1
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Howard K, Norris S, Salisbury A, Pearce A, Hay L, Stapleton B, Lean C, Last A, Kwedza R, White K, Rushton S. Women's Preferences for Hypofractionated Radiation Therapy for Treatment of Early-Stage Breast Cancer: A Discrete Choice Experiment. Int J Radiat Oncol Biol Phys 2024; 119:172-184. [PMID: 38110105 DOI: 10.1016/j.ijrobp.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 10/19/2023] [Accepted: 11/11/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE The primary treatment recommended for early-stage breast cancer is breast conserving surgery followed by external beam radiation therapy of the whole breast. Previously, radiation therapy for early-stage breast cancer was given using more fractions over longer durations. Guidelines support treatments with fewer fractions over a shorter time (hypofractionated radiation therapy). This study aimed to understand women's preferences for different features of treatments for early-stage breast cancer. METHODS AND MATERIALS A discrete choice experiment with 12 choice tasks was conducted, describing the treatments by extent of surgery, duration of radiation treatment, need to relocate for treatment, local side effects, changes in breast appearance, costs, and difficulty with daily activities during and after treatment. Participants were women with breast cancer and from the general population. Mixed logit analyses were conducted and trade-offs between attributes estimated. RESULTS Four hundred twenty respondents completed the discrete choice experiment. The relative importance of attributes varied by respondent characteristics; the most influential attribute for younger women was type of surgery (breast conserving surgery). Type of surgery did not influence older women's preferences. Shorter treatment duration, avoiding relocation, fewer local side effects, and less difficulty with daily activities all positively influenced treatment preference. Younger women were willing to accept 32 to 40 days of radiation treatment before a treatment that included mastectomy was potentially acceptable. CONCLUSIONS Attributes of treatment such as duration, need for relocation, side effects, and effects on normal daily activities during and after treatment significantly influenced women's preference for treatment, including surgery. Our findings have the potential for real impact for patients and services including supporting one-on-one clinical discussions, supporting program and patient resource development, and informing service funding, organization, and delivery.
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Affiliation(s)
- Kirsten Howard
- Menzies Centre for Health Policy and Economics; School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
| | | | | | - Alison Pearce
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Liz Hay
- NSW Ministry of Health, St Leonards, New South Wales, Australia
| | | | - Cynthia Lean
- Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Andrew Last
- School of Clinical Medicine, Rural Clinical Campus, UNSW Medicine & Health, Port Macquarie, New South Wales, Australia
| | - Ru Kwedza
- Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Kahren White
- Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Shelley Rushton
- Cancer Institute NSW, St Leonards, New South Wales, Australia
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2
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McLean L, Curtis K, Hodges J, King L, Wuellner L, Zheng A, Rushton S, O'Brien T. Enhancing Clinical Safety and Cancer Patient Experience Through Comprehensive eLearning on Central Venous Access Devices. Stud Health Technol Inform 2024; 310:1394-1395. [PMID: 38269663 DOI: 10.3233/shti231211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Health practitioners often insert and maintain central venous access devices (CVADs) as part of cancer care. One in four CVADs prematurely fail, which is associated with increased mortality, morbidity and a negative impact on quality of life. To support implementation of updated guidelines, eviQ Education developed a comprehensive, peer-reviewed, evidence-based CVADs eLearning package. An evaluation indicated that the eLearning supported clinicians' practice and increased knowledge and clinical competency in CVAD insertion and management.
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Affiliation(s)
| | - Kerrie Curtis
- Peter MacCallum Cancer Centre, VIC, Austin Health, VIC
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McLean L, Zheng A, Bullivant C, Wuellner L, Rushton S, O'Brien T. Improving Accessibility of Continuing Professional Development for Oncology Health Professionals Through the EviQ Education App. Stud Health Technol Inform 2024; 310:1532-1533. [PMID: 38269731 DOI: 10.3233/shti231279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Oncology clinicians must participate in continuing professional development (CPD) to stay up to date with best practice. The Cancer Institute NSW eviQ Education program produces evidence-based, peer-reviewed eLearning resources for oncology professionals. In response to user feedback, eviQ Education trialled a mobile app, EdApp, to improve accessibility of self-directed CPD materials. Following a pilot, users indicated that the EdApp improved CPD accessibility and user experience. EdApp will continue to be used to support evidence-based practice.
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McLean L, Bullivant C, Moeke T, Hodges J, Wuellner L, Rushton S, O'Brien T. User-Led Learning Preferences to Inform Rapid Learning Online Education Supporting Evidence-Based Best Practice in Oncology. Stud Health Technol Inform 2024; 310:1530-1531. [PMID: 38269730 DOI: 10.3233/shti231278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Effective eLearning design takes into account the learning needs and styles of users. eviQ Education, a program of the Cancer Institute NSW, considered evidence from user data to develop a range of clinical education resources in formats informed by user preferences, including mini-modules, videos and webinars. Through the website and mobile app, content is available on-demand, supporting health professionals to learn anytime, anywhere, on any device.
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Willcox D, Trent RJA, Lyons N, Meldrum C, Kennedy P, Lee T, Berman Y, Burgess B, Cannings JW, Canova MJ, Halliburton C, Hibbitt O, Norris SK, Penna A, Perkins A, Pilowsky E, Rushton S. Making good on the promise of genomics in healthcare: the NSW Health perspective. AUST HEALTH REV 2023:AH23112. [PMID: 37844625 DOI: 10.1071/ah23112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/19/2023] [Indexed: 10/18/2023]
Abstract
NSW Health is implementing genomics as a mainstream component of clinical care. The strategic, holistic approach is considering infrastructure, data governance and management, workforce, education, service planning and delivery. This work is generating insights about how to realise the promise of genomics in healthcare, highlighting the need for strong foundations, real-world application, accessibility and a focus on people using genomic information in clinical care.
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Roder D, Banham D, George J, Rushton S, O'Brien T. Demographic, health, and prognostic characteristics of Australians with liver cancer: a cohort study of linked data in New South Wales for informing cancer control. BMC Public Health 2023; 23:1957. [PMID: 37814225 PMCID: PMC10563226 DOI: 10.1186/s12889-023-16809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Australian age-standardized incidence and death rates for liver cancer are lower than world averages, but increasing as in other economically advanced western countries. World Health Organization emphasizes the need to address sociodemographic disparities in cancer risk. A more detailed sociodemographic risk profiling was undertaken for liver cancer in New South Wales (NSW) by diagnostic stage, than possible with NSW Cancer Registry (NSWCR) alone, by incorporating linked data from the Australian Bureau of Statistics (ABS). The purpose was to inform targeting and monitoring of cancer services. METHODS The ABS manages the Multi-Agency Data Integration Project (MADIP) which includes a wide range of health, educational, welfare, census, and employment data. These data were linked at person level to NSWCR liver cancer registrations for the period post 2016 census to December 2018. De-identified data were analyzed. Sex-specific age-adjusted odds ratios (95%CIs) of liver cancer were derived using logistic regression by age, country of birth, residential remoteness, proficiency in spoken English, household income, employment status, occupation type, educational attainment, sole person household, joblessness, socioeconomic status, disability status, multimorbidity, and other health-related factors, including GP consultations. These data complement the less detailed sociodemographic data available from the NSWCR, with alignment of numerators and population denominators for accurate risk assessment. RESULTS Results indicate liver cancer disproportionately affects population members already experiencing excess social and health disadvantage. Examples where 95% confidence intervals of odds ratios of liver cancer were elevated included having poor English-speaking proficiency, limited education, housing authority tenancy, living in sole-person households, having disabilities, multiple medicated conditions, and being carers of people with a disability. Also, odds of liver cancer were higher in more remote regions outside major cities, and in males, with higher odds of more advanced cancer stages (degrees of spread) at diagnosis in more remote regions. CONCLUSIONS Linked data enabled more detailed risk profiling than previously possible. This will support the targeting of cancer services and benchmarking.
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Affiliation(s)
- David Roder
- Cancer Institute NSW, NSW Government, Sydney, NSW, Australia
| | - David Banham
- Cancer Institute NSW, NSW Government, Sydney, NSW, Australia.
| | - Jacob George
- Storr Liver Centre, The Westmead Institute of Medical research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
| | - Shelley Rushton
- Cancer Institute NSW, NSW Government, Sydney, NSW, Australia
| | - Tracey O'Brien
- Cancer Institute NSW, NSW Government, Sydney, NSW, Australia
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Hardman G, Rushton S, Hogg R, Booth K, Dark J, Fisher A. The UK Lung Risk Index (UKLRI); An Objective Prognostic Score Based on Donor and Recipient Factors to Aid Decision Making in Lung Utilisation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.114] [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: 04/05/2023] Open
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White KM, Walton RJ, Kwedza RK, Rushton S, Currow DC, Seale H, Harrison R. Variation in ovarian cancer care in Australia: An analysis of patterns of care in diagnosis and initial treatment in New South Wales. Eur J Cancer Care (Engl) 2022; 31:e13649. [PMID: 35781903 PMCID: PMC9787805 DOI: 10.1111/ecc.13649] [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: 01/28/2021] [Revised: 05/17/2022] [Accepted: 06/24/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Ovarian cancer has the highest mortality of all gynaecological cancers. This study aimed to identify the extent to which women across New South Wales experienced variation in their care in diagnosis and initial treatment for ovarian cancer against the national optimal care pathway for ovarian cancer. METHOD Clinical audit methodology was utilised to explore variations for women with primary ovarian cancer; 171 eligible cases were identified through by the NSW Cancer Registry for the period of 1 March 2017 to 28 February 2018. RESULTS Limited variation was detected with 86% of women being reviewed by a specialist gynaecological oncology multidisciplinary team; 54% of women received their first treatment within 28 days of their first specialist appointment, 66% of women having their first surgery completed by a gynaecological oncologist and 45% of women received their first treatment in a specialist gynaecological oncology hospital. CONCLUSION Deviation from effective ovarian cancer care is apparent particularly in the location and timeliness of first treatment, with implications for the quality of care received and care outcomes. Understanding factors that contribute to variation is critical to ensure optimal and appropriate ovarian cancer care and to tackle systemic barriers to the provision of effective care.
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Affiliation(s)
- Kahren M. White
- Cancer Institute NSWSt LeonardsNew South WalesAustralia,School of Population HealthUniversity of New South WalesKensingtonNew South WalesAustralia
| | | | - Ru K. Kwedza
- Cancer Institute NSWSt LeonardsNew South WalesAustralia
| | | | | | - Holly Seale
- School of Population HealthUniversity of New South WalesKensingtonNew South WalesAustralia
| | - Reema Harrison
- School of Population HealthUniversity of New South WalesKensingtonNew South WalesAustralia
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Berman M, Ali A, Macklam D, Garcia Saez D, Jothidasan A, Husain M, Stock U, Mehta V, Venkateswaran R, Curry P, Messer S, Mukadam M, Mascaro J, Clarke S, Baxter J, Tsui S, Large S, Osman M, Kaul P, Boda G, Jenkins D, Simmonds J, Quigley R, Whitney J, Gardiner D, Watson C, Rubino A, Currie I, Foley J, Macleod A, Slater C, Marley F, Downward L, Rushton S, Armstrong L, Ayton L, Ryan M, Parker M, Gibson S, Spence S, Quinn K, Watson S, Forsythe J. UK National DCD Heart Transplant Program - First Year Experience. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Hardman G, Hogg R, Rushton S, Booth K, Fisher A, Dark J. Lung Transplantation and Utilisation Following Donation after Circulatory Death (DCD) in the UK. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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11
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Ali J, Mann S, Smith F, Rushton S, Parameshwar J, Catarino P, Berman M. Recipient Age, Not Donor Age, Impacts on Long Term Outcomes Following Heart Transplantation: A 23-year National Analysis from the United Kingdom. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Hardman G, Hogg R, Rushton S, Booth K, Fisher A, Dark J. Expanding Donor Age Criteria: The UK Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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Al-Banaa I, Hawkins L, Hill SL, Lupton DJ, Jackson G, Sandilands EA, Bradberry SM, Thompson JP, Rushton S, Thomas SHL. Effect of the UK Psychoactive Substances Act 2016 on episodes of toxicity related to new psychoactive substances as reported to the National Poisons Information Service. A time series analysis. Int J Drug Policy 2020; 77:102672. [PMID: 32032867 DOI: 10.1016/j.drugpo.2020.102672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND There have been recent increases in use of new psychoactive substances (NPS) associated with acute health harms including hospital presentations due to toxicity and increasing numbers of deaths. In response, the UK Government enacted generic legislation on 26th May 2016 (the Psychoactive Substances Act) making it an offence to produce, possess with intent to supply, supply, import or export, or possess within a custodial setting a psychoactive substance. We studied the impact of this Act on monthly frequency of enquiries made by health professionals to the UK National Poisons Information Service (NPIS) about NPS. We also studied five commonly used 'conventional' drugs of misuse that had been controlled prior to January 2009. METHOD Anonymised clinical enquiries to the NPIS and accesses to the poisons information database TOXBASE were reviewed retrospectively from January 2009 to December 2018 to ascertain the trends in reported toxicity for NPS, cocaine, heroin, cannabis, amphetamines and MDMA. Data were analysed using interrupted time series analysis with the date of the PSA used as an independent predictor. RESULTS Over the period of study there were 3,866 NPIS telephone enquiries and 79,271 TOXBASE user accesses made by UK health professionals concerning NPS. There were increases in monthly TOXBASE accesses (t = 7.408, P < 0.0001) and telephone enquiries (t = 4.74, P < 0.001) over the pre-specified period January 2009 to May 2016. Comparing the period after the PSA with that before, there were significant reductions in TOXBASE accesses (t = -3.327, P < 0.001) and telephone enquiries (t = -6.97, P < 0.001), although reductions started before May 2016. There were no significant changes for the five conventional drugs. There were significant reductions in telephone enquiries (t = -3.418, P < 0.001) and non-significant reductions in TOXBASE accesses (t = -1.713, P = 0.089) for NPS between June 2016 and December 2018. Increases in telephone enquiries for cocaine and reductions TOXBASE accesses for MDMA were also observed over that period. CONCLUSIONS There have been significant recent reductions in NPIS enquiry activity relating to NPS; although these began before enactment of the PSA in May 2016.
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Affiliation(s)
- I Al-Banaa
- Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle NE2 4HH, United Kingdom; College of Pharmacy, Department of Pharmacology and Toxicology, University of Mosul, Iraq.
| | - L Hawkins
- National Poisons Information Service (Newcastle Unit), Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Claremont Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - S L Hill
- National Poisons Information Service (Newcastle Unit), Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Claremont Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - D J Lupton
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - G Jackson
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - E A Sandilands
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - S M Bradberry
- National Poisons Information Service (Birmingham Unit), City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom
| | - J P Thompson
- National Poisons Information Service, Cardiff Unit, University Hospital Llandough, Penlan Road, Penarth, Vale of Glamorgan CF64 2XX, United Kingdom
| | - S Rushton
- School of Natural and Environmental Sciences, Newcastle University, Newcastle NE2 4HH, United Kingdom
| | - S H L Thomas
- Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle NE2 4HH, United Kingdom
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Singh SA, De SD, Rushton S, Banner N, Berry C, Al-Attar N. Survival after Primary Graft Dysfunction in Heart Transplantation: Outcomes of the National UK Data. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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15
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Shaw T, York S, White K, McGregor D, Rankin N, Hawkey A, Aranda S, Rushton S, Currow D. Defining success factors to describe coordinated care in cancer. Transl Behav Med 2018; 8:357-365. [PMID: 29800413 DOI: 10.1093/tbm/iby022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Providing coordinated care remains a challenge for cancer services globally. There is a lack of consensus in the literature about what constitutes successful coordinated care. This study aimed to define and prioritize a set of consensus-driven success factors that can lead to coordinated care. A mixed-methods approach was used that included literature review, a broad call for submissions from relevant stakeholders, and a priority-setting process based on a modified nominal group technique. Thirty articles that related to success factors in coordinated care were identified in the literature. Twenty submissions were received from a broad range of stakeholders. From these sources, a set of 20 success factors was derived. Seventy stakeholders attended a series of workshops across New South Wales, Australia, to review and prioritize these 20 success factors against significance and measurability. Clear consensus was reached on prioritizing two success factors linked to improving coordinated care from first presentation to diagnosis and ensuring that patients are routinely screened for physical and supportive care needs. Other highly ranked factors included the need for a comprehensive care plan and the identification of patients at higher risk for disjointed care. This study defines and prioritizes a set of success factors related to coordinated care in cancer. These success factors will be used to guide the development of interventions that target improving coordinated care as well as supporting the development of new funding models based on performance indicators derived from these factors.
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Affiliation(s)
- Tim Shaw
- Faculty of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Sarah York
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Sydney, Australia
| | | | - Deborah McGregor
- Faculty of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Nicole Rankin
- Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Sydney, Australia.,Cancer Council NSW, Sydney, Australia
| | - Alex Hawkey
- Faculty of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Centre for Health Research, Western Sydney University, Sydney, Australia
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Page A, Wong E, Rushton S, Mehew J, Berman M, Tsui S. Changing Trends in Acceptance Criteria for Cardiac Donors: 15 Year UK Experience. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Rushton S, Al-Aloul M, Carby M, Clark S, Thompson R, Parmar J, Tsui S. The Introduction of Urgent and Super-Urgent Lung Allocation Schemes in the United Kingdom. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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18
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Singh SA, Banner N, Rushton S, Al-Attar N. The Incidence and Outcome of Primary Graft Dysfunction After Adult Heart Transplantation in the United Kingdom. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Bell R, Glinianaia SV, van der Waal Z, Close A, Rushton S, Moloney E, Vale L, Milne E, Jones S, Hamilton S, Shucksmith J, Araujo-Soares V, Willmore M, White M. OP56 Evaluation of the implementation of a complex intervention (babyClear©) to promote increased smoking cessation rates among pregnant women. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Habes I, Rushton S, Johnston SJ, Sokunbi MO, Barawi K, Brosnan M, Daly T, Ihssen N, Linden DEJ. fMRI neurofeedback of higher visual areas and perceptual biases. Neuropsychologia 2016; 85:208-15. [PMID: 27020139 PMCID: PMC4863521 DOI: 10.1016/j.neuropsychologia.2016.03.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 11/03/2022]
Abstract
The self-regulation of brain activation via neurofeedback training offers a method to study the relationship between brain areas and perception in a more direct manner than the conventional mapping of brain responses to different types of stimuli. The current proof-of-concept study aimed to demonstrate that healthy volunteers can self-regulate activity in the parahippocampal place area (PPA) over the fusiform face area (FFA). Both areas are involved in higher order visual processing and are activated during the imagery of scenes and faces respectively. Participants (N=9) were required to upregulate PPA relative to FFA activity, and all succeeded at the task, with imagery of scenes being the most commonly reported mental strategy. A control group (N=8) underwent the same imagery and testing procedure, albeit without neurofeedback, in a mock MR scanner to account for any non-specific training effects. The upregulation of PPA activity occurred concurrently with activation of prefrontal and parietal areas, which have been associated with ideation and mental image generation. We tested whether successful upregulation of the PPA relative to FFA had consequences on perception by assessing bistable perception of faces and houses in a binocular rivalry task (before and after the scanning sessions) and categorisation of faces and scenes presented in transparent composite images (during scanning, interleaved with the self-regulation blocks). Contrary to our expectations, upregulation of the PPA did not alter the duration of face or house perception in the rivalry task and response speed and accuracy in the categorisation task. This conclusion was supported by the results of another control experiment (N=10 healthy participants) that involved intensive exposure to category-specific stimuli and did not show any behavioural or perceptual changes. We conclude that differential self-regulation of higher visual areas can be achieved, but that perceptual biases under conditions of stimulus rivalry are relatively robust against such internal modulation of localised brain activity. This study sets the basis for future investigations of perceptual and behavioural consequences of localised self-regulation of neural activity. Healthy participants trained differential self-regulation of higher visual areas. They were instructed to up-regulate the PPA whilst keeping FFA activity down. Up-regulation of the PPA was accompanied by frontal and parietal activation. No shift in perceptual biases in scene/face perceptual rivalry tasks was observed.
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Affiliation(s)
- I Habes
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - S Rushton
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - S J Johnston
- School of Human and Health Sciences, Department of Psychology, Swansea University, Swansea SA2 8PP, UK
| | - M O Sokunbi
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK; Cognitive Neuroscience Sector, International School for Advanced Studies (SISSA), 34136 Trieste, Italy
| | - K Barawi
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - M Brosnan
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK; Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin 2, Ireland
| | - T Daly
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff CF24 4XN, UK
| | - N Ihssen
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - D E J Linden
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK; Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff CF24 4XN, UK.
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Loke L, Ward R, Shapiro J, Lewis C, Rushton S, Rendel P. 514P eviQ Cancer Treatments Online (www.eviQ.org.au)- Use in Asia. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv535.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kleim BD, Malviya A, Rushton S, Bardgett M, Deehan DJ. Understanding the patient-reported factors determining time taken to return to work after hip and knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015; 23:3646-52. [PMID: 25193567 DOI: 10.1007/s00167-014-3265-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The key factors underscoring safe and early return to work after hip (THA) or knee (TKA) arthroplasty are poorly defined. The aim of this study was to evaluate the effect of patient-reported variables upon time taken to return to work after THA or TKA in a working population. METHODS Questionnaires asking about employment history, education, general health and experiences of returning to work after THA and TKA were administered by post and at outpatients' clinic. RESULTS One hundred and two from 272 eligible patients, of whom 52 had undergone THA and 50 TKA, were recruited sequentially. In total, 83 patients were employed pre-operatively and 80 returned to work at median 12 (2-64) weeks. Those in more manual occupations (p = 0.001) without pre-operative sick leave due to their hip or knee arthritis (p = 0.016) and a higher level of qualification (p = 0.041) returned to employment significantly quicker than the rest of the cohort. THA patients report a greater improvement in terms of performance at work (63 vs 44 %, p = 0.007) and job prospects (50 vs 36 %, p = 0.046) as compared with patients after TKA. CONCLUSIONS Patients with pre-operative sick leave, basic or no qualifications and more physically demanding occupations take longer to return to work. Operating patients before their arthritis forces them to become unemployed would improve their chances to return to work. Hip arthroplasty patients have a greater perceived benefit in terms of performance at work and job prospect. A more tailored return to work time predictions to allow a faster return to work and avoid frustration. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- B D Kleim
- Newcastle University, Framlington Place, Newcastle upon Tyne, NE1 7RU, UK
| | - A Malviya
- Newcastle University, Framlington Place, Newcastle upon Tyne, NE1 7RU, UK. .,Wansbeck General Hospital, Northumbria Healthcare NHS Foundation Trust, Woodhorn Lane, Ashington, NE63 9JJ, UK.
| | - S Rushton
- Newcastle University, Framlington Place, Newcastle upon Tyne, NE1 7RU, UK
| | - M Bardgett
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - D J Deehan
- Newcastle University, Framlington Place, Newcastle upon Tyne, NE1 7RU, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
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McNally R, Gomez Pozo B, Rushton S, Pearce M. 1034 Spatial epidemiology of lung cancer mortality in Andalucýa, Spain: Geographical heterogeneity and risk-factors assessment. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30460-9] [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: 11/26/2022]
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Ghosh KM, Hunt N, Blain A, Athwal KK, Longstaff L, Amis AA, Rushton S, Deehan DJ. Isolated popliteus tendon injury does not lead to abnormal laxity in posterior-stabilised total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015; 23:1763-9. [PMID: 25552404 DOI: 10.1007/s00167-014-3488-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 12/12/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE The popliteus tendon is crucial to postero-lateral stability and prone to iatrogenic injury intra-operatively. Its role in the stability of the replaced knee remains contentious. The aim of this study was to use computer navigation to quantify the effect of popliteus sectioning on the 'envelope of laxity' (EoL) offered by a posterior-stabilised (PS) total knee arthroplasty (TKA) and compare with that of the native knee. METHODS Loaded cadaveric legs were mounted on a purpose built rig. EoL was measured in 3 degrees of freedom using computer navigation. Knees were subjectively stressed in varus/valgus, internal/external rotation and anterior draw. This was performed preoperatively, during TKA and after sectioning of the popliteus tendon. Real-time data were recorded at 0°, 30°, 60° and 90° of flexion as the operating surgeon stressed the knee in 3 degrees of freedom to its subjective endpoint. Mixed-effect modelling was used to quantify the effects of intervention on degree of laxity. RESULTS In all conditions, there was an increase in laxity with knee flexion. Insertion of a PS TKA resulted in increased constraint, particularly in rotation. Sectioning of the popliteus did not result in a significant increase in knee laxity to 90º of knee flexion. However, at deeper flexion angles, tendon sectioning overcame the constraints of the implant resulting in a significant increase in rotatory and varus/valgus laxity towards the native condition. CONCLUSION These findings support the view that certain current designs of PS knee replacement can constrain the knee in flexion in the absence of postero-lateral deficiency. For this implant, isolated sectioning of the popliteus tendon did not substantially generate abnormal knee laxity.
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Affiliation(s)
- K M Ghosh
- Freeman Hospital, High Heaton, Newcastle upon Tyne, NE7 7DN, UK,
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Johnson C, Rushton S, Tieman J, Currow D, Aranda S. Reclaiming the midnight hours: up-to-date evidence in just one click. Eur J Cancer Care (Engl) 2014; 23:760-1. [PMID: 25352465 DOI: 10.1111/ecc.12265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- C Johnson
- Cancer Services and Information, Cancer Institute NSW, Sydney, New South Wales, Australia
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Ghosh KM, Blain AP, Longstaff L, Rushton S, Amis AA, Deehan DJ. Can we define envelope of laxity during navigated knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 2014; 22:1736-43. [PMID: 23832172 DOI: 10.1007/s00167-013-2574-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 06/10/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Functional outcomes after knee arthroplasty (TKA) remain poor. The ability to restore the soft tissue envelope intraoperatively may improve such outcomes. The aim of this study was to extend the scope of computer navigation as a tool to quantifying the envelope of laxity during subjective stress testing preoperatively and to quantify the effects of knee replacement and how it changes as a result of ligamentous failure. METHODS Loaded cadaveric legs were mounted on a purpose-built rig. Envelope of laxity was measured in 3 degrees of freedom using computer navigation. Knees were subjectively stressed in varus/valgus, internal/external rotation and anterior draw. This was performed preoperatively, during TKA and after sequential sectioning of ligaments. Real-time data were recorded at 0°, 30°, 60° and 90° of flexion. Mixed effect modelling was used to quantify the effects of intervention on degree of laxity. RESULTS In all cases, there was an increase in laxity with increasing flexion or ligament sectioning. Operator and movement cycle had no effect. Insertion of a TKA showed increased stability within the joint, especially in internal/external rotation and anterior drawer. Once the PCL and popliteus were cut, the implant only maintained some rotatory stability; thereafter, the soft tissue envelope failed. CONCLUSIONS This work has shown a novel way by which computer navigation can be used to analyse soft tissue behaviour during TKA beyond the coronal plane and throughout range of motion. Despite subjective stress testing, our results show reproducible patterns of soft tissue behaviour-in particular a wide range of mid-flexion excursion. It also quantifies the limits within which a cruciate-retaining TKR can maintain knee stability. This functionality may guide the surgeon in identifying and/or preventing soft tissue imbalances intra-operatively, improving functional results.
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Affiliation(s)
- K M Ghosh
- Newcastle Surgical Training Centre, Freeman Hospital, Freeman Rd., Newcastle Upon Tyne, NE7 7DN, UK,
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Bettridge JM, Lynch SE, Brena MC, Melese K, Dessie T, Terfa ZG, Desta TT, Rushton S, Hanotte O, Kaiser P, Wigley P, Christley RM. Infection-interactions in Ethiopian village chickens. Prev Vet Med 2014; 117:358-66. [PMID: 25085600 PMCID: PMC4235779 DOI: 10.1016/j.prevetmed.2014.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/12/2014] [Accepted: 07/03/2014] [Indexed: 11/19/2022]
Abstract
Chickens raised under village production systems are exposed to a wide variety of pathogens, and current or previous infections may affect their susceptibility to further infections with another parasite, and/or can alter the manifestation of each infection. It is possible that co-infections may be as important as environmental risk factors. However, in cross-sectional studies, where the timing of infection is unknown, apparent associations between infections may be observed due to parasites sharing common risk factors. This study measured antibody titres to 3 viral (Newcastle disease, Marek's disease and infectious bursal disease) and 2 bacterial (Pasteurella multocida and Salmonella) diseases, and the infection prevalence of 3 families of endo- and ecto-parasites (Ascaridida, Eimeria and lice) in 1056 village chickens from two geographically distinct populations in Ethiopia. Samples were collected during 4 cross-sectional surveys, each approximately 6 months apart. Constrained ordination, a technique for analysis of ecological community data, was used to explore this complex dataset and enabled potential relationships to be uncovered and tested despite the different measurements used for the different parasites. It was found that only a small proportion of variation in the data could be explained by the risk factors measured. Very few birds (9/1280) were found to be seropositive to Newcastle disease. Positive relationships were identified between Pasteurella and Salmonella titres; and between Marek's disease and parasitic infections, and these two groups of diseases were correlated with females and males, respectively. This may suggest differences in the way that the immune systems of male and female chickens interact with these parasites. In conclusion, we find that a number of infectious pathogens and their interactions are likely to impact village chicken health and production. Control of these infections is likely to be of importance in future development planning.
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Affiliation(s)
- J M Bettridge
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Liverpool CH64 7TE, United Kingdom; International Livestock Research Institute, Addis Ababa, Ethiopia.
| | - S E Lynch
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Liverpool CH64 7TE, United Kingdom; International Livestock Research Institute, Addis Ababa, Ethiopia
| | - M C Brena
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Liverpool CH64 7TE, United Kingdom
| | - K Melese
- Debre Zeit Agricultural Research Centre, Ethiopian Institute for Agriculture Research, Debre Zeit, Ethiopia
| | - T Dessie
- International Livestock Research Institute, Addis Ababa, Ethiopia
| | - Z G Terfa
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Liverpool CH64 7TE, United Kingdom; International Livestock Research Institute, Addis Ababa, Ethiopia
| | - T T Desta
- International Livestock Research Institute, Addis Ababa, Ethiopia; Centre for Genetics and Genomics, School of Biology, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - S Rushton
- School of Biology, Newcastle University, Newcastle Upon Tyne, NE1 7RU, United Kingdom
| | - O Hanotte
- Centre for Genetics and Genomics, School of Biology, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - P Kaiser
- The Roslin Institute and Royal (Dick) School of Veterinary Science, University of Edinburgh, Midlothian EH25 9RG, United Kingdom
| | - P Wigley
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Liverpool CH64 7TE, United Kingdom
| | - R M Christley
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Liverpool CH64 7TE, United Kingdom; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, L69 7BE, United Kingdom
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Baker PN, Rushton S, Jameson SS, Reed M, Gregg P, Deehan DJ. Patient satisfaction with total knee replacement cannot be predicted from pre-operative variables alone: A cohort study from the National Joint Registry for England and Wales. Bone Joint J 2013; 95-B:1359-65. [PMID: 24078532 DOI: 10.1302/0301-620x.95b10.32281] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Pre-operative variables are increasingly being used to determine eligibility for total knee replacement (TKR). This study was undertaken to evaluate the relationships, interactions and predictive capacity of variables available pre- and post-operatively on patient satisfaction following TKR. Using nationally collected patient reported outcome measures and data from the National Joint Registry for England and Wales, we identified 22 798 patients who underwent TKR for osteoarthritis between August 2008 and September 2010. The ability of specific covariates to predict satisfaction was assessed using ordinal logistic regression and structural equational modelling. Only 4959 (22%) of 22 278 patients rated the results of their TKR as 'excellent', despite the majority (71%, n = 15 882) perceiving their knee symptoms to be much improved. The strongest predictors of satisfaction were post-operative variables. Satisfaction was significantly and positively related to the perception of symptom improvement (operative success) and the post-operative EuroQol-5D score. While also significant within the models pre-operative variables were less important and had a minimal influence upon post-operative satisfaction. The most robust predictions of satisfaction occurred only when both pre- and post-operative variables were considered together. These findings question the appropriateness of restricting access to care based on arbitrary pre-operative thresholds as these factors have little bearing on post-operative satisfaction.
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Affiliation(s)
- P N Baker
- Newcastle University, Institute of Cellular Medicine, Newcastle upon Tyne NE1 7RU, UK
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Langton JM, Pesa N, Rushton S, Ward RL, Pearson SA. Uptake of a web-based oncology protocol system: how do cancer clinicians use eviQ cancer treatments online? BMC Cancer 2013; 13:112. [PMID: 23497080 PMCID: PMC3606250 DOI: 10.1186/1471-2407-13-112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 03/05/2013] [Indexed: 11/25/2022] Open
Abstract
Background The use of computerized systems to support evidence-based practice is commonplace in contemporary medicine. Despite the prolific use of electronic support systems there has been relatively little research on the uptake of web-based systems in the oncology setting. Our objective was to examine the uptake of a web-based oncology protocol system (http://www.eviq.org.au) by Australian cancer clinicians. Methods We used web-logfiles and Google Analytics to examine the characteristics of eviQ registrants from October 2009-December 2011 and patterns of use by cancer clinicians during a typical month. Results As of December 2011, there were 16,037 registrants; 85% of whom were Australian health care professionals. During a typical month 87% of webhits occurred in standard clinical hours (08:00 to 18:00 weekdays). Raw webhits were proportional to the size of clinician groups: nurses (47% of Australian registrants), followed by doctors (20%), and pharmacists (14%). However, pharmacists had up to three times the webhit rate of other clinical groups. Clinicians spent five times longer viewing chemotherapy protocol pages than other content and the protocols viewed reflect the most common cancers: lung, breast and colorectal. Conclusions Our results demonstrate eviQ is used by a range of health professionals involved in cancer treatment at the point-of-care. Continued monitoring of electronic decision support systems is vital to understanding how they are used in clinical practice and their impact on processes of care and patient outcomes.
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Affiliation(s)
- Julia M Langton
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
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31
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Foulkes A, Rushton S, Warren P. Effects of flow field noise and density on optic flow parsing. J Vis 2012. [DOI: 10.1167/12.9.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rushton S, Warren P. Successful detection of a size change during self-movement. J Vis 2011. [DOI: 10.1167/11.11.925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Carrington C, Stone L, Koczwara B, Searle C, Siderov J, Stevenson B, Michael M, Hyde S, Booth A, Rushton S. The Clinical Oncological Society of Australia (COSA) guidelines for the safe prescribing, dispensing and administration of cancer chemotherapy. Asia Pac J Clin Oncol 2011; 6:220-37. [PMID: 20887505 DOI: 10.1111/j.1743-7563.2010.01321.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The issue of medication safety is highly significant when anti-cancer therapy is used as a treatment modality due to the high potential for harm from these agents and the disease context in which they are being used. These guidelines provide recommendations on the safe prescribing, dispensing and administration of chemotherapy and related agents used in the treatment of cancer. The guidelines represent a multidisciplinary collaboration to standardise the complex process of providing chemotherapy for cancer and to enhance patient safety. These are consensus guidelines based on the best available evidence and expert opinion of professionals working in cancer care. The aim of these guidelines is to assist in the prevention of medication errors and to improve patient safety with respect to the treatment of cancer. This guidance is intended for a multi-disciplinary audience and will have most relevance for medical, nursing and pharmacy staff involved in the complex processes of delivering chemotherapy and associated treatment. The scope of the guidelines includes; all patients and age groups receiving chemotherapy and targeted therapy for the treatment of cancer and cancer therapy administered by any route in both the hospital and home setting. These guidelines should be seen as point of reference for practitioners providing cancer chemotherapy services.
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Affiliation(s)
- Christine Carrington
- Division of Cancer, Princess Alexandra Hospital/Cancer Control Team, Brisbane, Queensland, Australia.
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Brandwood T, Rushton S, Charron C. Exposure to displaced optic flow results in adaptation of visual straight ahead. J Vis 2010. [DOI: 10.1167/9.8.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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35
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Herlihey T, Rushton S, Charron C. Adaptation of visual straight ahead requires an unrestricted field of view. J Vis 2010. [DOI: 10.1167/10.7.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rushton S, Warren P. Detecting object movement during self-movement: The importance of local motion contrast, position change and optic flow. J Vis 2010. [DOI: 10.1167/9.8.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Congenital hepatic fibrosis is a disorder of biliary system development histologically characterized by diffuse periportal to bridging fibrosis with numerous small often-irregular bile ducts and reduction in the number of portal vein branches. The condition results from abnormal development of the ductal plate, the embryonic precursor to the interlobular bile ducts. It has rarely been reported in veterinary species, and it has never been reported in dogs. This article describes 5 cases of a ductal plate malformation in dogs consistent with congenital hepatic fibrosis. On light microscopy, all 5 livers had severe bridging fibrosis with a marked increase in the number of small bile ducts, which often had irregular, dilated profiles reminiscent of the developing ductal plate. In addition, 80% (4 of 5) of cases lacked typical portal vein profiles. Cytokeratin 7 and proliferating cell nuclear antigen immunohistochemistry was performed on the 3 cases for which paraffin-embedded tissue was available. The bile duct profiles were strongly positive for cytokeratin 7 in all 3 cases, and they were negative for proliferating cell nuclear antigen or only had rare positive cells. All 5 dogs presented with clinical signs of portal hypertension. Congenital hepatic fibrosis should be considered in the differential diagnosis in young dogs that present with portal hypertension and lesions that may have been interpreted as bridging biliary hyperplasia or extrahepatic biliary obstruction.
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Affiliation(s)
- D L Brown
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University Raleigh, NC, USA.
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Jarvstad A, Hahn U, Warren P, Rushton S. Exploring the limits of optimal motor-planning. J Vis 2010. [DOI: 10.1167/9.8.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rushton S, Sumner P, Singh K. The role of hMST in the perception of object movement during self-movement. J Vis 2010. [DOI: 10.1167/8.6.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pearce MS, Glinianaia SV, Rankin J, Rushton S, Charlton M, Parker L, Pless-Mulloli T. No association between ambient particulate matter exposure during pregnancy and stillbirth risk in the north of England, 1962-1992. Environ Res 2010; 110:118-22. [PMID: 19863953 PMCID: PMC2832733 DOI: 10.1016/j.envres.2009.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 10/01/2009] [Accepted: 10/02/2009] [Indexed: 05/22/2023]
Abstract
OBJECTIVES Research evidence suggests that exposure to ambient air pollutants can adversely affect the growth and development of the foetus and infant survival. Much less is known regarding the potential for an association between black smoke air pollution and stillbirth risk. This potential association was examined using data from the historical cohort UK Particulate Matter and Perinatal Events Research (PAMPER) study. METHODS Using data from paper-based neonatal records from the two major maternity hospitals in Newcastle upon Tyne (UK), a birth record database of all singletons born during 1961-1992 to mothers resident in the city was constructed. Weekly black smoke levels were obtained from routine data recorded at 20 air pollution monitoring stations over the study period. A two-stage statistical modelling strategy was used, incorporating temporally and spatially varying covariates to estimate black smoke exposure during each trimester and for the whole pregnancy period for each individual pregnancy. Conditional logistic regression models, with stratification on year of birth, were used to assess potential associations between black smoke exposures in pregnancy and stillbirth risk. RESULTS The PAMPER database consists of 90,537 births, between 1962 and 1992, with complete gestational age and residential address information, of which 812 were stillborn. There was no association between black smoke exposures in any trimester or across whole pregnancy and risk of stillbirth. Adjustment for potential confounders did not alter these results. CONCLUSIONS While black smoke in pregnancy is likely to be related to other pregnancy outcomes, our findings do not suggest that black smoke air pollution exposure during pregnancy increases the risk of stillbirth.
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Affiliation(s)
- M S Pearce
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
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Abstract
The associations between habitat and other factors that lead to the risk of bovine tuberculosis (bTB) in diary cattle were examined in an unmatched case-control study. Data from 60 herds with recent history of bTB and 60 controls were analysed using logistic regression. The predictors included farmland habitat, topography, indices of badger density and herd size. Information-theoretic approaches were used to identify those predictor variables explaining the greatest variation in cattle herd bTB breakdowns. Reduced risk of bTB was associated with the management of farmland in ways favourable to wildlife conservation, as encouraged by recent (2005) European Common Agricultural Policy reforms.
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Affiliation(s)
- F Mathews
- University of Oxford, Wildlife Conservation Research Unit, Tubney House, Abingdon Road, Tubney OX13 5QL, UK.
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Angold PG, Sadler JP, Hill MO, Pullin A, Rushton S, Austin K, Small E, Wood B, Wadsworth R, Sanderson R, Thompson K. Biodiversity in urban habitat patches. Sci Total Environ 2006; 360:196-204. [PMID: 16297440 DOI: 10.1016/j.scitotenv.2005.08.035] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We examined the biodiversity of urban habitats in Birmingham (England) using a combination of field surveys of plants and carabid beetles, genetic studies of four species of butterflies, modelling the anthropochorous nature of the floral communities and spatially explicit modelling of selected mammal species. The aim of the project was to: (i) understand the ecological characteristics of the biota of cities model, (ii) examine the effects of habitat fragment size and connectivity upon the ecological diversity and individual species distributions, (iii) predict biodiversity in cities, and (iv) analyse the extent to which the flora and fauna utilise the 'urban greenways' both as wildlife corridors and as habitats in their own right. The results suggest that cities provide habitats for rich and diverse range of plants and animals, which occur sometimes in unlikely recombinant communities. The studies on carabids and butterflies illustrated the relative importance of habitat quality on individual sites as opposed to site location within the conurbation. This suggests that dispersal for most of our urban species is not a limiting factor in population persistence, although elements of the woodland carabid fauna did appear to have some geographical structuring. Theoretical models suggested that dormice and water voles may depend on linear habitats for dispersal. The models also indicated that other groups, such as small and medium sized mammals, may use corridors, although field-based research did not provide any evidence to suggest that plants or invertebrates use urban greenways for dispersal. This finding indicates the importance of identifying a target species or group of species for urban greenways intended as dispersal routeways rather than as habitat in their own right. Their importance for most groups is rather that greenways provide a chain of different habitats permeating the urban environment. We suggest that planners can have a positive impact on urban biodiversity by slowing the pace of redevelopment and by not hurrying to tidy up and redevelop brownfield sites.
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Abstract
The C-type carbohydrate-recognition domains of E-selectin and rat serum mannose-binding protein have similar structures. Selectin/mannose-binding protein chimeras created by transfer of key sequences from E-selectin into mannose-binding protein have previously been shown to bind the selectin ligand sialyl-Lewis(X) through a Ca(2+)-dependent subsite, common to many C-type lectins, and an accessory site containing positively charged amino acid residues. Further characterization of these chimeras as well as analysis of novel constructs containing additional regions of E-selectin demonstrate that selectin-like interaction with sialyl-Lewis(X) can be faithfully reproduced even though structural evidence indicates that the mechanisms of binding to E-selectin and the chimeras are different. Selectin-like binding to the nonfucosylated sulfatide and sulfoglucuronyl glycolipids can also be reproduced with selectin/mannose-binding protein chimeras that contain the two subsites involved in sialyl-Lewis(X) binding. These results indicate that binding of structurally distinct anionic glycans to C-type carbohydrate-recognition domains can be mediated by the Ca(2+)-dependent subsite in combination with a positively charged region that forms an ionic strength-sensitive subsite.
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Affiliation(s)
- S Bouyain
- Glycobiology Institute, Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK
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45
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Abstract
Landscape management practices that alter the degree of habitat fragmentation can significantly affect the genetic structure of animal populations. British red squirrels use "stepping stone" patches of habitat to move considerable distances through a fragmented habitat. Over the past few decades, the planting of a large conifer forest has connected groups of forest fragments in the north of England with those in southern Scotland. This "defragmentation" of the landscape has resulted in substantial genetic mixing of Scottish and Cumbrian genes in squirrel populations up to 100 kilometers from the site of the new forest. These results have implications for the conservation management of animal and plant species in fragmented landscapes such as those found in Britain.
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Affiliation(s)
- M L Hale
- Department of Agricultural and Environmental Science, Centre for Life Science Modelling, University of Newcastle, Newcastle-upon-Tyne, NE1 7RU, UK.
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46
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Abstract
Virtual Reality (VR) technology is a relatively new application to rehabilitation medicine, yet it offers considerable potential to achieve significant successes in assessment, treatment and improved outcome, thereby increasing our knowledge of neuroplasticity. The capabilities of VR are especially evident in neurological rehabilitation, where cognitive and behavioural problems often interact with physical impairments to reduce the overall level of functioning and interaction. The need for effective interventions in neurological rehabilitation demands communication and collaboration between disciplines. This paper presents some of the current areas of the clinical applications of VR, emphasising the link between experimental evidence on recovery after brain damage and the clinical problems encountered in a ward setting.
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Affiliation(s)
- D A Johnson
- Department of Clinical Psychology, Astley Ainslie Hospital, Edinburgh.
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47
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Riva G, Bolzoni M, Carella F, Galimberti C, Griffin MJ, Lewis CH, Luongo R, Mardegan P, Melis L, Molinari-Tosatti L, Poerschmann C, Rovetta A, Rushton S, Selis C, Wann J. Virtual reality environments for psycho-neuro-physiological assessment and rehabilitation. Stud Health Technol Inform 1997; 39:34-45. [PMID: 10168930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation-is an European Community funded project (Telematics for health-HC 1053 http:/(/)www.etho.be/ht_projects/vrepar/) whose aim is: to develop a PC based virtual reality system (PC-VRS) for the medical market that can be marketed at a price which is accessible to its possible end-users (hospitals, universities and research centres) and which would have the modular, connectability and interoperability characteristics that the existing systems lack; to develop three hardware/software modules for the application of the PC VRS in psychoneurophysiological assessment and rehabilitation. The chosen development areas are eating disorders (bulimia, anorexia and obesity), movement disorders (Parkinson's disease and torsion dystonia) and stroke disorders (unilateral neglect and hemiparesis). This paper presents the rationale of the different approaches and the methodology used.
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Affiliation(s)
- G Riva
- Centro Auxologico Italiano, Applied Technology for Psychology Lab., Verbania, Italy
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48
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Abstract
The use of virtual reality (VR) display systems has escalated over the last 5 yr and may have consequences for those working within vision research. This paper provides a brief review of the literature pertaining to the representation of depth in stereoscopic VR displays. Specific attention is paid to the response of the accommodation system with its cross-links to vergence eye movements, and to the spatial errors that arise when portraying three-dimensional space on a two-dimensional window. It is suggested that these factors prevent large depth intervals of three-dimensional visual space being rendered with integrity through dual two-dimensional arrays.
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Affiliation(s)
- J P Wann
- Department of Psychology, University of Edinburgh, Scotland
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49
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Abstract
The short-term effects on binocular stability of wearing a conventional head-mounted display (HMD) to explore a virtual reality environment were examined. Twenty adult subjects (aged 19-29 years) wore a commercially available HMD for 10 min while cycling around a computer generated 3-D world. The twin screen presentations were set to suit the average interpupillary distance of our subject population, to mimic the conditions of public access virtual reality systems. Subjects were examined before and after exposure to the HMD and there were clear signs of induced binocular stress for a number of the subjects. The implications of introducing such HMDs into the workplace and entertainment environments are discussed.
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Affiliation(s)
- M Mon-Williams
- Department of Vision Science, Glasgow Caledonian University, UK
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50
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Galasko CS, Rushton S, Sylvester BS, Steingold RF, Noble J, Boston DA. The significance of peak expiratory flow rate in assessing prognosis of elderly patients undergoing operations on the hip. Injury 1985; 16:398-401. [PMID: 4008033 DOI: 10.1016/0020-1383(85)90055-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Peak expiratory flow rate (PEFR) was measured using a Wright peak flow meter in 190 patients with fracture of the proximal part of the femur, and in 110 patients who underwent elective total hip replacement. PEFR was significantly lower in the fracture group than in the elective group when similar age ranges were compared. In the fracture group, PEFR of less than 100 was associated with a 69.6 per cent mortality rate, whereas no deaths occurred where the PEFR was greater than 300. It is suggested that the patients' PEFR is a good indicator of their prospects and it can be easily measured on admission.
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