1
|
Skirgård H, Haynie HJ, Blasi DE, Hammarström H, Collins J, Latarche JJ, Lesage J, Weber T, Witzlack-Makarevich A, Passmore S, Chira A, Maurits L, Dinnage R, Dunn M, Reesink G, Singer R, Bowern C, Epps P, Hill J, Vesakoski O, Robbeets M, Abbas NK, Auer D, Bakker NA, Barbos G, Borges RD, Danielsen S, Dorenbusch L, Dorn E, Elliott J, Falcone G, Fischer J, Ghanggo Ate Y, Gibson H, Göbel HP, Goodall JA, Gruner V, Harvey A, Hayes R, Heer L, Herrera Miranda RE, Hübler N, Huntington-Rainey B, Ivani JK, Johns M, Just E, Kashima E, Kipf C, Klingenberg JV, König N, Koti A, Kowalik RG, Krasnoukhova O, Lindvall NL, Lorenzen M, Lutzenberger H, Martins TR, Mata German C, van der Meer S, Montoya Samamé J, Müller M, Muradoglu S, Neely K, Nickel J, Norvik M, Oluoch CA, Peacock J, Pearey IO, Peck N, Petit S, Pieper S, Poblete M, Prestipino D, Raabe L, Raja A, Reimringer J, Rey SC, Rizaew J, Ruppert E, Salmon KK, Sammet J, Schembri R, Schlabbach L, Schmidt FW, Skilton A, Smith WD, de Sousa H, Sverredal K, Valle D, Vera J, Voß J, Witte T, Wu H, Yam S, Ye J, Yong M, Yuditha T, Zariquiey R, Forkel R, Evans N, Levinson SC, Haspelmath M, Greenhill SJ, Atkinson QD, Gray RD. Grambank reveals the importance of genealogical constraints on linguistic diversity and highlights the impact of language loss. Sci Adv 2023; 9:eadg6175. [PMID: 37075104 PMCID: PMC10115409 DOI: 10.1126/sciadv.adg6175] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
While global patterns of human genetic diversity are increasingly well characterized, the diversity of human languages remains less systematically described. Here, we outline the Grambank database. With over 400,000 data points and 2400 languages, Grambank is the largest comparative grammatical database available. The comprehensiveness of Grambank allows us to quantify the relative effects of genealogical inheritance and geographic proximity on the structural diversity of the world's languages, evaluate constraints on linguistic diversity, and identify the world's most unusual languages. An analysis of the consequences of language loss reveals that the reduction in diversity will be strikingly uneven across the major linguistic regions of the world. Without sustained efforts to document and revitalize endangered languages, our linguistic window into human history, cognition, and culture will be seriously fragmented.
Collapse
Affiliation(s)
- Hedvig Skirgård
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Department of Linguistics, School of Culture, History and Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Corresponding author. (H.S.); (R.D.G.)
| | - Hannah J. Haynie
- Department of Linguistics, University of Colorado Boulder, Boulder, CO, USA
| | - Damián E. Blasi
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA
- Human Relation Area Files, Yale University, New Haven, CT, USA
| | - Harald Hammarström
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Department of Linguistics and Philology, Uppsala University, Uppsala, Sweden
| | - Jeremy Collins
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Department of Linguistics, Faculty of Arts, Radboud University, Nijmegen, Netherlands
| | - Jay J. Latarche
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Jakob Lesage
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Langage, Langues et Cultures d'Afrique (LLACAN), Centre National de la Recherche Scientifique (CNRS), Villejuif, France
- Institut National des Langues et Civilisations Orientales (INALCO), Paris, France
- Department of Asian and African Studies, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Weber
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Alena Witzlack-Makarevich
- Department of Linguistics, Faculty of Humanities, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sam Passmore
- Evolution of Cultural Diversity Initiative, School of Culture, History and Language, College of Asia and the Pacific, The Australian National University, Canberra, ACT, Australia
- Faculty of Environment and Information Studies, Keio University SFC (Shonan Fujisawa Campus), Tokyo, Japan
- Department of Anthropology and Archaeology, Faculty of Arts, University of Bristol, Bristol, UK
| | - Angela Chira
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Luke Maurits
- Department of Comparative Cultural Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Russell Dinnage
- Department of Biological Sciences, Institute of Environment, Florida International University, Miami, FL, USA
| | - Michael Dunn
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Department of Linguistics and Philology, Uppsala University, Uppsala, Sweden
| | - Ger Reesink
- Department of Linguistics, Faculty of Arts, Radboud University, Nijmegen, Netherlands
| | - Ruth Singer
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Research Unit for Indigenous Language, School of Languages and Linguistics, University of Melbourne, Melbourne, Australia
| | - Claire Bowern
- Department of Linguistics, Yale University, New Haven, CT, USA
| | - Patience Epps
- Department of Linguistics, University of Texas at Austin, Austin, TX, USA
| | - Jane Hill
- School of Anthropology, University of Arizona, Tucson, AZ, USA
| | - Outi Vesakoski
- Department of Biology, Turku University, Turku, Finland
- Department of Finnish and Finno-Ugric languages, University of Turku, Turku, Finland
| | - Martine Robbeets
- Department of Archaeology, Max Planck Institute for the Science of Human History, Jena, Germany
| | - Noor Karolin Abbas
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Daniel Auer
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Nancy A. Bakker
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Giulia Barbos
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Robert D. Borges
- Institute of Slavic Studies, Polish Academy of Sciences, Warsaw, Poland
| | - Swintha Danielsen
- Zentrum für Kleine und Regionale Sprachen, Friesisches Seminar, Europa-Universität Flensburg, Flensburg, Germany
- Centro de Investigaciones Históricas y Antropológicas (CIHA), Santa Cruz de la Sierra, Bolivia
- Europa-Universität Flensburg (EUF), Flensburg, Germany
| | - Luise Dorenbusch
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Institute of Linguistics, Leipzig University, Leipzig, Germany
| | - Ella Dorn
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - John Elliott
- Department of Linguistics, University of Hawaiʻi at Mānoa, Honolulu, HI, USA
| | - Giada Falcone
- Department of Linguistics and Philology, Uppsala University, Uppsala, Sweden
| | - Jana Fischer
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Yustinus Ghanggo Ate
- Department of Linguistics, School of Culture, History and Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Universitas Katolik Weetebula, Sumba Island, Indonesia
| | - Hannah Gibson
- Department of Languages and Linguistics, University of Essex, Essex, UK
| | - Hans-Philipp Göbel
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
- Department of Linguistics, University of Cologne, Cologne, Germany
| | - Jemima A. Goodall
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Victoria Gruner
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Andrew Harvey
- Faculty of Languages and Literatures, University of Bayreuth, Bayreuth, Germany
| | - Rebekah Hayes
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Leonard Heer
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Roberto E. Herrera Miranda
- Institut National des Langues et Civilisations Orientales (INALCO), Paris, France
- Institute of Linguistics, Leipzig University, Leipzig, Germany
- Structure et Dynamique des Langues (SeDyl), Centre National de la Recherche Scientifique (CNRS), Villejuif, France
- Sprachwissenschaftliches Seminar, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Nataliia Hübler
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Biu Huntington-Rainey
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London (UCL), University of London, London, UK
- Institutt for Filosofi, ide- og Kunsthistorie og Klassiske Språk (IFIKK), Det Humanistisk Fakultet, Universitet i Oslo, Oslo, Norway
| | - Jessica K. Ivani
- Department of Comparative Linguistics, University of Zürich, Zürich, Switzerland
| | - Marilen Johns
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Erika Just
- Department of Comparative Linguistics, University of Zürich, Zürich, Switzerland
| | - Eri Kashima
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Department of Linguistics, School of Culture, History and Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
| | - Carolina Kipf
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Janina V. Klingenberg
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Nikita König
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
- Department of Linguistics, European University Viadrina, Frankfur an der Oder, Germany
| | - Aikaterina Koti
- Department of Linguistics and Philology, Uppsala University, Uppsala, Sweden
| | | | - Olga Krasnoukhova
- Centre for Linguistics, Leiden University, Leiden, Netherlands
- Department of Linguistics, University of Antwerpen, Antwerpen, Belgium
| | - Nora L. M. Lindvall
- Department of Linguistics and Philology, Uppsala University, Uppsala, Sweden
| | - Mandy Lorenzen
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Hannah Lutzenberger
- Department of Linguistics, Faculty of Arts, Radboud University, Nijmegen, Netherlands
- Department of English Language and Linguistics, University of Birmingham, Birmingham, UK
| | - Tânia R. A. Martins
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Celia Mata German
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Suzanne van der Meer
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Jaime Montoya Samamé
- Facultad de Letras y Ciencias Humanas, Pontificia Universidad Católica del Perú, Lima, Perú
| | - Michael Müller
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Saliha Muradoglu
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
| | - Kelsey Neely
- Department of Linguistics, University of Texas at Austin, Austin, TX, USA
| | - Johanna Nickel
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Miina Norvik
- Institute of Estonian and General Linguistics, University of Tartu, Tartu, Estonia
- Department of Modern Languages, Uppsala University, Uppsala, Sweden
| | - Cheryl Akinyi Oluoch
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Jesse Peacock
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Department of Linguistics, Faculty of Arts, Radboud University, Nijmegen, Netherlands
| | - India O. C. Pearey
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Naomi Peck
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- University of Freiburg, Freiburg, Germany
| | - Stephanie Petit
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Sören Pieper
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Mariana Poblete
- Facultad de Letras y Ciencias Humanas, Pontificia Universidad Católica del Perú, Lima, Perú
- Universidad de Chile, Santiago, Chile
| | - Daniel Prestipino
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
| | - Linda Raabe
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Amna Raja
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Janis Reimringer
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Sydney C. Rey
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
- The Language Conservancy, Bloomington, IN, USA
| | - Julia Rizaew
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Eloisa Ruppert
- Department of Linguistics, Quantitative Lexicology and Variational Linguistics (QLVL), KU Leuven, Leuven, Belgium
| | - Kim K. Salmon
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Jill Sammet
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Rhiannon Schembri
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Division of Ecology and Evolution, Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - Lars Schlabbach
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Amalia Skilton
- Department of Linguistics, Cornell University, Ithaca, NY, USA
| | | | - Hilário de Sousa
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- Centre de Recherches Linguistiques sur l'Asie Orientale (CRLAO), École des Hautes Études en Sciences Sociales (EHESS), Aubervilliers, France
| | - Kristin Sverredal
- Department of Linguistics and Philology, Uppsala University, Uppsala, Sweden
| | - Daniel Valle
- Department of Modern Languages, University of Mississippi, Oxford, MS, USA
| | - Javier Vera
- Facultad de Letras y Ciencias Humanas, Pontificia Universidad Católica del Perú, Lima, Perú
| | - Judith Voß
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Tim Witte
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Frisian and General Linguistics, Department of General Linguistics, Institute for Scandinavian Studies, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Henry Wu
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- International College for Postgraduate Buddhist Studies, Tokyo, Japan
| | - Stephanie Yam
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Institute for General Linguistics, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Jingting Ye
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Department of Chinese Language and Literature, Fudan University, Shanghai, China
| | - Maisie Yong
- Department of Linguistics, School of Languages, Cultures and Linguistics, School of Oriental and African Studies (SOAS), University of London, London, UK
| | - Tessa Yuditha
- Department of Linguistics, Faculty of Arts, Radboud University, Nijmegen, Netherlands
- Department of Spanish, Linguistics, and Theory of Literature (Linguistics), Faculty of Philology, University of Seville, Seville, Spain
| | - Roberto Zariquiey
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Facultad de Letras y Ciencias Humanas, Pontificia Universidad Católica del Perú, Lima, Perú
| | - Robert Forkel
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Nicholas Evans
- ARC Centre of Excellence for the Dynamics of Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
- Department of Linguistics, School of Culture, History and Language, College of Asia and the Pacific, Australian National University, Canberra, Australia
| | - Stephen C. Levinson
- Department of Language and Cognition, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Martin Haspelmath
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Simon J. Greenhill
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- School of Psychology, University of Auckland, Auckland, New Zealand
| | | | - Russell D. Gray
- Department of Linguistic and Cultural Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- School of Psychology, University of Auckland, Auckland, New Zealand
- Corresponding author. (H.S.); (R.D.G.)
| |
Collapse
|
2
|
Hayes R, Cassidy M, Nevin R, Walsh K, Griffin A, Mealy B, Herbst J, Carroll KM. 294 INTEGRATION OF MUSIC THERAPY WITHIN A MULTIDISCIPLINARY TEAM FOR OLDER ADULTS IN AN ACUTE HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.258] [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
Music Therapy (MT) is an evidence-based intervention in which a music therapist uses music within a therapeutic relationship to achieve targeted goals. Studies show that MT may improve patient communication, cognition and mood, and facilitate rehabilitation by improving motor skills, particularly in those with stroke and Parkinson’s disease. We aimed to integrate MT within our geriatric multidisciplinary team (MDT) by: (1) promoting knowledge of MT among MDT staff; and (2) developing and implementing a MT referral pathway for patients. Furthermore, we aimed to assess its overall impact.
Methods
Music therapists delivered oral presentations and experiential learning through creative workshops, collaboration and feedback to allied health therapists in our geriatric MDT. Criteria for referrals for MT and a referral pathway were developed. Data on patients who received MT was collated.
Results
There were 70 referrals for MT from our MDT. 61% were female, mean age 77 years. Referral sources were occupational therapists (45%), speech therapists (34%), medical social workers (13%), physiotherapists (8%). Patients included those with stroke (41%), general medical conditions (23%), dementia (16%), Parkinson's (11%) and mental health concerns (9%). There were 16 joint MDT sessions and a mean of 5 MT sessions per patient (about 40 minutes in duration). Interventions included: Melodic Intonation Therapy (MIT), singing and vocal exercises, Rhythmic Auditory Stimulation (RAS), Musical Neglect Training (MNT), Therapeutic Instrumental Musical Performance (TIMP), reminiscence and song-writing. Overall, we identified better engagement with rehabilitation and improvements in mood, speech (voice strength and verbal fluency) and upper and lower limb co-ordination.
Conclusion
MT was successfully integrated into a geriatric MDT and had beneficial effects on patient mood, speech, communication and motor function. Education of MDT members was crucial in achieving appropriate MT referrals. Joint MDT’s also facilitated individualised MT interventions. Findings strongly support our model that incorporates MT within an MDT.
Collapse
Affiliation(s)
- R Hayes
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - M Cassidy
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - R Nevin
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - K Walsh
- St. James’s Hospital Speech and Language Therapy Department, , Dublin, Ireland
| | - A Griffin
- St. James’s Hospital Occupational Therapy Department, , Dublin, Ireland
| | - B Mealy
- St. James’s Hospital Physiotherapy Department, , Dublin, Ireland
| | - J Herbst
- St. James’s Hospital Medical Social Work Department, , Dublin, Ireland
| | - KM Carroll
- St. James’s Hospital Department of Gerontology, , Dublin, Ireland
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| |
Collapse
|
3
|
Cassidy M, Hayes R, Nevin R, Griffin A, Herbst J, Mealy B, Walsh K, Donnelly R, Harrison H, Jariol A, Joseph L, Carroll KM. 301 BENEFITS OF ENVIRONMENTAL MUSIC THERAPY IN AN ACUTE HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Environmental Music Therapy (EMT) uses live music played by a music therapist to enhance the surrounding environment and is increasingly used in clinical settings. Studies show that EMT may reduce anxiety, enhance wellbeing, promote better communication between patients and staff, and reduce patient perception of waiting times in hospital. We aimed to explore the benefit of EMT for older adults in a geriatric outpatient setting and on rehabilitation wards.
Methods
Harp music was played by a music therapist in the vicinity of ambulatory clinics and on rehabilitation wards for 4 hours per week (over a 2-day period) for 20 weeks. Music exposure on any given day was to an estimated 50 outpatients, as well as 50 people passing the vicinity or to about 30 patients on the rehabilitation ward. Music was selected and played in a dynamic process, responding to verbal and non-verbal reactions of patients, family, and staff. Voluntary responses were recorded and collated.
Results
There were 36 recorded responses and all reflected positively on EMT. Patients cited that the music created a welcoming space and stimulated interaction and conversation. Several patients waiting for their clinic appointment noted that it distracted from fearful expectation and was a source of comfort. Some commented that they felt more relaxed and that it reduced stress. On rehabilitation wards, patients found familiar music to be calming with nurses citing that it stimulated social interaction between patients, family and staff. Responses to EMT gave insights that resulted in patient referrals for music therapy.
Conclusion
Environmental music played by a music therapist was found to modify patient hospital experiences. In particular, it appeared to reduce self-perceived stress and stimulate positive social interaction and conversation. This supports the use of EMT to advance the integration of the arts for wellbeing in an acute hospital.
Collapse
Affiliation(s)
- M Cassidy
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - R Hayes
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - R Nevin
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - A Griffin
- St. James's Hospital Occupational Therapy Department, , Dublin, Ireland
| | - J Herbst
- St. James's Hospital Medical Social Work Department, , Dublin, Ireland
| | - B Mealy
- St. James's Hospital Physiotherapy Department, , Dublin, Ireland
| | - K Walsh
- St. James's Hospital Speech and Language Therapy Department, , Dublin, Ireland
| | - R Donnelly
- St. James’s Hospital Medicine for the Elderly Department, , Dublin, Ireland
| | | | | | - L Joseph
- St. James’s Hospital Medicine for the Elderly Department, , Dublin, Ireland
| | - KM Carroll
- St. James's Hospital Creative Life Centre, Mercer's Institute for Successful Ageing, , Dublin, Ireland
| |
Collapse
|
4
|
Fonseca De Freitas D, Patel I, Kadra-Scalzo G, Pritchard M, Shetty H, Broadbent M, Patel R, Downs J, Segev A, Khondoker M, Maccabe J, Bhui K, Hayes R. Ethnic inequalities in treatment with clozapine. Eur Psychiatry 2022. [PMCID: PMC9567955 DOI: 10.1192/j.eurpsy.2022.1565] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Ethnic disparities in treatment with clozapine, the antipsychotic recommended for treatment-resistant schizophrenia (TRS), have been reported. However, these investigations frequently suffer from potential residual confounding. For example, few studies have restricted the analyses to TRS samples and none has controlled for benign ethnic neutropenia. Objectives This study investigated if service-users’ ethnicity influenced clozapine prescription in a cohort of people with TRS. Methods Information from the clinical records of South London and Maudsley NHS Trust was used to identify a cohort of service-users with TRS between 2007 and 2017. In this cohort, we used logistic regression to investigate any association between ethnicity and clozapine prescription while adjusting for potential confounding variables, including sociodemographic factors, psychiatric multimorbidity, substance use, benign ethnic neutropenia, and inpatient and outpatient care received. Results
We identified 2239 cases that met the criteria for TRS. Results show that after adjusting for confounding variables, people with Black African ethnicity had half the odds of being treated with clozapine and people with Black Caribbean or Other Black background had about two-thirds the odds of being treated with clozapine compared White British service-users. No disparities were observed regarding other ethnic groups, namely Other White background, South Asian, Other Asian, or any other ethnicity. Conclusions There was evidence of inequities in care among Black ethnic groups with TRS. Interventions targeting barriers in access to healthcare are recommended. Disclosure During the conduction of the study, DFdF, GKS, and RH received funds from the NIHR Maudsley Biomedical Research Centre. For other activities outside the submitted work, DFdF received research funding from the UK Department of Health and Social Care, Janss
Collapse
|
5
|
Fonseca De Freitas D, Khondoker M, Nazroo J, Hayes R, Bhui K. Ethnic inequalities in multiple comorbidities among people with psychosis. Eur Psychiatry 2022. [PMCID: PMC9567012 DOI: 10.1192/j.eurpsy.2022.864] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Studies have shown ethnic inequalities in health, with a higher incidence of illnesses among people of some minoritised ethnic groups. Furthermore, it has been observed that people with severe mental illnesses have a higher risk for multimorbidity. However, no study has investigated ethnic disparities in comorbidity in people with a schizophrenia spectrum disorder. Objectives This study investigates potential ethnic disparities in physical health comorbidity in a cohort of people with psychosis. Methods Using a cross-sectional design, we identified service-users of the South London and Maudsley NHS Trust who were diagnosed with a schizophrenia spectrum disorder between 2007 and 2020. We assessed the prevalence of asthma, bronchitis, diabetes, hypertension, low blood pressure, overweight or obesity, and rheumatoid arthritis. Latent class analyses were used to investigate distinct profiles of comorbidity. Multinomial regression was then used to investigate ethnic disparities in these profiles. The regression model was adjusted for gender, age, neighbourhood deprivation, smoking and duration of care. Results On a sample of 23,418 service-users with psychosis, we identified two classes of comorbidity: low comorbidity and multiple comorbidities. Compared to the White British ethnicity, a higher risk for multiple comorbidities was observed for people with any Black background, Indian, Pakistani, Asian British, and mixed-race ethnicities. Furthermore, Black African women had a significantly higher risk for multiple comorbidities than their male counterparts. Conclusions Ethnic disparities are observed in multiple comorbidities among people with psychosis. Further research is needed to understand the impact of these disparities, especially in relation to mortality. Disclosure No significant relationships.
Collapse
|
6
|
Fonseca De Freitas D, Agbedjro D, Kadra-Scalzo G, Francis E, Ridler I, Pritchard M, Shetty H, Segev A, Casetta C, Smart S, Morris A, Downs J, Christensen S, Bak N, Kinon B, Stahl D, Hayes R, Maccabe J. Correlates of late-onset antipsychotic treatment resistance. Eur Psychiatry 2022. [PMCID: PMC9567017 DOI: 10.1192/j.eurpsy.2022.2018] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction There is emerging evidence of heterogeneity within treatment-resistance schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and a smaller group becoming treatment-resistant after an initial response period. It has been suggested that these groups have different aetiologies. Few studies have investigated socio-demographic and clinical differences between early and late onset of TRS. Objectives This study aims to investigate socio-demographic and clinical correlates of late-onset of TRS. Methods Using data from the electronic health records of the South London and Maudsley, we identified a cohort of people with TRS. Regression analyses were conducted to identify correlates of the length of treatment to TRS. Analysed predictors include gender, age, ethnicity, positive symptoms severity, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics. Results We observed a continuum of the length of treatment until TRS presentation. Having severe hallucinations and delusions at treatment start was associated shorter duration of treatment until the presentation of TRS. Conclusions Our findings do not support a clear cut categorisation between early and late TRS, based on length of treatment until treatment resistance onset. More severe positive symptoms predict earlier onset of treatment resistance. Disclosure DFdF, GKS, EF and IR have received research funding from Janssen and H. Lundbeck A/S. RDH and HS have received research funding from Roche, Pfizer, Janssen and Lundbeck. SES is employed on a grant held by Cardiff University from Takeda Pharmaceutical Comp
Collapse
|
7
|
Shanaube K, Schaap A, Klinkenberg E, Floyd S, Bwalya J, Cheeba M, de Haas P, Kosloff B, Ruperez M, Hayes R, Ayles H. SARS-CoV-2 seroprevalence and associated risk factors in periurban Zambia: a population-based study. Int J Infect Dis 2022; 118:256-263. [PMID: 35306205 PMCID: PMC8925090 DOI: 10.1016/j.ijid.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND We nested a seroprevalence survey within the TREATS (Tuberculosis Reduction through Expanded Antiretroviral Treatment and Screening) project. We aimed to measure the seroprevalence of SARS-CoV-2 infection and investigate associated risk factors in one community (population ∼27,000) with high prevalence of TB/HIV in Zambia. METHODS The study design was cross-sectional. A random sample of 3592 individuals aged ≥15 years enrolled in the TREATS TB-prevalence survey were selected for antibody testing. Randomly selected blocks of residence were visited between October 2020 and March 2021. Antibodies against SARS-CoV-2 were detected using Abbott- ARCHITECT SARS-CoV-2 IgG assay. RESULTS A total of 3035/3526 (86.1%) individuals had a blood sample taken. Antibody testing results were available for 2917/3035 (96.1%) participants. Overall, 401/2977 (13.5%) individuals tested positive for IgG antibodies. Seroprevalence was similar by sex (12.7% men vs 14.0% women) and was lowest in the youngest age group 15-19 years (9.7%) and similar in ages 20 years and older (∼15%). We found no evidence of an association between seroprevalence and HIV-status or TB. There was strong evidence (p <0.001) of variation by time of enrollment, with prevalence varying from 2.8% (95% CI 0.8-4.9) among those recruited in December 2020 to 33.7% (95% CI 27.7-39.7) among those recruited in mid-February 2021. CONCLUSION Seroprevalence was 13.5% but there was substantial variation over time, with a sharp increase to approximately 35% toward the end of the second epidemic wave.
Collapse
Affiliation(s)
| | - A Schaap
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| | | | - S Floyd
- London School of Hygiene and Tropical Medicine
| | | | | | - P de Haas
- KNCV Tuberculosis Foundation, Netherlands
| | - B Kosloff
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| | - M Ruperez
- London School of Hygiene and Tropical Medicine
| | - R Hayes
- London School of Hygiene and Tropical Medicine
| | - H Ayles
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| |
Collapse
|
8
|
Sabapathy K, Stöckl H, Mulubwa C, Mubekapi-Musadaidzwa C, Hoddinott G, Floyd S, Seeley J, Bond V, Bock P, Fidler S, Ayles H, Hayes R. Intimate Partner Violence (IPV) and Associated Factors in HPTN 071 (PopART) Study Communities in Zambia and South Africa-A Comparison by HIV Status. AIDS Behav 2022; 26:1355-1365. [PMID: 35165795 PMCID: PMC9001629 DOI: 10.1007/s10461-021-03492-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
The HPTN 071(PopART) study was a community-randomised trial in Zambia and South Africa, examining the impact of combination-prevention including universal testing and treatment (UTT), on HIV-incidence. This sub-study evaluated factors associated with IPV (physical and/or sexual) to identify differences by HIV status. During 2015-16, a random subset of adults who participated in the first year of the PopART intervention were recruited and standardised questionnaires were administered. Logistic regression was performed to estimate odds ratios of factors associated with IPV. Among > 700 women studied (300 HIV-negative;400 HIV-positive), ~ 20% reported experiencing physical and/or sexual violence in the last 12-months. Sexual violence was similar by HIV status, but physical violence and reporting both physical/sexual violence was more common among HIV-positive women. Spending nights away from the community in the last 12-months was associated with higher odds of IPV among both HIV-negative (aOR 3.17, 95% CI 1.02-9.81) and HIV-positive women (aOR 1.79, 95% CI 0.99-3.24). Among HIV-positive women, financial autonomy was associated with reduced IPV (aOR:0.41,95%CI:0.23-0.75) while pregnancy in the last 12-months (aOR 2.25, 95% CI 1.07-4.74), risk of alcohol dependence (aOR 2.75, 95% CI 1.51-5.00) and risk of mental distress (aOR 2.62, 95% CI 1.33-5.16) were associated with increased IPV. Among HIV-negative women reporting sex in the last 12-months, transactional sex (aOR 3.97, 95% CI 1.02-15.37) and not knowing partner's HIV status (aOR 3.01, 95% CI 1.24-7.29) were associated with IPV. IPV was commonly reported in the study population and factors associated with IPV differed by HIV status. The association of mobility with IPV warrants further research. The high prevalence of harmful alcohol use and mental distress, and their association with IPV among HIV-positive women require urgent attention.
Collapse
Affiliation(s)
- K. Sabapathy
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - H. Stöckl
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
- Ludwig-Maximilians-University, Munich, Germany
| | - C. Mulubwa
- Zambia AIDS Related TB Project, University of Zambia, Lusaka, Zambia
| | | | - G. Hoddinott
- Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch, Western Cape South Africa
| | - S. Floyd
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - J. Seeley
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - V. Bond
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
- Zambia AIDS Related TB Project, University of Zambia, Lusaka, Zambia
| | - P. Bock
- Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch, Western Cape South Africa
| | | | - H. Ayles
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
- Zambia AIDS Related TB Project, University of Zambia, Lusaka, Zambia
| | - R. Hayes
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - on behalf of HPTN 071 (PopART) Study Team
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
- Ludwig-Maximilians-University, Munich, Germany
- Zambia AIDS Related TB Project, University of Zambia, Lusaka, Zambia
- Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch, Western Cape South Africa
- Imperial College London, London, UK
| |
Collapse
|
9
|
Hensen B, Phiri M, Schaap A, Sigande L, Simwinga M, Floyd S, Belemu S, Simuyaba M, Shanaube K, Fidler S, Hayes R, Ayles HM. Uptake of HIV Testing Services Through Novel Community-Based Sexual and Reproductive Health Services: An Analysis of the Pilot Implementation Phase of the Yathu Yathu Intervention for Adolescents and Young People Aged 15-24 in Lusaka, Zambia. AIDS Behav 2022; 26:172-182. [PMID: 34302282 DOI: 10.1007/s10461-021-03368-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/24/2022]
Abstract
Adolescents and young people aged 15-24 are underserved by available HIV-testing services (HTS). Delivering HTS through community-based, peer-led, hubs may prove acceptable and accessible to adolescents and young people, thus increasing HIV-testing coverage. We used data from the pilot phase of a cluster-randomised trial of community-based sexual and reproductive health services for adolescents and young people in Lusaka, Zambia, between September 2019 and January 2020, to explore factors associated with uptake of HTS through community-based hubs. 5,757 adolescents and young people attended the hubs (63% female), among whom 75% tested for HIV (76% of females, 75% of males). Community-based hubs provided HTS to 80% of adolescents and young people with no history of HIV-testing. Among females, uptake of HTS was lower among married/cohabiting females; among males, uptake was lower among unmarried males and among individuals at risk of hazardous alcohol use. The high number of adolescents and young people accessing hubs for HIV testing suggests they are acceptable. Enhanced targeting of HTS to groups who may not perceive their HIV risk needs to be implemented.
Collapse
Affiliation(s)
- B Hensen
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
| | | | - A Schaap
- Zambart, Lusaka, Zambia
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - S Floyd
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - S Fidler
- Imperial College London, Imperial College National Institute of Heath Research BRC, London, UK
| | - R Hayes
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H M Ayles
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Zambart, Lusaka, Zambia
| |
Collapse
|
10
|
Bell-Mandla NF, Sloot R, Maarman G, Griffith S, Moore A, Floyd S, Hayes R, Fidler S, Ayles H, Bock P. Improving retention of community-recruited participants in HIV prevention research through Saturday household visits; findings from the HPTN 071 (PopART) study in South Africa. BMC Med Res Methodol 2021; 21:242. [PMID: 34749654 PMCID: PMC8574030 DOI: 10.1186/s12874-021-01415-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 09/28/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Identifying successful strategies to improve participant retention in longitudinal studies remains a challenge. In this study we evaluated whether non-traditional fieldworker shifts (after hours during the week and weekends) enhanced participant retention when compared to retention during traditional weekday shifts in the HPTN 071 (PopART) population cohort (PC). METHODS HPTN 071 (PopART) PC participants were recruited and followed up in their homes on an annual basis by research fieldworkers over a 3-4 year period. The average number of successful follow-up visits, where a PC participant was found and retained in the study, was calculated for each of 3 visit schedules (early weekday shift, late weekday shift, and Saturday shift), and standardized to account for variation in fieldwork shift duration. We used one-way univariate analysis of variance (ANOVA) to describe differences in mean-successful visits and 95% confidence intervals between the shift types. RESULTS Data on 16 651 successful visits were included. Successful visit rates were higher when conducting Saturday visits (14.0; 95% CI: 11.3-16.6) compared to both regular (4.5; 95% CI: 3.7-5.3) and late weekday shifts (5.3; 95% CI: 4.7-5.8) overall and in all subgroup analyses (P<0.001). The successful visit rate was higher amongst women than men were during all shift types (3.2 vs. 1.3, p<0.001). Successful visit rates by shift type did not differ significantly by age, over time, by PC round or by community triplet. CONCLUSION The number of people living with HIV continues to increase annually. High quality evidence from longitudinal studies remains critical for evaluating HIV prevention and treatment strategies. This study showed a significant benefit on participant retention through introduction of Saturday shifts for home visits and these data can make an important contribution to the emerging body of evidence for improving retention in longitudinal research. TRIAL REGISTRATION PopART was approved by the Stellenbosch University Health Research Ethics Committees (N12/11/074), London School of Hygiene and Tropical Medicine (6326) ethics committee and the Division of AIDS (DAIDS) (Protocol ID 11865). PopART was registered with ClinicalTrials.gov (registration number NCT01900977 ).
Collapse
Affiliation(s)
- N. F. Bell-Mandla
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - R. Sloot
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - G. Maarman
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | | | | | - S. Floyd
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - R. Hayes
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - S. Fidler
- Department of Medicine, Imperial College London, St Mary’s Campus, London, UK
| | - H. Ayles
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Zambart, Lusaka, Zambia
| | - P. Bock
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - on behalf of the HPTN 071 (PopART) study team
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- FHI 360, Durham, NC USA
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Department of Medicine, Imperial College London, St Mary’s Campus, London, UK
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Zambart, Lusaka, Zambia
| |
Collapse
|
11
|
Hensen B, Phiri M, Schaap A, Floyd S, Simuyaba M, Mwenge L, Sigande L, Belemu S, Shanaube K, Simwinga M, Fidler S, Hayes R, Ayles H. Yathu Yathu ("For us, by us"): Design of a cluster-randomised trial of the impact of community-based, peer-led comprehensive sexual and reproductive health services for adolescents and young people aged 15 to 24 in Lusaka, Zambia. Contemp Clin Trials 2021; 110:106568. [PMID: 34543725 DOI: 10.1016/j.cct.2021.106568] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/16/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In sub-Saharan Africa, the growing population of adolescents and young people aged 15 to 24 face a high burden of HIV, and other preventable and treatable sexually transmitted infections. Despite this burden, adolescents and young people are the population least served by available sexual and reproductive (SRH) services. This trial aims to evaluate the impact of community-based peer-led SRH services, combined with a novel incentivised "loyalty card" system, on knowledge of HIV status and coverage of SRH services. METHODS A cluster-randomised trial (CRT) with embedded process and economic evaluation. DISCUSSION With little available evidence of the impact of community-based, peer-led services on coverage of SRH services, our study will provide evidence critical to expanding our knowledge of how to reach adolescents and young people. The "loyalty card" system is also a novel approach to providing SRH services. The delivery of community-based services supported by incentives in the form of loyalty cards is innovative, and may prove a simple strategy to improve access to SRH services. Adolescents and young people remain underserved by available SRH services; there remains a critical need to identify ways to provide adolescents and young people with access to SRH services. Rigorous evidence of whether this innovative strategy, with strong links to the local health facility, increases coverage of critical SRH services would add to the evidence-base of how to reach adolescents and young people.
Collapse
Affiliation(s)
- B Hensen
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | | | - A Schaap
- Zambart, Lusaka, Zambia; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S Floyd
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | | | | | | | - S Fidler
- Imperial College and Imperial College NIHR BRC, London, United Kingdom
| | - R Hayes
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - H Ayles
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom; Zambart, Lusaka, Zambia
| |
Collapse
|
12
|
Wilkinson K, Ball S, Mitchell SB, Ukoumunne OC, O'Mahen HA, Tejerina-Arreal M, Hayes R, Berry V, Petrie I, Ford T. The longitudinal relationship between child emotional disorder and parental mental health in the British Child and Adolescent Mental Health surveys 1999 and 2004. J Affect Disord 2021; 288:58-67. [PMID: 33839559 DOI: 10.1016/j.jad.2021.03.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 12/22/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Research suggests parental psychopathology has an adverse effect on child mental health. However, due to the interactional nature of parent-child relationships and with a high rate of emotional disorders reported in school-age children, it is important to know whether the effect is reciprocal. METHODS We explored the longitudinal relationship between child and parent mental health in the British Child and Adolescent Mental Health Surveys (N=7,100 child-parent dyads) and their three-year follow-ups. The Development and Well-Being Assessment with DSM-IV diagnostic criteria was used to measure child psychiatric diagnoses, while parental mental health was assessed using the General Health Questionnaire. Multivariable logistic regression was used to explore the longitudinal association between child emotional disorder and parent mental health. RESULTS Parents of children who had an emotional disorder at baseline were more likely to have poor mental health three years later compared with parents whose children had no psychiatric diagnosis (33.3% versus 16.7%; crude odds ratio=2.52; adjusted odds ratio=2.19, 95% CI=1.58 to 3.05, p<0.001). Children of parents with poor mental health at baseline were more likely to develop an emotional disorder three years later compared with children whose parents had good mental health (5.2% versus 2.5%; crude odds ratio=2.08; adjusted odds ratio=1.63, 95% CI=1.18 to 2.25, p=0.003). LIMITATIONS The findings of this research are limited by the survey data collected, the measures used and survey dropout. CONCLUSIONS We detected a bi-directional relationship between child and parent mental health, suggesting that effective intervention for one individual may benefit other family members.
Collapse
Affiliation(s)
- K Wilkinson
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - S Ball
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - S B Mitchell
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - O C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - H A O'Mahen
- University of Exeter Mood Disorders Centre, Sir Henry Wellcome Building, Streatham Drive, Exeter, EX4 4QG, UK
| | - M Tejerina-Arreal
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - R Hayes
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - V Berry
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - I Petrie
- Child Mental Health Group, University of Exeter College of Medicine and Health, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - T Ford
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 2AH, UK
| |
Collapse
|
13
|
Mitchell KR, Erio T, Whitworth HS, Marwerwe G, Changalucha J, Baisley K, Lacey CJ, Hayes R, de SanJosé S, Watson-Jones D. Does the number of doses matter? A qualitative study of HPV vaccination acceptability nested in a dose reduction trial in Tanzania. Tumour Virus Res 2021; 12:200217. [PMID: 34051389 PMCID: PMC8233223 DOI: 10.1016/j.tvr.2021.200217] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/30/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background The multi-dose regimen is a known barrier to successful human papillomavirus (HPV) vaccination. Emerging evidence suggests that one vaccine dose could protect against HPV. While there are clear advantages to a single dose schedule, beliefs about vaccine dosage in low and middle income countries (LMICs) are poorly understood. We investigated acceptability of dose-reduction among girls, and parents/guardians of girls, randomised to receive one, two or three doses in an HPV vaccine dose-reduction and immunobridging study (DoRIS trial) in Tanzania. Methods Semi-structured interviews with girls (n = 19), and parents/guardians of girls (n = 18), enrolled in the study and completing their vaccine course. Results Most participants said they entrusted decisions about the number of HPV vaccine doses to experts. Random allocation to the different dose groups did not feature highly in the decision to participate in the trial. Given a hypothetical choice, girls generally said they would prefer fewer doses in order to avoid the pain of injections. Parental views were mixed, with most wanting whichever dose was most efficacious. Nonetheless, a few parents equated a higher number of doses with greater protection. Conclusion Vaccine trials and programmes will need to employ careful messaging to explain that one dose offers sufficient protection against HPV should emerging evidence from ongoing dose-reduction clinical trials support this. We interviewed girls, and parents/carers of girls, enrolled in an HPV Vaccine dose reduction trial. We found that enrolling in the trial in the context of community rumours required trust in the trial scientists. Scientists were trusted to decide on dosage; thus randomisation by dosage was not an acceptability issue. Girls preferred fewer vaccine doses in order to avoid injection-related pain. Parents/guardians generally wanted whichever dose regimen was most efficacious.
Collapse
Affiliation(s)
- K R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley St, Glasgow, G3 7HR, UK.
| | - T Erio
- Mwanza Intervention Trials Unit, National Institute of Medical Research, Isamilo, Mwanza, Tanzania.
| | - H S Whitworth
- Mwanza Intervention Trials Unit, National Institute of Medical Research, Isamilo, Mwanza, Tanzania; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - G Marwerwe
- Mwanza Intervention Trials Unit, National Institute of Medical Research, Isamilo, Mwanza, Tanzania.
| | - J Changalucha
- Mwanza Intervention Trials Unit, National Institute of Medical Research, Isamilo, Mwanza, Tanzania.
| | - K Baisley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - C J Lacey
- York Biomedical Research Institute & Hull York Medical School, University of York, John Hughlings Jackson Building, University Rd, Heslington, York YO10 5DD, UK.
| | - R Hayes
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - S de SanJosé
- Catalan Institute of Oncology, Avinguda de La Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain.
| | - D Watson-Jones
- Mwanza Intervention Trials Unit, National Institute of Medical Research, Isamilo, Mwanza, Tanzania; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| |
Collapse
|
14
|
Thompson JA, Hemming K, Forbes A, Fielding K, Hayes R. Comparison of small-sample standard-error corrections for generalised estimating equations in stepped wedge cluster randomised trials with a binary outcome: A simulation study. Stat Methods Med Res 2021; 30:425-439. [PMID: 32970526 PMCID: PMC8008420 DOI: 10.1177/0962280220958735] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Generalised estimating equations with the sandwich standard-error estimator provide a promising method of analysis for stepped wedge cluster randomised trials. However, they have inflated type-one error when used with a small number of clusters, which is common for stepped wedge cluster randomised trials. We present a large simulation study of binary outcomes comparing bias-corrected standard errors from Fay and Graubard; Mancl and DeRouen; Kauermann and Carroll; Morel, Bokossa, and Neerchal; and Mackinnon and White with an independent and exchangeable working correlation matrix. We constructed 95% confidence intervals using a t-distribution with degrees of freedom including clusters minus parameters (DFC-P), cluster periods minus parameters, and estimators from Fay and Graubard (DFFG), and Pan and Wall. Fay and Graubard and an approximation to Kauermann and Carroll (with simpler matrix inversion) were unbiased in a wide range of scenarios with an independent working correlation matrix and more than 12 clusters. They gave confidence intervals with close to 95% coverage with DFFG with 12 or more clusters, and DFC-P with 18 or more clusters. Both standard errors were conservative with fewer clusters. With an exchangeable working correlation matrix, approximated Kauermann and Carroll and Fay and Graubard had a small degree of under-coverage.
Collapse
Affiliation(s)
- JA Thompson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - K Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - A Forbes
- Biostatistics Unit, Monash University, Melbourne, Australia
| | - K Fielding
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - R Hayes
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
15
|
Leeme TB, Mine M, Lechiile K, Mulenga F, Mosepele M, Mphoyakgosi T, Muthoga C, Ngidi J, Nkomo B, Ramaabya D, Tau M, Tenforde MW, Hayes R, Jarvis JN. Utility of CD4 count measurement in the era of universal antiretroviral therapy: an analysis of routine laboratory data in Botswana. HIV Med 2020; 22:1-10. [PMID: 32876378 DOI: 10.1111/hiv.12951] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES National guidelines in Botswana recommend baseline CD4 count measurement and both CD4 and HIV viral load (VL) monitoring post-antiretroviral therapy (ART) initiation. We evaluated the utility of CD4 count measurement in Botswana in the era of universal ART. METHODS CD4 and VL data were analysed for HIV-infected adults undergoing CD4 count measurement in 2015-2017 at the Botswana Harvard HIV-Reference Laboratory. We determined (1) the proportion of individuals with advanced HIV disease (CD4 count < 200 cells/µL) at initial CD4 assessment, (2) the proportion with an initial CD4 count ≥ 200 cells/µL experiencing a subsequent decline in CD4 count to < 200 cells/µL, and (3) the proportion of these immunologically failing individuals who had virological failure. Logistic regression modelling examined factors associated with advanced HIV disease. CD4 count trajectories were assessed using locally weighted scatterplot smoothing (LOWESS) regression. RESULTS Twenty-five per cent (3571/14 423) of individuals with an initial CD4 assessment during the study period had advanced HIV disease at baseline. Older age [≥ 35 years; adjusted odds ratio (aOR) 1.9; 95% confidence interval (CI) 1.8-2.1] and male sex were associated with advanced HIV disease. Fifty per cent (7163/14 423) of individuals had at least two CD4 counts during the study period. Of those with an initial CD4 count ≥ 200 cells/µL, 4% (180/5061) experienced a decline in CD4 count to < 200 cells/µL; the majority of CD4 count declines were in virologically suppressed individuals and transient. CONCLUSIONS One-quarter of HIV-positive individuals in Botswana still present with advanced HIV disease, highlighting the importance of baseline CD4 count measurement to identify this at-risk population. Few with a baseline CD4 count ≥ 200 cells/µL experienced a drop below 200 cells/µL, suggesting limited utility for ongoing CD4 monitoring.
Collapse
Affiliation(s)
- T B Leeme
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - M Mine
- National Health Laboratory, Gaborone, Botswana
| | - K Lechiile
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - F Mulenga
- National Health Laboratory, Gaborone, Botswana
| | - M Mosepele
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - C Muthoga
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Botswana-UPenn Partnership, Gaborone
| | - J Ngidi
- National Health Laboratory, Gaborone, Botswana
| | - B Nkomo
- Ministry of Health and Wellness, Gaborone, Botswana
| | - D Ramaabya
- Ministry of Health and Wellness, Gaborone, Botswana
| | - M Tau
- Ministry of Health and Wellness, Gaborone, Botswana
| | | | - R Hayes
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - J N Jarvis
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
16
|
Bock P, Nel K, Fatti G, Sloot R, Ford N, Voget J, Gunst C, Grobbelaar N, Louis F, Floyd S, Hayes R, Ayles H, Beyers N, Fidler S. Renal dysfunction by baseline CD4 cell count in a cohort of adults starting antiretroviral treatment regardless of CD4 count in the HIV Prevention Trials Network 071 [HPTN 071; Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART)] study in South Africa. HIV Med 2019; 20:392-403. [PMID: 30963667 PMCID: PMC6767782 DOI: 10.1111/hiv.12729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Renal dysfunction is a significant cause of morbidity and mortality among HIV-positive individuals. This study evaluated renal dysfunction in a cohort of adults who started antiretroviral treatment (ART) regardless of CD4 count at three Department of Health (DOH) clinics included in the HIV Prevention Trials Network 071 (HPTN 071) Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART) trial. METHODS A retrospective cohort analysis of routine data for HIV-positive individuals starting ART between January 2014 and November 2015 was completed. Incident renal dysfunction was defined as an estimated glomerular filtration rate (eEGFR) < 60 mL/min after ART initiation among individuals with a baseline (pre-ART) eGFR ≥ 60 mL/min. RESULTS Overall, 2423 individuals, with a median baseline CD4 count of 328 cells/μL [interquartile range (IQR) 195-468 cells/μL], were included in the analysis. Forty-seven individuals had a baseline eGFR < 60 mL/min. Among 1634 nonpregnant individuals started on a tenofovir-containing ART regimen and with a baseline eGFR ≥ 60 mL/min, 27 developed an eGFR < 60 mL/min on ART. Regression analysis showed lower odds of baseline eGFR < 60 mL/min at baseline CD4 counts of > 500 cells/μL [adjusted odds ratio (aOR) 0.29; 95% confidence interval (CI) 0.11-0.80], 351-500 cells/μL (aOR 0.22; 95% CI 0.08-0.59) and 201-350 (aOR 0.48; 95% CI: 0.24-0.97) compared with baseline CD4 counts < 200 cells/μL. CONCLUSIONS This study showed low rates of renal dysfunction at baseline and on ART, with lower rates of baseline renal dysfunction among individuals with baseline CD4 counts > 200 cells/μL. Strategies that use baseline characteristics, such as age, to identify individuals at high risk of renal dysfunction on ART for enhanced eGFR monitoring may be effective and should be the subject of future research.
Collapse
Affiliation(s)
- P Bock
- Department of Paediatrics and Child HealthFaculty of Medicine and Health SciencesDesmond Tutu TB CentreStellenbosch UniversityCape TownSouth Africa
| | - K Nel
- Department of Paediatrics and Child HealthFaculty of Medicine and Health SciencesDesmond Tutu TB CentreStellenbosch UniversityCape TownSouth Africa
- City of Cape Town Health ServicesCape TownSouth Africa
| | - G Fatti
- Kheth’ Impilo, AIDS Free LivingCape TownSouth Africa
- Division of Epidemiology and BiostatisticsDepartment of Global HealthFaculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
| | - R Sloot
- Department of Paediatrics and Child HealthFaculty of Medicine and Health SciencesDesmond Tutu TB CentreStellenbosch UniversityCape TownSouth Africa
- Amsterdam Institute for Global Health and DevelopmentAmsterdamThe Netherlands
| | - N Ford
- Centre for Infectious Disease Epidemiology and ResearchUniversity of Cape TownCape TownSouth Africa
| | - J Voget
- Western Cape Department of HealthHIV/AIDS, STI & TB DirectorateCape TownSouth Africa
| | - C Gunst
- Faculty of Medicine and Health SciencesStellenbosch University Division of Family Medicine and Primary Health CareStellenbosch UniversityCape TownSouth Africa
- Western Cape Department of HealthCape Winelands DistrictBrewelskloof HospitalWorcesterSouth Africa
| | | | - F Louis
- Independent ConsultantCape TownSouth Africa
| | - S Floyd
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - R Hayes
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - H Ayles
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - N Beyers
- Department of Paediatrics and Child HealthFaculty of Medicine and Health SciencesDesmond Tutu TB CentreStellenbosch UniversityCape TownSouth Africa
| | - S Fidler
- Department of MedicineImperial College LondonLondonUK
| | | |
Collapse
|
17
|
Titheradge D, Hayes R, Longdon B, Allen K, Price A, Hansford L, Nye E, Ukoumunne O, Byford S, Norwich B, Fletcher M, Logan S, Ford T. Psychological distress among primary school teachers: a comparison with clinical and population samples. Public Health 2019; 166:53-56. [DOI: 10.1016/j.puhe.2018.09.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/31/2018] [Accepted: 09/25/2018] [Indexed: 11/26/2022]
|
18
|
Sabapathy K, Mulubwa C, Mathema H, Mubekapi‐Musadaidzwa C, Schaap A, Hoddinott G, Hargreaves J, Floyd S, Ayles H, Hayes R. Is home-based HIV testing universally acceptable? Findings from a case-control study nested within the HPTN 071 (PopART) trial. Trop Med Int Health 2018; 23:678-690. [PMID: 29608231 PMCID: PMC6001569 DOI: 10.1111/tmi.13055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The HPTN 071 (PopART) trial is examining the impact of a package including universal testing and treatment on community-level HIV incidence in Zambia and South Africa. We conducted a nested case-control study to examine factors associated with acceptance of home-based HIV testing and counselling (HB-HTC) delivered by community HIV-care providers (CHiPs) in PopART intervention communities. METHODS Of 295 447 individuals who were offered testing, random samples of individuals who declined HB-HTC (cases) and accepted HB-HTC (controls), stratified by gender and community, were selected. Odds ratios comparing cases and controls were estimated using multivariable logistic regression. RESULTS Data from 642 participants (313 cases, 329 controls) were analysed. There were no differences between cases and controls by demographic or behavioural characteristics including age, marital or socio-economic position. Participants who felt they could be open with CHiPs (AOR: 0.46, 95% CI: 0.30-0.71, P < 0.001); self-reported as not previously tested (AOR: 0.64; 95% CI: 0.43-0.95, P = 0.03); considered HTC at home to be convenient (AOR: 0.38, 95% CI: 0.27-0.54, P = 0.001); knowing others who had accepted HB-HTC from the CHiPs (AOR: 0.49, 95% CI: 0.31-0.77, P = 0.002); or were motivated to get treatment without delay (AOR: 0.60, 95% CI: 0.43-0.85, P = 0.004) were less likely to decline the offer of HB-HCT. Those who self-reported high-risk sexual behaviour were also less likely to decline HB-HCT (AOR: 0.61, 95% CI: 0.39-0.93, P = 0.02). Having stigmatising attitudes about HB-HTC was not an important barrier to HB-HCT uptake. Men who reported fear of HIV were more likely to decline HB-HCT (AOR: 2.68, 95% CI: 1.33-5.38, P = 0.005). CONCLUSION Acceptance of HB-HTC was associated with lack of previous HIV testing, positive attitudes about HIV services/treatment and perception of high sexual risk. Uptake of HB-HCT among those offered it was similar across a range of demographic and behavioural subgroups suggesting it was 'universally' acceptable.
Collapse
Affiliation(s)
- K. Sabapathy
- London School of Hygiene and Tropical MedicineLondonUK
| | - C. Mulubwa
- Zambia AIDS Related TB ProjectLusakaZambia
| | - H. Mathema
- Desmond Tutu TB CentreDepartment of Paediatric and Child HealthStellenbosch University
- Present address:
Division of Public Health Surveillance and ResponseNational Institute for Communicable DiseasesNational Health Laboratory ServiceSouth Africa
| | | | - A. Schaap
- Zambia AIDS Related TB ProjectLusakaZambia
| | - G. Hoddinott
- Desmond Tutu TB CentreDepartment of Paediatric and Child HealthStellenbosch University
| | - J. Hargreaves
- London School of Hygiene and Tropical MedicineLondonUK
| | - S. Floyd
- London School of Hygiene and Tropical MedicineLondonUK
| | - H. Ayles
- London School of Hygiene and Tropical MedicineLondonUK
- Zambia AIDS Related TB ProjectLusakaZambia
| | - R. Hayes
- London School of Hygiene and Tropical MedicineLondonUK
| | | |
Collapse
|
19
|
Zalawadiya S, Lindenfeld J, Shah A, Wigger M, Keebler M, Danter M, Brinkley M, Menachem J, Sacks S, Ooi H, Chung C, Perri R, Awad J, Smith S, Hayes R, Rueda Rios C, O’Dell H, Darragh C, Ruzevich-Scholl S, Schlendorf K. Trends in Renal Function Among Heart Transplant Recipients of Donors With Hepatitis C. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.477] [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
|
20
|
Zalawadiya S, Lindenfeld J, Haddad E, Wigger M, Danter M, Keebler M, Brinkley M, Menachem J, Sacks S, Ooi H, Perri R, Chung C, Awad J, Smith S, Hayes R, O’Dell H, Darragh C, Ruzevich-Scholl S, Schlendorf K. Intracoronary Intimal Thickness in Recipients of Hepatitis C-Positive Donor Hearts. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.251] [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
|
21
|
Schlendorf K, Zalawadiya S, Shah A, Wigger M, Chung C, Danter M, Keebler M, Brinkley D, Menachem J, Brown Sacks S, Ooi H, Perri R, Awad J, Smith S, Hayes R, O'dell H, Darragh C, Carver A, Edmonds C, Ruzevich-Scholl S, Lindenfeld J. Early Outcomes Using Hepatitis C-Exposed Donors for Cardiac Transplantation in the Era of Effective Direct-Acting Antiviral Treatments. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.873] [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: 10/17/2022] Open
|
22
|
Price A, Allen K, Ukoumunne OC, Hayes R, Ford T. Examining the psychological and social impact of relative age in primary school children: a cross-sectional survey. Child Care Health Dev 2017; 43:891-898. [PMID: 28547806 DOI: 10.1111/cch.12479] [Citation(s) in RCA: 7] [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: 07/08/2016] [Revised: 04/24/2017] [Accepted: 04/29/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND A number of studies demonstrate that children who are younger within their school year have poorer academic attainment and are more likely to have special educational needs. Few, however, have considered the impact relative age may have on child mental health, behaviour and happiness in school. METHODS This paper utilized data from the Supporting Teachers and Children in Schools study (2075 pupils aged 5 to 9 years from 80 primary schools) to explore the relationship among relative age, behaviour and happiness in school. Behavioural and emotional development was assessed by using the teacher-reported and parent-reported Strengths and Difficulties Questionnaire and the Pupil Behaviour Questionnaire. Children's happiness within school was assessed by using the How I Feel About My School Questionnaire. RESULTS Relatively younger children had higher Total Difficulties scores on the Strengths and Difficulties Questionnaire than their peers. There was a mean increase per 30-day decrease in relative age of 0.09 (95% CI: 0.03 to 0.16; p = 0.007) in teacher-reported and 0.08 (0.001 to 0.16; p = 0.05) in parent-reported scores. There was little evidence of a relationship between relative age and children's behaviour and happiness in school. CONCLUSIONS For children with complex difficulties, being relatively young for their school year may be an additional stressor that may undermine mental health.
Collapse
Affiliation(s)
- A Price
- Child Health, University of Exeter Medical School, Exeter, UK
| | - K Allen
- Child Health, University of Exeter Medical School, Exeter, UK
| | - O C Ukoumunne
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - R Hayes
- Child Health, University of Exeter Medical School, Exeter, UK
| | - T Ford
- Child Health, University of Exeter Medical School, Exeter, UK
| |
Collapse
|
23
|
Affiliation(s)
- J. Kotzerke
- School of Science, RMIT University, Melbourne, Australia
| | - S. A. Davis
- School of Science, RMIT University, Melbourne, Australia
| | - R. Hayes
- Forensic Services Department, Victoria Police, Forensic Services Centre, Melbourne, Australia
| | - K. J. Horadam
- School of Science, RMIT University, Melbourne, Australia
| |
Collapse
|
24
|
Li W, Youssef G, Procter-Gray E, Olendzki B, Cornish T, Hayes R, Churchill L, Kane K, Brown K, Magee MF. Racial Differences in Eating Patterns and Food Purchasing Behaviors among Urban Older Women. J Nutr Health Aging 2017; 21:1190-1199. [PMID: 29188879 PMCID: PMC5726305 DOI: 10.1007/s12603-016-0834-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine differences in diet and food purchasing behaviors between Black and White older women living in urban neighborhoods. DESIGN Cross-sectional observational study. SETTING Urban neighborhoods in Washington, DC, USA. PARTICIPANTS Community-dwelling White and Black women of age 65 and older. MEASUREMENTS Participants were queried on diet via 24-hour recalls, food purchasing habits, their use of neighborhood resources and local travel patterns. Frequency and location of self-reported food purchasing and consumption were compared by race. RESULTS In 2014 and 2015, 49 White and 44 Black older women were enrolled in the study. Compared to Whites, Blacks reported lower daily caloric intake (mean (SD) 1314 (404) vs. 1529 (448), p=0.02), with a higher percent of calories from protein and fat 1.8 (7.0), p=0.03), and a slightly higher polyunsaturated to saturated fat ratio (p=0.05). Blacks had substantially lower alternate healthy eating index (AHEI) (33.5 (10.2) vs. 43.9 (10.8) of 80 possible points, p<0.001), daily intake (grams) of total fiber (15.3 (8.1) vs. 22.9 (8.5), p<0.001), insoluble fiber (10.8 (6.9) vs. 15.9 (6.5), p<0.001), and soluble fiber (4.5 (2.0) vs. 6.9 (2.8), p<0.001). Blacks had lower intake of micronutrients, alcohol and caffeine. Blacks shopped for groceries less often (4.4 (3.0) vs. 6.2 (3.0) monthly; p=0.006) and spent a longer time traveling to stores (15.8 (9.1) vs. 11.5 (7.2) minutes per trip, p=0.02). A lower percent of Blacks walked to stores (14% vs. 40%, p=0.003) and a higher percent of Blacks rode in a car with someone else (33% vs. 6%, p<0.001). CONCLUSIONS In an urban setting, food consumption and purchasing behaviors differed substantially between older Black and White women, which should be further investigated and considered to promote healthy eating in older populations.
Collapse
Affiliation(s)
- W Li
- Wenjun Li, PhD, Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School S4-314, 55 Lake Avenue North, Worcester, MA 01655, Phone: 774-455-4215 Fax: 508-856-4543,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Murphy C, Hayes R, McDermott M, Kearns GJ. Odontogenic myxoma of the maxilla: surgical management and case report. Ir J Med Sci 2016; 186:243-246. [PMID: 26975322 DOI: 10.1007/s11845-016-1408-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 01/12/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Odontogenic myxoma is a benign odontogenic tumour of the jaw [1]. This tumour often presents as an asymptomatic expansile lesion without sensory nerve changes [2]. It is thought to arise from mesenchymal origin with cells of microscopic similarity to dental pulp and follicle [3]. Radiographically it presents most often as a multiloculated radiolucency [2]. It is a locally aggressive lesion which may require extensive treatment to prevent recurrence. METHOD The authors present the case of a 13-year-old boy with an extensive lesion in the maxilla. CONCLUSION We discuss various treatment approaches for management of this tumour.
Collapse
Affiliation(s)
- C Murphy
- Department of Oral and Maxillofacial Surgery, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland.
| | - R Hayes
- Department of Radiology, 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
| | - G J Kearns
- Department of Oral and Maxillofacial Surgery, St James Hospital, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland
| |
Collapse
|
26
|
Sugg S, Hayes R, Gbenon A, Lizarraga I, Erdahl L, Weigel R, Liao J, Menda Y, Scott-Conner C. Abstract P3-01-11: Sentinel lymph node (SLN) localization is highly successful after neoadjuvant chemotherapy (NCT) for breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-01-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Recent multi-center trial results are concerning for the ability to identify SLNs after NCT. SLN localization was shown to be less successful (80%) after NCT when compared with no NCT (99%) (SENTINA), and the SLN identification rate in Z1071 in which all patients received NCT was 93%.
Purpose: To examine the effect of NCT, patient and disease characteristics, imaging and surgical technique on SLN localization rates in breast cancer patients undergoing chemotherapy.
Methods: Retrospective, single institution study was performed on patients who underwent surgery for breast cancer from January 2008 to December 2013. All patients who underwent SLN biopsy and either adjuvant chemotherapy (ACT) or NCT, were included. All patients underwent lymphoscintigraphy, and SLN biopsy was performed with the definitive breast surgery.
Results: 68 patients underwent NCT, and 133 underwent ACT. Our SLN localization rate was 198/201 (98.5%) overall; 98.6% (67 of 68) with NCT and 97.7% (130/133) with ACT (p=1.0). Compared with the NCT group, the ACT patients were significantly older, white, with more ER/PR positive tumors. The NCT group had more positive nodes on preop imaging (64% v. 20%, p<0.001), FNA (82% v. 22%, p<0.001), and a lower use of blue dye (37% v. 61%, p=0.05) but there were no differences in the number of SLN removed (1.43 v. 1.33 p=0.32), or nodes that were positive on intraoperative evaluation (30 v. 33%, p=0.75). Comparing the patients who had successful and failed SLN localization, there were no differences in demographics, tumor type, Stage, prior breast surgery, preoperative node positivity on imaging or FNA or timing of chemotherapy.
Conclusion: In this single institution series, SLN non-localization was a rare event and not associated with NCT. We were unable to identify any patient or disease characteristics, imaging or surgical techniques associated with SLN non-localization. The etiology of the lower SLN identification rates with NCT in multi-institutional trials remains to be elucidated.
Citation Format: Sugg S, Hayes R, Gbenon A, Lizarraga I, Erdahl L, Weigel R, Liao J, Menda Y, Scott-Conner C. Sentinel lymph node (SLN) localization is highly successful after neoadjuvant chemotherapy (NCT) for breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-01-11.
Collapse
Affiliation(s)
- S Sugg
- University of Iowa, Iowa City, IA
| | - R Hayes
- University of Iowa, Iowa City, IA
| | - A Gbenon
- University of Iowa, Iowa City, IA
| | | | - L Erdahl
- University of Iowa, Iowa City, IA
| | - R Weigel
- University of Iowa, Iowa City, IA
| | - J Liao
- University of Iowa, Iowa City, IA
| | - Y Menda
- University of Iowa, Iowa City, IA
| | | |
Collapse
|
27
|
Hargreaves JR, Stangl A, Bond V, Hoddinott G, Krishnaratne S, Mathema H, Moyo M, Viljoen L, Brady L, Sievwright K, Horn L, Sabapathy K, Ayles H, Beyers N, Bock P, Fidler S, Griffith S, Seeley J, Hayes R. P14.13 Hiv-related stigma and universal testing and treatment for hiv prevention and care: design of an implementation science evaluation nested in the hptn 071 (popart) cluster-randomised trial in zambia and south africa. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
28
|
Bogdanowicz KM, Stewart R, Broadbent M, Hatch SL, Hotopf M, Strang J, Hayes R. OR03-4 * PSYCHIATRIC COMORBIDITY AND EXCESS ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY IN OPIOID ADDICTS. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu053.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
29
|
Houlihan CF, Sanjosé SD, Baisley K, Changalucha J, Ross D, Kapiga S, Godinez JM, Bozicevic I, Hayes R, Watson-Jones D. P3.056 Prevalent Human Papillomavirus in Tanzanian Adolescent Girls Who Report Not Having Passed Sexual Debut. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
30
|
Hayes R, Chang CK, Fernandes A, Begum A, To D, Broadbent M, Hotopf M, Stewart R. 695 – Associations between symptoms, functional status and all-cause mortality in people with schizophrenia. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)75924-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
31
|
Hayes R, Shrewsbury V, Chan A, Cowell C, Garnett S. Type 2 diabetes in children and adolescence: A retrospective review. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
32
|
Phillips G, Hayes R, Bottomley C, Petticrew M, Watts P, Lock K, Clow A, Draper A, Moore D, Schmidt E, Tobi P, Lais S, Yu G, Barrow-Guevara G, Renton A. OP06 Well London: Results of a Cluster-Randomised Trial of a Community Development Approach to Improving Health Behaviours and Mental Wellbeing in Deprived Inner-City Neighbourhoods. J Epidemiol Community Health 2012. [DOI: 10.1136/jech-2012-201753.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Scheuer A, Hirsch O, Hayes R, Vogel H, Votsmeier M. Efficient simulation of an ammonia oxidation reactor using a solution mapping approach. Catal Today 2011. [DOI: 10.1016/j.cattod.2011.03.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
34
|
Phillips G, Watts P, Petticrew M, Lock K, Hayes R, Bottomley C, Yu G, Schmidt E, Moore D, Frostick C, Clow A, Lais S, Renton A. Determinants of mental health and wellbeing in low income communities: A multilevel approach examining individual and neighbourhood characteristics. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
35
|
Watts P, Phillips G, Petticrew M, Hayes R, Bottomley C, Yu G, Schmidt E, Moore D, Frostick C, Lock K, Renton A. Determinants of physical activity in deprived communities in London: Examining the effects of individual and neighbourhood characteristics. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
36
|
Saha S, Wu J, Jenkins JN, McCarty JC, Hayes R, Stelly DM. Delineation of interspecific epistasis on fiber quality traits in Gossypium hirsutum by ADAA analysis of intermated G. barbadense chromosome substitution lines. Theor Appl Genet 2011; 122:1351-1361. [PMID: 21301803 DOI: 10.1007/s00122-011-1536-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 01/06/2011] [Indexed: 05/30/2023]
Abstract
Genetic diversity is the foundation of any crop improvement program, but the most cultivated Upland cotton [Gossypium hirsutum L., 2n = 52, genomic formula 2(AD)(1)] has a very narrow gene pool resulting from its evolutionary origin and domestication history. Cultivars of this cotton species (G. hirsutum L.) are prized for their combination of exceptional yield, other agronomic traits, and good fiber properties, whereas the other cultivated 52-chromosome species, G. barbadense L. [2n = 52, genomic formula 2(AD)(2)], is widely regarded as having the opposite attributes. It has exceptionally good fiber qualities, but generally lower yield and less desirable agronomic traits. Breeders have long aspired to combine the best attributes of G. hirsutum and G. barbadense, but have had limited success. F(1) hybrids are readily created and largely fertile, so the limited success may be due to cryptic biological and technical challenges associated with the conventional methods of interspecific introgression. We have developed a complementary alternative approach for introgression based on chromosome substitution line, followed by increasingly sophisticated genetic analyses of chromosome-derived families to describe the inheritance and breeding values of the chromosome substitution lines. Here, we analyze fiber quality traits of progeny families from a partial diallel crossing scheme among selected chromosome substitution lines (CS-B lines). The results provide a more detailed and precise QTL dissection of fiber traits, and an opportunity to examine allelic interaction effects between two substituted chromosomes versus one substituted chromosome. This approach creates new germplasm based on pair wise combinations of quasi-isogenic chromosome substitutions. The relative genetic simplicity of two-chromosome interactions departs significantly from complex or RIL-based populations, in which huge numbers of loci are segregating in all 26 chromosome pairs. Data were analyzed according to the ADAA genetic model, which revealed significant additive, dominance, and additive-by-additive epistasis effects on all of the fiber quality traits associated with the substituted chromosome or chromosome arm of CS-B lines. Fiber of line 3-79, the donor parent for the substituted chromosomes, had the highest Upper Half Mean length (UHM), uniformity ratio, strength, elongation, and lowest micronaire among all parents and hybrids. CS-B16 and CS-B25 had significant additive effects for all fiber traits. Assuming a uniform genetic background of the CS-B lines, the comparative analysis of the double-heterozygous hybrid combinations (CS-B × CS-B) versus their respective single heterozygous combinations (CS-B × TM-1) demonstrated that interspecific epistatic effects between the genes in the chromosomes played a major role in most of the fiber quality traits. Results showed that fiber of several hybrids including CS-B16 × CS-B22Lo, CS-B16 × CS-B25 and CS-B16 × TM-1 had significantly greater dominance effects for elongation and hybrid CS-B16 × CS-B17 had higher fiber strength than their parental lines. Multiple antagonistic genetic effects were also present for fiber quality traits associated with most of the substituted chromosomes and chromosome arms. Results from this study highlight the vital importance of epistasis in fiber quality traits and detected novel effects of some cryptic beneficial alleles affecting fiber quality on the 3-79 chromosomes, whose effects were not detected in the 3-79 parental lines.
Collapse
Affiliation(s)
- S Saha
- United States Department of Agriculture-Agricultural Research Service, Crop Science Research Laboratory, MS 39762, USA.
| | | | | | | | | | | |
Collapse
|
37
|
Affiliation(s)
- R Hayes
- School of Pharmacy and Pharmacology, University of Bath, Bath U.K
| | - G Fletcher
- School of Pharmacy and Pharmacology, University of Bath, Bath U.K
| | - D J G Davies
- School of Pharmacy and Pharmacology, University of Bath, Bath U.K
| |
Collapse
|
38
|
Pascoe SJS, Langhaug LF, Durawo J, Woelk G, Ferrand R, Jaffar S, Hayes R, Cowan FM. Increased risk of HIV-infection among school-attending orphans in rural Zimbabwe. AIDS Care 2010; 22:206-20. [PMID: 20390499 DOI: 10.1080/09540120903111528] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In Zimbabwe around 1.1 million children have been orphaned due to AIDS. We conducted a survey among school-attending youth in rural south-eastern Zimbabwe in 2003, and examined the association between orphaning and risk of HIV. We enrolled 30 communities in three provinces. All students attending Year 2 of secondary school were eligible. Each completed a questionnaire and provided a finger-prick blood specimen for testing for HIV-1 and HSV-2 antibodies. Female participants were tested for pregnancy. Six thousand seven hundred and ninety-one participants were recruited (87% of eligible); 35% had lost one or both parents (20% of participants had lost their father; 6% their mother; and 9% both parents). Orphans were not poorer than non-orphans based on reported access to income, household structure and ownership of assets. There was strong evidence that orphans, and particularly those who had lost both parents, were at increased sexual risk, being more likely to have experienced early sexual debut; to have been forced to have sex; and less likely to have used condoms. Fifty-one students were HIV positive (0.75%). Orphans were three times more likely to be HIV infected than non-orphans (adjusted odds ratio = 3.4; 95% confidence interval: 1.8-6.6). Over 60% of those HIV positive were orphaned. Among school-going youth, the rates of orphaning were very high; there was a strong association between orphaning and increased risk of HIV, and evidence of greater sexual risk taking among orphans. It is essential that we understand the mechanisms by which orphaned children are at increased risk of HIV in order to target prevention and support appropriately.
Collapse
Affiliation(s)
- S J S Pascoe
- Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
|
40
|
Raimondi S, Benhamou S, Coutelle C, Garte S, Hayes R, Kiemeney L, Lazarus P, Marchand LL, Morita S, Povey A, Romkes M, Zijno A, Taioli E. Association of metabolic gene polymorphisms with alcohol consumption in controls. Biomarkers 2010; 9:180-9. [PMID: 15370874 DOI: 10.1080/13547500410001728381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The objectives were to study the association between metabolic genes involved in alcohol metabolism (CYP2E1 RsaI, CYP2E1 DraI, ADH1C, NQO1) and alcohol consumption in a large sample of healthy controls. Healthy subjects were selected from the International Collaborative Study on Genetic Susceptibility to Environmental Carcinogens (GSEC). Subjects with information on both alcohol consumption and at least one of the studied polymorphisms were included in the analysis (n=2224). Information on the amount of alcohol consumption was available for a subset of subjects (n=844). None of the studied genes was significantly associated with drinking habits. A significant heterogeneity with age was observed when studying the association between CYP2E1 RsaI and alcohol drinking. CYP2E1 RsaI polymorphism was significantly associated with being a never drinker at older ages (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2-4.8; at ages above 68 years), while the association was reversed at ages below 47 years (OR 0.5, 95% CI 0.2-1.4). For subjects with detailed information on alcohol intake, no association between alcohol quantity and polymorphisms in metabolic genes was observed; subjects carrying the NQO1 polymorphism tended to drink more than subjects carrying the wild-type alleles. Therefore, no significant association between CYP2E1 RsaI, CYP2E1 DraI, ADH1C, NQO1 polymorphisms and alcohol consumption was observed in healthy controls.
Collapse
Affiliation(s)
- S Raimondi
- Molecular and Genetic Epidemiology Unit, Ospedale Policlinico IRCCS, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Cousens S, Hargreaves J, Bonell C, Armstrong B, Thomas J, Kirkwood BR, Hayes R. Alternatives to randomisation in the evaluation of public-health interventions: statistical analysis and causal inference. J Epidemiol Community Health 2009; 65:576-81. [PMID: 19666633 DOI: 10.1136/jech.2008.082610] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In non-randomised evaluations of public-health interventions, statistical methods to control confounding will usually be required. We review approaches to the control of confounding and discuss issues in drawing causal inference from these studies. METHODS Non-systematic review of literature and mathematical data-simulation. RESULTS Standard stratification and regression techniques will often be appropriate, but propensity scores may be useful where many confounders need to be controlled, and data are limited. All these techniques require that key putative confounders are measured accurately. Instrumental variables offer, in theory, a solution to the problem of unknown or unmeasured confounders, but identifying an instrument which meets the required conditions will often be challenging. Obtaining measurements of the outcome variable in both intervention and control groups before the intervention is introduced allows balance to be assessed, and these data may be used to help control confounding. However, imbalance in outcome measures at baseline poses challenges for the analysis and interpretation of the evaluation, highlighting the value of adopting a design strategy that maximises the likelihood of achieving balance. Finally, when it is not possible to have any concurrent control group, making multiple measures of outcome pre- and postintervention can enable the estimation of intervention effects with appropriate statistical models. CONCLUSION For non-randomised designs, careful statistical analysis can help reduce bias by confounding in estimating intervention effects. However, investigators must report their methods thoroughly and be conscious and critical of the assumptions they must make whenever they adopt these designs.
Collapse
Affiliation(s)
- S Cousens
- Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | | | | | | | | | | | | |
Collapse
|
42
|
Rowland M, Gallagher C, Canny G, Greally P, Slattery D, Hayes R, O'Laoide R, Daly L, Durie P, Bourke B. Outcome in Cystic Fibrosis Liver Disease. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
43
|
Baisley K, Changalucha J, Weiss HA, Mugeye K, Everett D, Hambleton I, Hay P, Ross D, Tanton C, Chirwa T, Hayes R, Watson-Jones D. Bacterial vaginosis in female facility workers in north-western Tanzania: prevalence and risk factors. Sex Transm Infect 2009; 85:370-5. [PMID: 19473997 PMCID: PMC2709714 DOI: 10.1136/sti.2008.035543] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To determine prevalence of, and risk factors for, bacterial vaginosis (BV) among herpes simplex virus (HSV) 2 seropositive Tanzanian women at enrollment into a randomised, placebo-controlled trial of HSV suppressive treatment. METHODS 1305 HSV-2 seropositive women aged 16-35 years working in bars, guesthouses and similar facilities were interviewed, examined and tested for HIV, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, BV, candidiasis and trichomoniasis. Factors associated with BV were analysed using logistic regression to estimate odds ratios and 95% confidence intervals. RESULTS BV prevalence was 62.9%; prevalence of Nugent score 9-10 was 16.1%. Independent risk factors for BV were work facility type, fewer dependents, increasing alcohol consumption, sex in the last week (adjusted OR 2.03; 95% CI 1.57 to 2.62), using cloths or cotton wool for menstrual hygiene, HIV (adjusted OR 1.41; 95% CI 1.09 to 1.83) and Trichomonas vaginalis infection. There was no association between BV and the frequency or method of vaginal cleansing. However, BV was less prevalent among women who reported inserting substances to dry the vagina for sex (adjusted OR 0.44; 95% CI 0.25 to 0.75). CONCLUSION BV was extremely prevalent among our study population of HSV-2 positive female facility workers in North-western Tanzania. Although recent sex was associated with increased BV prevalence, vaginal drying was associated with lower BV prevalence. Further studies of the effects of specific practices on vaginal flora are warranted.
Collapse
Affiliation(s)
- K Baisley
- London School of Hygiene & Tropical Medicine, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Crawford F, Wood M, Ferguson S, Mathura V, Gupta P, Humphrey J, Mouzon B, Laporte V, Margenthaler E, O'Steen B, Hayes R, Roses A, Mullan M. Apolipoprotein E-genotype dependent hippocampal and cortical responses to traumatic brain injury. Neuroscience 2009; 159:1349-62. [DOI: 10.1016/j.neuroscience.2009.01.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 01/14/2009] [Accepted: 01/19/2009] [Indexed: 11/24/2022]
|
45
|
Bonell CP, Hargreaves J, Cousens S, Ross D, Hayes R, Petticrew M, Kirkwood BR. Alternatives to randomisation in the evaluation of public health interventions: design challenges and solutions. J Epidemiol Community Health 2009; 65:582-7. [PMID: 19213758 DOI: 10.1136/jech.2008.082602] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There has been a recent increase in interest in alternatives to randomisation in the evaluation of public health interventions. We aim to describe specific scenarios in which randomised trials may not be possible and describe, exemplify and assess alternative strategies. METHODS Non-systematic exploratory review. RESULTS In many scenarios barriers are surmountable so that randomised trials (including stepped-wedge and crossover trials) are possible. It is possible to rank alternative designs but context will also determine which choices are preferable. Evidence from non-randomised designs is more convincing when confounders are well-understood, measured and controlled; there is evidence for causal pathways linking intervention and outcomes and/or against other pathways explaining outcomes; and effect sizes are large. CONCLUSION Non-randomised trials might provide adequate evidence to inform decisions when interventions are demonstrably feasible and acceptable, and where evidence suggests there is little potential for harm, but caution that such designs may not provide adequate evidence when intervention feasibility or acceptability is doubtful, and where existing evidence suggests benefits may be marginal and/or harms possible.
Collapse
Affiliation(s)
- C P Bonell
- Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | | | | | | | | | | | | |
Collapse
|
46
|
Klavs I, Rodrigues LC, Wellings K, Weiss HA, Hayes R. Sexual behaviour and HIV/sexually transmitted infection risk behaviours in the general population of Slovenia, a low HIV prevalence country in central Europe. Sex Transm Infect 2008; 85:132-8. [PMID: 19060036 PMCID: PMC2652029 DOI: 10.1136/sti.2008.034256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: To describe sexual and HIV/sexually transmitted infection (STI) risk behaviours in Slovenia. Methods: A nationally representative cross-sectional survey of the general population aged 18–49 years in 1999–2001 was conducted. The data were collected by face-to-face interviews and anonymous self-administered questionnaires. Statistical methods for complex survey data were used. Results: 849 men and 903 women were interviewed. In the past 5 years, both men and women reported a median of one heterosexual partner (means 3.2, 1.5, respectively), concurrent heterosexual partnerships were reported by 24.4% of men and 8.2% of women, heterosexual sex with non-Slovenian partners by 12.6% of men and 12.2% of women, forced sex by 4.8% of women, paid heterosexual sex by 2.6% of men, sex with another man by 0.6% of men and heterosexual sex with an injecting drug user by 1.2% of men and 1.3% of women. In the past year, 22.7% of men and 9.5% of women reported forming at least one new heterosexual partnership. The mean numbers of episodes of heterosexual sex in the previous 4 weeks were 6.1 for men and 6.0 for women. Consistent and inconsistent condom use was reported more frequently among men reporting multiple female partners and those not married or cohabiting. Conclusions: Recent patterns of reported sexual behaviour are consistent with a low risk of HIV and STI transmission in Slovenia. The results will inform Slovenian sexual health policies including HIV/STI prevention, and are particularly valuable because population-based data on HIV/STI risk behaviour have not previously been available in low HIV prevalence countries of central Europe.
Collapse
Affiliation(s)
- I Klavs
- AIDS/STI/HAI Unit, Communicable Diseases Department, Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia.
| | | | | | | | | |
Collapse
|
47
|
McKenzie DJ, Garofalo E, Winter MJ, Ceradini S, Verweij F, Day N, Hayes R, van der Oost R, Butler PJ, Chipman JK, Taylor EW. Complex physiological traits as biomarkers of the sub-lethal toxicological effects of pollutant exposure in fishes. Philos Trans R Soc Lond B Biol Sci 2008; 362:2043-59. [PMID: 17475615 PMCID: PMC2442853 DOI: 10.1098/rstb.2007.2100] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Complex physiological traits, such as routine aerobic metabolic rate or exercise performance, are indicators of the functional integrity of fish that can reveal sub-lethal toxicological effects of aquatic pollutants. These traits have proved valuable in laboratory investigations of the sub-lethal effects of heavy metals, ammonia and various xenobiotics. It is not known, however, whether they can also function as biomarkers of the complex potential range of effects upon overall functional integrity caused by exposure to mixtures of chemicals in polluted natural environments. The current study used portable swimming respirometers to compare exercise performance and respiratory metabolism of fish exposed in cages for three weeks to either clean or polluted sites on three urban European river systems: the river Lambro, Milan, Italy; the rivers Blythe, Cole and Tame, Birmingham, UK; and the river Amstel, Amsterdam, The Netherlands. The UK and Italian rivers were variously polluted with high levels of both bioavailable heavy metals and organics, and the Amstel by mixtures of bioavailable organics at high concentrations. In both the UK and Italy, indigenous chub (Leuciscus cephalus) exposed to clean or polluted sites swam equally well in an initial performance test, but the chub from polluted sites could not repeat this performance after a brief recovery interval. These animals were unable to raise the metabolic rate and allocate oxygen towards exercise in the second trial, an effect confirmed in successive campaigns in Italy. Swimming performance was therefore a biomarker indicator of pollutant exposure in chub exposed at these sites. Exposure to polluted sites on the river Amstel did not affect the repeat swimming performance of cultured cloned carp (Cyprinus carpio), indicating either a species-specific tolerance or relative absence of heavy metals. However, measurements of oxygen uptake during swimming revealed increased rates of routine aerobic metabolism in both chub and carp at polluted sites in all of the rivers studied, indicating a sub-lethal metabolic loading effect. Therefore, the physiological traits of exercise performance and metabolic rate have potential as biomarkers of the overall sub-lethal toxic effects of exposure to complex mixtures of pollutants in rivers, and may also provide insight into why fish do not colonize some polluted environments.
Collapse
Affiliation(s)
- D J McKenzie
- School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Haushalter TM, Friedrichs GS, Reynolds DL, Barecki-Roach M, Pastino G, Hayes R, Bass AS. The cardiovascular and pharmacokinetic profile of dofetilide in conscious telemetered beagle dogs and cynomolgus monkeys. Br J Pharmacol 2008; 154:1457-64. [PMID: 18604237 PMCID: PMC2492096 DOI: 10.1038/bjp.2008.275] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [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: 06/02/2008] [Accepted: 06/03/2008] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND PURPOSE The effects of dofetilide were studied in monkeys and dogs. Pharmacokinetic data were generated together with the monitoring of cardiovascular changes in order to compare effects relative to human exposure. EXPERIMENTAL APPROACH Beagle dogs and cynomolgus monkeys were telemetered to collect arterial blood pressure, heart rate and ECG for 6 h after selected oral doses of dofetilide. Pharmacokinetic parameters were determined for each dose. KEY RESULTS Dogs: increases in the QT(c) interval reached 56 ms in dogs dosed with 0.3 mg kg(-1) of dofetilide. Premature ventricular contractions and right bundle branch block were evident at this dose, without changes in cardiovascular parameters. The mean C(max) values were 3.35 and 60.15 ng mL(-1) at doses of 0.03 and 0.3 mg kg(-1), respectively. Monkeys: increases in QT(c) intervals reached 40-50 ms after 0.03 mg kg(-1). T-wave changes were observed after 0.03 mg kg(-1) without changes in cardiovascular parameters. The mean C(max) values following oral doses of 0.01 and 0.03 mg kg(-1) were 0.919 ng mL(-1) and 1.85 ng mL(-1), respectively. CONCLUSIONS AND IMPLICATIONS Despite dofetilide exposure comparable to that in humans, QT(c) responses in dogs were greater than those reported in humans. A comparable human dose used in the monkey achieved only half of the exposure but was associated with twofold greater increases in QT(c). Our data support the view that safety risk assessments of new drugs in animal models should ensure that the clinical therapeutic range of exposure is achieved and any untoward effects interpreted accordingly.
Collapse
Affiliation(s)
- T M Haushalter
- Investigational and Regulatory Safety Pharmacology, Schering-Plough Research Institute, Lafayette, NJ 07848-0032, USA.
| | | | | | | | | | | | | |
Collapse
|
49
|
Top J, Banga NMI, Hayes R, Willems RJ, Bonten MJM, Hayden MK. Comparison of multiple-locus variable-number tandem repeat analysis and pulsed-field gel electrophoresis in a setting of polyclonal endemicity of vancomycin-resistant Enterococcus faecium. Clin Microbiol Infect 2008; 14:363-9. [PMID: 18261124 DOI: 10.1111/j.1469-0691.2007.01945.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In order to assess whether multiple-locus-variable number tandem repeat analysis (MLVA) could replace pulsed-field gel electrophoresis (PFGE) for genotyping vancomycin-resistant isolates of Enterococcus faecium (VREF), this study compared the typeability, discriminatory power, concordance and costs of these methods for VREF isolates obtained from patients, environmental samples and the hands of healthcare workers (HCWs) in a medical intensive care unit (ICU) where VREF was endemic. Over a 58-day period, 393 VREF isolates (373 vanA, one vanA/B, 19 vanB) were cultured from patient rectal swabs (n = 76), the environment (n = 270) and the hands of HCWs (n = 47). PFGE was able to divide 358 (91.1%) isolates into 19 PFGE types (>six bands different) and 24 subtypes (one to three bands different). MLVA was able to type 391 (99.5%) isolates into 11 genotypes. The discriminatory power of PFGE subtypes was 83%, as compared to 68% for MLVA. Concordance between the two methods, based on matched or mismatched MLVA types and PFGE types or subtypes, was 67.5% and 82.8%, respectively. Using PFGE, 13 isolates could be genotyped in 3 days; MLVA genotyped 94 isolates in 2 days. For both methods, the estimated costs were Euro 7 ($10)/isolate. PFGE and MLVA produced highly concordant results when assigning genotypes to nosocomial VREF isolates. MLVA was faster, but PFGE subtyping was more discriminatory.
Collapse
Affiliation(s)
- J Top
- Department of Medical Microbiology, Division of Acute Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
50
|
O'Farrell N, Morison L, Moodley P, Pillay K, Vanmali T, Quigley M, Hayes R, Sturm AW. Acceptability of a penile wipe to promote male genital hygiene. Int J STD AIDS 2007; 18:363. [PMID: 17524207 DOI: 10.1258/095646207780749619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|