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Adamovich T, Watson R, Murdoch S, Giovino L, Kulkarni S, Luchak M, Smith-Turchyn J. Barriers and facilitators to physical activity participation for child, adolescent, and young adult cancer survivors: a systematic review. J Cancer Surviv 2024; 18:245-262. [PMID: 35665472 DOI: 10.1007/s11764-022-01217-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this systematic review is to explore and describe the barriers and facilitators to physical activity (PA) participation for child, adolescent, and young adult cancer survivors. METHODS MEDLINE, Embase, AMED, CINAHL, Cochrane, and Web of Science were searched for manuscripts published between January 2000 and February 2021. To be included in this review, studies had to report qualitative or quantitative data on barriers and facilitators to PA participation in child (4 to < 10 years), adolescent (10 to 19 years), and young adult (> 19 to < 40 years) cancer survivors. Six independent reviewers assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT-version 18) in duplicate. RESULTS Fifteen studies were included in this systematic review. Fatigue and psychological factors were the most prevalent barriers shared between children, adolescents, and young adults. Support from others was a shared facilitator between age groups. CONCLUSION Psychological barriers and social support are important to address in younger cancer survivors. Clinicians can use these findings to create exercise interventions to facilitate and overcome barriers to PA participation. IMPLICATIONS FOR CANCER SURVIVORS While PA is beneficial for cancer survivors of all ages, different barriers and facilitators to PA participation exist depending on a survivors age and life stage. Survivors should discuss PA with their healthcare team at all timepoints in the cancer treatment trajectory in order to gain the associated benefits during and after treatment.
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Affiliation(s)
- Tatsiana Adamovich
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Watson
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sydney Murdoch
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Liana Giovino
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sunket Kulkarni
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Michael Luchak
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
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Jovic TH, Watson R, Gorse SH, Drew PJ, Cubitt JJ. Quantifying the clinical and economic burden of desquamating dermatological conditions: Implications for a supraregional burns centre. J Plast Reconstr Aesthet Surg 2024; 88:352-359. [PMID: 38064914 DOI: 10.1016/j.bjps.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 01/02/2024]
Abstract
INTRODUCTION This study aimed to identify the spectrum of desquamating skin diseases referred for tertiary burns care and quantify the care requirements and expenses associated with caring for these patients within the burns service. METHODS Patient records were identified with nonburn-induced skin loss between 2016 and 2022. Data was extracted from inpatient records, operative notes, and dressing clinic records. A cost analysis was conducted using figures from the National Schedule of National Health Service Costs and our own unit-specific costs. RESULTS Twenty patients were identified, with a median age of 46.5 and a median total body surface area of 30%. The mean length of stay was 21.2 days, with 8/20 patients requiring intensive care. Overall mortality was 30%, rising to 50% if patients required intensive treatment unit (ITU) admission. Patients had a mean of 1.5 procedures under general anaesthesia and a mean operative time of 169 min per patient. Postoperatively, a mean of 8.3 dressing changes was required per patient (range 1-21). Of 75% of patients referred as suspected toxic epidermal necrolysis syndrome (TENS), only 32% of patients histologically had TENS (32%), with linear IgA disease, pemphigus vulgaris and bullous lupus comprising the other diagnoses. Cost analysis predicted a total cost to the unit of £1,422,106. CONCLUSION Desquamating dermatological diseases are life-threatening conditions with exhaustive care requirements. Our experiences highlight the importance of awareness of the range of desquamating skin conditions beyond TENS to enable optimum management and the need to ensure adequate financial provisions to accommodate the care requirements mandated by these patients.
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Affiliation(s)
- Thomas H Jovic
- Reconstructive Surgery & Regenerative Medicine Research Centre, Swansea University, Swansea, UK; Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK.
| | - Rebecca Watson
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | | | - Peter J Drew
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - Jonathan J Cubitt
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
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Supreeyaporn N, Watson R, Damrongpanit S, Orchard F, Reynolds S, Jenkins PE. Factor structure and measurement invariance of the Mood and Feelings Questionnaire: a cross-cultural study among Thai and British adolescents. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02268-8. [PMID: 37522960 DOI: 10.1007/s00787-023-02268-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/22/2023] [Indexed: 08/01/2023]
Abstract
The Mood and Feelings Questionnaire-child self-report (MFQ-C) is a widely used measure of child and adolescent depression. This study evaluated possible factor solutions and examined the measurement invariance of the MFQ-C as a prerequisite for its use in cross-cultural comparisons between Thai (N = 1272) and British samples (N = 1817) by using multigroup confirmatory factor analysis (MGCFA). The latent means of Thai and British samples were also examined. A five-factor structure of the MFQ-C was confirmed through confirmatory factor analysis. A partial scalar invariant model was supported, and thus latent means were compared, with British adolescents reporting significantly higher mean MFQ-C scores than Thai adolescents on four of the five factors (Vegetative Symptoms, Suicidality, Cognitive Symptoms, Agitated Distress). There was no difference for the Core Symptoms factor. The findings also suggest that the MFQ-C is a valid measure to assess depression in Thai and British adolescents and maybe useful in cross-cultural comparisons of adolescent depression.
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Affiliation(s)
- Nanthaka Supreeyaporn
- Department of Educational Foundations and Development, Chiang Mai University, Chiang Mai, Thailand.
- Centre of Multiculturalism and Education Policy, Multidisciplinary Research Institute, Chiang Mai University, Chiang Mai, Thailand.
| | - Rebecca Watson
- Department of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Suntonrapot Damrongpanit
- Department of Educational Foundations and Development, Chiang Mai University, Chiang Mai, Thailand
| | - Faith Orchard
- School of Psychology, University of Sussex, Sussex, UK
| | - Shirley Reynolds
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Watson R, Burgess L, Sellars E, Crooks J, McGowan R, Diffey J, Naughton G, Carrington R, Lovelock C, Temple R, Creswell C, McMellon C. A qualitative study exploring the benefits of involving young people in mental health research. Health Expect 2023. [PMID: 37073725 DOI: 10.1111/hex.13722] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION It is increasingly accepted that young people need to be centrally involved in research on issues that affect them. The aim of this study was to explore young people's perceptions of the benefits for them of being involved in mental health research and the processes that enabled these benefits. METHODS Qualitative interviews were conducted by co-researchers (young people with lived experience and/or interest in mental health) with 13 young people (aged 13-24 years) who had experience of being involved in mental health research when they were between 11 and 16 years of age. Reflective thematic analysis was used to identify important aspects of young people's experiences. RESULTS Four main themes were identified: (1) opportunity to have a meaningful impact, (2) opportunity to be part of a supportive community, (3) opportunity to learn and grow and (4) increasing opportunities for young people. CONCLUSION This study highlights young people's experiences of being involved in mental health research and identifies ways in which researchers can ensure that involvement opportunities bring benefits to both the young people and the research. PATIENT OR PUBLIC CONTRIBUTION This research was a response to issues raised by young people involved in research. The project was supported by co-researchers throughout, including design, data collection, analysis and write-up.
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Affiliation(s)
- Rebecca Watson
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Lowrie Burgess
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Elise Sellars
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Jodie Crooks
- Young People's Network, The McPin Foundation, London, UK
| | - Rose McGowan
- Young People's Network, The McPin Foundation, London, UK
| | - James Diffey
- Young People's Network, The McPin Foundation, London, UK
| | | | | | - Cassie Lovelock
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Rachel Temple
- Young People's Network, The McPin Foundation, London, UK
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Christina McMellon
- Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Loveland P, Eratne D, Holper S, Yassi N, Watson R. From CoNFLict to Confidence: Solving a Diagnostic Dilemma Using Neurofilament Light – A Case Report. EMJ 2023. [DOI: 10.33590/emj/10300573] [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: 03/06/2023] Open
Abstract
Distinguishing neurodegenerative from primary psychiatric conditions is often challenging for clinicians, particularly when assessing older people presenting with neuropsychiatric symptoms. Measurement of fluid biomarkers of neurodegeneration is an emerging approach offering improved diagnostic accuracy. This report explores the use of emerging fluid biomarkers to address diagnostic challenges, framed around a case where the diagnosis of delirium with dementia was revised based on biomarker analysis, enabling treatment of a primary mood disorder with disabling psychiatric symptoms.
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Affiliation(s)
- P.M. Loveland
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - D. Eratne
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Neuropsychiatry, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Department of Psychiatry & Melbourne Neuropsychiatry Centre, University of Melbourne, Parkville, Australia; National Dementia Diagnostics Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - S. Holper
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Department of Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - N. Yassi
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Department of Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - R. Watson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
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Sarma S, Hussain B, Gigante T, Davies A, Watson R, Branjerdporn G. Challenging stigma and attitudes towards ECT via an educational video. Int J Ment Health Nurs 2023; 32:884-892. [PMID: 36861759 DOI: 10.1111/inm.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 03/03/2023]
Abstract
While electroconvulsive therapy (ECT) is an effective therapeutic modality for the treatment of mental illness, negative attitudes and stigma exist about ECT in the general community and even within health services. Investigating interventions that improve the attitudes of health professionals towards ECT is beneficial as this reduces stigma and increases the acceptability of ECT for consumers. The primary aim of this study was to evaluate the change in attitude of nursing graduates and medical students towards ECT by watching an educational video. The secondary aim was to compare health professional attitudes to those of the general community. An educational video was co-designed with consumers and members of the mental health Lived Experience (Peer) Workforce Team about ECT outlining the procedure, side effects, treatment considerations and lived experiences. Nursing graduates and medical students completed the ECT Attitude Questionnaire (EAQ) prior to and after watching the video. Descriptive statistics, paired samples t-tests and one sample t-tests were completed. One hundred and twenty-four participants completed pre- and post- questionnaires. Attitudes towards ECT significantly improved after watching the video. Positive responses towards ECT increased from 67.09% to 75.72%. Participants in this study reported higher positive attitudes towards ECT than members of the general public before and after watching the intervention. Results indicated that the video educational intervention was effective in improving attitudes towards ECT for nursing graduates and medical students. While the video is promising as an educational tool, further research is required to explore the use of the video in reducing stigma for consumers and carers.
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Affiliation(s)
- Shanthi Sarma
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Besalat Hussain
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Titta Gigante
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Angela Davies
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Rebecca Watson
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Grace Branjerdporn
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
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Holper S, Watson R, Churilov L, Yates P, Lim YY, Barnham KJ, Yassi N. Protocol of a Phase II Randomized, Multi-Center, Double-Blind, Placebo-Controlled Trial of S-Adenosyl Methionine in Participants with Mild Cognitive Impairment or Dementia Due to Alzheimer's Disease. J Prev Alzheimers Dis 2023; 10:800-809. [PMID: 37874102 PMCID: PMC10186290 DOI: 10.14283/jpad.2023.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND S-adenosyl methionine (SAMe) is a pivotal metabolite in multiple pathways required for neuronal homeostasis, several of which are compromised in Alzheimer's disease (AD). Correction of the SAMe deficiency that is characteristic of the AD brain may attenuate or prevent pathological processes driving AD-associated neurodegeneration including aberrant tau hyperphosphorylation and DNA hypomethylation. OBJECTIVES The primary aim is to test the hypothesis that daily treatment with 400 mg oral SAMe for 180 days will lead to a greater reduction from baseline in plasma levels of p-tau181 compared to placebo in patients with mild cognitive impairment or dementia due to AD. DESIGN, SETTING, PARTICIPANTS This is a phase II, randomized, multi-center, double-blind, placebo-controlled trial among 60 participants with mild cognitive impairment or dementia due to AD. Participants will be randomized in a 1:1 ratio to receive either SAMe or matching placebo, to be taken as an adjunct to their AD standard of care. MEASUREMENTS AND RESULTS The primary outcome is change in plasma p-tau181 concentration between baseline and following 180 days of treatment, which will be compared between the active and placebo group. Secondary outcomes are the safety of SAMe administration (incidence of serious adverse events), change from baseline in cognitive performance (as measured by the Repeatable Battery for the Assessment of Neuropsychological Status), and epigenetic changes in DNA methylation. CONCLUSION Demonstration of effective and safe lowering of plasma p-tau181 with SAMe in this phase II trial would pave the way for an exciting field of translational research and a larger phase III trial.
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Affiliation(s)
- S Holper
- Sarah Holper, Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, 1G, Royal Parade, Parkville, VIC, 3052, Australia. . Telephone: +61 3 9345 2555. Fax: +61 3 9347 0852
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kiss O, Griffiths C, Wang R, Chien A, Kang S, O’Connor C, Watson R, Langton A. 515 Topical retinoids for the treatment of photoageing in skin of colour. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.530] [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: 11/19/2022]
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Taverner S, Eng C, Watson R, George S, Edwards A, Williams DM, Stephens JW. A series of diabetic ketoacidosis associated with the use of sodium-glucose co-transporter-2 inhibitors in secondary care. Diabetes Metab Syndr 2022; 16:102658. [PMID: 36371968 DOI: 10.1016/j.dsx.2022.102658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/11/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Sodium-glucose co-transporter-2 inhibitors (SGLT-2i) are associated with diabetic ketoacidosis (DKA), however limited case series are published. METHODS We evaluated the characteristics of patients admitted with SGLT-2i associated DKA. RESULTS Over 4 months, 22 patients were identified; 45.5% of DKA was not associated with concurrent illness. CONCLUSION DKA is not uncommonly associated with SGLT2i with no clear patient factors associated with severity.
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Affiliation(s)
- Sofia Taverner
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK.
| | - Cindy Eng
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Rebecca Watson
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Siba George
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Amanda Edwards
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - David M Williams
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Jeffrey W Stephens
- Department of Diabetes and Endocrinology, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK; Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
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Tsai Y, Langton A, Watson R. 230 Investigating the role of histone deacetylases in human epidermis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.241] [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: 11/19/2022]
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Williams DM, Taverner S, Watson R, George S, Edwards A, Shaikh A, Udiawar M. A series of patients with hospital-acquired diabetic ketoacidosis (HADKA): a descriptive analysis. Clin Med (Lond) 2022; 22:549-552. [PMID: 38589158 DOI: 10.7861/clinmed.2022-0300] [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] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hospital-acquired diabetic ketoacidosis (HADKA) can complicate hospital admission in people with type 1 diabetes (T1D) and type 2 diabetes (T2D). We aimed to determine the characteristics of such patients and the reasons for HADKA. METHODS A retrospective analysis of patients referred to diabetes services with HADKA at Morriston Hospital between January 2016 and January 2022 was undertaken. Patients that were included were admitted without diabetic ketoacidosis (DKA), were aged 18 years and over, and who subsequently developed DKA in hospital. RESULTS Twenty-five patients were included with a mean age of 65.2 years; nine (32.0%) were men, 13 (52.0%) had T1D and 12 (48.0%) had T2D. Patients had a mean pre-admission glycated haemoglobin of 84.7 mmol/mol, and 17 (68.0%) were insulin-treated. Most were admitted under medicine (n=14; 56.0%) and the remainder under surgery (n=11; 44.0%). More common reasons for HADKA were erroneous insulin administration (n=9; 36.0%), infection (n=7; 28.0%) and surgery (n=5; 20.0%). Five (20.0%) patients required intensive care admission, and the mean length of hospital stay was 42.6 days (range 2-173). Three (12.0%) patients died during the hospital admission. CONCLUSION HADKA was identified in a significant number of patients at our hospital and was associated with significant mortality. Earlier recognition of ketonaemia and associated medication use may prevent HADKA and improve outcomes.
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Catania G, Pagnucci N, Alvaro R, Cicolini G, Dal Molin A, Lancia L, Lusignani M, Mecugni D, Motta P, Watson R, Hayter M, Napolitano F, Zanini M, Sasso L, Bagnasco A. CN35 Workplace violence against cancer nurses during the COVID-19 pandemic: A correlational-predictive study. Ann Oncol 2022. [PMCID: PMC9472528 DOI: 10.1016/j.annonc.2022.07.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Burgess K, Winpenny R, Saiani A, Herrick A, Watson R. POS0478 TOPICAL CALCIUM CHELATORS FOR TARGETING CUTANEOUS CALCIFICATION: PRECLINICAL EVIDENCE OF EFFICACY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundCutis calcinosis, defined as sub-epidermal deposition of calcium salts, is a painful, disabling, disfiguring, problem in 20-40% of patients with systemic sclerosis. Its pathogenesis remains poorly understood and currently there is no effective disease-modifying pharmacotherapy. One potential strategy is topical application of calcium chelating agents, able to penetrate the epidermal barrier and dissolve subcutaneous calcinotic deposits in situ. To date, the only compound reported for this application has been sodium thiosulfate (STS), with often-contradictory results.ObjectivesTo test the hypothesis, in pre-clinical studies, that polycarboxylic acids can induce calcium dissolution without skin toxicity, with the long-term aim of developing an effective topical treatment for cutis calcinosis.MethodsWe compared the metal ion-chelating agents citric acid (CA) and ethylenediaminetetraacetic acid (EDTA) - polycarboxylic acids with well-characterised chelation profiles – to STS for their ability to chelate calcium, without inducing cytotoxicity or inflammation (pro-inflammatory cytokine expression and release), using in vitro 2D (keratinocyte [HaCaT]; fibroblast ([HCA2]) and recombinant human epidermal (RHE) models. The resultant data was subsequently used to predict therapeutic concentrations for assessment in a validated skin irritation model (SkinEthicTM; Episkin SA) and to assay maximal percutaneous absorption. At relative dermal concentrations, the dissolution performance of each chelator was further assessed using two different models of calcinosis: 1) pharmaceutical dissolution of a hydroxyapatite (HAp) tablet (1) and; 2) dissolution of a calcified extracellular matrix laid down by mineralising SaOS2 in vitro monolayer culture (2).ResultsIncubation with CA, EDTA and STS induced cytotoxicity in both in vitro cell lines studied at concentrations of >10 mM; only EDTA (10 mM) resulted in inflammatory cytokine release (IL8) from cells at these higher concentrations (cf positive control, Lipopolysaccharide 10 mg/mL). When applied topically to RHE models as near-saturated solutions, none of the chelators were categorised as skin irritants. Due to differences in their relative aqueous solubility, higher concentrations of CA (1600 mM) and STS (1200 mM) could be delivered through the RHE model than EDTA (200 mM). Using a simple linear regression model, the rate of compound absorption was: CA, 0.43 ± 0.05; STS, 0.26 ± 0.03 and; EDTA, 0.05 ± 0.01 g/L/hr. At each time-point, the cumulative concentration of compound in the receptor media was CA > STS > EDTA. Incubation with chelators had no effect on the integrity of the RHE by standard histology. Based on the rate of percutaneous absorption, the dissolution performance of each chelator was tested at relative dermal concentrations for phosphate dissolution (nmoles) of HAp (CA, 9.61 ±0.97; EDTA, 5.38 ± 0.28; 3.78 ± 0.58) and in the calcified in vitro model (Figure 1; CA, 3285 ± 105, STS, 947 ± 95, EDTA, 1174 ± 89), showing the superiority of CA in both model systems.Figure 1.Dissolution of a calcified extracellular matrix by citric acidConclusionOverall, this study highlights the promise of polycarboxylic acids, particularly CA, to target subcutaneous calcification, which are neither toxic nor inflammatory to the skin. Specifically, we have identified CA as a potentially more efficacious alternative to STS for the topical treatment of cutis calcinosis.References[1]Fei F, Gallas A, Chang YC, Rao Y, Hunter AC, Winpenny REP, Herrick AL, Lockyer NP, Blanford CF. 2017. Quartz crystal microbalance assay of clinical calcinosis samples and their synthetic models differentiates the efficacy of chelation-based treatments. ACS Appl Mater Interfaces, 9(33):27544-27552[2]Wang QG, Wimpenny I, Dey RE, Zhong X, Youle PJ, Downes S, Watts DC, Budd PM, Hoyland JA, Gough JE. 2018. The unique calcium chelation property of poly(vinyl phosphonic acid-co-acrylic acid) and effects on osteogenesis in vitro. J Biomed Mater Res Part A 2018:106A:168–179Disclosure of InterestsKyle Burgess: None declared, Richard Winpenny: None declared, Alberto Saiani: None declared, Ariane Herrick Speakers bureau: Janssen, Consultant of: Arena, Boehringer-Ingelheim, Camurus, CSL-Behring, Gesynta, Grant/research support from: Gesynta, Rachel Watson Consultant of: NAOS, AbbVie, Grant/research support from: Walgreens Alliance Boots.
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Ahmad MS, Hicks SR, Watson R, Ahmed RA, Jones L, Vaselli M, Wu MS, Hayat F, Ratcliffe L, McKenna M, Hine P, Defres S, Wingfield T. A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK. Wellcome Open Res 2022; 6:222. [PMID: 35118199 PMCID: PMC8787571 DOI: 10.12688/wellcomeopenres.17163.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) backgrounds. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME backgrounds, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.
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Affiliation(s)
- Muhammad Shamsher Ahmad
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
| | - Scott Rory Hicks
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Rebecca Watson
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Rajia Akter Ahmed
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Lewis Jones
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Marcella Vaselli
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Meng-San Wu
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Fatima Hayat
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Libuse Ratcliffe
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Mark McKenna
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Paul Hine
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
| | - Sylviane Defres
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
| | - Tom Wingfield
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
- WHO Collaborating Centre for Social Medicine and Tuberculosis, Department of Global Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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15
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Farmery AK, Alexander K, Anderson K, Blanchard JL, Carter CG, Evans K, Fischer M, Fleming A, Frusher S, Fulton EA, Haas B, MacLeod CK, Murray L, Nash KL, Pecl GT, Rousseau Y, Trebilco R, van Putten IE, Mauli S, Dutra L, Greeno D, Kaltavara J, Watson R, Nowak B. Food for all: designing sustainable and secure future seafood systems. Rev Fish Biol Fish 2022; 32:101-121. [PMID: 34092936 PMCID: PMC8164055 DOI: 10.1007/s11160-021-09663-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/21/2021] [Indexed: 05/19/2023]
Abstract
UNLABELLED Food from the sea can make a larger contribution to healthy and sustainable diets, and to addressing hunger and malnutrition, through improvements in production, distribution and equitable access to wild harvest and mariculture resources and products. The supply and consumption of seafood is influenced by a range of 'drivers' including ecosystem change and ocean regulation, the influence of corporations and evolving consumer demand, as well as the growing focus on the importance of seafood for meeting nutritional needs. These drivers need to be examined in a holistic way to develop an informed understanding of the needs, potential impacts and solutions that align seafood production and consumption with relevant 2030 Sustainable Development Goals (SDGs). This paper uses an evidence-based narrative approach to examine how the anticipated global trends for seafood might be experienced by people in different social, geographical and economic situations over the next ten years. Key drivers influencing seafood within the global food system are identified and used to construct a future scenario based on our current trajectory (Business-as-usual 2030). Descriptive pathways and actions are then presented for a more sustainable future scenario that strives towards achieving the SDGs as far as technically possible (More sustainable 2030). Prioritising actions that not only sustainably produce more seafood, but consider aspects of access and utilisation, particularly for people affected by food insecurity and malnutrition, is an essential part of designing sustainable and secure future seafood systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11160-021-09663-x.
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Affiliation(s)
- A. K. Farmery
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
| | - K. Alexander
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K. Anderson
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
| | - J. L. Blanchard
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C. G. Carter
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K. Evans
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - M. Fischer
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - A. Fleming
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Land and Water, Hobart, TAS Australia
| | - S. Frusher
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - E. A. Fulton
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - B. Haas
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C. K. MacLeod
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - L. Murray
- College of Health, Massey University, Massey, New Zealand
| | - K. L. Nash
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - G. T. Pecl
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - Y. Rousseau
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - R. Trebilco
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - I. E. van Putten
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - S. Mauli
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - L. Dutra
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - D. Greeno
- College of Arts, Law and Education, University of Tasmania, Hobart, TAS Australia
| | - J. Kaltavara
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - R. Watson
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - B. Nowak
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
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16
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Farmery AK, Alexander K, Anderson K, Blanchard JL, Carter CG, Evans K, Fischer M, Fleming A, Frusher S, Fulton EA, Haas B, MacLeod CK, Murray L, Nash KL, Pecl GT, Rousseau Y, Trebilco R, van Putten IE, Mauli S, Dutra L, Greeno D, Kaltavara J, Watson R, Nowak B. Food for all: designing sustainable and secure future seafood systems. Rev Fish Biol Fish 2022; 32:101-121. [PMID: 34092936 DOI: 10.22541/au.160322471.16891119/v1] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/21/2021] [Indexed: 05/23/2023]
Abstract
UNLABELLED Food from the sea can make a larger contribution to healthy and sustainable diets, and to addressing hunger and malnutrition, through improvements in production, distribution and equitable access to wild harvest and mariculture resources and products. The supply and consumption of seafood is influenced by a range of 'drivers' including ecosystem change and ocean regulation, the influence of corporations and evolving consumer demand, as well as the growing focus on the importance of seafood for meeting nutritional needs. These drivers need to be examined in a holistic way to develop an informed understanding of the needs, potential impacts and solutions that align seafood production and consumption with relevant 2030 Sustainable Development Goals (SDGs). This paper uses an evidence-based narrative approach to examine how the anticipated global trends for seafood might be experienced by people in different social, geographical and economic situations over the next ten years. Key drivers influencing seafood within the global food system are identified and used to construct a future scenario based on our current trajectory (Business-as-usual 2030). Descriptive pathways and actions are then presented for a more sustainable future scenario that strives towards achieving the SDGs as far as technically possible (More sustainable 2030). Prioritising actions that not only sustainably produce more seafood, but consider aspects of access and utilisation, particularly for people affected by food insecurity and malnutrition, is an essential part of designing sustainable and secure future seafood systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11160-021-09663-x.
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Affiliation(s)
- A K Farmery
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
| | - K Alexander
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K Anderson
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
| | - J L Blanchard
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C G Carter
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K Evans
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - M Fischer
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - A Fleming
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Land and Water, Hobart, TAS Australia
| | - S Frusher
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - E A Fulton
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - B Haas
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C K MacLeod
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - L Murray
- College of Health, Massey University, Massey, New Zealand
| | - K L Nash
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - G T Pecl
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - Y Rousseau
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - R Trebilco
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - I E van Putten
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - S Mauli
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - L Dutra
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - D Greeno
- College of Arts, Law and Education, University of Tasmania, Hobart, TAS Australia
| | - J Kaltavara
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - R Watson
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - B Nowak
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
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17
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Thacker P, Amaratunga D, Shah K, Watson R, Singh A, Allen D, Shirani J. Internal jugular vein ultrasound in patients with chronic congestive heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0858] [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: 11/15/2022] Open
Abstract
Abstract
Background
Bedside assessment of intravascular volume in patients with chronic congestive heart failure (CHF) is often difficult. Under- and over-diuresis are common causes of morbidity and readmissions in these patients.
Purpose
We hypothesized that ultrasound assessment of the internal jugular vein would be easier and more reproducible than clinically assessing jugular venous pressure (JVP). Our goal was to create a bedside test that would be simpler to learn than inferior vena cava (IVC) assessment and easier to perform in obese patients.
Methods
Adults with HF (n=53, 52% men, mean age 65 years, mean BMI 29.6 kg/m2, mean LVEF 44%) scheduled for right heart catheterization (RHC) had an ultrasound of their right internal jugular (RIJ) vein performed immediately prior. Cross-sectional area of RIJ was measured during normal breathing with patients at 90 and 45 degrees recumbency and was indexed by height (RIJI). JVP was also assessed clinically. Results were compared to right atrial pressure (RAP) measured by RHC. Operators were blinded to RHC results and vice versa.
Results
JVP was correctly assessed clinically in only 43%. RIJI at 90 and 45 degrees were significantly larger in patients with elevated RAP compared to euvolemic patients (Table). At 90 degrees, RIJI of >15 predicted a RAP of >10 mmHg with 68% sensitivity and 72% specificity. At 45 degrees, RIJI of >10 predicted a RAP of >10 mmHg with 94% sensitivity and a negative predictive value of 80% (Table). Simply being able to see the RIJ at 90 degrees (n=34) had an 82.4% positive predictive value for elevated RAP. IVC data could not be obtained on 23% of patients due to body habitus or inability to lay flat.
Conclusion
Ultrasonographic RIJI is more accurate than clinical assessment in patients with CHF and can be accurately performed even in obese patients. It requires only a basic linear ultrasound probe and was easily performed by clinicians at various stages of training with reproducible results. With the increased availability of bedside ultrasound in clinical practice, it is a feasible method of evaluating chronic CHF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Thacker
- St Lukes University Health Network, Bethlehem, United States of America
| | - D Amaratunga
- St Lukes University Health Network, Bethlehem, United States of America
| | - K Shah
- St Lukes University Health Network, Bethlehem, United States of America
| | - R Watson
- Abington Hospital - Jefferson Health, Abington, United States of America
| | - A Singh
- Atlantic Health System, Morristown, United States of America
| | - D Allen
- St Lukes University Health Network, Bethlehem, United States of America
| | - J Shirani
- St Lukes University Health Network, Bethlehem, United States of America
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18
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Langton A, Chien A, Kang S, Rhodes L, O’Connor C, Bell M, Griffiths C, Watson R. 148 Fibrillin-rich microfibrils: Key components of dermal-epidermal junction architecture? J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Webb PS, Zorman M, Watson R, Payne M, Coupe N, Hobbs C. P14.29 The treatment of melanoma brain metastases with stereotactic radiosurgery concurrently with immune checkpoint inhibition is associated with improved extracranial disease control and overall survival compared to the overall metastatic melanoma cohort - a synergistic effect reaching beyond local control? Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.150] [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
Melanoma brain metastases (MBM) are an increasingly common referral to the neuro-oncology MDT in the context of lengthening survivorship of metastatic melanoma (MM) patients in the immunotherapy era. Stereotactic radiosurgery (SRS) and immune checkpoint inhibition (ICI) are both effective in the management of MBM and, when combined, 12-month local control rates of >85% and overall survival (OS) >80% have been reported.[4,5] Recent local analysis of patients treated at our tertiary SRS referral centre has revealed even greater outcomes in this patient cohort. This study aimed to compare the outcomes of patients with MBM treated with concurrent SRS and ICI compared to the overall metastatic melanoma cohort, to elucidate whether the addition of SRS to ICI may improve disease control outside of the brain as well as within.
MATERIAL AND METHODS
A retrospective analysis of our local SRS database and an ARIA ePrescribing database search was performed to identify a cohort of patients treated with concurrent SRS and ICI for MBM, as well as a control cohort of MM patients who received ICI alone, over a 4 year period until February 2020. The primary endpoints were the extracranial progression free survival (PFS) and overall survival (OS) at 12 months. Secondary endpoints were the median PFS (mPFS) and OS (mOS). Kaplan-Meier curves and survival statistics were generated using SPSS v26.
RESULTS
A total of 34 MBM from 19 patients were identified in the SRS+ICI group and there were 200 patients in the control group. The minimum follow up was 12 months. The median patient age, duration of ICI and use of combination ICI favoured the SRS+ICI group. The number of sites of extracranial disease pre-ICI and overall anti-PD-1 usage was well matched. In the SRS+ICI group, there were no cases of extracranial progression and no deaths within 12 months. In the control group, the 12-month PFS and OS rates were 50.5% and 77.5% respectively. In terms of mPFS, this was not reached (estimated 37.6 months) in the SRS+ICI group, versus 13.4 months in the control group (log rank test, p=0.001). In terms of mOS, this was not reached in the SRS+ICI group, versus 55.8 months in the control group (log rank test, p=0.016).
CONCLUSION
We demonstrate improved extracranial disease control and survivorship amongst metastatic melanoma patients who develop brain metastases and are treated with concurrent SRS and ICI compared to those who do not. The outcomes of our control cohort are comparable to the 4-year follow up of the CheckMate 067 trial (n=945),[6] which strengthens the validity of the statistical comparisons made in this study. The improved extracranial disease control seen when SRS and ICI are combined in the treatment of MBM questions whether an abscopal effect may be at play, and therefore further accents the utility of SRS in MBM beyond that of local control alone. This could influence management in cases of borderline decisions for SRS.
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Affiliation(s)
- P S Webb
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - M Zorman
- Buckinghamshire Healthcare NHS Trust, Bucks, United Kingdom
| | - R Watson
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - M Payne
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - N Coupe
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - C Hobbs
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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20
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Robinson M, Sayal K, Tunstall C, Padmanaban S, Watson R, Pretorius P, Joseph R, Jeyaretna S, Hobbs C. P14.85 Impact of the neuro-radiologist and neuro-surgeon in contouring with the neuro-oncologist on local relapse rates for brain metastases treated with stereotactic radiosurgery. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
The audit evaluates the value of MDT, including neuro-radiologist and neuro-surgeon, review of contouring carried out by a clinical oncologist in stereotactic radiosurgery (SRS).
MATERIAL AND METHODS
A sequential audit was conducted of all patients receiving intracranial SRS at our local institution for the first 22 months of a new SRS service. Lesions were contoured first by clinical oncologist then reviewed/edited by the MDT. The initial contour was compared with final contour using Jaccard conformity and geographical miss indices. The dosimetric impact of a contouring change was assessed using plan metrics to both original and final contour. The impact of the contouring review on local relapse, overall survival and radio necrosis rate was evaluated with at least 24 months follow up (24–46 months).
RESULTS
113 patients and 142 lesions treated over 22 months were identified. Mean JCI was 0.92 (0.32–1.00) and 38% needed significant editing (JCI<0.95). Mean GMI was 0.03 (0.0–0.65) and 17% showed significant miss (GMI>0.05). Resection cavities showed more changes, with lower JCI and higher GMI (p<0.05). There was no significant improvement on JCI or GMI shown over time. Dosimetric analysis indicated a strong association of conformity metrics with PTV dose metrics; a 0.1 change in GTV conformity metric association with 6–17% change in dose to 95% of resulting PTV. Greater association was seen in resection cavity suggesting the geographical nature of a typical contouring error gives rise to greater potential change in dose. Clinical outcomes compared well with published series. Median survival was 20 months and local relapse free rate in the treated areas of 0.89 (0.8–0.94) at 40 months, and 0.9 (0.83–0.95) radio-necrosis free rate at 40 months with a median 17 months to developing radio-necrosis for those that did.
CONCLUSION
This work highlights that a MDT contour review adds significant value to SRS and the approach translates into reduced local recurrence rates at our local institution compared with previously published data. Radio-necrosis rates are below 10%. No improvement in clinical oncologist contouring over time was shown indicating a collaborative approach is needed regardless of experience of clinical oncologist. MDT input is recommended in particular in contouring of resection cavities.
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Affiliation(s)
- M Robinson
- Oxford Cancer Centre, Oxford, United Kingdom
| | - K Sayal
- Oxford Cancer Centre, Oxford, United Kingdom
| | - C Tunstall
- Oxford Cancer Centre, Oxford, United Kingdom
| | | | - R Watson
- Oxford Cancer Centre, Oxford, United Kingdom
| | - P Pretorius
- Department of Neuro-Radiology, Oxford University Hospials NHS Trust, Oxford, United Kingdom
| | - R Joseph
- Department of Neuro-Radiology, Oxford University Hospials NHS Trust, Oxford, United Kingdom
| | - S Jeyaretna
- Department of Neuro-Surgery, Oxford University Hospials NHS Trus, Oxford, United Kingdom
| | - C Hobbs
- Oxford Cancer Centre, Oxford, United Kingdom
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21
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Ahmad MS, Hicks SR, Watson R, Ahmed RA, Jones L, Vaselli M, Wu MS, Hayat F, Ratcliffe L, McKenna M, Hine P, Defres S, Wingfield T. A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK. Wellcome Open Res 2021; 6:222. [DOI: 10.12688/wellcomeopenres.17163.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) background. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME background, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.
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Watson R, McCabe C, Harvey K, Reynolds S. Development and validation of a new adolescent self-report scale to measure loss of interest and pleasure: The Anhedonia Scale for Adolescents. Psychol Assess 2021; 33:201-217. [PMID: 33779202 DOI: 10.1037/pas0000977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anhedonia, the loss of interest and pleasure in previously enjoyable experiences, is a core symptom of depression and a characteristic of other mental health and physical health problems. Most self-report measures of anhedonia has been developed for use with adults and their suitability for adolescents is questionable. In this article, we describe the development and psychometric qualities of a new measure, the Anhedonia Scale for Adolescents (ASA), designed specifically for use with adolescents aged 11-18 years. Items were generated from in-depth qualitative interviews with depressed young people, and then reviewed by an independent group of young people and clinically qualified experts in adolescent mental health. After piloting the new scale (n = 66), we established the structural validity of the measure with two groups of young people using exploratory (n = 1057) and confirmatory (n = 1041) factor analysis. The final scale consisted of 14 items, with 1 general factor and 3 specific factors producing the best fit to the data, (1) Enjoyment, Excitement, and Emotional Flattening (negatively framed); (2) Enthusiasm, Connection, and Purpose (positively framed); and (3) Effort, Motivation, and Drive (negatively framed). The ASA had high test-retest reliability and converged with standardized measures of depression, negative symptoms of schizophrenia, pleasure, and positive affect. Findings from these analyses provided evidence of incremental validity, as the ASA was a stronger predictor of clinical group (high vs. low depressive symptoms) than existing measures used to assess anhedonia. The ASA has potential as a new clinical and research tool to assess adolescent anhedonia. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Ciara McCabe
- School of Psychology and Clinical Language Sciences
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences
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23
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Watson R, Harvey K, Pass L, McCabe C, Reynolds S. A qualitative study exploring adolescents' experience of brief behavioural activation for depression and its impact on the symptom of anhedonia. Psychol Psychother 2021; 94:266-288. [PMID: 32918843 DOI: 10.1111/papt.12307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/05/2020] [Revised: 07/28/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Anhedonia, the loss of interest and pleasure, is a core symptom of depression and is associated with deficits in reward processing. Behavioural Activation for depression may address this symptom due to its focus on identifying and increasing intrinsically rewarding activities. DESIGN This was a qualitative study employing reflexive thematic analysis (TA). METHODS Participants were eight treatment-seeking adolescents with a recent primary diagnosis of depression who had received eight sessions of Brief Behavioural Activation. Qualitative semi-structured interviews were conducted after treatment was completed. RESULTS Three main themes emerged: (1) connecting, reviewing, and taking action: 'focus on getting better rather than what you're feeling'; (2) struggles, restrictors, and motivators: 'it seemed really unachievable'; and (3) feeling, acting, or seeing things differently: 'looking forwards in a more healthy way'. CONCLUSIONS Both specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic strategies (e.g., self-monitoring) may be helpful in treating the symptom of anhedonia in adolescent depression. Motivational aspects of anhedonia, as well as anxiety, fatigue, and academic pressures act as potential barriers to recovery. This highlights the need for psychological treatments for adolescent depression to include explicit and targeted strategies to enhance motivation. PRACTITIONER POINTS Young people reported that specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic techniques (e.g., self-monitoring) had a role in treating anhedonia. Barriers to engaging in Brief BA included: motivational anhedonia, fatigue, and academic demands.
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Affiliation(s)
| | | | - Laura Pass
- University of Reading, UK.,University of East Anglia, Norwich, UK
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24
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Wu MS, Watson R, Hayat F, Ratcliffe L, Beadsworth MB, McKenna M, Corney D, Plum C, Macfarlane JL, Matareed M, Butt S, Gupta S, Hine P, Defres S, Wingfield T. What do people hospitalised with COVID-19 think about their care? Results of a satisfaction survey during the first wave of COVID-19 in Liverpool. Future Healthc J 2021; 8:e70-e75. [PMID: 33791480 DOI: 10.7861/fhj.2020-0260] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite huge advances in vaccines, testing and treatments for COVID-19, there is negligible evidence on the perceptions of people hospitalised with COVID-19 about the care they received. To address this, we developed a satisfaction survey for people with COVID-19 admitted to our hospital during the first COVID-19 wave in Liverpool. Of those invited, 98/160 (61%) responded, of whom 94/98 (96%) completed the survey. Respondents rated overall care highly (mean 4.7/5) and 89/94 (95%) reported that they would recommend the hospital to friends and/or family. Most respondents felt safe on the ward (94%), with privacy maintained (93%) and pain well managed (90%). Fewer than two-thirds (63%) of respondents considered themselves adequately consulted regarding medications and side effects. Sleep and food/drink quality were also highlighted as areas for improvement. To overcome the issues raised, we generated a 'COVID-19 practice pointers' poster within an integrated educational bundle on COVID-19 wards. The impact of the bundle on perceptions of people hospitalised with COVID-19 will be evaluated in people hospitalised with COVID-19 in Liverpool in 2021. Whether hospitalised for COVID-19 or other conditions, our survey results are a timely reminder of the importance of involving patients in shaping the care that they receive.
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Affiliation(s)
- Meng-San Wu
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK and Imperial College Healthcare NHS Trust, London, UK
| | - Rebecca Watson
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Fatima Hayat
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Libuse Ratcliffe
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | - Mark McKenna
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | | | | | | | - Sundas Butt
- George Eliot Hospital NHS Trust, Nuneaton, UK
| | | | - Paul Hine
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK and Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sylviane Defres
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK, University of Liverpool, Liverpool, UK and Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tom Wingfield
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK, University of Liverpool, Liverpool, UK, Liverpool School of Tropical Medicine, Liverpool, UK and Karolinska Institutet, Stockholm, Sweden
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Finnegan A, Di Lemma L, Mcghee S, Watson R. Evaluating serious stress in military veterans, their carers and families: a protocol. BMJ Mil Health 2021; 169:263-268. [DOI: 10.1136/bmjmilitary-2020-001715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 11/04/2022]
Abstract
In 2018, the Armed Forces Covenant Fund Trust (ACFT) allocated approximately £4M to seven UK projects to address serious stress in military veterans, their carers and families. These programmes commenced between May and October 2019 and will conclude in August 2021.This paper outlines the protocol for the evaluation of the Tackling Serious Stress programme and the novel support provided to grant holders. Entry into the programmes was through multiple routes, including self-referrals with an anticipated sample of approximately 2000 participants. A common outcomes framework was designed to measure outcomes. Grant holders accepted ownership for data collection and quality and were supported through accompanying guidance material.Veterans were often reluctant to seek support, and the anonymous and confidential nature of the evaluation plus the study team’s military background helped address this. Participants’ voices were a key part in developing the protocol, leading to results to inform policy and highlight success, efficiency and cost effectiveness, and providing markers for future development.The study provided a reservoir of information. Interim reports indicated compliance with performance indicators and provided timely evidence. Shared learning provided grant holders with an indication of what was helping the beneficiaries and what needed to be improved. The combination of all data sets provided the ACFT with a resource to demonstrate success and insight into projects where improvement was required, and indicators of how to redress these problems. The study protocol provided a platform for building lasting partnerships.
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Haigh L, Chadwick H, Gillgrass L, Pollard K, Shaw N, Watson R, Williams E, Wood A, Wright S, Etherington C, Spoletini G, Clifton I, Peckham D. P206 Patient feedback following the introduction of a dedicated ‘Symkevi® Initiation Clinic’ prior to starting modulator therapy. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01231-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Murray G, O'Kane M, Watson R, Tobin AM. Psychosocial burden and out-of-pocket costs in patients with atopic dermatitis in Ireland. Clin Exp Dermatol 2020; 46:157-161. [PMID: 32803784 DOI: 10.1111/ced.14422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2020] [Indexed: 12/19/2022]
Abstract
Atopic dermatitis (AD) is one of the most common inflammatory skin diseases in the developed world, affecting 1-3% of the adult population in Europe. This inflammatory disease can have a marked impact on affected individuals, leading to significant impairment in physical wellbeing and quality of life (QoL). The aim of this study was to investigate the psychosocial impact and financial burden of AD on patients in Ireland. To increase our understanding of the psychosocial and financial aspects of AD disease burden in the Irish population, an online survey was designed. The survey was launched by the Irish Skin Foundation, and included questions focusing on disease severity, disease control, psychosocial impact, interrupted sleep, missed work and school days, and financial cost. The survey showed that the impact of AD on QoL was profound. The survey demonstrated that 85% of adults described interrupted sleep, 70% reported social anxiety, 65% avoid exercise and sports, 52% avoid social activities, 52% avoid sexual intimacy and 43% feel they are depressed as a result of their AD. Approximately one-quarter of those surveyed can spend up to €2300 annually on over-the-counter, prescription and alternative treatments. This study has shown the significant impact AD has on patients living in Ireland. It also highlights that out-of-pocket costs for patients is higher compared with previous studies across European countries.
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Affiliation(s)
- G Murray
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - M O'Kane
- Department of Dermatology, Beaumont Hospital, Dublin, Ireland.,Irish Skin Foundation, Dublin, Ireland
| | - R Watson
- Irish Skin Foundation, Dublin, Ireland
| | - A M Tobin
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland.,Irish Skin Foundation, Dublin, Ireland
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Watson R, Tong O, Nassiri I, Cooper R, Taylor C, Verge de los Aires A, Middleton M, Fairfax B. 1947P Single cell analysis reveals that CD8+ T cell clone size determines response to immune checkpoint blockade. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1339] [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: 10/23/2022] Open
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Mellody K, Bradley E, Bell M, Halai P, Cotterell L, Griffiths C, Watson R. 238 Retinol at a concentration of 0.3% restores fibrillin-rich microfibrils and modifies the epidermis in photoaged human skin in vivo in a manner similar to 1% retinol. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.243] [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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30
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Watson R, Harvey K, McCabe C, Reynolds S. Understanding anhedonia: a qualitative study exploring loss of interest and pleasure in adolescent depression. Eur Child Adolesc Psychiatry 2020; 29:489-499. [PMID: 31270605 PMCID: PMC7103575 DOI: 10.1007/s00787-019-01364-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/24/2019] [Indexed: 12/19/2022]
Abstract
Anhedonia (or loss of interest and pleasure) is a core symptom of depression and may predict poor treatment outcome. However, little is known about the subjective experience of anhedonia, and it is rarely targeted in psychological treatment for depression. The aim of this study is to examine how young people experience anhedonia in the context of depression. Semi-structured interviews were conducted with 34 adolescents with a primary diagnosis of depression (N = 12) or elevated depressive symptoms (N = 22). Thematic analysis was used to identify important aspects of adolescents' experiences. Four main themes were identified: (1) experiencing a loss of joy and a flattening of emotion; (2) struggling with motivation and active engagement; (3) losing a sense of connection and belonging; and (4) questioning sense of self, purpose, and the bigger picture. The results challenge the framing of anhedonia as simply the loss of interest and pleasure. Adolescents reported a range of experiences that mapped closely onto the cluster of negative symptoms associated with schizophrenia and were similar to the sense of 'apathy' characteristic in Parkinson's disease. This highlights the potential benefit of taking a trans-diagnostic approach to understanding and treating reward deficits associated with mental health problems.
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Affiliation(s)
- Rebecca Watson
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Ciara McCabe
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Shirley Reynolds
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Palese A, Decaro A, Bressan V, Marin M, Achil I, Hayter M, Watson R. Measuring the therapeutic properties of nursing home environments in the Italian context: findings from a validation and cross-sectional study design. Ann Ig 2020; 32:117-131. [PMID: 31944207 DOI: 10.7416/ai.2020.2236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The social and the physical features of the nursing home (NH) environment can offer a therapeutic support capable of maximising residents' physical and cognitive functions. A total of 23 instruments evaluating the therapeutic properties of a NH has been documented to date; among them, the most recent and widely used is the Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH) composed of 13 domains and 84 items: higher scores in each domain indicate a higher presence of therapeutic principles. Validating the Italian version of TESS-NH tool and describing the therapeutic properties of Italian NH environments were the aims of this study. STUDY DESIGN A validation and a cross-sectional study design, undertaken in 2017. METHODS After having ensured the cross-cultural and the conceptual equivalence, together with the face and the content validation, 13 NHs accounting for 1,161 beds and articulated in 31 units have been evaluated with the TESS-NH tool via direct observation by trained researchers. Inter-rater reliability, test-retest, criterion validity, inter-dimension correlations and internal consistency were measured. Descriptive statistics was also calculated. RESULTS The inter-rater reliability was Pearson (r) >0.917 for continuous variables and weighted kappa statistics (k) of > 0.779 for non-continuous variables; the test-retest reliability was r > 0.848 and k of > 0.778, respectively. The criterion validity was r > 0.500 between each dimension and the single TESS-NH global item; moreover, correlations among the domains varied from not significant to significantly strong, while the internal consistency resulted in all evaluable dimensions in Cronbach alpha > 0.600. In the involved NH units, the TESS-NH total score was on average 122.19 out of the possible score from 0 to 149 (confidence interval (CI) 95%, 115.89-128.49). 25% of the units (=7) reported a total score of ≤ 113, and another 25% reported scores ≥ 133, thus from poor to excellent therapeutic properties. CONCLUSION The TESS-NH tool can be used in Italian facilities to support managers and researchers in evaluating the therapeutic properties of NH environments. Furthermore, the tool can support the evaluation of the effectiveness of interventional studies or quality improvement projects aimed at improving the NH's environment.
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Affiliation(s)
- A Palese
- Department of Medical Sciences, University of Udine, Italy
| | - A Decaro
- Department of Medical Sciences, University of Udine, Italy
| | - V Bressan
- Department of Medical Sciences, University of Udine, Italy
| | - M Marin
- Local Health Care Trust, Bassa Friulana-Isontina, Gorizia, Italy
| | - I Achil
- Department of Medical Sciences, University of Udine, Italy
| | - M Hayter
- Hull University, Hull, HU6 7RX, United Kingdom
| | - R Watson
- Hull University, Hull, HU6 7RX, United Kingdom
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32
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Killien E, Watson R, Rivara F, Vavilala M, Weiss N. 53: COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE MOST AFFECTED FOLLOWING PEDIATRIC CRITICAL ILLNESS. Crit Care Med 2020. [DOI: 10.1097/01.ccm.0000618712.15544.4f] [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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Affiliation(s)
- S McCarthy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - D Murray
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| | - R Watson
- Department of Dermatology, Our Lady's Hospital for Sick Children, Dublin, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - V Dvorakova
- Department of Dermatology, Our Lady's Hospital for Sick Children, Dublin, Ireland
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34
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Padmanabhan D, Farwati M, Izath A, Al-Masry A, Kella D, Gamero S, Barout A, Assaf Y, Shetty D, Asirvatham S, Felmlee J, Watson R, Cha YM, Friedman P. P4126Safety of magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices: A systematic review and meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0698] [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: 11/12/2022] Open
Abstract
Abstract
Recent guideline statements approve the performance of magnetic resonance imaging (MRI) in patients with non-conditional cardiac implantable electronic devices (CIEDs) under certain closely monitored conditions. Data from current registries may have lower power to discern changes that may occur in the CIED after the MRI.
Objective
We aimed to systematically review the literature to identify the adverse events and significance of changes in device function associated with performing MRI in patients with CIEDs
Methods
A comprehensive literature search of the databases was performed between 1980- 2017. Two independent reviewers selected studies and extracted data. A random-effects model was used for meta-analysis.
Results
A total of 7,422 patients underwent 8,865 MRI studies. No death occurred post MRI. Clinical adverse events were extremely rare (mostly less than 1%) and are summarized in Table 1. No significant changes in the pooled mean effect size estimate was noted for the changes in the lead parameters (pacing threshold, sensing and impedance)
Binary outcomes post magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices Outcome Sample size Number of patients Rate SE LL of CI UL of CI Death 7401 0 0 0 0 0 Atrial arrhythmia 7173 10 0.001 0.0004 0.0007 0.0024 Ventricular arrhythmia 7371 9 0.0012 0.0004 0.0006 0.0022 Oversensing 4981 17 0.0034 0.0008 0.0020 0.0053 Inhibition of pacing 7371 6 0.0008 0.0003 0.0003 0.0016 Lead Failure/Generator Failure 7475/7475 2/8 0.0002/0.0011 0.0001/0.0004 0.0001/0.0005 0.0009/0.002 Power on Reset 1388 105 0.0131 0.0014 0.0107 0.0161 Did not complete scan 6851 13 0.0019 0.0005 0.0011 0.0031 Chest pain 7080 11 0.0021 0.0004 0.0008 0.0027. Lead threshold rise (>0.5v/>50%-A/V) 5076/6246 12/16 0.0024/0.0026 0.0007/0.0006 0.0013/0.0015 0.0040/0.0041 Change in Battery voltage >0.04V 7132 42 0.0061 0.0009 0.0043 0.0079 Sensing decrease >50%-A/V 5087/5834 17/9 0.0033/0.0015 0.0008/0.0005 0.0020/0.0008 0.0052/0.0028 Impedance changes >50ohms/>50% 5810 22 0.0038 0.0008 0.0024 0.0057 Rise in cardiac enzymes 1703 26 0.0152 0.0030 0.0102 0.0219 A, atrial; V, ventricular; SE, standard Error; LL, lower limit; UL, upper limit; CI, Confidence intervals.
Conclusions
MRI in patients with non-conditional CIEDs can be performed with high degree of safety and low rate of clinical events when performed under standardized protocols
Acknowledgement/Funding
None
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Affiliation(s)
- D Padmanabhan
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - M Farwati
- Mayo Clinic, Rochester, United States of America
| | - A Izath
- Mayo Clinic, Rochester, United States of America
| | - A Al-Masry
- Mayo Clinic, Rochester, United States of America
| | - D Kella
- Mayo Clinic, Rochester, United States of America
| | - S Gamero
- Mayo Clinic, Rochester, United States of America
| | - A Barout
- Mayo Clinic, Rochester, United States of America
| | - Y Assaf
- Mayo Clinic, Rochester, United States of America
| | - D Shetty
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - S Asirvatham
- Mayo Clinic, Rochester, United States of America
| | - J Felmlee
- Mayo Clinic, Rochester, United States of America
| | - R Watson
- Mayo Clinic, Rochester, United States of America
| | - Y.-M Cha
- Mayo Clinic, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Rochester, United States of America
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Abstract
Free flap microvascular surgery involves the transfer of a mobilised tissue flap with complete vascular reanastomosis at the new site. Ischaemia frequently threatens flap survival and may require a return to the operating theatre for anastomotic revision. Arterial spasm and hypoperfusion are recognised as factors in flap ischaemia. Phosphodiesterase inhibitors such as milrinone may improve flap blood flow and possibly flap survival by arterial dilation and increasing cardiac output. To investigate the role of milrinone in this type of surgery, a double-blinded randomised controlled trial was conducted with 88 patients receiving either a milrinone bolus and infusion throughout surgery or placebo (normal saline). We found that milrinone did not improve graft survival, return to theatre rate, or surgically graded arterial spasm, but did require more vasopressor support. We conclude that intraoperative milrinone did not improve flap outcomes in microvascular surgery.
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Affiliation(s)
- S. J. Jones
- Departments of Anaesthesia and Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia
- Department of Anaesthesia
| | - D. A. Scott
- Departments of Anaesthesia and Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia
- Department of Anaesthesia
| | - R. Watson
- Departments of Anaesthesia and Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia
- Department of Anaesthesia
| | - W. A. Morrison
- Departments of Anaesthesia and Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia
- Bernard O'Brien Institute of Microsurgery and Director, St Vincent's Hospital Department of Plastic Surgery
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Abstract
Emotions are expressed by the face, the voice and the whole body. Research on the face and the voice has not only demonstrated that emotions are perceived categorically, but that this perception can be manipulated. The purpose of this study was to investigate, via two separate experiments using adaptation and multisensory techniques, whether the perception of body emotion expressions also shows categorical effects and plasticity. We used an approach developed for studies investigating both face and voice emotion perception and created novel morphed affective body stimuli, which varied in small incremental steps between emotions. Participants were instructed to perform an emotion categorisation of these morphed bodies after adaptation to bodies conveying different expressions (Experiment 1), or while simultaneously hearing affective voices (Experiment 2). We show that not only is body expression perceived categorically, but that both adaptation to affective body expressions and concurrent presentation of vocal affective information can shift the categorical boundary between body expressions, specifically for the angry body expressions. Overall, our findings provide significant new insights into emotional body categorisation, which may prove important in gaining a deeper understanding of body expression perception in everyday social situations.
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Affiliation(s)
- Rebecca Watson
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, 6229 EV, Maastricht, The Netherlands
| | - Beatrice de Gelder
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, 6229 EV, Maastricht, The Netherlands.
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de Gelder B, Watson R, Zhan M, Diano M, Tamietto M, Vaessen MJ. Classical paintings may trigger pain and pleasure in the gendered brain. Cortex 2018; 109:171-180. [DOI: 10.1016/j.cortex.2018.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/12/2018] [Accepted: 09/18/2018] [Indexed: 12/13/2022]
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38
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Padmanabhan D, Kella D, Naksuk N, Isath A, Kapa S, Deshmukh A, Mulpuru S, Felmlee J, Dalzell C, Olson N, Jondal M, Asirvatham S, Watson R, Cha YM, Friedman P. P3698Correlation of lead length with procedural safety outcomes of magnetic resonance imaging in patients with legacy pacemakers and defibrillators. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3698] [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 Kella
- Mayo Clinic, Rochester, United States of America
| | - N Naksuk
- Mayo Clinic, Rochester, United States of America
| | - A Isath
- Mayo Clinic, Rochester, United States of America
| | - S Kapa
- Mayo Clinic, Rochester, United States of America
| | - A Deshmukh
- Mayo Clinic, Rochester, United States of America
| | - S Mulpuru
- Mayo Clinic, Rochester, United States of America
| | - J Felmlee
- Mayo Clinic, Rochester, United States of America
| | - C Dalzell
- Mayo Clinic, Rochester, United States of America
| | - N Olson
- Mayo Clinic, Rochester, United States of America
| | - M Jondal
- Mayo Clinic, Rochester, United States of America
| | - S Asirvatham
- Mayo Clinic, Rochester, United States of America
| | - R Watson
- Mayo Clinic, Rochester, United States of America
| | - Y.-M Cha
- Mayo Clinic, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Rochester, United States of America
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Wang W, Leu J, Watson R, Xu Z, Zhou H. Investigation of the Mechanism of Therapeutic Protein-Drug Interaction Between Methotrexate and Golimumab, an Anti-TNFα Monoclonal Antibody. AAPS J 2018; 20:63. [PMID: 29667047 DOI: 10.1208/s12248-018-0219-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/12/2018] [Indexed: 12/31/2022]
Abstract
A prominent example of human therapeutic protein-drug interaction (TP-DI) is between methotrexate (MTX) and anti-TNFα mAbs. One plausible mechanism for this TP-DI is through the pharmacodynamic effect of MTX on immunogenicity. However, there is no definitive evidence to substantiate this mechanism, and other competing hypotheses, such as MTX suppressing FcγRI expression thereby affecting mAb PK, have also been proposed. In order to understand this mechanism, a cynomolgus monkey study was conducted using golimumab as a model compound. Golimumab elicited high incidences of immunogenicity in healthy cynomolgus monkeys. Concomitant dosing of MTX delayed the onset and reduced the magnitude of anti-drug antibody (ADA) formation. The impact of MTX on golimumab PK correlated with the ADA status. Prior to ADA formation, MTX has no discernable effect on golimumab PK. Additionally, no alteration in FcγRI expression was observed following MTX treatment. The impact of MTX on golimumab immunogenicity and PK has been observed in patients with rheumatoid arthritis, psoriatic arthritis (PsA), and ankylosing spondylitis. In a representative phase 3 study of golimumab in patients with PsA, patients not receiving concomitant MTX was reported to have ~ 30% lower steady-state trough golimumab levels compared to those who received MTX. However, further analysis showed that PsA patients who were negative for ADA in both treatment groups had comparable trough levels of golimumab. Taken together, our results suggest that the mechanism of TP-DI between MTX and golimumab can mostly be attributed to the pharmacodynamic effect of MTX, i.e., the lowering of immunogenicity and immunogenicity-mediated clearance of mAbs.
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Affiliation(s)
- Weirong Wang
- Biologics Development Sciences, Janssen R&D, LLC, Spring House, Pennsylvania, 19477, USA
| | - Jocelyn Leu
- Global Clinical Pharmacology, Janssen R&D, LLC, Spring House, Pennsylvania, 19477, USA
| | - Rebecca Watson
- Biologics Development Sciences, Janssen R&D, LLC, Spring House, Pennsylvania, 19477, USA
| | - Zhenhua Xu
- Global Clinical Pharmacology, Janssen R&D, LLC, Spring House, Pennsylvania, 19477, USA
| | - Honghui Zhou
- Global Clinical Pharmacology, Janssen R&D, LLC, Spring House, Pennsylvania, 19477, USA.
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Polkinghorne RJ, Philpott J, Perovic J, Lau J, Davies L, Mudannayake W, Watson R, Tarr G, Thompson JM. The effect of packaging on consumer eating quality of beef. Meat Sci 2018; 142:59-64. [PMID: 29660545 DOI: 10.1016/j.meatsci.2018.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 10/31/2017] [Revised: 03/23/2018] [Accepted: 04/03/2018] [Indexed: 11/25/2022]
Abstract
This experiment examined 3 packaging systems: overwrap packaging using oxygen permeable film (OWP); vacuum skin packaging (VSP) and modified atmosphere packaging (MAP, 80%O2 and 20%CO2) on consumer sensory. Three primals from 48 carcasses were aged in vacuum packs for 5, 12 or 40 days. Steaks from longissimus lumborum, gluteus medius and psoas major muscles were packed in OWP, VSP and MAP for 9 days. Untrained consumers scored grilled steaks for tenderness, juiciness, liking of flavour and overall acceptability. Steaks in MAP had 10-12 points lower sensory scores (on a 100 point scale) compared to the OWP, or VSP systems (P < 0.001). The packaging effect was independent of days aging and muscle. It was concluded that high oxygen MAP has the potential to be included as an input variable in the Meat Standards Australia beef grading model. This would be contingent upon research into when the MAP effect occurred and the effect of using different gas mixtures on eating quality.
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Affiliation(s)
- R J Polkinghorne
- School of Environmental and Rural Science, University of New England, Armidale, NSW 2351, Australia; Birkenwood Pty. Ltd, 431 Timor Rd, Murrurundi, NSW 2338, Australia
| | - J Philpott
- Birkenwood Pty. Ltd, 431 Timor Rd, Murrurundi, NSW 2338, Australia
| | - Jessira Perovic
- MSA, The Short Run, University of New England, Armidale, NSW 2351, Australia
| | - J Lau
- MSA, The Short Run, University of New England, Armidale, NSW 2351, Australia
| | - L Davies
- Teys Australia Pty Ltd, 2728, Logan Road, Eight Mile Plains, QLD 4113, Australia
| | - W Mudannayake
- Teys Australia Pty Ltd, Lakes Creek Rd, North Rockhampton, QLD 4701, Australia
| | - R Watson
- School of Mathematics and Statistics, University of Melbourne, VIC 3010, Australia
| | - G Tarr
- School of Mathematics and Statistics, The University of Sydney, NSW 2006, Australia
| | - J M Thompson
- School of Environmental and Rural Science, University of New England, Armidale, NSW 2351, Australia.
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Longo K, Knott E, Swietlik J, Watson R, Lee F, Smolock A, Cannata J, Duryea A, Miller R, Xu Z, Cho C, Vlaisavljevich E, Ziemlewicz T. 4:03 PM Abstract No. 339 Robotically assisted sonic therapy (RAST) for hepatic ablation in a porcine model: mitigation of body wall damage. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.376] [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: 10/17/2022] Open
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Abstract
AIMS To generate an Arabic version of the Organizational Commitment Questionnaire that would be easily understood by Arabic speakers and would be sensitive to Arabic culture. BACKGROUND The nursing workforce in Saudi Arabia is undergoing a process of Saudization but there is a need to understand the factors that will help to retain this workforce. INTRODUCTION No organizational commitment tools exist in Arabic that are specifically designed for health organizations. An Arabic version of the organizational commitment tool could aid Arabic speaking employers to understand their employees' perceptions of their organizations. METHODS Translation and back-translation followed by factor analysis (principal components analysis and confirmatory factor analysis) to test the factorial validity and item response theory (Mokken scaling). RESULTS A two-factor structure was obtained for the Organizational Commitment Questionnaire comprising Factor 1: Value commitment; and Factor 2: Commitment to stay with acceptable reliability measured by internal consistency. A Mokken scale was obtained including items from both factors showing a hierarchy of items running from commitment to the organization and commitment to self. DISCUSSION This study shows that the Arabic version of the OCQ retained the established two-factor structure of the original English-language version. Although the two factors - 'value commitment' and 'commitment to stay' - repudiate the original developers' single factor claim. CONCLUSION A useful insight into the structure of the Organizational Commitment Questionnaire has been obtained with the novel addition of a hierarchical scale. IMPLICATIONS FOR NURSING POLICY The Organizational Commitment Questionnaire is now ready to be used with nurses in the Arab speaking world and could be used a tool to measure the contemporary commitment of nursing employees and in future interventions aimed at increasing commitment and retention of valuable nursing staff.
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Affiliation(s)
- M Al-Yami
- Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
| | - P Galdas
- Department of Health Sciences, University of York, York, UK
| | - R Watson
- Faculty of Health Sciences, School of Health & Social Work, University of Hull, Hull, UK
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Mahfoud ZR, Gkantaras I, Topping AE, Cannaby AM, Foreman B, Watson R, Thompson DR, Gray R. The educational preparation of nurses in a developing economy and patient mortality. Int Nurs Rev 2018; 65:434-440. [PMID: 29498040 DOI: 10.1111/inr.12450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Most studies have reported that higher levels (baccalaureate degree) of educational attainment by nurses are associated with lower levels of patient mortality. Researchers working in developed economies (e.g. North America and Europe) have almost exclusively conducted these studies. The value of baccalaureate nurse education has not been tested in countries with a developing economy. METHOD A retrospective observational study conducted in seven hospitals. Patient mortality was the main outcome of interest. Anonymized data were extracted from nurses and patients from two different administrative sources and linked using the staff identification number that exists in both systems. We used bivariate logistic regression models to test the association between mortality and the educational attainment of the admitting nurse (responsible for assessment and care planning). RESULTS Data were extracted for 11 918 (12, 830 admissions) patients and 7415 nurses over the first 6 months of 2015. The majority of nurses were educated in South Asia and just over half were educated to at least bachelor degree level. After adjusting for confounding and clustering, nurse education was not found to be associated with mortality. IMPLICATIONS FOR NURSING AND HEALTH POLICY Our observations may suggest that in a developing economy, the academic level of nurses' education is not associated with a reduction in patient mortality. Findings should be interpreted with considerable caution but do challenge widely held assumptions about the value of baccalaureate-prepared nurses. Further research focused on nursing education in developing economies is required to inform health policy and planning.
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Affiliation(s)
| | | | | | | | - B Foreman
- Hamad Medical Corporation, Doha, Qatar
| | - R Watson
- The University of Hull, Hull, UK
| | - D R Thompson
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - R Gray
- La Trobe University and Healthscope, Melbourne, Australia
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Affiliation(s)
- R. Watson
- Nursing; Faculty of Health and Social Care; University of Hull; Hull UK
| | - S. Rehman
- Faculty of Health and Social Care; University of Hull; Hull UK
| | - P.A. Ali
- The School of Nursing and Midwifery; The University of Sheffield; Sheffield UK
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Walker JD, Watson R, Flemer S, Yang Y, Madalengoitia JS. Intramolecular Formation of Zwitterionic Intermediates in 1,3-Diaza-Claisen Rearrangements. Org Lett 2017; 19:4010-4013. [DOI: 10.1021/acs.orglett.7b01746] [Citation(s) in RCA: 4] [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] [Indexed: 11/29/2022]
Affiliation(s)
- Joel D. Walker
- Department of Chemistry, University of Vermont, Burlington, Vermont 05405, United States
| | - Rebecca Watson
- Department of Chemistry, University of Vermont, Burlington, Vermont 05405, United States
| | - Stevenson Flemer
- Department of Chemistry, University of Vermont, Burlington, Vermont 05405, United States
| | - Yanbo Yang
- Department of Chemistry, University of Vermont, Burlington, Vermont 05405, United States
| | - José S. Madalengoitia
- Department of Chemistry, University of Vermont, Burlington, Vermont 05405, United States
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Murad A, O'Regan G, Watson R, McDermott M, O'Sullivan M, Irvine AD. Erythema elevatum diutinum in a healthy child. Clin Exp Dermatol 2017; 42:434-436. [DOI: 10.1111/ced.13083] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A. Murad
- Department of Dermatology; Our Lady's Children's Hospital; Crumlin Dublin 12 Ireland
| | - G. O'Regan
- Department of Dermatology; Our Lady's Children's Hospital; Crumlin Dublin 12 Ireland
| | - R. Watson
- Department of Dermatology; Our Lady's Children's Hospital; Crumlin Dublin 12 Ireland
| | - M. McDermott
- Department of Histopathology; Our Lady's Children's Hospital; Crumlin Dublin 12 Ireland
| | - M. O'Sullivan
- Department of Histopathology; Our Lady's Children's Hospital; Crumlin Dublin 12 Ireland
| | - A. D. Irvine
- Department of Dermatology; Our Lady's Children's Hospital; Crumlin Dublin 12 Ireland
- Department of Clinical Medicine; Chemistry Building; Trinity College; Dublin Ireland
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Bagnasco A, Watson R, Zanini M, Catania G, Aleo G, Sasso L. Developing a Stoma Acceptance Questionnaire to improve motivation to adhere to enterostoma self-care. J Prev Med Hyg 2017; 58:E190-E194. [PMID: 28900361 PMCID: PMC5584090] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
INTRODUCTION In stoma care, patient education is often weak in terms of improving patients' level of acceptance of living with a stoma. Self-care educational interventions in enterostomal patients, which according to Orem's Theory should take into account these patients' specific needs, require instruments that measure patients' stoma acceptance to improve motivation based on the resumption of activities they used to carry out before having a stoma. The aim of the study was to develop an instrument that measures the level of stoma acceptance to improve motivation to adhere to enterostoma self-care. METHODS Aspects that improve stoma acceptance and consequently motivation to adhere to enterostoma self-care were identified through 10 focus groups. In the focus groups, the motivation indicators were grouped, categorised and results entered into a Stoma Acceptance Questionnaire (SAQ). The SAQ was then piloted with 104 enterostomal patients from three general hospitals. To assess the construct validity of the SAQ, Mokken Scaling was used to explore the latent structure of the SAQ. Mokken scaling is a non-parametric method that falls under the umbrella of methods described as item response theories (IRT). RESULTS The theme "Living with a stoma"; "Autonomy"; "Support"; "Ability to deal with stoma", plus a common underlying theme: "Stoma acceptance" were dissussed by the Focus Groups. The experts identified the items of the (SAQ) through these themes. Mokken Scaling identified the "resumption of enterostomal patients' normal activities" as a measure of stoma acceptance, thus confirming the construct validity of the SAQ. CONCLUSIONS The tool proposed affords a pioneering example of how this gap can be bridged. Indeed, the SAQ could enable nurses adopting a standardized approach for the assessment of enterostomal patients' motivation to resume their normal activities and identify needs linked to this. The SAQ could also be used to measure the effectiveness of psychosocial and educational interventions aimed at improving stoma acceptance.
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Affiliation(s)
- A. Bagnasco
- Department of Health Sciences Department, University of Genoa, Italy;,Correspondence: Annamaria Bagnasco, Assistant Professor of Nursing & Education Coordinator, Department of Health Sciences, University of Genoa, via Pastore 1, 16132 Genoa, Italy - Tel. +39 010 3538515 - E-mail:
| | - R. Watson
- Faculty of Health and Social Care, University of Hull, UK
| | - M. Zanini
- Department of Health Sciences Department, University of Genoa, Italy
| | - G. Catania
- Department of Health Sciences Department, University of Genoa, Italy
| | - G. Aleo
- Department of Health Sciences Department, University of Genoa, Italy
| | - L. Sasso
- Department of Health Sciences Department, University of Genoa, Italy
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Jain S, Lyons C, Walker S, McQuaid S, Hynes S, Mitchell D, Pang B, Logan G, McCavigan A, O'Rourke D, Davidson C, Knight L, Sheriff A, Berge V, Neal D, Pandha H, Watson R, Mason M, Kay E, Harkin D, James J, Salto-Tellez M, Kennedy R, O'Sullivan J, Waugh D. OC-0126: A gene expression assay to predict the risk of distant metastases in localized prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30569-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Langton A, Alessi S, Chien A, Kang S, Sherratt M, Griffiths C, Watson R. 749 Impact of chronic sun exposure on the elastic fiber network of African-American and Caucasian skin. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Al-Fayoumi S, Watson R, O'Mahony A, Singer J. Comparative biomarker profiles of pacritinib, momelotinib, pexidartinib, and ruxolitinib using BioMAP Diversity PLUS panel. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33004-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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