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AbuOun M, O'Connor HM, Stubberfield EJ, Nunez-Garcia J, Sayers E, Crook DW, Smith RP, Anjum MF. Corrigendum: Characterizing Antimicrobial Resistant Escherichia coli and Associated Risk Factors in a Cross-Sectional Study of Pig Farms in Great Britain. Front Microbiol 2021; 12:693940. [PMID: 34122397 PMCID: PMC8194817 DOI: 10.3389/fmicb.2021.693940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Manal AbuOun
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom.,National Institute for Health Research, Health Protection Research Unit, University of Oxford in Partnership With Public Health England (PHE), Oxford, United Kingdom
| | - Heather M O'Connor
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Emma J Stubberfield
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Javier Nunez-Garcia
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Ellie Sayers
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Derick W Crook
- National Institute for Health Research, Health Protection Research Unit, University of Oxford in Partnership With Public Health England (PHE), Oxford, United Kingdom.,Modernising Medical Microbiology Consortium, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Richard P Smith
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Muna F Anjum
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom.,National Institute for Health Research, Health Protection Research Unit, University of Oxford in Partnership With Public Health England (PHE), Oxford, United Kingdom
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AbuOun M, O'Connor HM, Stubberfield EJ, Nunez-Garcia J, Sayers E, Crook DW, Smith RP, Anjum MF. Characterizing Antimicrobial Resistant Escherichia coli and Associated Risk Factors in a Cross-Sectional Study of Pig Farms in Great Britain. Front Microbiol 2020; 11:861. [PMID: 32523560 PMCID: PMC7261845 DOI: 10.3389/fmicb.2020.00861] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 05/15/2019] [Accepted: 04/09/2020] [Indexed: 12/18/2022] Open
Abstract
Combatting antimicrobial resistant (AMR) using a One-Health approach is essential as various bacteria, including Escherichia coli, a common bacteria, are becoming increasingly resistant and livestock may be a reservoir. The AMR gene content of 492 E. coli, isolated from 56 pig farms across Great Britain in 2014–2015, and purified on antibiotic selective and non-selective plates, was determined using whole genome sequencing (WGS). The E. coli were phylogenetically diverse harboring a variety of AMR profiles with widespread resistance to “old” antibiotics; isolates harbored up to seven plasmid Inc-types. None showed concurrent resistance to third-generation cephalosporins, fluoroquinolones and clinically relevant aminoglycosides, although ∼3% harbored AMR genes to both the former two. Transferable resistance to carbapenem and colistin were absent, and six of 117 E. coli STs belonged to major types associated with human disease. Prevalence of genotypically MDR E. coli, gathered from non-selective media was 35% and that of extended-spectrum-beta-lactamase E. coli was low (∼2% from non-selective). Approximately 72.6% of E. coli from ciprofloxacin plates and only 8.5% from the other plates harbored fluoroquinolone resistance due to topoisomerase mutations; the majority were MDR. In fact, multivariable analysis confirmed E. coli purified from CIP enrichment plates were more likely to be MDR, and suggested MDR isolates were also more probable from farms with high antibiotic usage, specialist finisher farms, and farms emptying their manure pits only after each batch. Additionally, farms from the South East were more likely to have MDR E. coli, whereas farms in Yorkshire and the Humber were less likely. Future investigations will determine whether suggested improvements such as better biosecurity or lower antimicrobial use decreases MDR E. coli on pig farms. Although this study focuses on pig farms, we believe the methodology and findings can be applied more widely to help livestock farmers in the United Kingdom and elsewhere to tackle AMR.
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Affiliation(s)
- Manal AbuOun
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom.,National Institute for Health Research, Health Protection Research Unit, University of Oxford in Partnership with Public Health England (PHE), Oxford, United Kingdom
| | - Heather M O'Connor
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Emma J Stubberfield
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Javier Nunez-Garcia
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Ellie Sayers
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Derick W Crook
- National Institute for Health Research, Health Protection Research Unit, University of Oxford in Partnership with Public Health England (PHE), Oxford, United Kingdom.,Modernising Medical Microbiology Consortium, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Richard P Smith
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Muna F Anjum
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom.,National Institute for Health Research, Health Protection Research Unit, University of Oxford in Partnership with Public Health England (PHE), Oxford, United Kingdom
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O'Connor HM, Zimmer KA, Elston DM, Forcucci JA. Tender white lesions on the groin. Cutis 2020; 105:E28-E30. [PMID: 32463860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Heather M O'Connor
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, USA
| | - Katelyn Anderson Zimmer
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, USA
| | - Dirk M Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, USA
| | - Jessica A Forcucci
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, USA
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Stubberfield E, AbuOun M, Sayers E, O'Connor HM, Card RM, Anjum MF. Use of whole genome sequencing of commensal Escherichia coli in pigs for antimicrobial resistance surveillance, United Kingdom, 2018. Euro Surveill 2019; 24:1900136. [PMID: 31847943 PMCID: PMC6918588 DOI: 10.2807/1560-7917.es.2019.24.50.1900136] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 08/01/2019] [Indexed: 12/19/2022] Open
Abstract
BackgroundSurveillance of commensal Escherichia coli, a possible reservoir of antimicrobial resistance (AMR) genes, is important as they pose a risk to human and animal health. Most surveillance activities rely on phenotypic characterisation, but whole genome sequencing (WGS) presents an alternative.AimIn this retrospective study, we tested 515 E. coli isolated from pigs to evaluate the use of WGS to predict resistance phenotype.MethodsMinimum inhibitory concentration (MIC) was determined for nine antimicrobials of clinical and veterinary importance. Deviation from wild-type, fully-susceptible MIC was assessed using European Committee on Antimicrobial Susceptibility Testing (EUCAST) epidemiological cut-off (ECOFF) values. Presence of AMR genes and mutations were determined using APHA SeqFinder. Statistical two-by-two table analysis and Cohen's kappa (k) test were applied to assess genotype and phenotype concordance.ResultsOverall, correlation of WGS with susceptibility to the nine antimicrobials was 98.9% for test specificity, and 97.5% for the positive predictive value of a test. The overall kappa score (k = 0.914) indicated AMR gene presence was highly predictive of reduced susceptibility and showed excellent correlation with MIC. However, there was variation for each antimicrobial; five showed excellent correlation; four very good and one moderate. Suggested ECOFF adjustments increased concordance between genotypic data and kappa values for four antimicrobials.ConclusionWGS is a powerful tool for accurately predicting AMR that can be used for national surveillance purposes. Additionally, it can detect resistance genes from a wider panel of antimicrobials whose phenotypes are currently not monitored but may be of importance in the future.
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Affiliation(s)
- Emma Stubberfield
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, United Kingdom
| | - Manal AbuOun
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, United Kingdom
| | - Ellie Sayers
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, United Kingdom
- University of East Anglia/Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
| | - Heather M O'Connor
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge, Surrey, United Kingdom
| | - Roderick M Card
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, United Kingdom
| | - Muna F Anjum
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, United Kingdom
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5
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Keene DJ, Alsousou J, Harrison P, Hulley P, Wagland S, Parsons SR, Thompson JY, O'Connor HM, Schlüssel MM, Dutton SJ, Lamb SE, Willett K. Platelet rich plasma injection for acute Achilles tendon rupture: PATH-2 randomised, placebo controlled, superiority trial. BMJ 2019; 367:l6132. [PMID: 31748208 PMCID: PMC6863552 DOI: 10.1136/bmj.l6132] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine whether an injection of platelet rich plasma improves outcomes after acute Achilles tendon rupture. DESIGN Randomised, placebo controlled, two arm, parallel group, participant and assessor masked, superiority trial. SETTING Secondary care trauma units across 19 hospitals in the United Kingdom's health service. PARTICIPANTS Recruitment commenced in July 2015 and follow-up was completed in March 2018. 230 adults aged 18 years and over were included, with acute Achilles tendon rupture presenting within 12 days of injury and managed with non-surgical treatment. Exclusions were injury at the insertion or musculotendinous junction, major leg injury or deformity, diabetes mellitus, platelet or haematological disorder, systemic corticosteroids, anticoagulation treatment, and other contraindicating conditions. INTERVENTIONS Participants were randomised 1:1 to platelet rich plasma (n=114) or placebo (dry needle; n=116) injection. All participants received standard rehabilitation care (ankle immobilisation followed by physiotherapy). MAIN OUTCOMES AND MEASURES Primary outcome was muscle tendon function at 24 weeks, measured objectively with the limb symmetry index (injured/uninjured×100) in maximal work done during the heel rise endurance test (an instrumented measure of repeated single leg heel rises until fatigue). Secondary outcomes included patient reported function (Achilles tendon rupture score), quality of life (short form 12 version 2®), pain (visual analogue scale), goal attainment (patient specific functional scale), and adverse events. A central laboratory analysed the quality and content of platelet rich plasma. Analyses were by modified intention to treat. RESULTS Participants were 46 years old on average, and 57 (25%) of 230 were female. At 24 weeks, 202 (88%) participants completed the heel rise endurance test and 216 (94%) the patient reported outcomes. The platelet rich plasma was of good quality, with expected growth factor content. No difference was detected in muscle tendon function between participants receiving platelet rich plasma injections and those receiving placebo injections (limb symmetry index, mean 34.7% (standard deviation 17.7%) v 38.5% (22.8%); adjusted mean difference -3.9% (95% confidence interval -10.5% to 2.7%)) or in any secondary outcomes or adverse event rates. Complier average causal effect analyses gave similar findings. CONCLUSIONS There is no evidence to indicate that injections of platelet rich plasma can improve objective muscle tendon function, patient reported function, or quality of life after acute Achilles tendon rupture compared with placebo, or that they offer any patient benefit. TRIAL REGISTRATION ISRCTN54992179.
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Affiliation(s)
- David J Keene
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Joseph Alsousou
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Paul Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Philippa Hulley
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan Wagland
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Scott R Parsons
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jacqueline Y Thompson
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Heather M O'Connor
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Michael Maia Schlüssel
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan J Dutton
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Keith Willett
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Collins NG, O'Connor HM, Lindsey KG. Erythrophagocytosis by leukemic blasts in acute myeloid leukemia with a normal karyotype and no detectable mutations. Proc (Bayl Univ Med Cent) 2019; 33:65-66. [PMID: 32063774 DOI: 10.1080/08998280.2019.1674051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022] Open
Abstract
The phagocytosis of erythrocytes by leukemic blasts is a rare finding in acute myeloid leukemia and has been reported most commonly in monocytic and megakaryocytic morphologies. In the reported cases, erythrophagocytosis by leukemic blasts has been associated with t(8;16). This translocation is associated with a poor outcome independent of erythrophagocytosis. There has only been one reported case of erythrophagocytosis by leukemic blasts occurring in a patient with a normal karyotype. We report a 62-year-old woman with acute myeloid leukemia with monocytic features and a normal karyotype noted to have erythrophagocytosis by leukemic blasts.
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Affiliation(s)
- N Grant Collins
- Department of Pathology and Laboratory Medicine, Medical University of South CarolinaCharlestonSouth Carolina
| | - Heather M O'Connor
- Department of Pathology and Laboratory Medicine, Medical University of South CarolinaCharlestonSouth Carolina
| | - Kathryn G Lindsey
- Department of Pathology and Laboratory Medicine, Medical University of South CarolinaCharlestonSouth Carolina
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O'Connor HM, Wu Q, Lauzon SD, Forcucci JA. Diffuse dermal angiomatosis associated with calciphylaxis: A 5‐year retrospective institutional review. J Cutan Pathol 2019; 47:27-30. [DOI: 10.1111/cup.13585] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/03/2019] [Accepted: 09/27/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Heather M. O'Connor
- Department of Pathology and Laboratory MedicineMedical University of South Carolina Charleston South Carolina
| | - Qiong Wu
- Department of Dermatology, Renji Hospital, School of MedicineShanghai Jiao Tong University Shanghai China
- Department of Dermatology and Dermatologic SurgeryMedical University of South Carolina Charleston South Carolina
| | - Steven D. Lauzon
- Department of Public Health SciencesMedical University of South Carolina Charleston South Carolina
| | - Jessica A. Forcucci
- Department of Pathology and Laboratory MedicineMedical University of South Carolina Charleston South Carolina
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Wu Q, O'Connor HM, Elston DM. Retrospective analysis of Verhoeff-Van Gieson elastic staining, diffractive microscopy, and Masson trichrome staining in the diagnosis of alopecia. J Am Acad Dermatol 2019; 82:247-249. [PMID: 31442539 DOI: 10.1016/j.jaad.2019.08.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Qiong Wu
- Department of Dermatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
| | - Heather M O'Connor
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Dirk M Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
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Sanz S, O'Connor HM, Martí-Centelles V, Comar P, Pitak MB, Coles SJ, Lorusso G, Palacios E, Evangelisti M, Baldansuren A, Chilton NF, Weihe H, McInnes EJL, Lusby PJ, Piligkos S, Brechin EK. [MIII2MII3] n+ trigonal bipyramidal cages based on diamagnetic and paramagnetic metalloligands. Chem Sci 2017; 8:5526-5535. [PMID: 28970932 PMCID: PMC5618769 DOI: 10.1039/c7sc00487g] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 02/01/2017] [Accepted: 05/18/2017] [Indexed: 11/24/2022] Open
Abstract
A family of five [MIII2MII3] n+ trigonal bipyramidal cages (MIII = Fe, Cr and Al; MII = Co, Zn and Pd; n = 0 for 1-3 and n = 6 for 4-5) of formulae [Fe2Co3L6Cl6] (1), [Fe2Zn3L6Br6] (2), [Cr2Zn3L6Br6] (3), [Cr2Pd3L6(dppp)3](OTf)6 (4) and [Al2Pd3L6(dppp)3](OTf)6 (5) (where HL is 1-(4-pyridyl)butane-1,3-dione and dppp is 1,3-bis(diphenylphosphino)propane) are reported. Neutral cages 1-3 were synthesised using the tritopic [MIIIL3] metalloligand in combination with the salts CoIICl2 and ZnIIBr2, which both act as tetrahedral linkers. The assembly of the cis-protected [PdII(dppp)(OTf)2] with [MIIIL3] afforded the anionic cages 4-5 of general formula [MIII2PdII3](OTf)6. The metallic skeleton of all cages describes a trigonal bipyramid with the MIII ions occupying the two axial sites and the MII ions sitting in the three equatorial positions. Direct current (DC) magnetic susceptibility, magnetisation and heat capacity measurements on 1 reveal weak antiferromagnetic exchange between the FeIII and CoII ions. EPR spectroscopy demonstrates that the distortion imposed on the {MO6} coordination sphere of [MIIIL3] by complexation in the {MIII2MII3} supramolecules results in a small, but measurable, increase of the zero field splitting at MIII. Complete active space self-consistent field (CASSCF) calculations on the three unique CoII sites of 1 suggest DCo ≈ -14 cm-1 and E/D ≈ 0.1, consistent with the magnetothermal and spectroscopic data.
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Affiliation(s)
- S Sanz
- EaStCHEM School of Chemistry , The University of Edinburgh , David Brewster Road , Edinburgh , EH9 3FJ , UK . ; ;
| | - H M O'Connor
- EaStCHEM School of Chemistry , The University of Edinburgh , David Brewster Road , Edinburgh , EH9 3FJ , UK . ; ;
| | - V Martí-Centelles
- EaStCHEM School of Chemistry , The University of Edinburgh , David Brewster Road , Edinburgh , EH9 3FJ , UK . ; ;
| | - P Comar
- EaStCHEM School of Chemistry , The University of Edinburgh , David Brewster Road , Edinburgh , EH9 3FJ , UK . ; ;
| | - M B Pitak
- UK National Crystallography Service , Chemistry , University of Southampton , Highfield Campus , Southampton , SO17 1BJ , UK
| | - S J Coles
- UK National Crystallography Service , Chemistry , University of Southampton , Highfield Campus , Southampton , SO17 1BJ , UK
| | - G Lorusso
- Instituto de Ciencia de Materiales de Aragón (ICMA) , CSIC - Universidad de Zaragoza , Departamento de Física de la Materia Condensada , 50009 Zaragoza , Spain
| | - E Palacios
- Instituto de Ciencia de Materiales de Aragón (ICMA) , CSIC - Universidad de Zaragoza , Departamento de Física de la Materia Condensada , 50009 Zaragoza , Spain
| | - M Evangelisti
- Instituto de Ciencia de Materiales de Aragón (ICMA) , CSIC - Universidad de Zaragoza , Departamento de Física de la Materia Condensada , 50009 Zaragoza , Spain
| | - A Baldansuren
- School of Chemistry , The University of Manchester , Oxford Road , Manchester , M13 9PL , UK .
| | - N F Chilton
- School of Chemistry , The University of Manchester , Oxford Road , Manchester , M13 9PL , UK .
| | - H Weihe
- Department of Chemistry , University of Copenhagen , Universitetsparken 5 , DK-2100 , Copenhagen , Denmark .
| | - E J L McInnes
- School of Chemistry , The University of Manchester , Oxford Road , Manchester , M13 9PL , UK .
| | - P J Lusby
- EaStCHEM School of Chemistry , The University of Edinburgh , David Brewster Road , Edinburgh , EH9 3FJ , UK . ; ;
| | - S Piligkos
- Department of Chemistry , University of Copenhagen , Universitetsparken 5 , DK-2100 , Copenhagen , Denmark .
| | - E K Brechin
- EaStCHEM School of Chemistry , The University of Edinburgh , David Brewster Road , Edinburgh , EH9 3FJ , UK . ; ;
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Brennan ML, Wright N, Wapenaar W, Jarratt S, Hobson-West P, Richens IF, Kaler J, Buchanan H, Huxley JN, O'Connor HM. Exploring Attitudes and Beliefs towards Implementing Cattle Disease Prevention and Control Measures: A Qualitative Study with Dairy Farmers in Great Britain. Animals (Basel) 2016; 6:ani6100061. [PMID: 27727168 PMCID: PMC5082307 DOI: 10.3390/ani6100061] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [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: 05/05/2016] [Revised: 08/31/2016] [Accepted: 09/19/2016] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Further understanding of why dairy farmers do not engage in disease prevention and control strategies (biosecurity) is required. Using semi-structured interviews informed by a health psychology approach with 25 dairy farmers, a number of barriers, such as disease testing inaccuracies, types of disease transmission, perceived lack of risk and effectiveness of measures, were identified. Motivators included being advised to undertake measures by veterinarians, and the increased threat and severity of the disease in focus. These results suggest there is an advantage to farm advisors and herd health professionals understanding and working with the beliefs of individual dairy farmers to target appropriate communication and advice strategies relating to biosecurity recommendations. Abstract Disease prevention and control practices are frequently highlighted as important to ensure the health and welfare of farmed animals, although little is known as to why not many practices are carried out. The aim of this study was to identify the motivators and barriers of dairy cattle farmers towards the use of biosecurity measures on dairy farms using a health psychology approach. Twenty-five farmers on 24 farms in Great Britain (GB) were interviewed using the Theory of Planned Behaviour framework. Results indicated that farmers perceived they had the ability to control what happened on their farms in terms of preventing and controlling disease, and described benefits from being proactive and vigilant. However, barriers were cited in relation to testing inaccuracies, effectiveness and time-efficiency of practices, and disease transmission route (e.g., airborne transmission). Farmers reported they were positively influenced by veterinarians and negatively influenced by the government (Department for Environment Food & Rural Affairs (DEFRA)) and the general public. Decisions to implement practices were influenced by the perceived severity of the disease in question, if disease was diagnosed on the farm already, or was occurring on other farms. Farmers described undertaking a form of personal risk assessment when deciding if practices were worth doing, which did not always involve building in disease specific factors or opinions from veterinarians or other advisors. These results indicate that further guidance about the intricacies of control and prevention principles in relation to specific animal diseases may be required, with an obvious role for veterinarians. There appears to be an opportunity for farm advisors and herd health professionals to further understand farmer beliefs behind certain attitudes and target communication and advice accordingly to further enhance dairy cattle health and welfare.
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Affiliation(s)
- Marnie L Brennan
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Nick Wright
- The University of Nottingham, University Park Campus, Nottingham NG7 2RD, UK.
| | - Wendela Wapenaar
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Susanne Jarratt
- The University of Nottingham, University Park Campus, Nottingham NG7 2RD, UK.
| | - Pru Hobson-West
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Imogen F Richens
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Jasmeet Kaler
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Heather Buchanan
- Queen's Medical Centre, The University of Nottingham, Nottingham NG7 2UH, UK.
| | - Jonathan N Huxley
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Heather M O'Connor
- School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
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Abstract
OBJECTIVES Facing dramatic reductions of inpatient beds and fewer faculty tutors, the Queen's University medical school has had to consider alternatives to the traditional inpatient encounter for the early acquisition of clinical skills. The purpose of this study was to investigate the feasibility and impact on students of a model for a first-year clinical skills course, using exclusively standardized patients in place of inpatients, and using a smaller ratio of faculty to students. DESIGN Twenty volunteers were selected from the first-year class of 75 students to participate as the experimental group. The remaining 55 students formed the control group. SETTING Queen's University medical school, Ontario, Canada. SUBJECTS First-year medical students. RESULTS In measures of student satisfaction with the amount of performance feedback received during the course, there was a non-significant trend towards greater satisfaction among the experimental group compared to the control group. This occurred despite a tutor to student ratio of 1.5:10 in the experimental group compared to 3:10 in the control group. In the student evaluation of their tutors, mean scores for the two groups were 4.28 for the experimental group and 4. 06 for the control group (P = 0.10). The mean OSCE scores for the two groups were 76.4 for the experimental group and 76.5 for the control group (P = 0.93). There is no practical or statistical difference in either of these two scores. CONCLUSIONS We conclude that this new model is feasible, was well received by the students and that the reduced tutor to student ratio and lack of inpatient encounters did not appear to adversely affect their learning.
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Affiliation(s)
- R C McGraw
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
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Abstract
Computer simulation is a recognized decision support tool, one which has been used in many healthcare applications. Simulation offers the benefit of constructing and analyzing multiple "what if" scenarios without disrupting patient care or incurring significant cost. This article describes the successful use of computer simulation in the evaluation of multiple restructuring options in the emergency departments of a health sciences centre. Healthcare executives require timely and meaningful information to assist with strategic choices, and computer simulation can play a significant role in decision support.
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Affiliation(s)
- M I Edmonds
- Joint Planning Office, Kingston General Hospital-Providence Continuing Care, Ontario
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13
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Abstract
The purpose of this study was to develop objective assessment instruments for use in psychomotor skill training and to test the instruments for interobserver reliability. Two checklist style instruments, one for suturing and one for endotracheal intubation, were developed through a process of review of standard texts, consultation with local experts and field testing. Following development they were used by paired examiners in an Objective Structured Clinical Examination (OSCE) setting to test the instruments for interobserver reliability. A total of 88 final year medical students were recruited from the five Ontario medical schools to participate as examinees. The checklists worked well within the practical constraints of a 10 minute OSCE station and demonstrated a high level of interobserver reliability with Kappa scores of 0.65 for the suturing checklist and 0.71 for the intubation checklist Furthermore, the Kappa scores for individual checklist items served to identify items which demonstrated poor interobserver reliability and thus highlighted them for review.
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Affiliation(s)
- H M O'Connor
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
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14
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Abstract
BACKGROUND A major obstacle in the wide implementation of objective clinical structured examinations (OSCEs) is their high cost, averaging $200 to $300 (Canadian dollars, CDN) per candidate and estimated at up to CDN$900 per candidate if all "hidden" administrative costs are included. METHODS A detailed cost analysis of preparing and administering OSCEs at 1 institution was undertaken over 2 years. An 18-station, 6-minute-per-station OSCE was given to a 72-student third-year medical class. RESULTS The total cost of the OSCE was CDN$5,010, or $70 per student. The key factors in reaching this significantly lower per-student OSCE cost included: judicious use of standardized patients, use of academic faculty for preparing and marking the stations, and decreased secretarial and other administrative costs. CONCLUSIONS Data suggest that OSCEs can be set up with reasonable cost and limited resources even in smaller institutions. Cost should not be considered a major obstacle in implementing this excellent examination type in undergraduate medical education.
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Affiliation(s)
- D Poenaru
- Department of Surgery, Faculty of Medicine, Queen's University, Kingston, Ontario
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15
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O'Connor HM, Davidson JR. Emergency Medicine Skills: Are primary care physicians adequately prepared? Can Fam Physician 1992; 38:1789-1793. [PMID: 21221310 PMCID: PMC2145739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Family physicians who completed postgraduate training at one center were asked to identify important patient management and procedural skills in emergency medicine and to indicate their perceived competence, both at the completion of training and in their current practice setting. There were several important skills in which many respondents did not feel several important skills in which many respondents did not feel competent, suggesting a need to reevaluate educational opportunities.
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16
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Brison RJ, Davidson JR, Dreyer JF, Jones G, Maloney J, Munkley DP, O'Connor HM, Rowe BH. Cardiac arrest in Ontario: circumstances, community response, role of prehospital defibrillation and predictors of survival. CMAJ 1992; 147:191-9. [PMID: 1623465 PMCID: PMC1336161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To describe the patient characteristics, circumstances and community response in cases of out-of-hospital cardiac arrest; to evaluate the effect on survival of the introduction of prehospital defibrillation; and to identify factors that predict survival. DESIGN Population-based before-and-after clinical trial. SETTING Five Ontario communities: London, Sudbury, the Greater Niagara region, Kingston and Ottawa. PATIENTS A consecutive sample of 1510 primary cardiac arrest patients who were transported to hospital by ambulance over 2 years. INTERVENTION The use of defibrillators by ambulance attendants. MAIN OUTCOME MEASURES Patient characteristics (sex and age), circumstances of arrest (place, whether arrest was witnessed and cardiac rhythm), citizen response (whether cardiopulmonary resuscitation [CPR] was started by a bystander, time to access to emergency medical services and time to initiation of CPR), emergency medical services response (ambulance response time, time to initiation of CPR and time to rhythm analysis with defibrillator) and survival rates. MAIN RESULTS A total of 92.1% of the patients were 50 years of age or older, and 68.3% were men. Overall, 79.6% of the arrests occurred in the home. The average ambulance response time for witnessed cases was 7.8 minutes. The overall survival rate was 2.5%. The survival rates before and after defibrillators were introduced were similar, and the general functional outcome of the survivors did not differ significantly between the two phases. Factors predicting survival included patient's age, ambulance response time and whether CPR was started before the ambulance arrived. CONCLUSIONS The survival rate was lower than expected. The availability of prehospital defibrillation did not affect survival. To improve survival rates after cardiac arrest ambulance response times must be reduced and the frequency of bystander-initiated CPR increased. Once these changes are in place a beneficial effect from advanced manoeuvres such as prehospital defibrillation may be seen.
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Affiliation(s)
- R J Brison
- Division of Emergency Medicine, Queen's University, Kingston, ON
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17
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Vandersluis R, O'Connor HM. The seat-belt syndrome. CMAJ 1987; 137:1023-4. [PMID: 3676947 PMCID: PMC1267426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- R Vandersluis
- Department of Surgery, Queen's University, Kingston, Ont
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18
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Abstract
We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of intramuscular parenteral chlorpromazine (CPZ) in the treatment of the acute migraine attack. Thirty-six patients who presented to the emergency department with migraine headache were given either CPZ (1 mg/kg) or a saline placebo and were observed for one hour. Of those receiving CPZ, nine of 19 (47.4%) had sufficient relief from their headache to carry on with their activities of daily living, compared with four of 17 (23.5%) of the control group. This difference was not statistically significant. However, the drug was more often effective than a placebo in giving some relief from the headache (P less than .005) and in relieving nausea significantly more often than placebo (P less than .001). The only significant side effects were drowsiness (P less than .01), and an asymptomatic drop in blood pressure (10 mm Hg systolic) (P less than .05). This controlled study demonstrates that CPZ is a safe medication that provides some relief from migraine headaches, but it is less efficacious than suggested in earlier reports.
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O'Connor HM, Stringer DG. Review of traumatic injuries in regional federal penitentiaries. Can Med Assoc J 1985; 133:204-5. [PMID: 4016624 PMCID: PMC1346149] [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: 01/08/2023]
Abstract
The incidence of major injuries in inmates of Canadian prisons has steadily increased in recent years. The medical records of the emergency department serving virtually all prisoners at federal penitentiaries in the Kingston, Ont. area were reviewed for cases of traumatic injury. In the 30-month period ending Mar. 1, 1984 there were 353 visits to the emergency department, of which 140 were for accidental injuries and 213 for injuries resulting from violence. Of the injuries caused by violence 75 (35%) were self-inflicted and 138 (65%) were inflicted by others. Of the 75 inmates with self-inflicted injuries 17 required admission to hospital, and 12 of these underwent surgery. Of the 138 inmates injured by others 50 were admitted to hospital, and 6 of these were transferred to the neurosurgical or cardiothoracic department at Kingston General Hospital; 31 of the 50 underwent surgery, and 4 died in hospital as a result of their injuries.
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O'Connor HM, Masley KA, Riffin J. Preventive nutrition in the nursing curriculum? J Pract Nurs 1977; 27:31-3. [PMID: 587163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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