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Barnard A, Petra H, Owen L, Goffe K, Bergbaum C, Wickham H, Fox O, Pleming J, Steel A. 1286 IS VIRTUAL ADVANCE CARE PLANNING SIMULATION AS EFFECTIVE AS FACE-TO-FACE LEARNING? Age Ageing 2023. [DOI: 10.1093/ageing/afac322.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Introduction
Advance care planning (ACP) is about what matters to patients, enabling their wishes to be respected, even when they become unable to engage in decision-making. Evidence shows ACP improves end of life care for patients and reduces relatives’ bereavement reactions (Detering KM et al. BMJ. 2010; 340:1345). A simulation course for multidisciplinary healthcare professionals, using actors, was developed to improve understanding of ACP, and confidence in having these conversations. In response to the COVID-19 pandemic, the course was adapted to an online format.
Method
Participants were asked about their ACP confidence and understanding pre- and post-course, using a Likert scale (1-Not at all to 5-Very confident). Data between 2018-2022 was analysed to compare face-to-face and online course responses. Free-text responses to ‘How do you feel about attending the course online?’ were analysed qualitatively. Ethics approval was not required.
Results
Five face-to-face and five virtual sessions trained 128 and 133 attendees respectively. Confidence in having ACP discussions improved significantly following the course in both cohorts; from a mean Likert rating of 2.77 (95% CI 2.60-2.94, n=132) to 4.11 following face-to-face training (95% CI 3.97-4.25, n=128), and from 2.79 (95% CI 2.66-2.91, n=149) to 4.11 following the online course (95% CI 4.01-4.21, n=133). Additionally, 97% (n=132) of face-to-face attendees and 99.2% (n=133) of virtual attendees said their practice would change because of the course. Following the training, 100% of participants across both cohorts reported that they ‘fully understood’ what was meant by ACP, from a baseline of 77.3% (n=132) in the face-to-face cohort and 81.9% (n=149) of virtual participants. Free-text analysis highlighted the convenience of attending online (n=22, 21%), and only a minority reported technical difficulties (n=8,8%).
Conclusion
This course was successfully adapted to a virtual format, improving participants’ ACP confidence and understanding as effectively as in-person training, whilst being more accessible.
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Affiliation(s)
- A Barnard
- East Surrey Hospital Dept of Respiratory
| | - H Petra
- Barnet Hospital Dept of Acute Medicine
| | - L Owen
- Barnet Hospital Dept of Geriatric Medicine
| | - K Goffe
- Barnet Hospital Dept of Neurology
| | - C Bergbaum
- Barnet Hospital Dept of Geriatric Medicine
| | - H Wickham
- Royal Free Hospital Dept of Geriatric Medicine
| | - O Fox
- University College London
| | - J Pleming
- Barnet Hospital Dept of Geriatric Medicine
| | - A Steel
- Barnet Hospital Dept of Geriatric Medicine
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Barnard A. Todd, Emmanuel; trans. Andrew Brown. Lineages of modernity: a history of humanity from the Stone Age to Homo americanus. xx, 427 pp., maps, tables, figs, illus., bibliogr. Cambridge: Polity, 2019. £30.00 (cloth). Royal Anthropological Inst 2022. [DOI: 10.1111/1467-9655.13801] [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: 11/29/2022]
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Burger H, Krause R, Blanchard C, Ambler J, Ganca L, Barnard A, Meiring M, Ratshikana-Moloko M, Brits H, Brand T, Scott M, Mabuza L, Bac M, Zele-Mqonci N, Yogeswaran P, Gwyther L. Position paper on undergraduate Palliative Medicine education for doctors in South Africa. Afr J Prim Health Care Fam Med 2022; 14:e1-e7. [PMID: 35924627 PMCID: PMC9350482 DOI: 10.4102/phcfm.v14i1.3202] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/03/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Basic palliative care teaching should be included in training curricula for health care providers (HCPs) at all levels of the health service to ensure that the goal set by the South African (SA) National Policy Framework and Strategy for Palliative Care, to have an adequate number of appropriately trained HCPs in South Africa, is achieved. Furthermore, palliative learning objectives for nurses and doctors should be standardised. Many SA medical schools have integrated elements of Palliative Medicine (PM) teaching into undergraduate medical training programmes for doctors; however, the degree of integration varies widely, and consensus and standardisation of the content, structure and delivery of such PM training programmes are not yet a reality. Aim This joint position paper aims to describe the current state of undergraduate medical PM teaching in South Africa and define the PM competencies required for an SA generalist doctor. Setting Palliative Medicine programme leads and teachers from eight medical schools in South Africa. Methods A survey exploring the structure, organisation and content of the respective medical undergraduate PM programmes was distributed to PM programme leads and teachers. Results Responses were received from seven medical schools. Through a process of iterative review, competencies were defined and further grouped according to suitability for the pre-clinical and clinical components of the curriculum. Conclusion Through mapping out these competencies in a spiralled medical curriculum, the authors hope to provide guidance to medical curriculum designers to effectively integrate PM teaching and learning into current curricula in line with the goals of the SA National Policy Framework and Strategy on Palliative Care (NPFSPC).
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Affiliation(s)
- Henriette Burger
- Division of Radiation Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Division of Radiation Oncology, Tygerberg Academic Hospital, Cape Town.
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Krause R, Barnard A, Burger H, De Vos A, Evans K, Farrant L, Fouche N, Kalula S, Morgan J, Mohamed Z, Panieri E, Ras T, Raubenheimer P, Verburg E, Boyd K, Gwyther L. A Delphi study to guide the development of a clinical indicator tool for palliative care in South Africa. Afr J Prim Health Care Fam Med 2022; 14:e1-e7. [PMID: 35695438 PMCID: PMC9210161 DOI: 10.4102/phcfm.v14i1.3351] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/14/2022] [Accepted: 03/31/2022] [Indexed: 11/09/2022] Open
Abstract
Background The South African National Policy Framework and Strategy on Palliative Care (NPFSPC) recommends that when integrating palliative care (PC) into the health system, a PC indicators tool should be used to guide clinicians to recognise a patient who should receive PC. The policy document recommends ‘a simple screening tool developed for use in South Africa that would assist healthcare professionals (HCPs) to recognise patients who may have unmet palliative care needs’. Aim This research study sought to develop South African consensus on indicators for PC to assist clinicians to recognise a patient in need of PC. Setting The South African healthcare setting. Methods A Delphi study was considered suitable as a methodology to develop consensus. The methodology was based on the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies to ensure rigour and transparency in conducting and reporting. Six different Delphi rounds were used to develop consensus. Each round allowed participants to anonymously rate statements with predefined rating scales. Results Cognisant of the disparities in healthcare provision and access to equitable healthcare in South Africa, the expert advisory group recommended, especially for South Africa, that ‘this tool is for deteriorating patients with an advanced life-limiting illness where all available and appropriate management for underlying illnesses and reversible complications has been offered’. The expert advisory group felt that disease-specific indicators should be described before the general indicators in the South African indicators tool, so all users of the tool orientate themselves to the disease categories first. This study included three new domains to address the South African context: trauma, infectious diseases and haematological diseases. General indicators for PC aligned with the original Supportive and Palliative Care Indicators Tool (SPICT) tool. Conclusion The Supportive and Palliative Care Indicators Tool for South Africa (SPICTTM-SA) is a simple screening tool for South Africa that may assist HCPs to recognise patients who may have unmet PC needs.
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Affiliation(s)
- Rene Krause
- Department of Family Medicine and Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town.
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Bolt M, Shelley C, Hollingdale R, Chadwick S, Barnard A, Leverton A, Stewart A, Adams E, South C. PO-1574 Evaluation of automated plan quality for cervical cancer using the Ethos TPS. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08025-7] [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: 11/28/2022]
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Dunnell L, Chu K, Barnard A, Walker G. 467 FRAILTY IN SITU SIMULATION. Age Ageing 2021. [DOI: 10.1093/ageing/afab116.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The ability to recognise and manage frailty and its associated presentations is variable among acute hospital staff. Patients living with frailty who are admitted to hospital are more likely to suffer adverse effects than those without. We created an inter-professional in-situ simulation programme designed to improve recognition and management of frailty and its common adverse events. The programme objectives align with recommendations from the British Geriatric Society’s ‘Frailty Hub’ and Royal College of Physicians’ ‘Acute Care Toolkit’ for frailty.
Method
Over a two month period, seven sessions were completed on the Older Persons Unit (OPU) at St Thomas’ Hospital. These comprised a simulated scenario followed by facilitated debrief—including technical skills and human factors highlighted by the scenario. Quantitative data was collected through pre and post session questionnaires using the Human Factors Skills for Healthcare Instrument (HuFSHI) and frailty based questions. Post session qualitative data was also collected.
Results
30 participants attended the sessions (nursing, medical and allied health professional). All participants completing the post course questionnaire found the sessions useful. When comparing pre and post session data, participant confidence in 10/12 sections of the HuFSHI and 8/9 frailty based questions demonstrated improvement. The qualitative data showed common learning themes around improved communication, teamwork and escalation. Participants found that the sessions were a valuable ‘opportunity to reflect’ and ‘debrief’, and learn together as a multidisciplinary team.
Conclusion
In-situ simulation is an effective tool for improving knowledge and confidence in managing frail patients. It increases awareness and understanding of human factors, which are key to the multidisciplinary approach frail patients require. The course is being expanded across the OPU and now has funding for a departmental manikin. The programme can be disseminated to other units to help improve the care and safety of those with frailty in hospital.
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Affiliation(s)
- L Dunnell
- Older Persons' Unit, Guy's and St Thomas' NHS Foundation Trust
| | - K Chu
- Older Persons' Unit, Guy's and St Thomas' NHS Foundation Trust
| | - A Barnard
- Older Persons' Unit, Guy's and St Thomas' NHS Foundation Trust
| | - G Walker
- Older Persons' Unit, Guy's and St Thomas' NHS Foundation Trust
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Gurung A, Sendall MC, Barnard A. To transfer or not to transfer: Aged care nurses’ decision-making in transferring residents to the emergency department. Collegian 2021. [DOI: 10.1016/j.colegn.2020.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cunningham M, Azcarate-Peril MA, Barnard A, Benoit V, Grimaldi R, Guyonnet D, Holscher HD, Hunter K, Manurung S, Obis D, Petrova MI, Steinert RE, Swanson KS, van Sinderen D, Vulevic J, Gibson GR. Shaping the Future of Probiotics and Prebiotics. Trends Microbiol 2021; 29:667-685. [PMID: 33551269 DOI: 10.1016/j.tim.2021.01.003] [Citation(s) in RCA: 203] [Impact Index Per Article: 67.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/15/2022]
Abstract
Recent and ongoing developments in microbiome science are enabling new frontiers of research for probiotics and prebiotics. Novel types, mechanisms, and applications currently under study have the potential to change scientific understanding as well as nutritional and healthcare applications of these interventions. The expansion of related fields of microbiome-targeted interventions, and an evolving landscape for implementation across regulatory, policy, prescriber, and consumer spheres, portends an era of significant change. In this review we examine recent, emerging, and anticipated trends in probiotic and prebiotic science, and create a vision for broad areas of developing influence in the field.
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Affiliation(s)
- Marla Cunningham
- Department of Science and Innovation, Metagenics, PO Box 675, Virginia BC, QLD, 4014, Australia.
| | - M Andrea Azcarate-Peril
- UNC Departments of Medicine and Nutrition, Microbiome Core Facility, University of North Carolina, Chapel Hill, NC, USA
| | | | - Valerie Benoit
- Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, USA
| | | | - Denis Guyonnet
- Diana Nova, Symrise Nutrition, Clichy-la-Garenne, France
| | - Hannah D Holscher
- Department of Food Science and Human Nutrition and Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | - Kirsty Hunter
- Department of Sport Science, Nottingham Trent University, UK
| | - Sarmauli Manurung
- Emerging Sciences Research, Reckitt Benckiser, Nijmegen, The Netherlands
| | - David Obis
- Danone Nutricia Research, Palaiseau Cedex, France
| | | | - Robert E Steinert
- R&D Human Nutrition and Health, DSM Nutritional Products Ltd, Basel, Switzerland; Department of Surgery, Division of Visceral and Transplantation Surgery, University Hospital Zürich, Switzerland
| | - Kelly S Swanson
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Douwe van Sinderen
- Microbiology BioSciences Institute, University College Cork, Cork, Ireland
| | - Jelena Vulevic
- veMico Ltd, Reading, UK; Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Glenn R Gibson
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
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Vandenborne K, Kim S, Willcocks R, Morales J, Lingineni K, Barnard A, Schmidt S, Daniels M, Triplett W, Larkindale J, Walter G, Rooney W, Steering Committe DMR. MUSCLE IMAGING – MRI. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.163] [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: 11/29/2022]
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10
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Atreya S, Jeba J, Pease N, Thyle A, Murray S, Barnard A, Munday D, Mathews L, Leng M, Palat G, Ganesh A, Chakraborty S, Anbarasi S, Kumar R, Muckaden M, Grant E. Primary palliative care competency framework for primary care and family physicians in India-Collaborative work by Indian Association of Palliative Care and Academy of Family Physicians of India. J Family Med Prim Care 2019; 8:2563-2567. [PMID: 31548932 PMCID: PMC6753829 DOI: 10.4103/jfmpc.jfmpc_451_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 06/19/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022] Open
Abstract
The discrepancy in the demand for palliative care and distribution of specialist palliative care services will force patients to be eventually cared for by primary care/family physicians in the community. This will necessitate primary care/family physicians to equip themselves with knowledge and skills of primary palliative care. Indian National Health Policy (2017) recommended the creation of continuing education programs as a method to empower primary care/family physicians. With this intention, a taskforce was convened for incorporating primary palliative care into family/primary care practice. The taskforce comprising of National and International faculties from Palliative Care and Family Medicine published a position paper in 2018 and subsequently brainstormed on the competency framework required for empowering primary care/family physicians. The competencies were covered under the following domains: knowledge, skills and attitude, ethical and legal aspects, communication and team work. The competency framework will be presented to the National Board of Examinations recommending to be incorporated in the DNB curriculum for Family Medicine.
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Affiliation(s)
- Shrikant Atreya
- Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Jenifer Jeba
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nikki Pease
- Department of Palliative Medicine, Velindre NHS Trust, Cardiff, Wales, UK
| | - Ann Thyle
- Emmanuel Hospital Association, New Delhi, India
| | - Scott Murray
- Emeritus Professor of Primary Palliative Care, Primary Palliative Care Research Group, The University of Edinburgh, Edinburgh, Scotland
| | - Alan Barnard
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Dan Munday
- National Academy of Medical Sciences, Kathmandu, Nepal
| | - Lulu Mathews
- Institute of Palliative Medicine, Kozhikode, Kerala, India
| | - Mhoira Leng
- Makerere University, Kampala, Uganda, Africa
| | - Gayatri Palat
- MNJ Institute of Oncology and Regional Cancer Center, Hyderabad, Telangana, India
| | - Alka Ganesh
- Department of Medicine, G Kuppuswamy Memorial Hospital, Coimbatore, Tamil Nadu, India
| | - Sulagna Chakraborty
- Department of Palliative Medicine, AMRI Dhakuria, Kolkata, West Bengal, India
| | - Sahaya Anbarasi
- Department of Distance Education, Christian Medical College, Vellore, Tamil Nadu, India
| | - Raman Kumar
- Academy of Family Physicians of India, New Delhi, India
| | - Maryann Muckaden
- Department of Palliative Medicine, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Elizabeth Grant
- Global Health Academy and the Primary Palliative Care Group, The University of Edinburgh, Edinburgh, Scotland
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Affiliation(s)
- Scott A. Murray
- Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Fred Burge
- Department of Family Practice, Dalhousie University, Halifax, Canada
| | - Alan Barnard
- Division of Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - David Nowels
- Department of Family Medicine, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, USA
| | - Rodger Charlton
- Institute of Clinical Education, the Medical School, University of Warwick, England, UK
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Hepburn AC, Steele RE, Veeratterapillay R, Wilson L, Kounatidou EE, Barnard A, Berry P, Cassidy JR, Moad M, El-Sherif A, Gaughan L, Mills IG, Robson CN, Heer R. The induction of core pluripotency master regulators in cancers defines poor clinical outcomes and treatment resistance. Oncogene 2019; 38:4412-4424. [PMID: 30742096 PMCID: PMC6546609 DOI: 10.1038/s41388-019-0712-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 12/31/2022]
Abstract
Stem cell characteristics have been associated with treatment resistance and poor prognosis across many cancer types. The ability to induce and regulate the pathways that sustain these characteristic hallmarks of lethal cancers in a novel in vitro model would greatly enhance our understanding of cancer progression and treatment resistance. In this work, we present such a model, based simply on applying standard pluripotency/embryonic stem cell media alone. Core pluripotency stem cell master regulators (OCT4, SOX2 and NANOG) along with epithelial–mesenchymal transition (EMT) markers (Snail, Slug, vimentin and N-cadherin) were induced in human prostate, breast, lung, bladder, colorectal, and renal cancer cells. RNA sequencing revealed pathways activated by pluripotency inducing culture that were shared across all cancers examined. These pathways highlight a potential core mechanism of treatment resistance. With a focus on prostate cancer, the culture-based induction of core pluripotent stem cell regulators was shown to promote survival in castrate conditions—mimicking first line treatment resistance with hormonal therapies. This acquired phenotype was shown to be mediated through the upregulation of iodothyronine deiodinase DIO2, a critical modulator of the thyroid hormone signalling pathway. Subsequent inhibition of DIO2 was shown to supress expression of prostate specific antigen, the cardinal clinical biomarker of prostate cancer progression and highlighted a novel target for clinical translation in this otherwise fatal disease. This study identifies a new and widely accessible simple preclinical model to recreate and explore underpinning pathways of lethal disease and treatment resistance.
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Affiliation(s)
- A C Hepburn
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
| | - R E Steele
- Prostate Cancer UK/Movember Centre of Excellence for Prostate Cancer, Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast, BT9 7AE, UK
| | - R Veeratterapillay
- Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK
| | - L Wilson
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - E E Kounatidou
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - A Barnard
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - P Berry
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - J R Cassidy
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - M Moad
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - A El-Sherif
- Department of Pathology, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK
| | - L Gaughan
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - I G Mills
- Prostate Cancer UK/Movember Centre of Excellence for Prostate Cancer, Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast, BT9 7AE, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, OX3 9DU, UK
| | - C N Robson
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
| | - R Heer
- Northern Institute for Cancer Research, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK. .,Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK.
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Bates D, Mitchell B, Barnard A. Prolotherapy in the treatment of pelvic instability. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jeba J, Atreya S, Chakraborty S, Pease N, Thyle A, Ganesh A, Palat G, Matthew L, Anbarasi S, Kumar R, Muckaden MA, Barnard A, Leng M, Munday D, Murray SA. Joint position statement Indian Association of Palliative Care and Academy of Family Physicians of India - The way forward for developing community-based palliative care program throughout India: Policy, education, and service delivery considerations. J Family Med Prim Care 2018; 7:291-302. [PMID: 30090767 PMCID: PMC6060921 DOI: 10.4103/jfmpc.jfmpc_99_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals. Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines. Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home.
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Affiliation(s)
- Jenifer Jeba
- Department of Medical Oncology, Christian Medical College Hospital, Vellore, India
| | - Shrikant Atreya
- Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sulagna Chakraborty
- Department of Palliative Medicine, AMRI Dhakuria, Kolkata, West Bengal, India
| | - Nikki Pease
- Palliative Medicine, Velindre NHS Trust, Cardiff, Wales, UK
| | - Ann Thyle
- Emmanuel Hospital Association, New Delhi, India
| | - Alka Ganesh
- Deptartment of Medicine, G Kuppuswamy Memorial Hospital, Coimbatore, Tamil Nadu, India
| | - Gayatri Palat
- MNJ Institute of Oncology and Regional Cancer Center, Hyderabad, Telangana, India
| | - Lulu Matthew
- Institute of Palliative Medicine, Kozhikode, Kerala, India
| | - Sahaya Anbarasi
- Department of Distance Education, Christian Medical College Hospital, Vellore, India
| | - Raman Kumar
- Academy of Family Physicians of India, Mumbai, Maharashtra, India
| | - Mary Ann Muckaden
- Department of Palliative Medicine, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Alan Barnard
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Dan Munday
- National Academy of Medical Sciences, Kathmandu, Nepal
| | - Scott A Murray
- St Columba's Hospice Chair of Primary Palliative Care, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
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Barnard A. Hunter-Gatherers and Their Neighbors in Asia, Africa, and South America. Kazunobu Ikeya and Robert K. Hitchcock, eds. Osaka: National Museum of Ethnology, Senri Ethnological Series 94, 2016, 298 pp. No price, paper. ISBN 978-4-906962-48-8. Journal of Anthropological Research 2018. [DOI: 10.1086/696167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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16
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Barnard A. Custred, Glynn. A history of anthropology as a holistic science. xii, 253 pp., tables, bibliogr. Lanham, Md: Lexington Books, 2016. $90.00 (cloth). J R Anthropol Inst 2018. [DOI: 10.1111/1467-9655.12777] [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: 11/30/2022]
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Affiliation(s)
| | - Alan Barnard
- School of Nursing; Queensland University of Technology; Brisbane QLD Australia
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Willcocks R, Forbes S, Lott D, Senesac C, Arora H, Barnard A, Harrington A, Daniels M, Finanger E, Tennekoon G, Finkel R, Wang D, Rooney W, Walter G, Sweeney H, Vandenborne K. Magnetic resonance biomarkers in the proximal and distal upper extremity in a large cohort of boys with Duchenne muscular dystrophy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Barnard A. Morris, Brian (introduction by PeterMarshall). Anthropology, ecology, and anarchism: a Brian Morris reader. xx, 252 pp, bibliogr. London: PM Press, 2015. £21.99 (paper). J R Anthropol Inst 2017. [DOI: 10.1111/1467-9655.12687] [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: 11/30/2022]
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20
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Barnard A. What's next for the Ju/'hoansi?
Affluence Without Abundance: The Disappearing Worldof the Bushmen
James Suzman
Bloomsbury USA, 2017. 320 pp. Science 2017; 356:1340. [DOI: 10.1126/science.aan6309] [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: 11/02/2022]
Abstract
A community of Kalahari hunter-gatherers struggles to find their way in a changing world
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Affiliation(s)
- Alan Barnard
- The reviewer is at the School of Social and Political Science,
University of Edinburgh, Edinburgh EH8 9LD, UK
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Mitchell B, Verrills P, Vivian D, Barnard A. Sacral nerve stimulation for the treatment of chronic low back, pelvic girdle and leg pain – A prospective study. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2016.12.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Mitchell B, Bates D, Verrills P, Vivian D, Barnard A. Biological cell therapies for discogenic low back pain. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Huang SH, Barnard A, Katherine Wang KW, Sheu SJ, Chiang HH. To Contain the Suffering of Keeping the Baby Gestation: A Qualitative Study of the Experiences of Women with Hospitalized Tocolysis. Womens Health Issues 2017. [DOI: 10.4172/2325-9795.1000276] [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: 11/09/2022]
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Freitag J, Boyd R, Bates D, Huguenin L, Shah K, Barnard A. To evaluate the effect of autologous adipose derived mesenchymal stem cell therapy in the treatment of osteoarthritis – A case series analysis. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2016.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Han CY, Lin CC, Goopy S, Hsiao YC, Barnard A, Wang LH. Waiting and hoping: a phenomenographic study of the experiences of boarded patients in the emergency department. J Clin Nurs 2016; 26:840-848. [PMID: 27805751 DOI: 10.1111/jocn.13621] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To understand the experiences and concerns of patients in the emergency department during inpatient boarding. BACKGROUND Boarding in the emergency department is an increasingly common phenomenon worldwide. Emergency department staff, patients and their families become more stressed as the duration of boarding in the emergency department increases. Yet, there is limited knowledge of the experiences and concerns of boarded patients. DESIGN The qualitative approach of phenomenography was used in the study. METHODS The phenomenographic study was conducted in one emergency department that treats approximately 15,000 patients each month. Twenty emergency department boarding patients were recruited between July-September 2014. Semi-structured interviews were used for data collection. The seven steps of qualitative data analysis for a phenomenographic study - familiarisation, articulation, condensation, grouping, comparison, labelling and contrasting - were employed to develop an understanding of participants' experiences and concerns during their inpatient boarding in the emergency department. RESULTS The perceptions that emerged from the data were collected into four categories of description of the phenomenon of emergency department boarding patients: a helpless choice; loyalty to specific hospitals and doctors; an inevitable challenge of life; and distrust of the healthcare system. The outcome space for the emergency department boarding patients was waiting and hoping for a cure. CONCLUSION The experiences and concerns of emergency department boarding patients include physical, psychological, spiritual and health system dimensions. It is necessary to develop an integrated model of care for these patients. RELEVANCE TO CLINICAL PRACTICE Understanding the experiences and concerns of patients who are placed on boarding status in the ED will help emergency healthcare professionals to improve the quality of emergency care. There is a need to develop a care model and associated intervention measures for emergency department patients during the boarding process. The results of this study will help health regulatory authorities to develop an appropriate emergency department boarding system so that patients receive better emergency care.
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Affiliation(s)
- Chin-Yen Han
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Chun-Chih Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Suzanne Goopy
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Ya-Chu Hsiao
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Alan Barnard
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Li-Hsiang Wang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
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Barnard A, Hou XY, Lukin B. Director of nursing experiences of a hospital in the nursing home program in South East Queensland. Collegian 2016. [DOI: 10.1016/j.colegn.2016.03.001] [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: 11/29/2022]
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Barnard A, Harvey T, Theobald K, Tippett V, Rider T. SUPPORTING CLINICAL FACILITATORS THROUGH PEER REVIEW OF TEACHING. Aust Nurs Midwifery J 2016; 24:34-35. [PMID: 29249091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The QUT School of Nursing is currently trialling peer review of teaching (PRoT) as one strategy to support clinical facilitators working with undergraduate students. Work integrated learning (WIL) relies on collaborative partnerships and clinical facilitators need specific skills and knowledge.
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Wang LH, Goopy S, Lin CC, Barnard A, Han CY, Liu HE. The emergency patient's participation in medical decision-making. J Clin Nurs 2016; 25:2550-8. [PMID: 27133134 DOI: 10.1111/jocn.13296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. BACKGROUND Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. DESIGN This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. METHODS Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. RESULTS The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. CONCLUSIONS The findings fill a gap in knowledge about the decision-making process among emergency patients. RELEVANCE TO CLINICAL PRACTICE The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff.
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Affiliation(s)
- Li-Hsiang Wang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Suzanne Goopy
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Chun-Chih Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Alan Barnard
- Queensland University of Technology, Brisbane, Qld, Australia
| | - Chin-Yen Han
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Hsueh-Erh Liu
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
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Barnard A, Hou XY, Lukin B. Director ofnursingexperiencesofa hospital inthenursinghomeprogramin South EastQueensland. Collegian 2016; 23:341-348. [PMID: 29115811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In Australiathereislimitedaccesstoacutecaresupportforresidentslivingwithin the residentialagedcaresector.Competingdemandsfromfamilies,residents,government agencies andtheacutecaresectorhasmeantthatstaffwiththesectorstruggleoftento meet theacutecareneedsofresidents,leadingsometimestotransferofresidentsto emergency departmentswithmajorhospitals.Hospitalinthenursinghomeisacaredeliverymodel designed to reduce transfers, facilitate appropriate care intervention, effectively utilize existing healthresources,andextendsupporttotheresidentialcaresector.Thisresearchproject used aninterpretivequalitativeframeworktoexplorethroughfocusgroupmethod,hospital in thehomeexperiencesof20residentialcareDirectorsofNursinginSouthEastQueensland. Researchoutcomesemphasizehospitalinthenursinghomeasamutuallybeneficialsupport strategy thatcanimproveresidentialbasedmanagementofacuteandchronicillness,can positively assistfamilysupport,andassistswithdecisionmakingandongoingcommunication. Hospital inthehomeemphasisesamovefromhospitaldestinationbasedacutecareservicesto community based delivery supported by a multidisciplinary team.
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Barnard A. A Prehistory of Western North America: The Impact of Uto-Aztecan Languages by David Leedom Shaul Albuquerque: University of New Mexico Press, 2014. 400 pp. American Anthropologist 2015. [DOI: 10.1111/aman.12435] [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: 11/27/2022]
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DuToit N, Mitchell B, Joseph J, Barnard A. Movement and muscle activation patterns following medial branch blocks for facet joint pain, and sacroiliac injection for sacroiliac joint pain. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.485] [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: 10/22/2022]
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Affiliation(s)
- Alan Barnard
- School of Nursing; Queensland University of Technology; Kelvin Grove Queensland Australia
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Barnard A, Romero de Mello Sa S, Willcocks R, Senesac C, Finkel R, Forbes S, Sweeney H, Tennekoon G, Triplett W, Lott D, Wang D, Byrne B, Hammers D, Pham J, Rooney W, Finanger E, Walter G, Vandenborne K, Russman B. Genetic polymorphisms modify intramuscular fat infiltration in Duchenne muscular dystrophy. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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35
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Jumelle C, Mauclair C, Houzet J, Barnard A, He Z, Piselli S, Perrache C, Gain P, Thuret G. Transfer of molecules into the endothelial cells of whole human corneas using carbon nanoparticles activated by femtosecond laser. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0596] [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: 11/28/2022]
Affiliation(s)
- C. Jumelle
- Corneal Graft Biology- Engineering and Imaging Laboratory- EA2521- Federative Institute of Research in Sciences and Health Engineering- Faculty of Medicine; University Jean Monnet; Saint-Etienne France
| | - C. Mauclair
- Laboratory Hubert Curien- UMR-CNRS 5516; University Jean Monnet; Saint-Etienne France
| | - J. Houzet
- Laboratory Hubert Curien- UMR-CNRS 5516; University Jean Monnet; Saint-Etienne France
| | - A. Barnard
- Corneal Graft Biology- Engineering and Imaging Laboratory- EA2521- Federative Institute of Research in Sciences and Health Engineering- Faculty of Medicine; University Jean Monnet; Saint-Etienne France
| | - Z. He
- Ophthalmology; University Hospital; Saint-Etienne France
| | - S. Piselli
- Corneal Graft Biology- Engineering and Imaging Laboratory- EA2521- Federative Institute of Research in Sciences and Health Engineering- Faculty of Medicine; University Jean Monnet; Saint-Etienne France
| | - C. Perrache
- Corneal Graft Biology- Engineering and Imaging Laboratory- EA2521- Federative Institute of Research in Sciences and Health Engineering- Faculty of Medicine; University Jean Monnet; Saint-Etienne France
| | - P. Gain
- Corneal Graft Biology- Engineering and Imaging Laboratory- EA2521- Federative Institute of Research in Sciences and Health Engineering- Faculty of Medicine; University Jean Monnet; Saint-Etienne France
| | - G. Thuret
- Corneal Graft Biology- Engineering and Imaging Laboratory- EA2521- Federative Institute of Research in Sciences and Health Engineering- Faculty of Medicine and Institut Universitaire de France- Bd St Michel- Paris; University Jean Monnet; Saint-Etienne France
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Abstract
Published research on discharge planning is written from the perspective of hospital wards and community services. Limited research focuses on discharge planning in the emergency department (ED). The objective of this study was to identify ED nurses' perceptions of factors influencing the implementation of discharge planning. This qualitative study collected data from 25 ED nurses through in-depth interviews and a drawing task in which participants were asked to depict on paper the implementation of discharge planning in their practice. Factors influencing discharge planning were grouped into three categories: discharge planning as a neglected issue in the ED, heavy workload, and the negative attitudes of ED patients and their families. The study highlighted a need for effective discharge planning to be counted as an essential clinical competency for ED nurses and factored into their everyday workload. Nurses perceived that organizational culture, and parents' and relatives' attitudes were barriers to implementing discharge teaching in the ED.
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Affiliation(s)
- Wen Chang
- Chang Gung University of Science and Technology, Taiwan, Republic of China
| | | | - Chun-Chih Lin
- Chang Gung University of Science and Technology, Taiwan, Republic of China
| | - Alan Barnard
- Queensland University of Technology, Brisbane, Australia
| | | | - Chin-Yen Han
- Chang Gung University of Science and Technology, Taiwan, Republic of China
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Murray SA, Firth A, Schneider N, Van den Eynden B, Gomez-Batiste X, Brogaard T, Villanueva T, Abela J, Eychmuller S, Mitchell G, Downing J, Sallnow L, van Rijswijk E, Barnard A, Lynch M, Fogen F, Moine S. Promoting palliative care in the community: production of the primary palliative care toolkit by the European Association of Palliative Care Taskforce in primary palliative care. Palliat Med 2015; 29:101-11. [PMID: 25395577 DOI: 10.1177/0269216314545006] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND A multidisciplinary European Association of Palliative Care Taskforce was established to scope the extent of and learn what facilitates and hinders the development of palliative care in the community across Europe. AIM To document the barriers and facilitators for palliative care in the community and to produce a resource toolkit that palliative care specialists, primary care health professionals or policymakers, service developers, educationalists and national groups more generally could use to facilitate the development of palliative care in their own country. DESIGN (1) A survey instrument was sent to general practitioners with knowledge of palliative care services in the community in a diverse sample of European countries. We also conducted an international systematic review of tools used to identify people for palliative care in the community. (2) A draft toolkit was then constructed suggesting how individual countries might best address these issues, and an online survey was then set up for general practitioners and specialists to make comments. Iterations of the toolkit were then presented at international palliative care and primary care conferences. RESULTS Being unable to identify appropriate patients for palliative care in the community was a major barrier internationally. The systematic review identified tools that might be used to help address this. Various facilitators such as national strategies were identified. A primary palliative care toolkit has been produced and refined, together with associated guidance. CONCLUSION Many barriers and facilitators were identified. The primary palliative care toolkit can help community-based palliative care services to be established nationally.
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Affiliation(s)
- Scott A Murray
- Primary Palliative Care Research Group, Medical School, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Xavier Gomez-Batiste
- WHO Collaborating Centre for Public Health Palliative Care Programmes, Catalan Institute of Oncology, Barcelona, Spain
| | - Trine Brogaard
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | | | | | - Steffen Eychmuller
- Center for Palliative Care, Kantonsspital St. Gallen Institute, St. Gallen, Switzerland
| | | | - Julia Downing
- Makerere University, Kampala, Uganda Development of Palliative Care Services, Belgrade, Republic of Serbia
| | | | | | - Alan Barnard
- University of Cape Town, Cape Town, South Africa
| | - Marie Lynch
- The Irish Hospice Foundation, Dublin, Ireland
| | - Frederic Fogen
- Centre Hospitalier Luxembourg (CHL), Rue Nicolas Ernest Barblé, Luxembourg
| | - Sébastien Moine
- Laboratoire de pédagogie de la santé, Université Paris 13 Département de recherche en éthique, Université Paris-Sud, Orsay, France
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Mitchell B, Verrills P, Vivian D, Barnard A. Peripheral nerve field stimulation therapy for patients with thoracic pain: A prospective study. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mitchell B, Barnard A. Is intradiscal methylene blue injection an effective treatment alternative for discogenic low back pain? J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mitchell B, Verrills P, Vivian D, Barnard A. Sacral nerve stimulation for the treatment of chronic intractable pelvic pain—A prospective study. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.100] [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: 11/29/2022]
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Illsley M, Barnard A, Landau D. 152 Variation in maximal oesophageal dose with respiration during radical radiotherapy for NSCLC. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70152-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Freitag J, Barnard A. The next step in osteoarthritis management–Photoactivated Platelet Rich Plasma injections: A case study. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.328] [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]
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Sauer MJ, Roesler CS, Werdell PJ, Barnard A. Under the hood of satellite empirical chlorophyll a algorithms: revealing the dependencies of maximum band ratio algorithms on inherent optical properties. Opt Express 2012; 20:20920-20933. [PMID: 23037216 DOI: 10.1364/oe.20.020920] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Empirically-based satellite estimates of chlorophyll a [Chl] (e.g. OC3) are an important indicator of phytoplankton biomass. To correctly interpret [Chl] variability, estimates must be accurate and sources of algorithm errors known. While the underlying assumptions of band ratio algorithms such as OC3 have been tacitly hypothesized (i.e. CDOM and phytoplankton absorption covary), the influence of component absorption and scattering on the shape of the algorithm and estimated [Chl] error has yet to be explicitly revealed. We utilized the NOMAD bio-optical data set to examine variations between satellite estimated [Chl] and in situ values. We partitioned the variability into (a) signal contamination and (b) natural phytoplankton variability (variability in chlorophyll-specific phytoplankton absorption). Not surprisingly, the OC3 best-fit curve resulted from a balance between these two different sources of variation confirming the bias by detrital absorption on global scale. Unlike previous descriptions of empirical [Chl] algorithms, our study (a) quantified the mean detrital:phytoplankton absorption as ~1:1in the global NOMAD data set, and (b) removed detrital (CDOM + non-algal particle) absorption in radiative transfer models directly showing that the scale of the remaining variability in the band ratio algorithm was dominated by phytoplankton absorption cross section.
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Affiliation(s)
- Michael J Sauer
- US Geological Survey, 6000 J Street, Placer Hall, Sacramento, California 95819, USA.
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Mitchell B, Rose R, Barnard A. Prolotherapy for sacro-iliac joint pain: Reduction in pain and increases in strength. J Sci Med Sport 2011. [DOI: 10.1016/j.jsams.2011.11.138] [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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Abstract
Gaining an improved understanding of people diagnosed with schizophrenia has the potential to influence priorities for therapy. Psychosis is commonly understood through the perspective of the medical model. However, the experience of social context surrounding psychosis is not well understood. In this research project we used a phenomenological methodology with a longitudinal design to interview 7 participants across a 12-month period to understand the social experiences surrounding psychosis. Eleven themes were explicated and divided into two phases of the illness experience: (a) transition into emotional shutdown included the experiences of not being acknowledged, relational confusion, not being expressive, detachment, reliving the past, and having no sense of direction; and (b) recovery from emotional shutdown included the experiences of being acknowledged, expression, resolution, independence, and a sense of direction. The experiential themes provide clinicians with new insights to better assess vulnerability, and have the potential to inform goals for therapy.
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Affiliation(s)
- James A Le Lievre
- Queensland University of Technology, Brisbane, Queensland, Australia.
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Wirihana LA, Barnard A. Women's perceptions of their healthcare experience when they choose not to breastfeed. Women Birth 2011; 25:135-41. [PMID: 21903496 DOI: 10.1016/j.wombi.2011.08.005] [Citation(s) in RCA: 13] [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: 03/31/2011] [Revised: 08/10/2011] [Accepted: 08/10/2011] [Indexed: 11/29/2022]
Abstract
RESEARCH QUESTION How do women who choose not to breastfeed perceive their healthcare experience? METHOD This qualitative research study used a phenomenographic approach to explore the healthcare experience of women who do not breastfeed. Seven women were interviewed about their healthcare experience relating to their choice of feeding, approximately 4 weeks after giving birth. Six conceptions were identified and an outcome space was developed to demonstrate the relationships and meaning of the conceptions in a visual format. FINDINGS There were five unmet needs identified by the participants during this study. These needs included equity, self sufficiency, support, education and the need not to feel pressured. CONCLUSION Women in this study who chose not to breastfeed identified important areas where they felt that their needs were not met. In keeping with the Code of Ethics for Nurses and Midwives, the identified needs of women who do not breastfeed must be addressed in a caring, compassionate and just manner. The care and education of women who formula feed should be of the highest standard possible, even if the choice not to breastfeed is not the preferred choice of healthcare professionals.
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Affiliation(s)
- Lisa A Wirihana
- School of Nursing and, Midwifery at Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Seib C, English R, Barnard A. Teaching undergraduate students community nursing: using action research to increase engagement and learning. J Nurs Educ 2011; 50:536-9. [PMID: 21627051 DOI: 10.3928/01484834-20110531-03] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 04/19/2011] [Indexed: 11/20/2022]
Abstract
Nurses play a pivotal role in responding to the changing needs of community health care. Therefore, nursing education must be relevant, responsive, and evidence based. We report a case study of curriculum development in a community nursing unit embedded within an undergraduate nursing degree. We used action research to develop, deliver, evaluate, and redesign the curriculum. Feedback was obtained through self-reflection, expert opinion from community stakeholders, formal student evaluation, and critical review. Changes made, especially in curriculum delivery, led to improved learner focus and more clearly linked theory and practice. The redesigned unit improved performance, measured with the university's student evaluation of feedback instrument (increased from 0.3 to 0.5 points below to 0.1 to 0.5 points above faculty mean in all domains), and was well received by teaching staff. The process confirmed that improved pedagogy can increase student engagement with content and perception of a unit as relevant to future practice.
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Affiliation(s)
- Charrlotte Seib
- School of Nursing and Midwifery, Queensland University of Technology, Queensland, Australia.
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Barnard A. Interactions between hunter-gatherers and farmers: from prehistory to present - Edited by Kazunobu Ikeya, Hidefumi Ogawa & Peter Mitchell. Journal of the Royal Anthropological Institute 2010. [DOI: 10.1111/j.1467-9655.2010.01632_14.x] [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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