrier to the implementation of effective psychological interventions in routine clinical care is a lack of cost-effectiveness data. This paper describes the planned economic evaluation alongside a randomised controlled trial of a psychoeducational intervention for people with a history of melanoma who are at high risk of developing new primary disease. METHOD AND ANALYSIS The economic evaluation is a within-trial analysis to evaluate the incremental costs and health outcomes of a psychoeducational intervention compared to usual care from the perspective of the Australian healthcare system. Cost-effectiveness and cost-utility analyses will be conducted, providing estimates of the cost to reduce fear of melanoma recurrence and the cost per quality-adjusted life-year (QALY) gained. Fear of melanoma recurrence will be measured using the Fear of Cancer Recurrence Inventory and preference-based quality of life measured using the Assessment of Quality of Life-8 Dimensions (AQoL-8D) instrument. The AQoL-8D will provide utilities for estimation of QALYs in the cost-utility analysis. Unit costs of health services and medicines will be taken from the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme national databases. Health outcomes, and health service and medication use will be collected at baseline, 6 and 12 months follow-up. The within-trial analysis will be conducted at 12 months, consistent with the end point of the trial. ETHICS AND DISSEMINATION Approval to conduct the study was granted by the Sydney Local Health District (RPAH zone) Ethics Review Committee (X13-0065 and HREC/13/RPAH/86), the Department of Health and Ageing Human Research Ethics Committee (21/2013), the University of Sydney Human Research Ethics Committee (2013/595), and the Australian Institute of Health and Welfare Ethics Committee (EO 2013/4/58). TRIAL REGISTRATION NUMBER ACTRN12613000304730; Pre-results.
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Affiliation(s)
- M Dieng
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia
| | - N A Kasparian
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - P Butow
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - D S J Costa
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - S W Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - G J Mann
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - R L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Madronio CM, Armstrong BK, Watts CG, Goumas C, Morton RL, Curtin A, Menzies SW, Mann GJ, Thompson JF, Cust AE. Doctors' recognition and management of melanoma patients' risk: An Australian population-based study. Cancer Epidemiol 2016; 45:32-39. [PMID: 27689254 DOI: 10.1016/j.canep.2016.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/12/2016] [Accepted: 09/17/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Guidelines recommend that health professionals identify and manage individuals at high risk of developing melanoma, but there is limited population-based evidence demonstrating real-world practices. OBJECTIVE A population-based, observational study was conducted in the state of New South Wales, Australia to determine doctors' knowledge of melanoma patients' risk and to identify factors associated with better identification and clinical management. METHODS Data were analysed for 1889 patients with invasive, localised melanoma in the Melanoma Patterns of Care study. This study collected data on all melanoma diagnoses notified to the state's cancer registry during a 12-month period from 2006 to 2007, as well as questionnaire data from the doctors involved in their care. RESULTS Three-quarters (74%) of patients had doctors who were aware of their risk factor status with respect to personal and family history of melanoma and the presence of many moles. Doctors working in general practice, skin cancer clinics and dermatology settings had better knowledge of patients' risk factors than plastic surgeons. Doctors were 15% more likely to know the family history of younger melanoma patients (<40years) than of those ≥80 years (95% confidence interval 4-26%). Early detection-related follow-up advice was more likely to be given to younger patients, by doctors aware of their patients' risk status, by doctors practising in plastic surgery, dermatology and skin cancer clinic settings, and by female doctors. CONCLUSION Both patient-related and doctor-related factors were associated with doctors' recognition and management of melanoma patients' risk and could be the focus of strategies for improving care.
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Affiliation(s)
- C M Madronio
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.
| | - B K Armstrong
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia
| | - C G Watts
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia
| | - C Goumas
- Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
| | - R L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - A Curtin
- School of Public Health, Rural Health Northern Rivers, Lismore, Australia
| | - S W Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney, Australia; The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - G J Mann
- Melanoma Institute Australia, The University of Sydney, North Sydney, Australia; Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Australia
| | - J F Thompson
- Melanoma Institute Australia, The University of Sydney, North Sydney, Australia; Central Clinical School, The University of Sydney, Australia
| | - A E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia; Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
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Stead LF, Bruns A, Morton R, Harrison S, Chakrabarty A, Ismail A, King H, Ashton K, Syed K, Short S. P08.40 RNAseq of paired primary and recurrent glioblastoma samples. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
SummaryBecause there are no boundary conditions, extra properties are required in order to identify the correct potential cost function. A solution of the Dynamic Programming equation for one-dimensional processes leads to an optimal solution within a wide class of alternatives (Theorem 1), and is completely optimal if certain conditions are satisfied (Theorem 2). Necessary conditions are also given. Several examples are solved, and some extension to the multidimensional case is shown.
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Abstract
A control scheme for the immunisation of susceptibles in the Kermack-McKendrick epidemic model for a closed population is proposed. The bounded control appears linearly in both dynamics and integral cost functionals and any optimal policies are of the “bang-bang” type. The approach uses Dynamic Programming and Pontryagin's Maximum Principle and allows one, for certain values of the cost and removal rates, to apply necessary and sufficient conditions for optimality and show that a one-switch candidate is the optimal control. In the remaining cases we are still able to show that an optimal control, if it exists, has at most one switch.
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Wyld MLR, Lee CMY, Zhuo X, White S, Shaw JE, Morton RL, Colagiuri S, Chadban SJ. Cost to government and society of chronic kidney disease stage 1-5: a national cohort study. Intern Med J 2016; 45:741-7. [PMID: 25944415 DOI: 10.1111/imj.12797] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 04/27/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Costs associated with chronic kidney disease (CKD) are not well documented. Understanding such costs is important to inform economic evaluations of prevention strategies and treatment options. AIM To estimate the costs associated with CKD in Australia. METHODS We used data from the 2004/2005 AusDiab study, a national longitudinal population-based study of non-institutionalised Australian adults aged ≥25 years. We included 6138 participants with CKD, diabetes and healthcare cost data. The annual age and sex-adjusted costs per person were estimated using a generalised linear model. Costs were inflated from 2005 to 2012 Australian dollars using best practice methods. RESULTS Among 6138 study participants, there was a significant difference in the per-person annual direct healthcare costs by CKD status, increasing from $1829 (95% confidence interval (CI): $1740-1943) for those without CKD to $14 545 (95% CI: $5680-44 842) for those with stage 4 or 5 CKD (P < 0.01). Similarly, there was a significant difference in the per-person annual direct non-healthcare costs by CKD status from $524 (95% CI: $413-641) for those without CKD to $2349 (95% CI: $386-5156) for those with stage 4 or 5 CKD (P < 0.01). Diabetes is a common cause of CKD and is associated with increased health costs. Costs per person were higher for those with diabetes than those without diabetes in all CKD groups; however, this was significant only for those without CKD and those with early stage (stage 1 or 2) CKD. CONCLUSION Individuals with CKD incur 85% higher healthcare costs and 50% higher government subsidies than individuals without CKD, and costs increase by CKD stage. Primary and secondary prevention strategies may reduce costs and warrant further consideration.
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Affiliation(s)
- M L R Wyld
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - C M Y Lee
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
| | - X Zhuo
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, USA
| | - S White
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - J E Shaw
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - R L Morton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - S Colagiuri
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
| | - S J Chadban
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Boissinot M, Adams M, Higgins J, King H, Tams D, Steele L, Morton R, Hayes J, Droop A, Bond J, Tomlinson D, Lawler S, Short S. PO24A HIGH-THROUGHPUT SCREEN IDENTIFIES MICRORNA-1300 AS A POTENTIAL THERAPEUTIC MICRORNA CAUSING CYTOKINESIS FAILURE AND APOPTOSIS IN GLIOBLASTOMA CELLS. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov284.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- R L Morton
- School of Public Health, The University of Sydney, Sydney, NSW, Australia; Health Economics Research Centre (HERC), Nuffield Department of Population Health, University of Oxford, Headington, U.K.
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Watts CG, Dieng M, Morton RL, Mann GJ, Menzies SW, Cust AE. Clinical practice guidelines for identification, screening and follow-up of individuals at high risk of primary cutaneous melanoma: a systematic review. Br J Dermatol 2014; 172:33-47. [PMID: 25204572 DOI: 10.1111/bjd.13403] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 11/26/2022]
Abstract
Understanding how individuals at high-risk of primary cutaneous melanoma are best identified, screened and followed up will help optimize melanoma prevention strategies and clinical management. We conducted a systematic review of international clinical practice guidelines and documented the quality of supporting evidence for recommendations for clinical management of individuals at high risk of melanoma. Guidelines published between January 2000 and July 2014 were identified from a systematic search of Medline, Embase and four guideline databases; 34 guidelines from 20 countries were included. High-risk characteristics that were consistently reported included many melanocytic naevi, dysplastic naevi, family history, large congenital naevi, and Fitzpatrick Type I and II skin types. Most guidelines identify risk factors and recommend that individuals at high risk of cutaneous melanoma be monitored, but only half of the guidelines provide recommendations for screening based on level of risk. There is disagreement in screening and follow-up recommendations for those with an increased risk of future melanoma. High-level evidence supports long-term screening of individuals at high risk and monitoring using dermoscopy. Evidence is low for defining screening intervals and duration of follow-up, and for skin self-examination, although education about skin self-examination is widely encouraged. Clinical practice guidelines would benefit from a dedicated section for identification, screening and follow-up of individuals at high risk of melanoma. Guidelines could be improved with clear definitions of multiple naevi, family history and frequency of follow-up. Research examining the benefits and costs of alternative management strategies for groups at high risk will enhance the quality of recommendations.
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Affiliation(s)
- C G Watts
- Cancer Epidemiology and Services Research (CESR), The University of Sydney, Australia
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Mathieu E, Merom D, Morton R. Exercise and quality of life in older adults: Is walking as beneficial as other exercises? J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hamid R, Loveman C, Morton R, Millen J, Hassan Y. Burden On Secondary Care Of Overactive Bladder Patients Who Are Inadequately Managed With Anticholinergics In England. Value Health 2014; 17:A470-A471. [PMID: 27201346 DOI: 10.1016/j.jval.2014.08.1334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- R Hamid
- Department of NeuroUrology, Royal National Orthopaedic Hospital & University College Hospital, London, UK, Stanmore, UK
| | | | - R Morton
- Allergan Holdings Ltd, Marlow, UK
| | - J Millen
- Allergan Holdings Ltd., Marlow, UK
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Ghoraishi T, Wang Z, Paul M, Morton R, Habib M, Bishop G, Sharland A. Can esRAGE Protect Pancreatic Integrity in Brain-Dead Donor Mice? Transplantation 2014. [DOI: 10.1097/00007890-201407151-01223] [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: 11/25/2022]
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Morton R. MO-F-16A-08: Have An Impact On More Patients From Your Ideas And Inventions. Med Phys 2014. [DOI: 10.1118/1.4889179] [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: 11/07/2022] Open
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Vanikar AV, Trivedi HL, Dave SD, Kute VB, Rawal MN, Patel HV, Gumber MR, Afghahi H, Pirouzifard M, Svensson AM, Eliasson B, Svensson MK, Dumann K, Horrmann B, Lammert A, Rheinberger M, Gorski M, Kramer BK, Heid IM, Boger CA, Demirtas L, Akbas EM, Timuroglu A, Ozcicek F, Turkmen K, Fernandez-Fernandez B, Sanchez-Nino MD, Martin-Cleary C, Izquierdo MC, Elewa U, Ortiz A, Petrica L, Vlad A, Gluhovschi G, Gadalean F, Dumitrascu V, Gluhovschi C, Velciov S, Bob F, Vlad D, Popescu R, Petrica M, Jianu DC, Milas O, Izvernari O, Ursoniu S, Makino Y, Konoshita T, Nyumura I, Babazono T, Yoshida N, Uchigata Y, Handisurya A, Kerscher C, Tura A, Werzowa J, Heinzl H, Ristl R, Kautzky-Willer A, Pacini G, Saemann M, Schmidt A, Halbesma N, Metcalfe W, Bulum T, Prka in I, Blaslov K, Zibar K, Duvnjak L, Idorn T, Knop FK, Jorgensen MB, Christensen M, Holst JJ, Hornum M, Feldt-Rasmussen B, Naess H, Hartmann A, Jenssen TG, Holdaas H, Horneland R, Grzyb K, Bitter J, Midtvedt K, Yoshida N, Babazono T, Uchigata Y, Timar R, Gluhovschi G, Gadalean F, Velciov S, Petrica L, Timar B, Gluhovschi C, Soro-Paavonen A, Fleming T, Forsblom C, Gordin D, Tolonen N, Harjutsalo V, Nawroth PP, Groop PH, Tsuda A, Ishimura E, Uedono H, Yasumoto M, Nakatani S, Ichii M, Ohno Y, Ochi A, Mori K, Fukumoto S, Emoto M, Inaba M, Rheinberger M, Hormann B, Lammert A, Dumann K, Gorski M, Heid IM, Kramer BK, Boger CA, Siddaramaiah NH, Tez DK, Linker NJ, Bilous M, Winship S, Marshall SM, Bilous RW, Lampropoulou IT, Papagianni A, Stangou M, Didangelos T, Iliadis F, Efstratiadis G, Esposito P, Debarbieri G, Mereu R, Ditoro A, Montagna F, Groop PH, Bernardi L, Dal Canton A, Garland JS, Holden R, Morton R, Ross R, Adams M, Pruss C, Akbas EM, Demirtas L, Timuroglu A, Ozcicek F, Turkmen K, Bulum T, Prka in I, Blaslov K, Zibar K, Duvnjak L, Theodoridis M, Panagoutsos S, Bounta T, Roumeliotis S, Kantartzi K, Pouloutidis G, Passadakis P, Polaina Rusillo M, Borrego Utiel FJ, Ortega Anguiano S, Liebana Canada A, Gaber EW, Abdel Rehim WM, Ibrahim NA, Mahmoud BF, Silva AP, Fragoso A, Tavares N, Silva C, Santos N, Camacho A, Neves P, Rodriguez R, Porrini E, Gonzalez-Rinne A, De Vries A, Torres A, Salido E, Kato S, Makino H, Uzu T, Koya D, Nishiyama A, Imai E, Ando M, Jorgensen MB, Knop FK, Idorn T, Holst JJ, Hornum M, Feldt-Rasmussen B, Vaduva C, Popa S, Mitrea A, Mota M, Mota E, Theodoridis M, Panagoutsos S, Roumeliotis S, Bounta T, Kriki P, Roumeliotis A, Passadakis P, Ogawa T, Okazaki S, Hatano M, Hara H, Inamura M, Kiba T, Iwashita T, Shimizu T, Tayama Y, Kanozawa K, Kato H, Matsuda A, Hasegawa H, Elewa U, Fernandez B, Egido J, Ortiz A, Rottembourg J, Guerin A, Diaconita M, Dansaert A, Chakraborty J, Prabhu R, Nagaraju SP, Bairy M, Satyamoorthy K, Kosuru S, Parthasarathy R, Tomilina N, Zhilinskaya T, Stolyarevich E, Silva AP, Fragoso A, Guilherme P, Silva C, Santos N, Rato F, Camacho A, Neves P, Pasko N, Strakosha A, Toti F, Dedej T, Marku N, Petrela E, Zekollari E, Kacorri V, Thereska N, Roumeliotis SK, Roumeliotis AK, Theodoridis M, Tavridou A, Panagoutsos S, Passadakis P, Vargemezis V, Kim IY, Lee SB, Lee DW, Kim MJ, Shin MJ, Rhee H, Yang BY, Song SH, Seong EY, Kwak IS, Celebi K, Sengul E, Cekmen MB, Yilmaz A, Sonikian M, Dona A, Skarakis J, Miha T, Trompouki S, Karaitianou A, Spiliopoulou C, Dimas GG, Iliadis FS, Tegos TJ, Spiroglou SG, Kanellos IE, Fotiadis SD, Didaggelos TP, Savopoulos CG, Hatzitolios AI, Grekas DM, Hsu YH, Huang MC, Chang HY, Shin SJ, Wahlqvist ML, Chang YL, Hsu KC, Hsu CC, Miarka P, Grabowska-Polanowska B, Faber J, Skowron M, Pietrzycka A, Walus-Miarka M, Sliwka I, Sulowicz W. DIABETES CLINICAL. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hawke C, Passalent L, Morton R, Alnaqbi K, Haroon N, Wolman S, Silverberg M, Steinhart H, Inman R. AB0526 A novel approach to the early detection of axial spondyloarthritis in patients with inflammatory bowel disease: the implementation of an advanced practice physiotherapistled screening program. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.2848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Morton R, Bintley K, Alexander Z, Kahr V. P31 Assessing the effectiveness of tuberculosis (TB) screening in new entrant healthcare workers using different time cut-offs to define high risk individuals: Abstract P31 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Morton R, Moyen N, Mundel T, Judelson D. Exercise-induced elevated rectal temperature: Sex differences and humidity effects. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kang R, Passalent L, Morton R, Hawke C, Blair J, Lake A, Doucet M, MacGarvie D, Wong K, Inman R. AB0808 Utilization of an informational needs assessment to develop an education program for patients with ankylosing spondylitis and related axial spondyloarthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Darr A, Small N, Ahmad WIU, Atkin K, Corry P, Benson J, Morton R, Modell B. Examining the family-centred approach to genetic testing and counselling among UK Pakistanis: a community perspective. J Community Genet 2012; 4:49-57. [PMID: 23086468 DOI: 10.1007/s12687-012-0117-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 09/12/2012] [Indexed: 11/25/2022] Open
Abstract
WHO advice suggests a family-centred approach for managing the elevated risk of recessively inherited disorders in consanguineous communities, whilst emerging policy recommends community engagement as an integral component of genetic service development. This paper explores the feasibility of the family-centred approach in the UK Pakistani origin community. The study took place within a context of debate in the media, professional and lay circles about cousin marriage causing disability in children. Using qualitative methods, a total of six single-sex focus group discussions (n = 50) were conducted in three UK cities with a high settlement of people of Pakistani origin. Tape-recorded transcripts were analysed using framework analysis. Kinship networks within Pakistani origin communities are being sustained and marriage between close blood relatives continues to take place alongside other marriage options. Study participants were critical of what was perceived as a prevalent notion that cousin marriage causes disability in children. They were willing to discuss cousin marriage and disability, share genetic information and engage with genetic issues. A desire for accurate information and a public informed about genetic issues was articulated whilst ineffective communication of genetic risk information undermined professionals in their support role. This study suggests a community that is embracing change, one in which kinship networks are still active and genetic information exchange is taking place. At the community level, these are conditions supportive of the family-centred approach to genetic testing and counselling.
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Affiliation(s)
- A Darr
- School of Health Studies, University of Bradford, Richmond Rd, Bradford, BD7 1DP, UK,
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Peet DJ, Morton R, Hussein M, Alsafi K, Spyrou N. Radiation protection in fixed PET/CT facilities--design and operation. Br J Radiol 2012; 85:643-6. [PMID: 21976626 PMCID: PMC3479878 DOI: 10.1259/bjr/32969351] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 01/13/2011] [Accepted: 01/19/2011] [Indexed: 12/15/2022] Open
Abstract
We describe the design of a fixed positron emission tomography (PET)/CT facility and the use of a simulated instantaneous dose-rate plot to visually highlight areas of potentially high radiation exposure. We also illustrate the practical implementation of basic radiation protection principles based on the use of distance and shielding and the minimisation of time spent in hot areas. Staff whole body doses for 4 years are presented with results of an optimisation study analysing the dose arising from the different phases within each study using direct reading dosemeters. The total whole body dose for all staff for each patient fell from 9.5 μSv in the first full year of operation to 4.8 µSv in 2008. The maximum dose to an individual member of staff per patient decreased over the same period from 3.2 to 0.9 µSv. The optimisation study showed that the highest dose was recorded during the injection phase.
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Affiliation(s)
- D J Peet
- Department of Medical Physics, Royal Surrey County Hospital, Guildford, UK.
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Morton R, Barnette G, Hancock M, Dalton J, Steiner M. POD-03.06 GTx-758, an Oral ER? Agonist Being Developed for ADT, Lowers Serum Testosterone. Urology 2011. [DOI: 10.1016/j.urology.2011.07.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Webster DP, Young BC, Morton R, Collyer D, Batchelor B, Turton JF, Maharjan S, Livermore DM, Bejon P, Cookson BD, Bowler ICJW. Impact of a clonal outbreak of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in the development and evolution of bloodstream infections by K. pneumoniae and Escherichia coli: an 11 year experience in Oxfordshire, UK. J Antimicrob Chemother 2011; 66:2126-35. [PMID: 21693458 DOI: 10.1093/jac/dkr246] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objectives of this study were: (i) to describe an outbreak of multidrug-resistant Klebsiella pneumoniae in our population; (ii) to identify the potential source of this outbreak by examining antibiotic resistance trends in urocultures; (iii) to evaluate the contribution of this outbreak to resistance patterns over time in the two commonest Gram-negative blood culture isolates, namely K. pneumoniae and Escherichia coli; and (iv) to assess risk factors for multidrug resistance and the impact of this resistance on mortality and length of stay. METHODS We searched Microbiology and Patient Administration Service databases retrospectively and describe resistance trends in E. coli and K. pneumoniae bloodstream infections (BSIs) in Oxfordshire, UK, over an 11 year period. RESULTS An outbreak of a multidrug-resistant, CTX-M-15 extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae clone was identified and shown by multilocus sequence typing to belong to a novel sequence type designated ST490. This was associated with a sporadic change in resistance rates in K. pneumoniae BSIs with rates of multidrug resistance (defined as resistance to three or more antibiotic classes) reaching 40%. A case-control study showed prior antibiotic exposure as a risk factor for infection with this organism. During the same time period, rates of ESBL-producing Klebsiella spp. isolated from urocultures increased from 0.5% to almost 6%. By contrast, the rate of multidrug resistance in E. coli rose more steadily from 0% in 2000 to 10% in 2010. CONCLUSIONS Changes in resistance rates may be associated with outbreaks of resistant clones in K. pneumoniae. Changing resistance patterns may affect important health economic issues such as length of stay.
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Affiliation(s)
- D P Webster
- Brighton and Sussex Medical School, Falmer, UK.
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Roberts T, Morton R, Al-Ali S. Microstructure of the vocal fold in elderly humans. Clin Anat 2011; 24:544-51. [DOI: 10.1002/ca.21114] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 08/12/2010] [Accepted: 11/08/2010] [Indexed: 11/09/2022]
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Tayebi M, David M, Bate C, Jones D, Taylor W, Morton R, Pollard J, Hawke S. Epitope-specific anti-prion antibodies upregulate apolipoprotein E and disrupt membrane cholesterol homeostasis. J Gen Virol 2010; 91:3105-15. [DOI: 10.1099/vir.0.023838-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Morton RL, Tong A, Howard K, Snelling P, Webster AC. The views of patients and carers in treatment decision making for chronic kidney disease: systematic review and thematic synthesis of qualitative studies. BMJ 2010; 340:c112. [PMID: 20085970 PMCID: PMC2808468 DOI: 10.1136/bmj.c112] [Citation(s) in RCA: 342] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2009] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To synthesise the views of patients and carers in decision making regarding treatment for chronic kidney disease, and to determine which factors influence those decisions. DESIGN Systematic review of qualitative studies of decision making and choice for dialysis, transplantation, or palliative care, and thematic synthesis of qualitative studies. DATA SOURCES Medline, PsycINFO, CINAHL, Embase, social work abstracts, and digital theses (database inception to week 3 October 2008) to identify literature using qualitative methods (focus groups, interviews, or case studies). Review methods Thematic synthesis involved line by line coding of the findings of the primary studies and development of descriptive and analytical themes. RESULTS 18 studies that reported the experiences of 375 patients and 87 carers were included. 14 studies focused on preferences for dialysis modality, three on transplantation, and one on palliative management. Four major themes were identified as being central to treatment choices: confronting mortality (choosing life or death, being a burden, living in limbo), lack of choice (medical decision, lack of information, constraints on resources), gaining knowledge of options (peer influence, timing of information), and weighing alternatives (maintaining lifestyle, family influences, maintaining the status quo). CONCLUSIONS The experiences of other patients greatly influenced the decision making of patients and carers. The problematic timing of information about treatment options and synchronous creation of vascular access seemed to predetermine haemodialysis and inhibit choice of other treatments, including palliative care. A preference to maintain the status quo may explain why patients often remain on their initial therapy.
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Affiliation(s)
- R L Morton
- Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia.
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Morton R, Kailasnath V, Vancleave B, Eid N. Silent Airflow Obstruction and Air Trapping in Children Admitted to the Hospital with Asthma. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Glioblastomas in children usually occur in the brainstem and are often untreatable and associated with an extremely poor prognosis. Such tumours may however occur in supratentorial locations more typically associated with adult gliomas, where the outcome is more variable, but still poor. This report describes the case of a boy with fragile X who also developed an inoperable midbrain glioblastoma, but who has survived 8 years after diagnosis.
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Affiliation(s)
- R Kalkunte
- Paediatric Intensive Care, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Affiliation(s)
- R Morton
- Department of Otorhinolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Manukau, New Zealand.
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