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Frank HE, Cain G, Freeman J, Benito KG, O’Connor E, Kemp J, Kim B. Parent-identified barriers to accessing exposure therapy: A qualitative study using process mapping. Front Psychiatry 2023; 14:1068255. [PMID: 37020732 PMCID: PMC10067909 DOI: 10.3389/fpsyt.2023.1068255] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/21/2023] [Indexed: 04/07/2023] Open
Abstract
Background Youth with anxiety and obsessive-compulsive disorder (OCD) rarely access exposure therapy, an evidence-based treatment. Known barriers include transportation, waitlists, and provider availability. Efforts to improve access to exposure require an understanding of the process that families take to find therapists, yet no prior studies have examined parents' perspectives of the steps involved. Methods Parents of children who have received exposure therapy for anxiety and/or OCD (N = 23) were recruited from a hospital-based specialty anxiety clinic where the majority of their children previously received exposure. Recruitment was ongoing until thematic saturation was reached. Parents completed questionnaires and attended an online focus group during which they were asked to describe each step they took-from recognizing their child needed treatment to beginning exposure. A process map was created and shown in real-time, edited for clarity, and emailed to parents for member checking. Authors analyzed process maps to identify common themes. Results Several themes emerged, as visually represented in a final process map. Participants identified a "search-outreach" loop, in which they repeated the cycle of looking for therapists, contacting them, and being unable to schedule an appointment due to factors such as cost, waitlists, and travel time. Parents often did not know about exposure and reported feeling guilty about their lack of knowledge and inability to find a suitable provider. Parents reported frustration that medical providers did not often know about exposure and sometimes dismissed parents' concerns. Participants emphasized the difficulty of navigating the mental health system; many reported that it took years to find an exposure therapist, and that the search was sometimes stalled due to fluctuating symptoms. Conclusion A common thread among identified barriers was the amount of burden placed on parents to find treatment with limited support, and the resultant feelings of isolation and guilt. Findings point to several directions for future research, such as the development of parent support groups for navigating the mental health system; enhancing coordination of care between medical and mental health providers; and streamlining referral processes.
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Affiliation(s)
- Hannah E. Frank
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
- Bradley Hospital, East Providence, RI, United States
- *Correspondence: Hannah E. Frank,
| | - Grace Cain
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
- Bradley Hospital, East Providence, RI, United States
| | - Jennifer Freeman
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
- Bradley Hospital, East Providence, RI, United States
| | - Kristen G. Benito
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
- Bradley Hospital, East Providence, RI, United States
| | - Erin O’Connor
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
- Bradley Hospital, East Providence, RI, United States
| | - Josh Kemp
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
- Bradley Hospital, East Providence, RI, United States
| | - Bo Kim
- VA Center for Healthcare Organization and Implementation Research, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Skidmore ER, Shih M, Terhorst L, O’Connor E. Lesion location may attenuate response to strategy training in acute stroke. PM R 2022; 14:329-336. [PMID: 33728742 PMCID: PMC8446102 DOI: 10.1002/pmrj.12590] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/25/2021] [Accepted: 03/08/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Strategy training, a rehabilitation intervention, reduces disability and improves functional skills associated with goal-directed behavior. Stroke lesions impacting selected ventromedial regions of interest associated with initiation of goal-directed behavior may attenuate intervention response. If so, strategy training may not be optimal for people with stroke lesions in these regions. OBJECTIVE To examine whether ventromedial regions of interest attenuate changes in disability status attributed to strategy training. DESIGN Secondary analysis of data from two randomized controlled clinical trials. SETTING Inpatient stroke rehabilitation. PARTICIPANTS People with acute stroke diagnosis and available diagnostic studies enrolled in inpatient rehabilitation randomized controlled studies between 2009 and 2017. INTERVENTION Participants were randomized to strategy training or a control condition in addition to the usual care during inpatient rehabilitation. MAIN OUTCOME MEASURES Diagnostic magnetic resonance imaging studies were retrieved from electronic medical records, and stroke lesion location was characterized by a neuroradiologist. Intervention response was defined by Functional Independence Measure change scores of 22 points or greater. RESULTS Only 186 of 275 participants had diagnostic studies available; 13 patients showed no apparent lesion on their diagnostic study. Among 173 cases, 156 had complete data at discharge (strategy training n = 71, control n = 85). Twenty-five cases had a lesion within a region of interest (strategy training n = 14, control n = 11). Intervention response was attenuated in the strategy training group for those with lesions in regions of interest [χ2 (1, n = 71) = 4.60, P = .03], but not for those in the control group [Fisher exact test, n = 85, P = .19). CONCLUSIONS Lesions in the ventromedial regions of interest may attenuate response to strategy training.
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Affiliation(s)
- Elizabeth R. Skidmore
- Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences
| | - Minmei Shih
- Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences,Data Center, University of Pittsburgh School of Health and Rehabilitation Sciences
| | - Erin O’Connor
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine
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Norton S, Condon C, O’Kelly P, Cooney A, O’Connor E, Power R, Forde J, Ferede A, Robertson I, Smyth G, Little D, Mohan P. The Paediatric Renal Transplant Recipient: A retrospective review of the changing trends of transplantation in Ireland. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00201-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pang K, Campi R, Omar M, Yuan C, Karavitakis M, Manso M, Arteaga S, Nic An Riogh A, O’Connor E, Sakalis V, Sihra N, Tzelves L, Arlandis S, Bo K, Costantini E, Farag F, Groen J, Lapitan M, Nambiar A, Peyronnet B, Phé V, Van Der Vaart C, Harding C. What are the different diagnostic tests for female Bladder Outlet Obstruction (fBOO)? A systematic review from the European Association of Urology non-neurogenic female LUTS Guidelines Panel. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00689-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nobrega R, O’Connor E, Pakzad M, Hamid R, Ockrim J, Greenwell T. Right iliac fossa or umbilical stoma for a mitrofanoff – which is the best site? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00745-4] [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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Peyronnet B, Omar M, O’Connor E, Tzelves L, Nic An Riogh A, Manso M, Yuan C, Arlandis S, Bo K, Costantini E, Farag F, Groen J, Nambiar A, Phé V, Van Der Vaart H, N’Dow J, Harding C, Lapitan M. Benefits and harms of conservative, pharmacological, and surgical management options for women with bladder outlet obstruction: A systematic review from the European Association of Urology non-neurogenic female LUTS guidelines panel. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00690-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Xiang R, MacLeod IM, Daetwyler HD, de Jong G, O’Connor E, Schrooten C, Chamberlain AJ, Goddard ME. Genome-wide fine-mapping identifies pleiotropic and functional variants that predict many traits across global cattle populations. Nat Commun 2021; 12:860. [PMID: 33558518 PMCID: PMC7870883 DOI: 10.1038/s41467-021-21001-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [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: 02/18/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023] Open
Abstract
The difficulty in finding causative mutations has hampered their use in genomic prediction. Here, we present a methodology to fine-map potentially causal variants genome-wide by integrating the functional, evolutionary and pleiotropic information of variants using GWAS, variant clustering and Bayesian mixture models. Our analysis of 17 million sequence variants in 44,000+ Australian dairy cattle for 34 traits suggests, on average, one pleiotropic QTL existing in each 50 kb chromosome-segment. We selected a set of 80k variants representing potentially causal variants within each chromosome segment to develop a bovine XT-50K genotyping array. The custom array contains many pleiotropic variants with biological functions, including splicing QTLs and variants at conserved sites across 100 vertebrate species. This biology-informed custom array outperformed the standard array in predicting genetic value of multiple traits across populations in independent datasets of 90,000+ dairy cattle from the USA, Australia and New Zealand.
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Affiliation(s)
- Ruidong Xiang
- grid.1008.90000 0001 2179 088XFaculty of Veterinary and Agricultural Science, The University of Melbourne, Parkville, VIC Australia ,grid.452283.a0000 0004 0407 2669Agriculture Victoria, AgriBio, Centre for AgriBiosciences, Bundoora, VIC Australia
| | - Iona M. MacLeod
- grid.452283.a0000 0004 0407 2669Agriculture Victoria, AgriBio, Centre for AgriBiosciences, Bundoora, VIC Australia
| | - Hans D. Daetwyler
- grid.452283.a0000 0004 0407 2669Agriculture Victoria, AgriBio, Centre for AgriBiosciences, Bundoora, VIC Australia ,grid.1018.80000 0001 2342 0938School of Applied Systems Biology, La Trobe University, Bundoora, VIC Australia
| | | | | | | | - Amanda J. Chamberlain
- grid.452283.a0000 0004 0407 2669Agriculture Victoria, AgriBio, Centre for AgriBiosciences, Bundoora, VIC Australia
| | - Michael E. Goddard
- grid.1008.90000 0001 2179 088XFaculty of Veterinary and Agricultural Science, The University of Melbourne, Parkville, VIC Australia ,grid.452283.a0000 0004 0407 2669Agriculture Victoria, AgriBio, Centre for AgriBiosciences, Bundoora, VIC Australia
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O’Connor E, Koschel S, Bagguley D, Sathianathen NJ, Cumberbatch MG, Thangasamy IA, Moon D, Murphy DG. Robotic prostatectomy after abandoned open radical prostatectomy—Technical aspects and outcomes. BJUI Compass 2020; 1:174-179. [PMID: 35475212 PMCID: PMC8988844 DOI: 10.1002/bco2.34] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/21/2020] [Accepted: 07/25/2020] [Indexed: 11/10/2022] Open
Abstract
Objective To describe the technical aspects and outcomes of robotic‐assisted radical prostatectomy (RARP) following abandoned open radical prostatectomy (ORP). Patients and Methods A retrospective review was performed of patients who underwent RARP following abandonment of ORP between 2016 and 2020. RARP was undertaken by two highly experienced robotic surgeons. Analysis of patient and operative characteristics, outcomes, and reasons for abandonment of ORP were described. Results Six patients were included for analysis with a median age of 63.5 years [50.3‐67.5]. The median body mass index (BMI) was 34.7 [27.8‐36.2]. All patients had intermediate‐risk prostate cancer. Small prostate and deep pelvis were given as reasons for abandoning ORP in five cases (83.3%), with four of these also attributing increased BMI as a factor. Extensive mesh from previous bilateral inguinal hernia repair was cited as the reason for abandonment in the remaining patient. One patient had commenced androgen deprivation therapy following abandoned ORP. Extensive retropubic adhesions were noted at the time of RARP in five of six patients, with intraoperative complication of small bladder lacerations encountered in the patient with prior mesh hernia repair. The median time from abandoned ORP to RARP was 128 days [40‐216]. Median operating time was 160 minutes [139‐190] and estimated blood loss was 225 mL [138‐375]. Negative margins were obtained in four of six cases, with further salvage treatment being required in one case at a median follow‐up duration of 10.5 months [6.5‐25.3]. Conclusion Abandonment of ORP is an uncommonly reported event, however, in this small case series, we demonstrate that, in the hands of experienced surgeons, RARP is a safe and technically feasible alternative in such cases. Increased BMI, small prostate size and pelvic anatomical constraints appear to be common catalysts for abandonment of open surgery in this cohort. Identifying these high‐risk patients early and considering referral to robotic centers may be preferred.
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Affiliation(s)
- E. O’Connor
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
- Department of Surgery University of MelbourneAustin Hospital Heidelberg VIC Australia
| | - S. Koschel
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
| | - D. Bagguley
- EJ Whitten Prostate Cancer Research Centre at Epworth Melbourne VIC Australia
- Department of UrologyNorthern Health Melbourne VIC Australia
| | - N. J. Sathianathen
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
| | - M. G. Cumberbatch
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
- Department of Academic Urology Royal Hallamshire Hospital Sheffield UK
| | - I. A. Thangasamy
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
- Faculty of Medicine University of Queensland Brisbane QLD Australia
| | - D. Moon
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
| | - D. G. Murphy
- Division of Cancer SurgeryPeter MacCallum Cancer Centre Melbourne VIC Australia
- Sir Peter MacCallum Department of Oncology University of Melbourne Parkville VIC Australia
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Inder S, O’Connell C, Keane K, Omer S, O’Connor E, Madden A, Smyth L, Flynn R, Thomas A, Manecksha R. Electronic Urology Handover – A Quality improvement project. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Wright JK, Tan DHS, Walmsley SL, Hulme J, O’Connor E, Snider C, Cheng I, Chan AK, Borgundvaag B, McLeod S, Gollob MH, Clarke RJ, Dresser L, Haji F, Mazzulli T, Mubareka S, Jüni P, Lee D, Tomlinson G, Kain KC, Landes M. Protecting Frontline Health Care Workers from COVID-19 with Hydroxychloroquine Pre-exposure Prophylaxis: A structured summary of a study protocol for a randomised placebo-controlled multisite trial in Toronto, Canada. Trials 2020; 21:647. [PMID: 32665039 PMCID: PMC7359423 DOI: 10.1186/s13063-020-04577-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Primary Objective: To determine if pre-exposure prophylaxis (PrEP) with 400mg hydroxychloroquine (HCQ), taken orally once daily reduces microbiologically confirmed COVID-19 among front line health care workers at high risk for SARS-CoV-2 exposure. Secondary Objectives: To compare the following between study arms: adverse events; symptomatic COVID-19; duration of symptomatic COVID-19; days hospitalized attributed to COVID-19; respiratory failure attributable to COVID-19 requiring i) non-invasive ventilation or ii) intubation/mechanical ventilation; mortality attributed to COVID-19, number of days unable to work attributed to COVID-19, seroconversion (COVID-19 negative to COVID-19 positive over the study period); ability of participant plasma to neutralize SARS-CoV-2 virus in vitro; To describe short-term psychological distress associated with risk of COVID-19 exposure at 1, 60, 120 days of the study. To explore laboratory markers within participants with confirmed COVID-19: including circulating markers of host immune and endothelial activation in participant plasma and their correlation with disease severity and outcome TRIAL DESIGN: The HEROS study is a two-arm, parallel-group, individually randomized (1:1 allocation ratio), placebo controlled, participant and investigator-blinded, multi-site superiority trial of oral HCQ 400 mg taken once daily for 90 days as PrEP to prevent COVID-19 in health care workers at high risk of SARS-CoV-2 exposure. At 90 days, there is an open label extension wherein all participants are offered a one-month course of HCQ 400mg once daily for PrEP of COVID-19. PARTICIPANTS Frontline HCWs aged 18 years of age or older, at high risk of SARS-CoV-2 exposure (including staff of emergency departments, intensive care units, intubation teams, COVID-wards, and staff deployed to Long Term Care facilities) of five academic hospitals in downtown Toronto, Canada. Exclusion criteria include: currently pregnant, planning to become pregnant during the study period, and/or breast feeding; known hypersensitivity/allergy to hydroxychloroquine or to 4-aminoquinoline compounds; current use of hydroxychloroquine; known prolonged QT syndrome and/or baseline resting ECG with QTc>450 ms and/or concomitant medications which simultaneously may prolong the QTc that cannot be temporarily suspended/replaced; known pre-existing retinopathy, G6PD deficiency, porphyria, liver disease including cirrhosis, encephalopathy, hepatitis or alcoholism, diabetes on oral hypoglycemics or insulin, or renal insufficiency/failure; disclosure of self-administered use of hydroxychloroquine or chloroquine within 12 weeks prior to study; confirmed symptomatic COVID-19 at time of enrollment. INTERVENTION AND COMPARATOR Intervention: hydroxychloroquine, 400mg (2 tablets) orally per day. Comparator: placebo, two tablets visually identical to the intervention, orally per day MAIN OUTCOMES: The primary outcome is microbiologically confirmed COVID-19 (i.e. SARS-CoV-2 infection). This is a composite endpoint which includes positive results from any validated SARS-CoV-2 diagnostic assay including detection of viral RNA, and/or seroconversion. Participants will be assessed at baseline, and then undergo monthly follow-up at day 30, 60, and 90, 120. At each visit, participants will provide an oropharyngeal sample, blood sample, and will undergo electrocardiogram monitoring of the QTc interval. Secondary outcome measures include: adverse events; symptom duration of COVID-19; days of hospitalization attributed to COVID-19; respiratory failure requiring ventilator support attributed to COVID-19; mortality attributed to COVID-19; total days off work attributed to COVID-19; seropositivity (reactive serology by day 120); and short term psychological impact of exposure to SARS-CoV-2 at day 1, 60, 120 days using the K10, a validated measure of non-specific psychological distress. RANDOMISATION Within each site, participants will be individually randomized to either the intervention arm with HCQ or the placebo arm using a fixed 1:1 allocation ratio using an interactive web-based response system to ensure concealment of allocation. Randomization schedules will be computer-generated and blocked using variable block sizes. BLINDING (MASKING) All participants, research coordinators, technicians, clinicians and investigators will be blinded to the participant allocation group. Numbers to be randomised (sample size) N=988, randomised into two groups of 494 patients. TRIAL STATUS This summary describes protocol version No. 1.6, May 15, 2020. Recruitment is ongoing - started April 20, 2020 and anticipated end date is July 30, 2021 TRIAL REGISTRATION: ISRCTN.com Identifier: ISRCTN14326006, registered April 14, 2020. FULL PROTOCOL The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
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Affiliation(s)
- Julie K. Wright
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Eliot Phillipson Clinician Scientist Training Program, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario Canada
- Division of Infectious Diseases, Department of Medicine, University Health Network/Sinai Health System, Toronto, Ontario Canada
- Sandra Rotman Laboratories, Sandra Rotman Centre for Global Health, UHN-Toronto General Hospital, Toronto, Ontario Canada
| | - Darrell H. S. Tan
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
- Division of Infectious Diseases, Department of Medicine, St. Michael’s Hospital, Toronto, Ontario Canada
- MAP Centre for Urban Health Solutions, St Michaels Hospital, Toronto, Ontario Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario Canada
| | - Sharon L. Walmsley
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
- Immunodeficiency Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario Canada
| | - Jennifer Hulme
- Divisions of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario Canada
- Emergency Department, University Health Network, Toronto, Ontario Canada
| | - Erin O’Connor
- Emergency Department, University Health Network, Toronto, Ontario Canada
- Divisions of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Carolyn Snider
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario Canada
- Divisions of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Emergency Department, St. Michael’s Hospital, Toronto, Ontario Canada
| | - Ivy Cheng
- Divisions of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Emergency Department, Sunnybrook Health Sciences Centre, Toronto, Ontario Canada
| | - Adrienne K. Chan
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario Canada
| | - Bjug Borgundvaag
- Divisions of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario Canada
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario Canada
| | - Shelley McLeod
- Divisions of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario Canada
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario Canada
| | - Michael H. Gollob
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario Canada
| | - Rosemarie J. Clarke
- Immunodeficiency Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario Canada
| | - Linda Dresser
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario Canada
- Antimicrobial Stewardship Program, Sinai Health System/University Health Network, Toronto, Ontario Canada
| | - Fatima Haji
- Investigational Pharmacy Services, University Health Network, Toronto, Ontario Canada
| | - Tony Mazzulli
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario Canada
- Division of Infectious Diseases, Department of Medicine, University Health Network/Sinai Health System, Toronto, Ontario Canada
- Department of Microbiology, University Health Network / Sinai Health System, Toronto, Ontario Canada
| | - Samira Mubareka
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario Canada
| | - Peter Jüni
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
- Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Applied Health Research Centre (AHRC), St. Michael’s Hospital, Toronto, Ontario Canada
| | - Dominic Lee
- Applied Health Research Centre (AHRC), St. Michael’s Hospital, Toronto, Ontario Canada
| | - George Tomlinson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
- Department of Medicine, University Health Network, Toronto, Ontario Canada
| | - Kevin C. Kain
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario Canada
- Division of Infectious Diseases, Department of Medicine, University Health Network/Sinai Health System, Toronto, Ontario Canada
- Sandra Rotman Laboratories, Sandra Rotman Centre for Global Health, UHN-Toronto General Hospital, Toronto, Ontario Canada
| | - Megan Landes
- Divisions of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario Canada
- Emergency Department, University Health Network, Toronto, Ontario Canada
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Coleman E, O’Connor E. The role of WhatsApp® in medical education; a scoping review and instructional design model. BMC Med Educ 2019; 19:279. [PMID: 31345202 PMCID: PMC6659203 DOI: 10.1186/s12909-019-1706-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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: 05/27/2019] [Accepted: 07/11/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Technological advances have driven huge change in educational practices though concerns exist about a lack of evidence informing this change, in particular with social media-based medical education activities. The purpose of this study was to conduct a scoping review of WhatsApp use in medical education, narratively describing how it has been used and evaluated, and the theoretical considerations in relevant articles. METHODS A modified 5-stage scoping review model was used. We performed 2 searches from February 2009 to February 2019 in EBSCO, SCOPUS, Web of Science, EMBASE, Medline PubMed and Google Scholar) using the term "WhatsApp" in all search fields. A 3-stage process for study selection was performed. Only original articles in English presenting original data about WhatsApp in medical education were included. The Kirkpatrick model of training evaluation was used to describe learning outcomes in included studies. RESULTS Twenty-three articles were selected for review. Three strategies for WhatsApp use were apparent; primarily educational use with a pre-defined curriculum (n = 5), primarily educational use without a curriculum (n = 11), and primarily non-educational use (n = 7). Most of the educational studies used an online moderator and were in a local hospital or university department. Studies not primarily educational were national or international and seldom included an online moderator. All 5 studies with a pre-defined curriculum reported Kirkpatrick level 2 learner knowledge outcomes. A majority of the remaining studies only reported Kirkpatrick level 1 learner attitudes. Seven studies with 647 participants reported an improvement in learners' knowledge following WhatsApp learning, though methodological weaknesses were apparent. Evidence for underlying learning theory considerations were scant throughout the studies. CONCLUSIONS WhatsApp is popular and convenient in medical education. Current published literature suggests it may also be effective as a medical learning tool. By combining the 3 strategies for WhatsApp use and the exploration-enactment-assessment integrated learning design framework, we propose an instant messenger design model for medical education. This may address the need for theory-driven instructional design in social media learning. Further research would clarify the role of WhatsApp and our design model in this area.
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Affiliation(s)
- E. Coleman
- Department of Intensive Care and Anaesthesia, St James’s Hospital, Trinity College, Dublin 8, Dublin, Ireland
| | - E. O’Connor
- Department of Intensive Care and Anaesthesia, St James’s Hospital, Trinity College, Dublin 8, Dublin, Ireland
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Corry E, O’Connor E, Eogan M, Fitzpatrick M, O’Sullivan S, Imcha M. A Dedicated Perineal Clinic – An Audit in Support. Ir Med J 2019; 112:913. [PMID: 31241280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims To assess the quality of care in both the initial management of obstetric anal sphincter injury (OASI) and subsequent follow up postnatally in a tertiary maternity hospital without direct access to a perineal clinic. Methods Medical records were reviewed over a one-year period in University Maternity Hospital Limerick (UMHL) to determine the characteristics of patients sustaining OASI, how and where the repair was undertaken, the complications recorded and their follow up in the postpartum period. This pathway of care was compared with care currently available in three dedicated perineal clinics nationally. Results There were 44 patients with OASI recorded over a one-year period in UMHL. The majority were diagnosed in primiparous women having an operative vaginal delivery (OVD). Only 23 of 44 women had a documented review postnatally. Conclusion Audit of OASI is paramount to providing the best standard of care for affected women. It also aids clinician training and will be important in the establishment of a dedicated perineal clinic in UMHL.
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Affiliation(s)
- E Corry
- University Maternity Hospital Limerick, Ennis Road, Limerick
| | - E O’Connor
- University Maternity Hospital Limerick, Ennis Road, Limerick
| | - M Eogan
- The Rotunda Hospital, Parnell Square, Dublin 1
| | - M Fitzpatrick
- The National Maternity Hospital, Holles Street, Dublin 2
| | - S O’Sullivan
- Cork University Maternity Hospital, Wilton, Cork
| | - M Imcha
- University Maternity Hospital Limerick, Ennis Road, Limerick
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O’Connor E. Performative Rhetorics in Invisibility: Phoebe Philo's Undone Authorship. Australian Feminist Studies 2019. [DOI: 10.1080/08164649.2019.1567254] [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: 10/27/2022]
Affiliation(s)
- Erin O’Connor
- Moody College of Communication, University of Texas at Austin, Austin, TX, USA
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Suchy Y, Ziemnik R, Niermeyer M, Lopez S, Ray A, Heyrend R, O’Connor E, Nilssen A, Ocanovic Z. Executive Function - 3
Self-Reported Complexity of Daily Life Moderates the Association Between Executive Functioning and Daily Medication Management in Community Dwelling Older Adults. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy060.18] [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: 11/14/2022] Open
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Sullivan R, O’Connor E, Lynch D, Hanna M, Houlden H. Novel loss-of-function mutation in ACBD5 found in family with ataxia. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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O’Connor E, Phan V, Cairns G, Cordts I, Hettwer S, Roos A, Lochmuller H. Testing a novel therapy in a MYO9A-related Congenital Myasthenic Syndrome zebrafish model. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30371-7] [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: 10/17/2022]
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O’Connor E, Jackson R, Tran L, Lakshminarayanan B. WITHDRAWN: A late diagnosis of a complicated Meckel’s diverticulum - The first case of an enterocolic fistula secondary to a Meckel’s diverticulum in a paediatric patient and review of the literature. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.09.027] [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: 10/18/2022] Open
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O’Connor E, Cordts I, Roos A, Lochmüller H. Characterisation of MYO9A as a pre-synaptic CMS gene. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30318-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Moloney BM, Hynes DA, Kelly ME, Iqbal A, O’Connor E, Lowe D, McAnena OJ. The role of laparoscopic sleeve gastrectomy as a treatment for morbid obesity; review of outcomes. Ir J Med Sci 2016; 186:143-149. [DOI: 10.1007/s11845-016-1484-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 07/25/2016] [Indexed: 12/13/2022]
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Huang S, O’Connor E, Clark R, Lindup H, Macdougall I, Greenwood S. Reliability and validity of the five-repetition sit-to-stand test in adult kidney transplant recipients. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3429] [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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Koppenhaver S, Harris D, Harris A, O’Connor E, Dummar M, Croy T, Walker M, Flynn T. The reliability of rehabilitative ultrasound imaging in the measurement of infraspinatus muscle function in the symptomatic and asymptomatic shoulders of patients with unilateral shoulder impingement syndrome. Int J Sports Phys Ther 2015; 10:128-135. [PMID: 25883861 PMCID: PMC4387720] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Rehabilitative ultrasound Imaging (RUSI) is increasingly used in the management of musculoskeletal conditions as it provides an objective measure of muscle function while being less invasive than needle electromyography. While research has documented the ability to reliably measure trunk muscles in patients with back pain, no study to date has used RUSI to quantify infraspinatus muscle function in patients with shoulder impingement syndrome (SIS). HYPOTHESIS/PURPOSE The purpose of this study was to examine the intra-rater and inter-rater reliability of measuring infraspinatus muscle thickness with RUSI and to compare such measures during resting versus contracted muscle states and in the symptomatic versus asymptomatic shoulders in patients with SIS. STUDY DESIGN Cross-sectional, measurement study. METHODS Fifty-two participants with unilateral SIS underwent a standard baseline examination to include RUSI of the infraspinatus muscle bilaterally. Images were acquired at rest and during a submaximal isometric contraction, by two novice examiners. The isometric contraction was elicited by having prone participants externally rotate their shoulder from a position of 90° abduction into a dynamometer and hold a static force of 20 mmHg (approximately 20-30% maximal voluntary contraction). Images were captured using a standardized placement of the transducer placed just inferior to the spine of the scapula along the medial scapular border and measured off-line using Image J software (V1.38t, National Institutes of Health, Bethesda, Maryland). RESULTS Estimates (ICCs) for thickness measurements ranged between 0.96 and 0.98 for intra-rater reliability and between 0.87 and 0.92 for inter-rater reliability. Reliability was substantially lower (ICC = 0.43 to 0.79) for calculations of percent thickness change. The infraspinatus muscle was significantly thicker when contracted (19.1mm) than during rest (16.2mm) in both shoulders (p < 0.001). There was also a statistically significant interaction between contraction state and shoulder (p = 0.026), indicating that the change in thickness that occurred during contraction was significantly smaller in the symptomatic shoulder than in the asymptomatic shoulder. CONCLUSION RUSI measurements of infraspinatus muscle thickness appear to be highly reliable, both within the same examiner and between different examiners, in patients with SIS. Moreover, such measurements were different in rested and contracted states of the infraspinatus, as well as, between the symptomatic and asymptomatic shoulders of patients with unilateral SIS. LEVEL OF EVIDENCE Level 2.
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Affiliation(s)
- Shane Koppenhaver
- U.S. Army‐Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Danny Harris
- Physical Therapy Student During Study, U.S. Army‐Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Amanda Harris
- Physical Therapy Student During Study, U.S. Army‐Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Erin O’Connor
- Physical Therapy Student During Study, U.S. Army‐Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Max Dummar
- Physical Therapy Student During Study, U.S. Army‐Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Theodore Croy
- U.S. Army‐Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Michael Walker
- South College Doctor of Physical Therapy Program, Knoxville, TN, USA
| | - Tim Flynn
- South College Doctor of Physical Therapy Program, Knoxville, TN, USA
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Jamal A, Agaku IT, O’Connor E, King BA, Kenemer JB, Neff L. Current cigarette smoking among adults--United States, 2005-2013. MMWR Morb Mortal Wkly Rep 2014; 63:1108-12. [PMID: 25426653 PMCID: PMC5779518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tobacco use is the leading cause of preventable disease and death in the United States, resulting in more than 480,000 premature deaths and $289 billion in direct health care expenditures and productivity losses each year. Despite progress over the past several decades, millions of adults still smoke cigarettes, the most commonly used tobacco product in the United States. To assess progress made toward the Healthy People 2020 target of reducing the proportion of U.S. adults who smoke cigarettes to ≤12.0% (objective TU-1.1), CDC used data from the 2013 National Health Interview Survey (NHIS) to provide updated national estimates of cigarette smoking prevalence among adults aged ≥18 years. Additionally, for the first time, estimates of cigarette smoking prevalence were assessed among lesbian, gay, or bisexual persons (LGB) using NHIS data. The proportion of U.S. adults who smoke cigarettes declined from 20.9% in 2005 to 17.8% in 2013, and the proportion of daily smokers declined from 16.9% to 13.7%. Among daily cigarette smokers, the proportion who smoked 20-29 cigarettes per day (CPD) declined from 34.9% to 29.3%, and the proportion who smoked ≥30 CPD declined from 12.7% to 7.1%. However, cigarette smoking remains particularly high among certain groups, including adults who are male, younger, multiracial or American Indian/Alaska Native, have less education, live below the federal poverty level, live in the South or Midwest, have a disability/limitation, or who are LGB. Proven population-based interventions, including tobacco price increases, comprehensive smoke-free policies in worksites and public places, high-impact anti-tobacco mass media campaigns, and easy access to smoking cessation assistance, are critical to reducing cigarette smoking and smoking-related disease and death among U.S. adults, particularly among subpopulations with the greatest burden.
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Affiliation(s)
- Ahmed Jamal
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC,Corresponding author: Ahmed Jamal, , 770-488-5077
| | - Israel T. Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Erin O’Connor
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Brian A. King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - John B. Kenemer
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Linda Neff
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Auricchio A, O’Connor E, Weiner D, Gao GP, Hildinger M, Wang L, Calcedo R, Wilson JM. Noninvasive gene transfer to the lung for systemic delivery of therapeutic proteins. J Clin Invest 2002. [DOI: 10.1172/jci0215780] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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O’Byrne P, Collins P, Johnson A, Ledwith M, Lane B, Bouchier-Hayes D, MacMathuna P, O’Reilly T, Barry M, Duanes-Laita A, Feely J, Keeling PWN, Cotter P, Burke G, Waldron R, Zinner MJ, Jaffe BM, Givan F, Keye G, Byrne P, O’Brien M, O’Farrelly C, Stevens F, McCarthy C, Feighery C, Weir DG, Hannigan MC, Stevens FM, McCarthy CF, Fottrell PF, O’Connor MP, Kennedy NP, Courtney MG, Kelleher D, Weir DW, Senapati A, Kitler ME, Thompson RPH, O’Shea B, Madigan D, Keeling P, Hennessy TPJ, Meenan JJ, Gaffney EF, Duigan JP, Johnson AH, Collins PB, Healy MV, Skehill R, Grimes H, O’Farrelly C, Kelly J, Rees R, Hoey H, Humphreys H, Dooley C, O’Leary D, Bourke S, McKenna D, Power B, Keane C, Sweeney E, O’Morain CA, Afdhal NH, McCormick A, O’Donoghue DP, Quigley EMM, Turnberg LA, Moorehead RJ, Hoper M, McKelvey STD, Tobbia I, Rafferty R, Gillen P, Stuart R, Dawson K, Collins JSA, McKnigh JA, Pyper PC, Love AHG, Dillon ME, O’Connor E, Keeling PWN, Broe PJ, Harte PI, Keane T, Garstin WIH, Buchanan KD, Walsh JP, Bloomfield FJ, Maxwell WJ, Hogan FP, O’Malley VP, Postier RG, Lombard M, Craven C, Spencer S, Crowe J, Quinn F, Templeton JL, Tobin MV, Hughes S, Gilmore IT, Keane RM, Johnson AB, Duenas-Laita A, Younger K, O’Brien T, Cotter J, Cullinane T, Whelton MJ, Waldron D, Bowes K, Given HF, Gawley WF, Gorey TF, Osborne DH, Lane BE, Collins PG, Boston VE, O’Mahony C. Irish society of gastroenterology. Ir J Med Sci 1986. [DOI: 10.1007/bf02962975] [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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