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Kassis A, Moles R, Carter S. Stakeholders' perspectives and experiences of the pharmacist's role in deprescribing in ambulatory care: A qualitative meta-synthesis. Res Social Adm Pharm 2024:S1551-7411(24)00150-5. [PMID: 38685144 DOI: 10.1016/j.sapharm.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Deprescribing is an effective strategy to manage polypharmacy and improve patient outcomes. The notion of a potential role for pharmacists in a multidisciplinary team approach to deprescribing has been identified in quantitative and qualitative literature. However, stakeholders' perceptions of this role, and factors that may impede or facilitate the pharmacist's involvement have not been elucidated. The application in ambulatory care also requires clarification. Understanding stakeholders' views is essential to optimise involvement of the pharmacist in deprescribing and improve practice. OBJECTIVES First, to synthesize the perspectives and experiences of stakeholders (primary care providers, pharmacists, patients, and carers) regarding the role and involvement of the pharmacist in deprescribing in ambulatory care settings. Second, to identify barriers and strategies to enhancing pharmacist involvement in deprescribing. METHODS A systematic search was conducted across CINAHL, Embase, Medline, and Scopus from database inception to April 2023 for qualitative studies in English exploring the pharmacist's role in deprescribing. Data were extracted for iterative and inductive development of themes. A meta-synthesis facilitated the identification of overarching themes. Qualitative secondary analysis enabled identification of barriers and facilitators to the pharmacist's involvement in deprescribing. RESULTS From 285 articles identified, 9 studies were included which explored the views of general practitioners, specialist physicians, pharmacists, nurse practitioners, patients, carers, and general practice and clinic staff as stakeholders in deprescribing in ambulatory care. The meta-synthesis identified 4 over-arching themes: (1) therapeutic impetus and the status quo mentality, (2) role and responsibility, (3) multidisciplinary care, and (4) conflicting interests in pharmacy practice. Strategies to enhance pharmacists' involvement in deprescribing emerged from the data, and the pharmacist's role was strongly encouraged by stakeholders despite logistical and perceptual barriers identified. CONCLUSIONS Incorporation of the strategies to enhance the pharmacist's involvement in deprescribing identified in this review is encouraged to optimise patient-centred care and improve practice.
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Affiliation(s)
- Amanda Kassis
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW, Australia.
| | - Rebekah Moles
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW, Australia
| | - Stephen Carter
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW, Australia
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Rezae F, Kelly A, Dey S, Moles R, Carter S. Healthcare professionals' perspectives and experiences of osteoporosis medication treatment: a qualitative systematic review. Arch Osteoporos 2024; 19:8. [PMID: 38191760 DOI: 10.1007/s11657-023-01359-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Abstract
This systematic review aimed to explore healthcare professionals' (HCPs) experiences and perspectives of osteoporosis medication treatment through thematic synthesis of qualitative studies. We found themes about how osteoporosis is perceived as a disease, treatment decision-making and what empowers HCPs to provide the best possible care. PURPOSE The systematic review aimed to describe the perspectives and experiences of HCPs regarding osteoporosis medication treatment. METHODS We performed searches in four electronic databases (Medline, Embase, PsycINFO and CINAHL) from database inception until May 2023 in any language. Data was analysed through inductive thematic synthesis. RESULTS We included 27 primary studies that incorporated the views of 495 different HCPs. The following themes were identified: low-priority disease, challenges in treatment decision-making, minimising drug burden, conscious of communication barriers, fragmented care and advice, confidence through experience and collaboration. CONCLUSIONS HCPs were enthusiastic about optimising osteoporosis care through interprofessional collaboration and expertise, as well as educating and monitoring patients on treatment. They advocated for safety, comfort and reducing overall drug burden, especially in older patients with comorbidities. However, they had differences in opinions regarding who has responsibility for diagnosing and treating osteoporosis and struggled to provide the best possible care due to competing priorities, limited time and lack of adequate knowledge or evidence. The findings highlight the important and complementary role of different HCPs in osteoporosis treatment through a multidisciplinary model of care.
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Affiliation(s)
- Fatima Rezae
- School of Pharmacy, University of Sydney, Sydney, Australia.
| | - Ayano Kelly
- Rheumatology Department, Liverpool Hospital, Sydney, Australia
- Ingham Institute of Applied Medical Research, Sydney, Australia
- School of Health and Medicine, South Western Sydney Campus, University of New South Wales, Sydney, Australia
| | - Sagarika Dey
- School of Clinical Medicine, South Western Sydney Campus, University of New South Wales, Sydney, Australia
| | - Rebekah Moles
- School of Pharmacy, University of Sydney, Sydney, Australia
| | - Stephen Carter
- School of Pharmacy, University of Sydney, Sydney, Australia
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Strowel C, Raynes-Greenow C, Pham L, Carter S, Birkness K, Moles RJ, O'Reilly CL, Chen TF, Raduescu C, Murphy A, Gardner D, El-Den S. Perinatal depression screening in community pharmacy: Exploring pharmacists' roles, training and resource needs using content analysis. Int J Clin Pharm 2023; 45:1212-1222. [PMID: 37792255 PMCID: PMC10600310 DOI: 10.1007/s11096-023-01647-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Perinatal depression (PND) screening is often recommended in primary care settings, which includes the community pharmacy setting. However, there is limited research exploring pharmacists' perspectives on their roles in screening for perinatal mental illness. AIM This study aimed to explore pharmacists' views of pharmacists' roles in PND screening, as well as training and resource needs for PND screening in community pharmacy settings. METHOD A questionnaire including three open-ended questions focusing on pharmacists' perspectives of their role in PND screening, their training, and resource needs in this area, was disseminated to pharmacists across Australia via professional organisations and social media. Each open-ended question was separately analysed by inductive content analysis. Subcategories were deductively mapped to the Theoretical Framework of Acceptability. RESULTS Responses (N = 149) from the first open-ended question about pharmacists' roles in PND screening resulted in three categories (PND screening in primary care settings will support the community, community pharmacy environment, and system and policy changes) and ten subcategories. Responses to question two on training needs (n = 148) were categorised as: training content, training length, and training delivery while responses about resource needs (n = 147) fell into three categories: adapting community pharmacy operating structures, pharmacist-specific resources, and consumer-specific resources. CONCLUSION While some pharmacists were accepting of a role in PND screening due to pharmacists' accessibility and positive relationships with consumers, others had concerns regarding whether PND screening was within pharmacists' scope of practice. Further training and resources are needed to facilitate pharmacists' roles in PND screening, referral and care.
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Affiliation(s)
- Clara Strowel
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stephen Carter
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Timothy F Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Corina Raduescu
- The University of Sydney Business School, University of Sydney, Sydney, NSW, 2050, Australia
| | - Andrea Murphy
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - David Gardner
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Henderson SR, Horsley H, Frankel P, Khosravi M, Goble T, Carter S, Antonelou M, Evans RDR, Zhang X, Chu TY, Lin HH, Gordon S, Salama AD. Proteinase 3 promotes formation of multinucleated giant cells and granuloma-like structures in patients with granulomatosis with polyangiitis. Ann Rheum Dis 2023; 82:848-856. [PMID: 36801813 PMCID: PMC10314067 DOI: 10.1136/ard-2021-221800] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/08/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVES Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) are autoimmune vasculitides associated with antineutrophil cytoplasm antibodies that target proteinase 3 (PR3) or myeloperoxidase (MPO) found within neutrophils and monocytes. Granulomas are exclusively found in GPA and form around multinucleated giant cells (MGCs), at sites of microabscesses, containing apoptotic and necrotic neutrophils. Since patients with GPA have augmented neutrophil PR3 expression, and PR3-expressing apoptotic cells frustrate macrophage phagocytosis and cellular clearance, we investigated the role of PR3 in stimulating giant cell and granuloma formation. METHODS We stimulated purified monocytes and whole peripheral blood mononuclear cells (PBMCs) from patients with GPA, patients with MPA or healthy controls with PR3 or MPO and visualised MGC and granuloma-like structure formation using light, confocal and electron microscopy, as well as measuring the cell cytokine production. We investigated the expression of PR3 binding partners on monocytes and tested the impact of their inhibition. Finally, we injected zebrafish with PR3 and characterised granuloma formation in a novel animal model. RESULTS In vitro, PR3 promoted monocyte-derived MGC formation using cells from patients with GPA but not from patients with MPA, and this was dependent on soluble interleukin 6 (IL-6), as well as monocyte MAC-1 and protease-activated receptor-2, found to be overexpressed in the cells of patients with GPA. PBMCs stimulated by PR3 formed granuloma-like structures with central MGC surrounded by T cells. This effect of PR3 was confirmed in vivo using zebrafish and was inhibited by niclosamide, a IL-6-STAT3 pathway inhibitor. CONCLUSIONS These data provide a mechanistic basis for granuloma formation in GPA and a rationale for novel therapeutic approaches.
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Affiliation(s)
| | - Harry Horsley
- UCL Department of Renal Medicine, Royal Free Hospital, London, UK
| | - Paul Frankel
- UCL Institute of Cardiovascular Science Faculty of Population Health Sciences, London, UK
| | - Maryam Khosravi
- Department of Cell and Developmental Biology, UCL Division of Biosciences, London, UK
| | - Talya Goble
- Department of Cell and Developmental Biology, UCL Division of Biosciences, London, UK
| | - Stephen Carter
- Department of Cell and Developmental Biology, UCL Division of Biosciences, London, UK
| | | | - Rhys D R Evans
- UCL Department of Renal Medicine, Royal Free Hospital, London, UK
| | - Xiang Zhang
- UCL Department of Renal Medicine, Royal Free Hospital, London, UK
| | - Tai-Ying Chu
- Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan
| | - Hsi-Hsien Lin
- Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan
- Department of Anatomic Pathology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Siamon Gordon
- Graduate Institute of Biomedical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Sir William Dunn School of Pathology, Oxford University, Oxford, UK
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Kapelios C, Tseliou E, Alharethi R, Shah K, Hanff T, Kyriakopoulos C, Sideris K, Taleb I, Stehlik J, Carter S, Kfoury A, Caine W, Selzman C, Fang J, Wever-Pinzon O, Drakos S. Impaired Liver Function is Associated with Hypotension and Elevated Right Atrial Pressure but Not Depressed Cardiac Index in Chronic Heart Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.503] [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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Kyriakopoulos C, Giannouchos T, Mylavarapu R, Krauspe E, Sheffield E, Sideris K, Elmer A, Vance N, Carter S, Hanff T, Wever-Pinzon O, Stehlik J, Selzman C, Drakos S, Goodwin M. Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.782] [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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Watkins JD, Carter S, Atkinson G, Koumanov F, Betts JA, Holst JJ, Gonzalez JT. Glucagon-like peptide-1 secretion in people with versus without type 2 diabetes: a systematic review and meta-analysis of cross-sectional studies. Metabolism 2023; 140:155375. [PMID: 36502882 DOI: 10.1016/j.metabol.2022.155375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS The aim of this systematic review was to synthesise the study findings on whether GLP-1 secretion in response to a meal tolerance test is affected by the presence of type 2 diabetes (T2D). The influence of putative moderators such as age, sex, meal type, meal form, and assay type were also explored. METHODS A literature search identified 32 relevant studies. The sample mean and SD for fasting GLP-1TOTAL and GLP-1TOTAL iAUC were extracted and used to calculate between-group standardised mean differences (SMD), which were meta-analysed using a random-effects model to derive pooled estimates of Hedges' g and 95 % prediction intervals (PI). RESULTS Pooled across 18 studies, the overall SMD in GLP-1TOTAL iAUC between individuals with T2D (n = 270, 1047 ± 930 pmol·L-1·min) and individuals without T2D (n = 402, 1204 ± 937 pmol·L-1·min) was very small, not statistically significant and heterogenous across studies (g = -0.15, p = 0.43, PI: -1.53, 1.23). Subgroup analyses demonstrated an effect of assay type whereby Hedges' g for GLP-1 iAUC was greater in individuals with, versus those without T2D when using ELISA or Mesoscale (g = 0.67 [moderate], p = 0.009), but not when using RIA (g = -0.30 [small], p = 0.10). Pooled across 30 studies, the SMD in fasting GLP-1TOTAL between individuals with T2D (n = 580, 16.2 ± 6.9 pmol·L-1) versus individuals without T2D (n = 1363, 12.4 ± 5.7 pmol·L-1) was small and heterogenous between studies (g = 0.24, p = 0.21, PI: -1.55, 2.02). CONCLUSIONS Differences in fasting GLP-1TOTAL and GLP-1TOTAL iAUC between individuals with, versus those without T2D were generally small and inconsistent between studies. Factors influencing study heterogeneity such as small sample sizes and poor matching of groups may help to explain the wide prediction intervals observed. Considerations to improve comparisons of GLP-1 secretion in T2D and potential mediating factors more important than T2D diagnosis per se are outlined. PROSPERO ID CRD42020195612.
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Affiliation(s)
- J D Watkins
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK.
| | - S Carter
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK
| | - G Atkinson
- Liverpool John Moores University, Liverpool, UK
| | - F Koumanov
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK
| | - J A Betts
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK
| | - J J Holst
- Biomedical Sciences, Endocrinology Research Section, University of Copenhagen, Denmark
| | - J T Gonzalez
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK.
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Pham L, Moles RJ, O’Reilly CL, Carter S, Raynes-Greenow C, Chen TF, Raduescu C, Randall S, Bloomfield J, Strowel C, Murphy A, Gardner D, El-Den S. Perinatal Women's Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study. Int J Environ Res Public Health 2022; 19:16295. [PMID: 36498368 PMCID: PMC9738857 DOI: 10.3390/ijerph192316295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Internationally, 20% of women experience perinatal depression (PND). Healthcare providers including general practitioners and midwives are critical in providing PND screening and support; however, the current workforce is unable to meet growing demands for PND care. As accessible and trusted primary healthcare professionals, pharmacists could provide PND care to complement existing services, thereby contributing to early detection and intervention. This study aimed to explore perinatal women's views of community pharmacist-delivered PND screening and care, with a focus on their attitudes towards and acceptability of PND screening implementation in community pharmacy. Semi-structured interviews with women (n = 41) were undertaken, whereby interview data were transcribed verbatim and then inductively and thematically analysed. Five overarching themes emerged; "patient experience with existing PND support and screening services"; "familiarity with pharmacists' roles"; "pharmacist visibility in PND screening care"; "patient-pharmacist relationships" and "factors influencing service accessibility". Themes and subthemes were mapped to the Consolidated Framework for Implementation Research. Findings highlight participants' generally positive attitudes towards community pharmacist-delivered PND screening and care, and the potential acceptability of such services provided pharmacists are trained and referral pathways are established. Addressing perceived barriers and facilitators would allow community pharmacist-delivered PND screening and care to support existing PND care models.
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Affiliation(s)
- Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Rebekah J. Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Claire L. O’Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stephen Carter
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Timothy F. Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Corina Raduescu
- The University of Sydney Business School, University of Sydney, Sydney, NSW 2050, Australia
| | - Sue Randall
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Jacqueline Bloomfield
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Clara Strowel
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Andrea Murphy
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Gardner
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
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Baranauskas M, Blechschmid T, Long E, Thomas D, Carter S. Evidence For Altered Gas Exchange During Light-to-Moderate Intensity Aerobic Exercise In Women Recovering From Sars-CoV-2. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000876840.48229.90] [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: 11/21/2022]
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10
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Ke GN, Grajfoner D, Carter S, DeLima N, Khairudin R, Lau WY, Kamal KA, Lee SC. Psychological Wellbeing and Employability of Retrenched Workforce During COVID-19: A Qualitative Study Exploring the Mitigations for Post Pandemic Recovery Phase. Front Public Health 2022; 10:907797. [PMID: 35875037 PMCID: PMC9304802 DOI: 10.3389/fpubh.2022.907797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022] Open
Abstract
The ongoing COVID-19 pandemic has triggered several employment-related issues, followed by different response strategies. With retrenchment measures being a common response strategy during economic downturns, many individuals have been faced with unemployment. This study aimed to explore the effect of the COVID-19 pandemic related retrenchment on the psychological wellbeing of the Malaysian workforce, using a qualitative research approach and based on the Latent-deprivation Model. A purposive sample of 30 retrenched participants was interviewed via telephone during Malaysia's Movement Control Order (MCO). Thematic analysis was subsequently conducted to identify key themes in the data set. Six themes emerged from the thematic analysis: (1) Retrenchment leading to the deterioration of psychological wellbeing; (2) Unemployment, financial strain and economic uncertainty; (3) Emotions related to the COVID-19 virus; (4) Coping with lifestyle change; (5) Recommendations to improve the psychological wellbeing and mental health of the retrenched workforce, and (6) Career and financial support at the recovery phase. The present study provides valuable insight into the wellbeing of retrenched workforce who are forced to cope with both unemployment and a global pandemic, and workforce perspectives regarding types of support needed during the recovery phase.
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Affiliation(s)
- Guek-Nee Ke
- Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
- *Correspondence: Guek-Nee Ke
| | - Dasha Grajfoner
- Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, United Kingdom
| | - Stephen Carter
- Edinburgh Business School, Heriot-Watt University, Edinburgh, United Kingdom
| | - Nicole DeLima
- Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Rozainee Khairudin
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, National University of Malaysia, Bangi, Malaysia
| | - Wee-Yeap Lau
- Department of Applied Statistics, Faculty of Economics and Administration, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Shen Chieng Lee
- Malaysian Institute of Economic Research (MIER), Kuala Lumpur, Malaysia
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Ke GN, Grajfoner D, Wong RMM, Carter S, Khairudin R, Lau WY, Kamal KA, Lee SC. Building the Positive Emotion-Resilience-Coping Efficacy Model for COVID-19 Pandemic. Front Psychol 2022; 13:764811. [PMID: 35369195 PMCID: PMC8969746 DOI: 10.3389/fpsyg.2022.764811] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/17/2022] [Indexed: 12/14/2022] Open
Abstract
The world faces unprecedented challenges because of the Coronavirus Disease 2019 (COVID-19). Existing theories of human flourishing and coping efficacy are too broad and general to address COVID-19 unprecedented mental health challenges. This study examined two main objectives, first the associations between psychological outcomes (i.e., depression, anxiety, and stress) and psychological wellbeing of this phenomenon, and second, moderating and mediating factors emotions, resilience and coping self-efficacy. A nationwide survey was carried out on a Malaysian sample (n = 920). Participants completed an on-line survey that assessed psychological outcomes, psychological wellbeing, positive-negative emotions, resilience, and coping self-efficacy. The relationship between psychological states and psychological wellbeing was successfully mediated by coping self-efficacy (direct effects of -0.31 to -0.46 at p < 0.01) and resilience (direct effects of -0.06 to -0.26 at p < 0.01). Moreover, positive emotion significantly moderated depression (b = -0.02, p < 0.01) and anxiety (b = -0.14, p = 0.05) with psychological wellbeing. Findings highlighted the importance of these factors in developing a dedicated model to be built into the recovery plan to ameliorate the negative impact of COVID-19 on psychological wellbeing. Hence, the Positive Emotion-Resilience-Coping Efficacy Model was developed.
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Affiliation(s)
- Guek Nee Ke
- Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Dasha Grajfoner
- Department of Psychology, School of Social Sciences, Heriot-Watt University Edinburgh, Edinburgh, United Kingdom
| | - Rachel Mei Ming Wong
- Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Stephen Carter
- Edinburgh Business School, School of Social Sciences, Heriot-Watt University Edinburgh, Edinburgh, United Kingdom
| | | | - Wee Yeap Lau
- Faculty of Economics and Administration, Department of Applied Statistics, University Malaya, Kuala Lumpur, Malaysia
| | | | - Shen Chieng Lee
- Malaysian Institute of Economic Research (MIER), Kuala Lumpur, Malaysia
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Tran S, Smith L, El-Den S, Carter S. The Use of Gamification and Incentives in Mobile Health Apps to Improve Medication Adherence: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e30671. [PMID: 35188475 PMCID: PMC8902658 DOI: 10.2196/30671] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 05/24/2021] [Revised: 09/19/2021] [Accepted: 12/13/2021] [Indexed: 12/24/2022] Open
Abstract
Background Emerging health care strategies addressing medication adherence include the use of direct-to-patient incentives or elements adapted from computer games. However, there is currently no published evidence synthesis on the use of gamification or financial incentives in mobile apps to improve medication adherence. Objective The aim of this scoping review is to synthesize and appraise the literature pertaining to the use of mobile apps containing gamification or financial incentives for medication adherence. There were two objectives: to explore the reported effectiveness of these features and to describe and appraise the design and development process, including patient involvement. Methods The following databases were searched for relevant articles published in English from database inception to September 24, 2020: Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science. The framework by Arksey and O’Malley and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist guided this scoping review. Using a systematic screening process, studies were included if incentives or game features were used within mobile apps to specifically address medication adherence. An appraisal using risk of bias tools was also applied to their respective study design. Results A total of 11 studies from the initial 691 retrieved articles were included in this review. Across the studies, gamification alone (9/11, 82%) was used more than financial incentives (1/11, 9%) alone or a combination of the two (1/11, 9%). The studies generally reported improved or sustained optimal medication adherence outcomes; however, there was significant heterogeneity in the patient population, methodology such as outcome measures, and reporting of these studies. There was considerable variability in the development process and evaluation of the apps, with authors opting for either the waterfall or agile methodology. App development was often guided by a theory, but across the reviewed studies, there were no common theories used. Patient involvement was not commonly evident in predevelopment phases but were generally reserved for evaluations of feasibility, acceptance, and effectiveness. Patient perspectives on gamified app features indicated a potential to motivate positive health behaviors such as medication adherence along with critical themes of repetitiveness and irrelevance of certain features. The appraisal indicated a low risk of bias in most studies, although concerns were identified in potential confounding. Conclusions To effectively address medication adherence via gamified and incentivized mobile apps, an evidence-based co-design approach and agile methodology should be used. This review indicates some adoption of an agile approach in app development; however, patient involvement is lacking in earlier stages. Further research in a generalized cohort of patients living with chronic conditions would facilitate the identification of barriers, potential opportunities, and the justification for the use of gamification and financial incentives in mobile apps for medication adherence.
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Affiliation(s)
- Steven Tran
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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13
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Holroyd CR, Carter S, Crozier SR, D'Angelo S, Curtis EM, Moon RJ, Davies JH, Ward KA, Dennison EM, Inskip HM, Godfrey KM, Cooper C, Harvey NC. Differential relationships between parent-child DXA and pQCT bone measures: Results from the Southampton Women's Survey. Bone 2021; 153:116134. [PMID: 34332160 PMCID: PMC7611825 DOI: 10.1016/j.bone.2021.116134] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/13/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
AIM To investigate the associations between indices of bone health in childhood and corresponding parental measures. METHODS The Southampton Women's Survey characterised 12,583 non-pregnant women aged 20-34 years; 3158 subsequently had singleton live births. In a subset, dual-energy X-ray absorptiometry (DXA) measurements of bone area (BA), bone mineral content (BMC) and areal bone mineral density (aBMD) lumbar spine and total hip were obtained in the parent/offspring (aged 8-9 years) trios. Another subset of children (aged 6-7 years), and their parents, had peripheral quantitative computed tomography (pQCT; 4% and 38% tibia) measures. Using multivariable linear regression we examined relationships between mother/father and offspring, adjusting for parental age, habitual walking speed and education; offspring age and sex; and the corresponding bone measure in the other parent (β-coefficients (95%CI) unit/unit for each bone measure). RESULTS Data were available for 260 trios with DXA and 99 with pQCT. There were positive associations for BA, BMC and aBMD between either parent and offspring. Mother-child associations were of greater magnitude than father-child; for example, mother-child aBMD (β = 0.26 g·cm-2/g·cm-2 (0.21,0.32)) and father-child aBMD (β = 0.16 g·cm-2/g·cm-2 (0.11,0.21)), P-difference in β = 0.007. In the subset with pQCT there was a positive association for mother-offspring 4% tibial total area (β = 0.33 mm2/mm2 (0.17,0.48)), but little evidence of a father-offspring association (β = -0.06 mm2/mm2 (-0.17,0.06)). In contrast offspring 38% cortical density was more strongly associated with this measure in fathers (β = 0.48 mg·cm-3/mg·cm-3 (0.15,0.82)) than mothers (β = 0.27 mg·cm-3/mg·cm-3 (-0.03,0.56)). In general mother-father differences were attenuated by adjustment for height. CONCLUSIONS Whilst offspring bone measures are independently associated with those of either parent, the magnitude of the association is often greater for maternal than paternal relationships. These findings are consistent with an in utero influence on offspring growth but might also reflect genetic and/or epigenetic parent of origin effects. SUMMARY In an established parent-offspring cohort, associations between parent and offspring bone indices were generally greater in magnitude for mother-offspring than father-offspring relationships.
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Affiliation(s)
- C R Holroyd
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Carter S, van Rees CB, Hand BK, Muhlfeld CC, Luikart G, Kimball JS. Testing a Generalizable Machine Learning Workflow for Aquatic Invasive Species on Rainbow Trout ( Oncorhynchus mykiss) in Northwest Montana. Front Big Data 2021; 4:734990. [PMID: 34734177 PMCID: PMC8558495 DOI: 10.3389/fdata.2021.734990] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Biological invasions are accelerating worldwide, causing major ecological and economic impacts in aquatic ecosystems. The urgent decision-making needs of invasive species managers can be better met by the integration of biodiversity big data with large-domain models and data-driven products. Remotely sensed data products can be combined with existing invasive species occurrence data via machine learning models to provide the proactive spatial risk analysis necessary for implementing coordinated and agile management paradigms across large scales. We present a workflow that generates rapid spatial risk assessments on aquatic invasive species using occurrence data, spatially explicit environmental data, and an ensemble approach to species distribution modeling using five machine learning algorithms. For proof of concept and validation, we tested this workflow using extensive spatial and temporal hybridization and occurrence data from a well-studied, ongoing, and climate-driven species invasion in the upper Flathead River system in northwestern Montana, USA. Rainbow Trout (RBT; Oncorhynchus mykiss), an introduced species in the Flathead River basin, compete and readily hybridize with native Westslope Cutthroat Trout (WCT; O. clarkii lewisii), and the spread of RBT individuals and their alleles has been tracked for decades. We used remotely sensed and other geospatial data as key environmental predictors for projecting resultant habitat suitability to geographic space. The ensemble modeling technique yielded high accuracy predictions relative to 30-fold cross-validated datasets (87% 30-fold cross-validated accuracy score). Both top predictors and model performance relative to these predictors matched current understanding of the drivers of RBT invasion and habitat suitability, indicating that temperature is a major factor influencing the spread of invasive RBT and hybridization with native WCT. The congruence between more time-consuming modeling approaches and our rapid machine-learning approach suggest that this workflow could be applied more broadly to provide data-driven management information for early detection of potential invaders.
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Affiliation(s)
- S Carter
- Numerical Terradynamic Simulation Group, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States
| | - C B van Rees
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States
| | - B K Hand
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States
| | - C C Muhlfeld
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States.,U.S. Geological Survey, Northern Rocky Mountain Science Center, Glacier National Park, West Glacier, MT, United States.,Department of Ecosystem and Conservation Sciences, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States
| | - G Luikart
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States
| | - J S Kimball
- Numerical Terradynamic Simulation Group, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States.,Department of Ecosystem and Conservation Sciences, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States
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Kashetsky N, Mukovozov IM, Pereira J, Manion R, Carter S, Alhusayen R. Patient experiences with hidradenitis suppurativa: the Hidradenitis Patient Experience survey. Clin Exp Dermatol 2021; 47:72-79. [PMID: 34235774 DOI: 10.1111/ced.14826] [Citation(s) in RCA: 3] [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] [Received: 01/25/2021] [Revised: 05/03/2021] [Accepted: 07/06/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Better understanding of the experience of people living with hidradenitis suppurativa (HS) is essential to identify gaps in current patient care and inform healthcare decision-making. AIM To describe the patient experience of individuals with HS, including their path to diagnosis, symptom control, treatments, healthcare utilization, patient needs and impact on quality of life. METHODS The Hidradenitis Suppurativa Patient Experience survey was created, extensively reviewed and disseminated through engaging HS-related patient organizations, physician groups and social media groups. RESULTS In total, 537 respondents completed the survey; the mean age was 38 years (range 14-73 years) and 95% (510 of 537) were female. The mean number of treatment types per respondent was 15, and included antibacterial soaps (93.3%; 431 of 462), avoidance of tight clothing (90.9%; 419 of 462), use of oral antibiotics (79.7%; 368 of 462), nonprescription drugs (79.7%; 368 of 462) and topical antibiotics (77.1%; 356 of 262). Pain was poorly controlled in 46% of respondents (184 of 401). HS had a negative impact on the ability to work and attend school for 81% of respondents (337 of 415), with 59% (245 of 415) missing at least 2 days of work a month and 16% (66 of 415) missing > 11 days of work. The mean number of misdiagnoses per respondent was three and the median time to diagnosis was 10 years. CONCLUSION Individuals with HS experience a delay in diagnosis and have suboptimal control of the disease. We propose 11 recommendations to improve diagnosis, treatment and quality of life for individuals living with HS.
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Affiliation(s)
- N Kashetsky
- Faculty of Medicine, Memorial University of Newfoundland, St John's, NL, Canada
| | - I M Mukovozov
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - J Pereira
- JRL Research & Consulting Inc, Mississauga, ON, Canada
| | - R Manion
- Canadian Skin Patient Alliance, Ottawa, ON, Canada
| | | | - R Alhusayen
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
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16
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Keeler J, Greenshields J, Freemas J, Baker T, Johnson B, Carter S, Schlader Z. Acute Consumption of a Caffeinated Soft Drink Sweetened with High Fructose Corn Syrup Does Not Modify the Cutaneous Microvascular Response to Ischemia‐Reperfusion Injury. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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McDeavitt J, Freeman J, Greenshields J, Baker T, Carter S, Johnson B, Shlader Z. Arterial stiffness is not acutely modified by consumption of a caffeinated soft drink sweetened with high fructose corn syrup in young healthy adults. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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18
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Bjorkman C, Carter S, Amin A, Joshi P. Moderate Association of Coronary Artery Calcium and Cardiac Allograft Vasculopathy in Heart Transplant Recipients on Non-Gated CT. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.600] [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] Open
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19
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Carter S, Ng R, El-Den S, Schneider C. Low perceived service quality in community pharmacy is associated with poor medication adherence. Patient Educ Couns 2021; 104:387-394. [PMID: 32788130 DOI: 10.1016/j.pec.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/26/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Community pharmacists are highly accessible healthcare professionals, whose regular contact with patients provides ongoing opportunities to improve medication safety and promote medication adherence. This study investigates whether patients who experience low service quality in community pharmacies are less adherent to their regular medications. METHODS Eight Australian pharmacies were recruited, 5 self-identified as having a price promotion business strategy and 3 with a service-focused business strategy. Patients taking regular prescribed medicines who had previously attended the pharmacy completed e-surveys in-store with measures of perceived service quality (pSQ) and self-reported adherence. Multivariate regression using multilevel modelling with bootstrapping was used to explore the relationships between variables. RESULTS Surveys were completed by 319 respondents. Attending pharmacies with a price promotion business strategy was predictive of lower pSQ and poor medication adherence. The between-pharmacy slope of the relationship between pSQ and adherence was 2.25 (with 95 % confidence intervals = 1.50, 2.86) and was highest in pharmacies with lowest pSQ. CONCLUSION This study highlights that when patients experience low service quality, in community pharmacies they are more likely to report poor adherence to their regular prescribed medicines. PRACTICE IMPLICATIONS Community pharmacies need to be designed and managed to allow pharmacists to provide high levels of patient-centred care.
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Affiliation(s)
- Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia.
| | - Ricki Ng
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
| | - Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
| | - Carl Schneider
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
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20
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Pope CE, Vo AT, Hayden HS, Weiss EJ, Durfey S, McNamara S, Ratjen A, Grogan B, Carter S, Nay L, Parsek MR, Singh PK, McKone EF, Aitken ML, Rosenfeld MR, Hoffman LR. Changes in fecal microbiota with CFTR modulator therapy: A pilot study. J Cyst Fibros 2021; 20:742-746. [PMID: 33390317 DOI: 10.1016/j.jcf.2020.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 05/13/2020] [Revised: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Abstract
Studies have demonstrated that people with CF with pancreatic insufficiency (PI) have fecal dysbioses. Evidence suggests the causes of these dysbioses are multifactorial, and that important drivers include antibiotic exposure, dietary intake, and CF gastrointestinal tract dysfunction, including nutrient malabsorption. In this pilot study, we tested whether initiation of the CFTR modulator treatments ivacaftor (in a cohort of pancreatic sufficient (PS) people with CF and an R117H CFTR variant) or lumacaftor/ivacaftor (in a cohort of PI people with CF and an F508del variant) changed fecal measures of malabsorption or fecal microbiomes. While we identified no statistically significant fecal changes with either treatment, we detected trends in the PI cohort when initiating lumacaftor/ivacaftor towards decreased fecal fat content and towards fecal microbiomes that more closely resembled the fecal microbiota of people without PI. While these findings support a model in which nutrient malabsorption resulting from CF-induced PI drives fecal dysbiosis, they must be validated in future, larger studies of fecal microbiome and malabsorption outcomes with highly effective CFTR modulator therapies.
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Affiliation(s)
- C E Pope
- University of Washington, Seattle, USA
| | - A T Vo
- University of Washington, Seattle, USA
| | | | - E J Weiss
- University of Washington, Seattle, USA
| | - S Durfey
- University of Washington, Seattle, USA
| | | | - A Ratjen
- University of Washington, Seattle, USA
| | - B Grogan
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Carter
- St. Vincent's University Hospital, Dublin, Ireland
| | - L Nay
- University of Washington, Seattle, USA
| | | | - P K Singh
- University of Washington, Seattle, USA
| | - E F McKone
- St. Vincent's University Hospital, Dublin, Ireland
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21
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Arrow P, Piggott S, Carter S, McPhee R, Atkinson D, Mackean T, Kularatna S, Tonmukayakul U, Brennan D, Nanda S, Palmer D, Jamieson L. Atraumatic Restorative Treatments in Australian Aboriginal Communities: A Cluster-randomized Trial. JDR Clin Trans Res 2020; 6:430-439. [PMID: 33016169 DOI: 10.1177/2380084420963949] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The management of early childhood caries (ECC) is challenging. OBJECTIVES A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia. METHODS Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities. RESULTS A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group. CONCLUSION A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health. KNOWLEDGE TRANSFER STATEMENT This cluster-randomized trial tested a multi-component model of dental care to young children with ECC in remote Aboriginal communities in Australia. The intervention, based on the atraumatic approaches using minimally invasive techniques encompassing preventive care, Atraumatic Restorative Treatment and the Hall Technique (ART-HT), delivered more restorative care and reduced the incidence of caries. This model of care was more effective than available standard care and should be incorporated into mainstream service delivery programs.
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Affiliation(s)
- P Arrow
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Piggott
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - S Carter
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - R McPhee
- Kimberley Aboriginal Medical Services, Broome, Australia
| | - D Atkinson
- Rural Clinical School of Western Australia, University of Western Australia, Broome, Australia
| | - T Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - U Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Nanda
- Health Department Western Australia, Office of Chief Dental Officer, Perth, Australia
| | - D Palmer
- Community Development, Community Development, Murdoch University, Perth, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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Hernández-Vara J, Sáez-Francàs N, Lorenzo-Bosquet C, Corominas-Roso M, Cuberas-Borròs G, Lucas-Del Pozo S, Carter S, Armengol-Bellapart M, Castell-Conesa J. BDNF levels and nigrostriatal degeneration in “drug naïve” Parkinson's disease patients. An “in vivo” study using I-123-FP-CIT SPECT. Parkinsonism Relat Disord 2020; 78:31-35. [DOI: 10.1016/j.parkreldis.2020.06.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 01/01/2023]
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Trappe A, Useckaite Z, Ward M, Davage H, Lennon J, Carter S, McKone E, Donnelly S, McNally P, Coppinger J. ePS3.02 Increased extracellular vesicles mediate inflammatory signalling in cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30302-7] [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: 11/30/2022]
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Jayawardene W, Kosobud A, Carter S, Dickinson S, Chen X. Determining the Fasting Length in Time-Restricted Feeding: Analysis of Endocrine Function Among Young, Healthy, Normal Weight, European Men. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa047_008] [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
Objectives
Intermittent calorie restriction has emerged as an effective alternative to continuous calorie restriction to impart favorable health benefits. However, there remains a degree of uncertainty about the optimal fasting length to simultaneously improve metabolic flexibility and promote positive behavior-change. While a 16-hr fast is commonly employed, it is possible that a shorter fast could result in similar metabolic benefits and better longer term adherence. Thus, we compared changes in hormone response between two 4-hr time intervals of fasting – 11–15 hrs. vs. 15–19 hrs.
Methods
Secondary analyses were performed from a 38-hr fasting study that enrolled 24 healthy, European men (18–30 y) with normal body mass index. Participants initiated a fast at 2300, arrived to the laboratory at 0800, and continued fasting in individual rooms. Venous blood was sampled at 13 time-points to measure insulin, glucose, adrenocorticotropin (ACTH), C-peptide, cortisol, and adiponectin via immunoassays. Data were normally distributed without outliers or missing values. Within-group differences were analyzed with paired t-tests.
Results
Insulin (pmol/L) declined between 11–15 hrs. (7.00; CI = 0.97, 13.02; P = .025), but not 15–19 hrs. (5.67; CI = –0.65, 11.98; P = .076). The decline in C-peptide (nmol/L) was sharper between 11–15 hrs. (0.09; CI = 0.05, 0.13; P = < .001), compared to 15–19 hrs. (0.06; CI = 0.02, 0.09; P = .003). Cortisol (nmol/L) also steeply declined between 11–15 hrs. (60.09; CI = 30.58, 89.59; P = < .001), but slightly increased between 15–19 hrs. (10.75; CI = −33.15, 11.65; P = 0.331). The change in glucose (mmol/L) was not different between 11–15 hrs. (0.02 mmol/L; CI = −0.15, 0.19; P = 0.784), but sharply decreased between 15–19 hrs. (0.24; CI = 0.10, 0.39; P = 0.002). No differences were detected for ACTH or adiponectin.
Conclusions
Though substrate oxidation was not measured, changes in insulin, C-peptide, cortisol, and glucose were consistent with increased gluconeogenesis during 11–15 hrs. and lipid oxidation during 15–19 hrs. of fasting. Whereas cortisol often declines throughout the day, a slight increase was noted between 15–19 hrs. – evidence of a heightened sympathetic activity. Further study of hormone response during intermittent fasting will inform optimal length to promote health benefits and longer term adherence.
Funding Sources
None
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Affiliation(s)
| | - Ann Kosobud
- Indiana University School of Medicine-Indianapolis
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Litwic AE, Westbury LD, Carter S, Ward KA, Cooper C, Dennison EM. Self-perceived Fracture Risk in the Global Longitudinal Study of Osteoporosis in Women: Its Correlates and Relationship with Bone Microarchitecture. Calcif Tissue Int 2020; 106:625-636. [PMID: 32140759 PMCID: PMC7188698 DOI: 10.1007/s00223-020-00680-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/21/2020] [Indexed: 11/13/2022]
Abstract
The purpose of this study is to examine correlates of self-perceived fracture risk (SPR) and relationships between SPR and subsequent bone density and microarchitecture in the UK arm of the Global Longitudinal Study of Osteoporosis in Women. 3912 women completed baseline questionnaires detailing medical history and SPR; 492 underwent HRpQCT scans of the radius and tibia and DXA scans of total body, hip, femoral neck and lumbar spine a median of 7.5 years later. Correlates of SPR were examined and a cluster analysis of potential predictors of SPR performed. SPR in relation to HRpQCT and aBMD parameters was examined using linear regression with and without adjustment for anthropometric, demographic and lifestyle covariates. Mean (SD) baseline age was 69.0 (9.0) years; 56.6% reported a similar SPR; 28.6% lower SPR; 14.9% higher SPR compared to women of similar age. In mutually-adjusted analysis, higher SPR was associated (p < 0.05) with: lower physical activity and educational attainment; use of anti-osteoporosis medications (AOM) and calcium supplements; greater number of falls in the previous year; history of fracture since aged 45; family history of hip fracture; and increased comorbidity. Higher SPR, history of fracture, and use of AOM, calcium and vitamin D clustered together. Even after adjustments that included AOM use, higher SPR was associated with: lower radial trabecular volumetric density and number, and higher trabecular separation; lower tibial cortical area and trabecular volumetric density; and lower aBMD at the femoral neck. Despite greater AOM use, women with higher baseline SPR had poorer subsequent bone health.
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Affiliation(s)
- A E Litwic
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - L D Westbury
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- Victoria University of Wellington, Wellington, New Zealand.
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Peacock M, Paterson J, Reed L, Davies S, Carter S, Coe A, Clarkson J. Innovation in Fischer–Tropsch: Developing Fundamental Understanding to Support Commercial Opportunities. Top Catal 2020. [DOI: 10.1007/s11244-020-01239-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractIn this contribution we provide details of the BP-Johnson Matthey proprietary Fischer–Tropsch technology and the advanced CANS reactor and catalyst system. The advanced CANS catalyst carrier reactor provides superior heat transfer, reduced pressure drop and higher productivity that lead to major economic savings. Fundamental understanding of catalyst behaviour is also key to obtaining a catalyst that is stable over the lifetime of its use. Synthesis, calcination and reduction steps introduce changes in the catalyst properties prior to syngas introduction. In particular, the presence of water can affect the final catalyst performance. The activity of a good catalyst can be significantly reduced by a sub-optimal activation or start-up. Similarly, stable operation and minimising deactivation are vital for long and stable catalyst life, with years of operation without requiring regeneration. In this report we also share a fundamental study on the catalyst activation across different catalyst supports. This combines advanced in situ techniques with reactor testing to explore the role of the support on catalyst performance. The results illustrate the critical need for a logical and systematic catalyst development programme to explore these effects to optimise the whole FT process. The combination of a joint approach in development plays a key role in a long term success in a process. The fundamental catalyst understanding, optimisation and improvements in combination with the novel CANS reactor design maximise their potential and offer the potential for a world leading technology.
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El-Den S, Schneider C, Mirzaei A, Carter S. How to measure a latent construct: Psychometric principles for the development and validation of measurement instruments. International Journal of Pharmacy Practice 2020; 28:326-336. [DOI: 10.1111/ijpp.12600] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022]
Abstract
Abstract
Measurement instruments are used to collect data about respondents. In social pharmacy, measurement instruments are often used to measure latent constructs, such as attitudes, among healthcare professionals and patients. This paper aims to describe the fundamental aspects of designing and validating instruments, which aim to measure latent constructs. The main focus of this manuscript is to describe the considerations and processes relating to exploratory and confirmatory factor analyses, when used to develop measures of latent psychosocial constructs. However, it also presents a detailed summary of the current evidence and suggestions for item generation and sample selection, as well as, an in-depth description of approaches to content and face validation. Suggestions for further reading are also provided.
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Affiliation(s)
- Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Carl Schneider
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Ardalan Mirzaei
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Tong B, Rollo C, Carter S, Carberry J, Martins R, Osman A, Eckert D. An investigation into the differences in the phenotypic causes of obstructive sleep apnoea in obese versus non-obese people. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1084] [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: 11/16/2022]
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Carter S, Carberry J, Grunstein R, Eckert D. High dose zopiclone does not change OSA severity, the respiratory arousal threshold, genioglossus muscle responsiveness or next-day sleepiness and alertness in selected people with OSA. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.154] [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: 11/27/2022]
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Carter S, Keogan B, O'Reilly P, Coughlan S, Cooke G, De Gascun C, Gallagher C, McKone E. P176 Detection of respiratory viruses in cystic fibrosis: comparison of nasal FLOQ Swabs™ and sputum using the FilmArray® platform. J Cyst Fibros 2019. [PMCID: PMC7129069 DOI: 10.1016/s1569-1993(19)30470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carter S. Orthomolecular Medicine. Integr Med (Encinitas) 2019; 18:74. [PMID: 32549818 PMCID: PMC7217400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Carter S, Clifton PM, Keogh JP. Flash glucose monitoring for the safe use of a 2-day intermittent energy restriction in patients with type 2 diabetes at risk of hypoglycaemia: An exploratory study. Diabetes Res Clin Pract 2019; 151:138-145. [PMID: 30959146 DOI: 10.1016/j.diabres.2019.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022]
Abstract
AIMS Two medication change protocols were tested, both based on haemoglobin A1c (HbA1c), with one protocol also accounting for hypoglycaemic events. The aim was to compare the two protocols during intermittent energy restriction (5:2 diet). METHODS Forty-two adults with type 2 diabetes (HbA1c ≥ 7% [53 mmol/mol], BMI of ≥27 kg/m2) treated with sulphonylureas and/or insulin were recruited and randomised 1:1 to fixed or adjusted medication protocols. Participants experiencing hypoglycaemia during a 2-week usual diet period then followed the 5:2 diet for 2 weeks (2 non-consecutive very-low-calorie days [500-600 kcal] and 5 habitual eating days/week), following the allocated medication protocol. The primary outcome was to determine if the adjusted protocol was superior to the fixed protocol at reducing hypoglycaemic events during the 5:2 diet. Flash glucose monitoring was used throughout to detect hypoglycaemia. RESULTS There was a significant difference in change in the number of hypoglycaemic events between fixed and adjusted protocols (-1.0 vs. -3.5; P = 0.04). Over 60% of participants on the adjusted protocol had no hypoglycaemic events. CONCLUSIONS This pilot study demonstrates the importance of assessing the risk of hypoglycaemia before starting a 5:2 diet and that the adjusted medication protocol is likely the best option for patients at risk. CLINICAL TRIAL REGISTRY This study has been registered with the Australia New Zealand Clinical Trial Registry (ANZCTR) www.anzctr.org.au and given the registration number ACTRN12617000512325.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia.
| | - J P Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
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Sakeena M, Bennett AA, Carter S, McLachlan AJ. Antibiotics and Pharmacy students in Australia and Sri Lanka. Res Social Adm Pharm 2019. [DOI: 10.1016/j.sapharm.2019.03.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Carter S, Clifton PM, Keogh JB. The effect of intermittent compared with continuous energy restriction on glycaemic control in patients with type 2 diabetes: 24-month follow-up of a randomised noninferiority trial. Diabetes Res Clin Pract 2019; 151:11-19. [PMID: 30902672 DOI: 10.1016/j.diabres.2019.03.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/11/2019] [Accepted: 03/14/2019] [Indexed: 11/23/2022]
Abstract
AIMS We investigated the effects of intermittent compared to continuous energy restriction on glycaemic control in patients with type 2 diabetes mellitus. METHODS Adults (N = 137) with type 2 diabetes (mean [SD] HbA1c level, 7.3% (56 mmol/mol) [1.3%] [14.2 mmol/mol]) were randomised to one of two diets for 12 months. The intermittent group (n = 70) followed a 2100-2500 kJ (500-600 kcal) diet 2 non-consecutive days/week and their usual diet for 5 days/week. The continuous group (n = 67) followed a 5000-6300 kJ (1200-1500 kcal) diet for 7 days/week. Follow-up occurred at 24 months, 12 months after the completed intervention. The primary outcome was change in HbA1c and the secondary outcome was weight loss. RESULTS Intention-to-treat analysis showed an increase in mean [SEM] HbA1c level at 24 months in both the continuous and intermittent groups (0.4% [0.3%] vs 0.1% [0.2%] respectively; P = 0.32) (4.4 [3.3 mmol/mol] vs 1.1 [2.2 mmol/mol]; P = 0.32), with a between-group difference of 0.3% (90% CI, -0.31 to 0.83%) (3.3 mmol/mol [90% CI, -3.2 to 9.1 mmol/mol]) outside the prespecified boundary of ± 0.5% (5.5 mmol/mol), so statistical equivalence was not shown. Weight loss was maintained (P < 0.001) at -3.9 kg [1.1 kg] in both groups at 24 months, with a between-group difference of 0.07 kg (90% CI, -2.5 to 2.6 kg) outside the prespecified boundary of ±2.5 kg. There were no significant differences between groups in body composition, fasting glucose levels, lipid levels, or total medication effect score at 24 months, which remained less than baseline. CONCLUSIONS In this prospective analysis weight loss was maintained but despite this HbA1c increased to above baseline levels in both groups.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Australia
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Roberts S, Miter S, Shukrullah B, Keller B, Lee M, Yurjevic T, Carter S, Pope-Harman A, Lee P, Whitson B. Impact of Lung Allograft Oversizing on Pleural Cavity Expansion in Transplant Recipients with Idiopathic Pulmonary Fibrosis. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.455] [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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Duncanson L, Armston J, Disney M, Avitabile V, Barbier N, Calders K, Carter S, Chave J, Herold M, Crowther TW, Falkowski M, Kellner JR, Labrière N, Lucas R, MacBean N, McRoberts RE, Meyer V, Næsset E, Nickeson JE, Paul KI, Phillips OL, Réjou-Méchain M, Román M, Roxburgh S, Saatchi S, Schepaschenko D, Scipal K, Siqueira PR, Whitehurst A, Williams M. The Importance of Consistent Global Forest Aboveground Biomass Product Validation. Surv Geophys 2019; 40:979-999. [PMID: 31395994 PMCID: PMC6647371 DOI: 10.1007/s10712-019-09538-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/27/2019] [Indexed: 05/17/2023]
Abstract
Several upcoming satellite missions have core science requirements to produce data for accurate forest aboveground biomass mapping. Largely because of these mission datasets, the number of available biomass products is expected to greatly increase over the coming decade. Despite the recognized importance of biomass mapping for a wide range of science, policy and management applications, there remains no community accepted standard for satellite-based biomass map validation. The Committee on Earth Observing Satellites (CEOS) is developing a protocol to fill this need in advance of the next generation of biomass-relevant satellites, and this paper presents a review of biomass validation practices from a CEOS perspective. We outline the wide range of anticipated user requirements for product accuracy assessment and provide recommendations for the validation of biomass products. These recommendations include the collection of new, high-quality in situ data and the use of airborne lidar biomass maps as tools toward transparent multi-resolution validation. Adoption of community-vetted validation standards and practices will facilitate the uptake of the next generation of biomass products.
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Affiliation(s)
- L. Duncanson
- Department of Geographical Sciences, University of Maryland, College Park, 2181 Lefrak Hall, College Park, MD 20742 USA
| | - J. Armston
- Department of Geographical Sciences, University of Maryland, College Park, 2181 Lefrak Hall, College Park, MD 20742 USA
| | - M. Disney
- Department of Geography, University College London, Gower Street, London, WC1E 6BT UK
| | - V. Avitabile
- European Commission, Joint Research Centre (JRC), Via E. Fermi 2749, 21027 Ispra, Italy
| | - N. Barbier
- AMAP, IRD, CIRAD,
CNRS, INRA, Montpellier University, TA A51/PS2, 34398 Montpellier cedex 5, France
| | - K. Calders
- CAVElab – Computational and Applied Vegetation Ecology, Ghent University, Room A2.089, Coupure Links 653, 9000 Ghent, Belgium
| | - S. Carter
- Laboratory of Geo-Information Science and Remote Sensing, Wageningen University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - J. Chave
- Laboratoire Evolution et Diversit. Biologique, UMR 5174, CNRS, Universit. Toulouse Paul Sabatier, 118 route de Narbonne, 31062 Toulouse cedex 9, France
| | - M. Herold
- Laboratory of Geo-Information Science and Remote Sensing, Wageningen University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - T. W. Crowther
- Institute of Integrative Biology, ETH Zürich, Univeritätstrasse 16, 8006 Zurich, Switzerland
| | - M. Falkowski
- Department of Ecosystem Science and Sustainability, Colorado State University, Fort Collins, CO 80523 USA
| | - J. R. Kellner
- Institute at Brown for Environment and Society, Brown University, Providence, RI 02912 USA
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI 02912 USA
| | - N. Labrière
- Laboratoire Evolution et Diversit. Biologique, UMR 5174, CNRS, Universit. Toulouse Paul Sabatier, 118 route de Narbonne, 31062 Toulouse cedex 9, France
| | - R. Lucas
- Earth Observation and Ecosystem Dynamics Research Group, Department of Geography and Earth Sciences (DGES), Aberystwyth University, Aberystwyth, Wales SY23 3DB UK
| | - N. MacBean
- Department of Geography, Indiana University, 701 E. Kirkwood Ave., Bloomington, IN 47405 USA
| | - R. E. McRoberts
- USDA Forest Service, Northern Research Station, Saint Paul, 1992 Folwell Ave, St Paul, MN 55108 USA
| | - V. Meyer
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - E. Næsset
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, NMBU, P.O. Box 5003, 1432 Ås, Norway
| | - J. E. Nickeson
- NASA Goddard Space Flight Center/Science Systems and Applications Inc., 10210 Greenbelt Rd #600, Lanham, MD 20706 USA
| | - K. I. Paul
- CSIRO Land and Water, GPO Box 1700, Canberra, ACT 2601 Australia
| | - O. L. Phillips
- School of Geography, University of Leeds, Leeds, LS2 9JT UK
| | - M. Réjou-Méchain
- AMAP, IRD, CIRAD,
CNRS, INRA, Montpellier University, TA A51/PS2, 34398 Montpellier cedex 5, France
| | - M. Román
- Earth from Space Institute, Universities Space Research Association, Columbia, MD USA
| | - S. Roxburgh
- CSIRO Land and Water, GPO Box 1700, Canberra, ACT 2601 Australia
| | - S. Saatchi
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - D. Schepaschenko
- International Institute for Applied Systems Analysis, Schlossplatz 1, 2361 Laxenburg, Austria
| | - K. Scipal
- European Space Agency, ESTEC, Keplerlaan 1, 2201 AZ Noordwijk, The Netherlands
| | - P. R. Siqueira
- Department of Electrical and Computer Engineering, 201 Marcus Hall, University of Massachusetts, 100 Natural Resources Road, Amherst, MA 01003 USA
| | - A. Whitehurst
- Arctic Slope Federal Technical Services, 7000 Muirkirk Meadows Dr #100, Laurel, MD 20707 USA
| | - M. Williams
- School of GeoScience, University of Edinburgh, Drummond St, Edinburgh, EH8 9XP UK
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McLaughlin T, Abbasi F, Lamendola C, Yee G, Carter S, Cushman SW. Dietary weight loss in insulin-resistant non-obese humans: Metabolic benefits and relationship to adipose cell size. Nutr Metab Cardiovasc Dis 2019; 29:62-68. [PMID: 30497926 PMCID: PMC6410738 DOI: 10.1016/j.numecd.2018.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Overweight and obesity increase risk for diabetes and cardiovascular disease, largely through development of insulin resistance. Benefits of dietary weight loss are documented for obese individuals with insulin resistance. Similar benefits have not been shown in overweight individuals. We sought to quantify whether dietary weight loss improves metabolic risk profile in overweight insulin-resistant individuals, and evaluated potential mediators between weight loss and metabolic response. METHODS AND RESULTS Healthy volunteers with BMI 25-29.9 kg/m2 underwent detailed metabolic phenotyping including insulin-mediated-glucose disposal, fasting/daylong glucose, insulin, triglycerides, FFA, and cholesterol. Subcutaneous fat biopsies were performed for measurement of adipose cell size. After 14 weeks of hypocaloric diet and 2 weeks of weight maintenance, cardiometabolic measures and biopsies were repeated. Changes in weight, % body fat, waist circumference, adipose cell size and FFA were evaluated as predictors of change in insulin resistance. Weight loss (4.3 kg) yielded significant improvements in insulin resistance and all cardiovascular risk markers except glucose, HDL-C, and LDL-C. Improvement in insulin sensitivity was greater among those with <2 vs >2 cardiovascular risk factors at baseline. Decrease in adipose cell size and waist circumference, but not weight or body fat, independently predicted improvement in insulin resistance. CONCLUSIONS Weight loss yields metabolic health benefits in insulin-resistant overweight adults, even in the absence of classic cardiovascular risk factors. Weight loss-related improvement in insulin sensitivity may be mediated through changes in adipose cell size and/or central distribution of body fat. The insulin-resistant subgroup of overweight individuals should be identified and targeted for dietary weight loss. CLINICAL TRIALS IDENTIFIER NCT00186459.
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Affiliation(s)
- T McLaughlin
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - F Abbasi
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - C Lamendola
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - G Yee
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - S Carter
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - S W Cushman
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
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O'Brien JW, Grant S, Banks APW, Bruno R, Carter S, Choi PM, Covaci A, Crosbie ND, Gartner C, Hall W, Jiang G, Kaserzon S, Kirkbride KP, Lai FY, Mackie R, Marshall J, Ort C, Paxman C, Prichard J, Thai P, Thomas KV, Tscharke B, Mueller JF. A National Wastewater Monitoring Program for a better understanding of public health: A case study using the Australian Census. Environ Int 2019; 122:400-411. [PMID: 30554870 DOI: 10.1016/j.envint.2018.12.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 05/28/2023]
Abstract
Wastewater contains a large range of biological and chemical markers of human activity and exposures. Through systematic collection and analysis of these markers within wastewater samples it is possible to measure the public health of whole populations. The analysis of effluent and biosolids can also be used to understand the release of chemicals from wastewater treatment plants into the environment. Wastewater analysis and comparison with catchment specific data (e.g. demographics) however remains largely unexplored. This manuscript describes a national wastewater monitoring study that combines influent, effluent and biosolids sampling with the Australian Census. An archiving program allows estimation of per capita exposure to and consumption of chemicals, public health information, as well as per capita release of chemicals into the environment. The paper discusses the study concept, critical steps in setting up a coordinated national approach and key logistical and other considerations with a focus on lessons learnt and future applications. The unique combination of archived samples, analytical data and associated census-derived population data will provide a baseline dataset that has wide and potentially increasing applications across many disciplines that include public health, epidemiology, criminology, toxicology and sociology.
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Affiliation(s)
- Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia.
| | - Sharon Grant
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Andrew P W Banks
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Raimondo Bruno
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7005, Australia
| | - Stephen Carter
- Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland 4108, Australia
| | - Phil M Choi
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Adrian Covaci
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Nicholas D Crosbie
- Melbourne Water, 990 La Trobe Street, Docklands, Victoria 2008, Australia
| | - Coral Gartner
- School of Public Health, Faculty of Medicine, The University of Queensland, St. Lucia, Queensland 4072, Australia; Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Herston, Queensland 4029, Australia
| | - Guangming Jiang
- Advanced Water Management Centre, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Sarit Kaserzon
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - K Paul Kirkbride
- College of Science and Engineering, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Foon Yin Lai
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
| | - Rachel Mackie
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Judi Marshall
- Phycotec Environmental Management, Clifton Beach, Tasmania 7020, Australia
| | - Christoph Ort
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH 8600 Dübendorf, Switzerland
| | - Christopher Paxman
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Jeremy Prichard
- Faculty of Law, University of Tasmania, Hobart, Tasmania 7005, Australia
| | - Phong Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Ben Tscharke
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
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Bay V, Griffiths B, Carter S, Evans NJ, Lenzi L, Bicalho RC, Oikonomou G. 16S rRNA amplicon sequencing reveals a polymicrobial nature of complicated claw horn disruption lesions and interdigital phlegmon in dairy cattle. Sci Rep 2018; 8:15529. [PMID: 30341326 PMCID: PMC6195575 DOI: 10.1038/s41598-018-33993-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/08/2018] [Indexed: 11/08/2022] Open
Abstract
Lameness represents an intractable problem for the dairy industry. Complicated claw horn disruption lesions, interdigital hyperplasia, and interdigital phlegmon are important lameness causing foot lesions. Their aetiology is multifactorial, but infectious processes are likely implicated in disease pathogenesis. Our aim was to investigate the bacterial profiles of these lesions using 16S rRNA gene sequencing of samples obtained from 51 cattle across ten farms in the UK. In this study, interdigital hyperplasia, interdigital hyperplasia with signs of interdigital dermatitis, interdigital phlegmon, complicated sole ulcers, complicated toe ulcers lesions, and complicated white line lesions were investigated; corresponding healthy skin control samples were also analysed. All diseased tissues displayed reduced microbial richness and diversity (as described by Chao1, Shannon, and Simpson alpha-diversity indices) compared to their healthy skin control samples. Our results confirm the association of Treponema spp with some of these disorders. Other anaerobic bacteria including Fusobacterium spp., Fastidiosipila spp. and Porphyromonas spp. were implicated in the aetiology of all these lesions with the exception of interdigital hyperplasia. Complicated claw horn disruption lesions, and interdigital phlegmon were found to have similar bacterial profiles. Such sharing of bacterial genera suggests many of the infectious agents detected in these foot lesions are acting opportunistically; this finding could contribute towards future treatment and control strategies.
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Affiliation(s)
- V Bay
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - B Griffiths
- Department of Livestock Health and Welfare, Institute of Veterinary Sciences, University of Liverpool, Liverpool, UK
| | - S Carter
- Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - N J Evans
- Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - L Lenzi
- Centre for Genomic Research, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - R C Bicalho
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, USA
| | - G Oikonomou
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
- Department of Livestock Health and Welfare, Institute of Veterinary Sciences, University of Liverpool, Liverpool, UK.
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Gottlieb K, Le C, Wacher V, Sliman J, Cruz C, Porter T, Carter S. Erratum: Selection of a cut-off for high- and low-methane producers using a spot-methane breath test: results from a large north American dataset of hydrogen, methane and carbon dioxide measurements in breath. Gastroenterol Rep (Oxf) 2018; 6:242. [PMID: 30151210 PMCID: PMC6101576 DOI: 10.1093/gastro/gox015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Klaus Gottlieb
- Synthetic Biologics Inc., Rockville, Maryland, USA
- Corresponding author. Synthetic Biologics, Inc., 9605 Medical Center Dr. Suite 270, Rockville, MD 20850, USA. Tel: +1-240-472-0899;
| | - Chenxiong Le
- Synthetic Biologics Inc., Rockville, Maryland, USA
| | - Vince Wacher
- Synthetic Biologics Inc., Rockville, Maryland, USA
| | - Joe Sliman
- Synthetic Biologics Inc., Rockville, Maryland, USA
| | - Christine Cruz
- Commonwealth Laboratories LLC, Salem, Massachusetts, USA
| | - Tyler Porter
- Commonwealth Laboratories LLC, Salem, Massachusetts, USA
| | - Stephen Carter
- Commonwealth Laboratories LLC, Salem, Massachusetts, USA
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Zimmer AS, Gril B, Steinberg S, Smart D, Gilbert M, Armstrong T, Xiao L, Houston N, Biassou N, Brastianos P, Carter S, Lyden DC, Lipkowitz S, Steeg P. Abstract OT2-06-01: Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-Positive breast cancer brain metastases following stereotactic radiosurgery. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-06-01] [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: Brain metastases occur in up to 25-40% of HER2+ breast cancer patients. Standard treatment is limited to surgery or stereotactic radiosurgery (SRS) and/or whole brain radiation therapy (WBRT), with high levels of recurrence or progression, limiting survival and quality of life in most patients. Our group has demonstrated that low doses of temozolomide (TMZ) administered in a prophylactic, metronomic fashion can significantly prevent development of brain metastases in murine models of breast cancer. Based on these findings, we propose a secondary-prevention clinical trial.
Trial Design: Phase I/II open label study. Phase I will follow a standard 3+3 design: T-DM1 3.6 mg/kg IV every 21 days plus TMZ 30, 40 or 50 mg/m2 daily. Phase II: randomization T-DM1 3.6 mg/kg versus T-DM1 3.6mg/kg plus TMZ at recommended phase 2 dose (RP2D). Patients will undergo radiology guided lumbar puncture at baseline and after 6 weeks of treatment (C3D1) for correlative studies, brain MRI, systemic restaging CTs, and questionnaires for evaluation of symptoms and quality of life (MDASI-BT and PROMIS®) every 6 weeks.
Eligibility: HER2+ breast cancer with ≤3 brain metastases, treated with SRS and/or resection ≤6 weeks before enrollment, no leptomeningeal metastases, no previous WBRT, able to complete brain MRI with contrast evaluations, willing to undergo lumbar puncture, ECOG ≤2 and adequate organ and marrow function. HBV, HCV or HIV-positive patients are ineligible.
Specific Aims: Phase I: to identify the maximum tolerated dose (MTD) of TMZ combined with T-DM1. Phase II: to determine if the combination regimen of T-DM1 and TMZ improves the recurrence-free incidence from distant new brain metastases at one year as compared to T-DM1 alone. Biomarkers, including cell free DNA sequencing from CSF, serum and tumor block, serum markers for neuroinflammation, and patient reported outcomes, will be analyzed in an exploratory fashion.
Statistical Methods: Phase I, MTD will be identified based on the dose level at which 0 or 1 patient in 6 has a DLT. Phase II, to test whether TMZ will increase RFS from 50% to 65% at 12 months. RFS Kaplan-Meier curves will be created for each of the randomized arms and compared using a one-tailed log-rank test, with a one-sided 0.10 significance level of interest to be detected. Patients will be stratified for number of brain lesions and status of systemic metastases (controlled or not).
Target Accrual: 49 evaluable patients per arm (total 98), plus 9 to 18 patients during phase I. Trial will open in Summer 2017, at NIH in Bethesda, MD.
Contact Information: Principal Investigator: Alexandra S Zimmer, MD alexandra.zimmer@nih.gov
Citation Format: Zimmer AS, Gril B, Steinberg S, Smart D, Gilbert M, Armstrong T, Xiao L, Houston N, Biassou N, Brastianos P, Carter S, Lyden DC, Lipkowitz S, Steeg P. Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-Positive breast cancer brain metastases following stereotactic radiosurgery [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-06-01.
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Affiliation(s)
- AS Zimmer
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - B Gril
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Steinberg
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - D Smart
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - M Gilbert
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - T Armstrong
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - L Xiao
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - N Houston
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - N Biassou
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - P Brastianos
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Carter
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - DC Lyden
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Lipkowitz
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - P Steeg
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
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Carter S, Channon A, Berrington A, Carter S. Variations in the Risk of Labour Induction Across Hospitals and NHS Trusts in the United Kingdom. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Channon
- University of Southampton, Southampton, UK
| | | | - S Carter
- University of Southampton, Southampton, UK
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Buckley R, Reilly CM, Kelly S, Ward E, O'Connor C, Carter S, Gallagher CG, McKone EF. Corrigendum to "WS04.1 The effect of Orkambi® on exercise capacity and muscle strength" [J Cyst Fibros, volume 16, supplement 1, June 2017, pages S6-S7]. J Cyst Fibros 2017; 16:S1569-1993(17)30771-3. [PMID: 28826587 DOI: 10.1016/j.jcf.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Buckley
- St. Vincent's University Hospital, Dublin, Ireland.
| | - C M Reilly
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Kelly
- St. Vincent's University Hospital, Dublin, Ireland
| | - E Ward
- St. Vincent's University Hospital, Dublin, Ireland
| | - C O'Connor
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Carter
- St. Vincent's University Hospital, Dublin, Ireland
| | | | - E F McKone
- St. Vincent's University Hospital, Dublin, Ireland
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Gottlieb K, Le C, Wacher V, Sliman J, Cruz C, Porter T, Carter S. Selection of a cut-off for high- and low-methane producers using a spot-methane breath test: results from a large north American dataset of hydrogen, methane and carbon dioxide measurements in breath. Gastroenterol Rep (Oxf) 2017; 5:193-199. [PMID: 28130375 PMCID: PMC5554383 DOI: 10.1093/gastro/gow048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/27/2016] [Accepted: 12/06/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Levels of breath methane, together with breath hydrogen, are determined by means of repeated collections of both, following ingestion of a carbohydrate substrate, at 15-20 minutes intervals, until 10 samples have been obtained. The frequent sampling is required to capture a rise of hydrogen emissions, which typically occur later in the test: in contrast, methane levels are typically elevated at baseline. If methane emissions represent the principal objective of the test, a spot methane test (i.e. a single-time-point sample taken after an overnight fast without administration of substrate) may be sufficient. METHODS We analysed 10-sample lactulose breath test data from 11 674 consecutive unique subjects who submitted samples to Commonwealth Laboratories (Salem, MA, USA) from sites in all of the states of the USA over a one-year period. The North American Consensus (NAC) guidelines criteria for breath testing served as a reference standard. RESULTS The overall prevalence of methane-positive subjects (by NAC criteria) was 20.4%, based on corrected methane results, and 18.9% based on raw data. In our USA dataset, the optimal cut-off level to maximize sensitivity and specificity was ≥4 ppm CH4, 94.5% [confidential interval (CI): 93.5-95.4%] and 95.0% (CI: 94.6-95.5%), respectively. The use of a correction factor (CF) (5% CO2 as numerator) led to reclassifications CH4-high to CH4-low in 0.7 % and CH4-low to CH4-high in 2.1%. CONCLUSIONS A cut-off value for methane at baseline of either ≥4 ppm, as in our USA dataset, or ≥ 5 ppm, as described in a single institution study, are both highly accurate in identifying subjects at baseline that would be diagnosed as 'methane-positive' in a 10-sample lactulose breath test for small intestinal bacterial overgrowth.
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Affiliation(s)
| | - Chenxiong Le
- Synthetic Biologics Inc., Rockville, Maryland, USA
| | - Vince Wacher
- Synthetic Biologics Inc., Rockville, Maryland, USA
| | - Joe Sliman
- Synthetic Biologics Inc., Rockville, Maryland, USA
| | - Christine Cruz
- Commonwealth Laboratories LLC, Salem, Massachusetts, USA
| | - Tyler Porter
- Commonwealth Laboratories LLC, Salem, Massachusetts, USA
| | - Stephen Carter
- Commonwealth Laboratories LLC, Salem, Massachusetts, USA
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Carter S, Clifton PM, Keogh JB. The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial. Diabetes Res Clin Pract 2016; 122:106-112. [PMID: 27833048 DOI: 10.1016/j.diabres.2016.10.010] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/12/2016] [Indexed: 01/06/2023]
Abstract
AIMS Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups. METHOD Sixty-three overweight or obese participants (BMI 35.2±5kg/m2) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks. RESULTS At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite. CONCLUSIONS In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
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Carter S, Yeo ACM. Students-as-customers’ satisfaction, predictive retention with marketing implications. International Journal of Educational Management 2016. [DOI: 10.1108/ijem-09-2014-0129] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to investigate two areas of interest: first, to determine business student customer satisfiers that could be contributors to students’ current and predicted retention in a higher educational institution (HEI) and second, to use these satisfiers to inform HEI marketing planning.
Design/methodology/approach
– The survey used 10 per cent of the sampling frame from the faculty total business students population. Descriptive statistics and correlation were employed to describe and measure the relationship between the teaching and non-teaching antecedents of student satisfaction and their five constructs (academic experience, teaching quality, campus life, facilities and placement support) and current and intended retention. Standard multiple regressions were run to measure the β and significant values of the composite variables as stated.
Findings
– Quantitative results revealed that students were most satisfied with academic experience and it was also the most dominant predictor of students’ retention. Other elements such as quality teaching, facilities and internship, though important for student satisfaction, were not predictors of retention.
Research limitations/implications
– Findings based on one Malaysian institution could not be used as a representation of other institutions either locally or internationally.
Practical implications
– Suggestions are made as to how HEIs can defend and safeguard their existing and future position by giving maximum attention to both “hard” and “soft” student satisfiers which would add customer value and strengthen their competitive position.
Originality/value
– Based on teaching and non-teaching antecedents and constructs, enable HEIs to predict retention and so inform marketing planning in a highly competitive higher education environment.
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Carter S, Scott E. Impact of Three G-CSF Mobilzation/Collection Schedules and Total Blood Volume Processed on the Yield of CD34+ Cells From Leukaphereses Collected From Normal Healthy Subjects Using the COBE Spectra. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.076] [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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Headland M, Pedersen E, Carter S, Clifton P, Keogh J. The on/off diet: Effects of week-on, week-off energy restriction compared to continuous energy restriction. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.230] [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: 10/21/2022] Open
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Shahid M, Albergo N, Purvis T, Heron K, Gaston L, Carter S, Grimer R, Jeys L. Management of sarcomas possibly involving the knee joint when to perform extra-articular resection of the knee joint and is it safe? Eur J Surg Oncol 2016; 43:175-180. [PMID: 27266818 DOI: 10.1016/j.ejso.2016.05.018] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/07/2016] [Accepted: 05/13/2016] [Indexed: 12/18/2022] Open
Abstract
We reviewed the oncological and functional outcomes of patients treated for a primary sarcoma possibly involving the knee joint and present an algorithm to guide treatment. The records of 76 patients who had a primary bone or soft tissue sarcoma possibly invading the knee between 1996 and 2012 were identified. Mean age and follow-up was 32 years (9-74) and 64 months (12-195), respectively. Patients were grouped according to the resection (Intra-articular [IAR] vs. Extra-articular [EAR] vs. Amputation/rotationplasty) for survival and functional outcomes. Overall 5 and 10 year survival was 61% and 53%, respectively. No differences in survival were found between the 3 groups (p = 0.55). Sixteen patients developed local recurrence with no difference between the groups. Mean MSTS score was 24.5 (12-30). Mean flexion at final follow-up was 106° (70-130°). We conclude that EAR of the knee allows for good oncologic and functional outcomes but with an increased risk of complications compared to IAR. Intra-operative assessment of joint involvement can be done in patients where joint infiltration by the tumour is not clear to avoid an unnecessary EAR. For chondrosarcoma patients with joint involvement, an EAR should be carefully considered because they present a significantly higher local recurrence risk.
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Affiliation(s)
- M Shahid
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
| | - N Albergo
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - T Purvis
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - K Heron
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - L Gaston
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - S Carter
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - R Grimer
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - L Jeys
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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Parry MC, Laitinen M, Albergo J, Jeys L, Carter S, Gaston CL, Sumathi V, Grimer RJ. Osteosarcoma of the pelvis. Bone Joint J 2016; 98-B:555-63. [DOI: 10.1302/0301-620x.98b4.36583] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 05/27/2015] [Accepted: 10/27/2015] [Indexed: 11/05/2022]
Abstract
Aims Osteosarcoma of the pelvis is a particularly difficult tumour to treat as it often presents late, may be of considerable size and/or associated with metastases when it presents, and is frequently chondroid in origin and resistant to chemotherapy. The aim of this study was to review our experience of managing this group of patients and to identify features predictive of a poor outcome. Patients and Methods Between 1983 and 2014, 121 patients, (74 females and 47 males) were treated at a single hospital: 74 (61.2%) patients had a primary osteosarcoma and 47 (38.8%) had an osteosarcoma which was secondary either to Paget’s disease (22; 18.2%) or to previous pelvic irradiation (25; 20.7%). The mean age of those with a primary osteosarcoma was 29.3 years (nine to 76) and their mean follow-up 2.9 years (0 to 29). The mean age of those with a secondary sarcoma was 61.9 years (15 to 85) and their mean follow-up was one year (0 to 14). A total of 22 patients with a primary sarcoma (52.4%) and 20 of those with a secondary sarcoma (47.6%) had metastases at the time of presentation. Results The disease-specific survival at five years for all patients was 27.2%. For those without metastases at the time of diagnosis, the five-year survival was 32.7%. Factors associated with a poor outcome were metastases at diagnosis and secondary tumours. In primary osteosarcoma, sacral location, surgical margin and a diameter > 10 cm were associated with a poor outcome. Conclusion In this, the largest single series of patients with an osteosarcoma of the pelvis treated in a single hospital, those with secondary tumours and those with metastases at presentation had a particularly poor outcome. For those with a primary sarcoma, sacral location, an intralesional margin and a diameter of > 10 cm were poor prognostic indicators. Cite this article: Bone Joint J 2016;98-B:555–63.
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Affiliation(s)
- M. C. Parry
- The Royal Orthopaedic Hospital, Bristol
Road South, Birmingham, B31
2AP, UK
| | - M. Laitinen
- Tampere University Hospital, Tampere,
Finland and, Oncology Unit, Royal Orthopaedic
Hospital NHS Foundation Trust, Birmingham, UK
| | - J. Albergo
- Hospital Italiano Buenos Aires, Buenos
Aires, Argentina and, Oncology Unit, Royal Orthopaedic
Hospital NHS Foundation Trust, Birmingham, UK
| | - L. Jeys
- The Royal Orthopaedic Hospital, Bristol
Road South, Birmingham, B31
2AP, UK
| | - S. Carter
- The Royal Orthopaedic Hospital, Bristol
Road South, Birmingham, B31
2AP, UK
| | - C. L. Gaston
- The Royal Orthopaedic Hospital, Bristol
Road South, Birmingham, B31
2AP, UK
| | - V. Sumathi
- The Royal Orthopaedic Hospital, Bristol
Road South, Birmingham, B31
2AP, UK
| | - R. J. Grimer
- The Royal Orthopaedic Hospital, Bristol
Road South, Birmingham, B31
2AP, UK
| |
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