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Murgia MV, Sharan S, Kaur J, Austin W, Hagen L, Wu L, Chen L, Scott JA, Flaherty DP, Scharf ME, Watts VJ, Hill CA. High-content phenotypic screening identifies novel chemistries that disrupt mosquito activity and development. Pestic Biochem Physiol 2022; 182:105037. [PMID: 35249647 DOI: 10.1016/j.pestbp.2022.105037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/22/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
New classes of chemistries are needed to control insecticide resistant populations of mosquitoes and prevent transmission of vector-borne diseases (VBDs). Organismal screens of chemical collections have played an important role in the search for new vector insecticides and the identification of active ingredients (AIs) that cause rapid mortality of mosquitoes. Advances in image-based screening offer an opportunity to identify chemistries that operate via novel biochemical modes and investigate the range of phenotypes exhibited by mosquitoes following exposure to lethal and sub-lethal chemical dose. An automated, high throughput phenotypic screen (HTS) employing high-content imaging of first instar (L1) Aedes aegypti larvae was developed to identify chemistries associated with mortality and atypical morphological phenotypes. A pilot screen of the Library of Pharmacologically Active Compounds (LOPAC1280) identified 92 chemistries that disrupted larval activity and development, including conventional insecticides and chemistries known to modulate G protein-coupled receptors (GPCRs) and other molecular targets in mammalian systems. Secondary assay series were used to evaluate a selection of chemistries for impacts on mosquito activity, survival and development. Ritodrine hydrochloride reduced mobility of larvae but had no observable effect on survival and development of mosquitoes. High doses of metergoline suppressed larval activity and sub-lethal dose resulted in pupal mortality. Assay data support the utility of phenotypic screening and diverse entomological end-points for discovery of novel insecticidal chemical scaffolds. The insecticide discovery process must consider how multi-modal efficacy spectra contribute to vector and VBD control.
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Affiliation(s)
- M V Murgia
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - S Sharan
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - J Kaur
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - W Austin
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - L Hagen
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - L Wu
- Chemical Genomics Facility at Purdue Institute for Drug Discovery, Purdue University, West Lafayette, IN 47907-2089, USA
| | - L Chen
- Chemical Genomics Facility at Purdue Institute for Drug Discovery, Purdue University, West Lafayette, IN 47907-2089, USA
| | - J A Scott
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - D P Flaherty
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - M E Scharf
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - V J Watts
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907-2089, USA
| | - C A Hill
- Department Entomology, Purdue University, West Lafayette, IN 47907-2089, USA.
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2
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Bennett JC, Hetrich MK, Garcia Quesada M, Sinkevitch JN, Deloria Knoll M, Feikin DR, Zeger SL, Kagucia EW, Cohen AL, Ampofo K, Brandileone MCC, Bruden D, Camilli R, Castilla J, Chan G, Cook H, Cornick JE, Dagan R, Dalby T, Danis K, de Miguel S, De Wals P, Desmet S, Georgakopoulou T, Gilkison C, Grgic-Vitek M, Hammitt LL, Hilty M, Ho PL, Jayasinghe S, Kellner JD, Kleynhans J, Knol MJ, Kozakova J, Kristinsson KG, Ladhani SN, MacDonald L, Mackenzie GA, Mad’arová L, McGeer A, Mereckiene J, Morfeldt E, Mungun T, Muñoz-Almagro C, Nuorti JP, Paragi M, Pilishvili T, Puentes R, Saha SK, Sahu Khan A, Savrasova L, Scott JA, Skoczyńska A, Suga S, van der Linden M, Verani JR, von Gottberg A, Winje BA, Yildirim I, Zerouali K, Hayford K. Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 Following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project. Microorganisms 2021; 9:microorganisms9040696. [PMID: 33801760 PMCID: PMC8066231 DOI: 10.3390/microorganisms9040696] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3 + 0 schedule constrains generalizability and data from these settings are needed.
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Affiliation(s)
- Julia C. Bennett
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
- Correspondence: (J.C.B.); (M.D.K.)
| | - Marissa K. Hetrich
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
| | - Maria Garcia Quesada
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
| | - Jenna N. Sinkevitch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
| | - Maria Deloria Knoll
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
- Correspondence: (J.C.B.); (M.D.K.)
| | | | - Scott L. Zeger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
| | - Eunice W. Kagucia
- KEMRI-Wellcome Trust Research Programme, Epidemiology and Demography Department, Centre for Geographic Medicine-Coast, P.O. Box 230-80108 Kilifi, Kenya; (E.W.K.); (J.A.S.)
| | - Adam L. Cohen
- World Health Organization, 1202 Geneva, Switzerland;
| | - Krow Ampofo
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA;
| | - Maria-Cristina C. Brandileone
- National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz (IAL), São Paulo 01246-902, Brazil;
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK 99508, USA;
| | - Romina Camilli
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), 00161 Rome, Italy;
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.C.); (C.M.-A.)
- Instituto de Salud Pública de Navarra—IdiSNA, 31003 Pamplona, Navarra, Spain
| | - Guanhao Chan
- Singapore Ministry of Health, Communicable Diseases Division, Singapore 308442, Singapore;
| | - Heather Cook
- Centre for Disease Control, Department of Health and Community Services, Darwin, NT 8000, Australia;
| | - Jennifer E. Cornick
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool CH64 7TE, UK;
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, P.O. Box 30096 Blantyre, Malawi
| | - Ron Dagan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, 8410501 Beer-Sheva, Israel;
| | - Tine Dalby
- Bacteria, Parasites and Fungi, Statens Serum Institut, DK-2300 Copenhagen, Denmark;
| | - Kostas Danis
- Santé Publique France, the French National Public Health Agency, Saint Maurice CEDEX, 94415 Paris, France;
| | - Sara de Miguel
- Epidemiology Department, Dirección General de Salud Pública, 28009 Madrid, Spain;
| | - Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, Québec, QC G1V 0A6, Canada;
| | - Stefanie Desmet
- Department of Microbiology, Immunology and Transplantation, KU Leuven, BE-3000 Leuven, Belgium;
- National Reference Centre for Streptococcus Pneumoniae, University Hospitals Leuven, 3000 Leuven, Belgium
| | | | - Charlotte Gilkison
- Epidemiology Team, Institute of Environmental Science and Research, Porirua, Wellington 5240, New Zealand;
| | - Marta Grgic-Vitek
- Communicable Diseases Centre, National Institute of Public Health, 1000 Ljubljana, Slovenia;
| | - Laura L. Hammitt
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
- KEMRI-Wellcome Trust Research Programme, Epidemiology and Demography Department, Centre for Geographic Medicine-Coast, P.O. Box 230-80108 Kilifi, Kenya; (E.W.K.); (J.A.S.)
| | - Markus Hilty
- Swiss National Reference Centre for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, 3012 Bern, Switzerland;
| | - Pak-Leung Ho
- Department of Microbiology and Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China;
| | - Sanjay Jayasinghe
- National Centre for Immunisation Research and Surveillance and Discipline of Child and Adolescent Health, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia;
| | - James D. Kellner
- Department of Pediatrics, University of Calgary, and Alberta Health Services, Calgary, AB T3B 6A8, Canada;
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa; (J.K.); (A.v.G.)
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Mirjam J. Knol
- National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands;
| | - Jana Kozakova
- National Institute of Public Health (NIPH), 100 42 Praha, Czech Republic;
| | - Karl G. Kristinsson
- Department of Clinical Microbiology, Landspitali—The National University Hospital, Hringbraut, 101 Reykjavik, Iceland;
| | - Shamez N. Ladhani
- Immunisation and Countermeasures Division, Public Health England, London NW9 5EQ, UK;
| | | | - Grant A. Mackenzie
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK;
- Medical Research Council Unit the Gambia at London School of Hygiene & Tropical Medicine, P.O. Box 273 Banjul, The Gambia
- New Vaccines Group, Murdoch Children’s Research Institute, Parkville, Melbourne, VIC 3052, Australia
| | - Lucia Mad’arová
- National Reference Centre for Pneumococcal and Haemophilus Diseases, Regional Authority of Public Health, 975 56 Banská Bystrica, Slovakia;
| | - Allison McGeer
- Toronto Invasive Bacterial Diseases Network, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Jolita Mereckiene
- HSE Health Protection Surveillance Centre, Mountjoy, Dublin D01 A4A3, Ireland;
| | - Eva Morfeldt
- Department of Microbiology, Public Health Agency of Sweden, 171 82 Solna, Sweden;
| | - Tuya Mungun
- National Center of Communicable Diseases (NCCD), Ministry of Health, Bayanzurkh District, Ulaanbaatar 13336, Mongolia;
| | - Carmen Muñoz-Almagro
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.C.); (C.M.-A.)
- Medicine Department, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Molecular Microbiology Department, Hospital Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - J. Pekka Nuorti
- Department of Health Security, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland;
- Health Sciences Unit, Faculty of Social Sciences, University of Tampere, 33100 Tampere, Finland
| | - Metka Paragi
- Centre for Medical Microbiology, National Laboratory of Health, Environment and Food, 2000 Maribor, Slovenia;
| | - Tamara Pilishvili
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (T.P.); (J.R.V.)
| | - Rodrigo Puentes
- Instituto de Salud Pública de Chile, Santiago 7780050, Santiago Metropolitan, Chile;
| | - Samir K. Saha
- Child Health Research Foundation, Dhaka 1207, Bangladesh;
| | | | - Larisa Savrasova
- Centre for Disease Prevention and Control of Latvia, 1005 Riga, Latvia;
- Doctoral Studies Department, Riga Stradinš University, 1007 Riga, Latvia
| | - J. Anthony Scott
- KEMRI-Wellcome Trust Research Programme, Epidemiology and Demography Department, Centre for Geographic Medicine-Coast, P.O. Box 230-80108 Kilifi, Kenya; (E.W.K.); (J.A.S.)
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, 00-725 Warsaw, Poland;
| | - Shigeru Suga
- Infectious Disease Center and Department of Clinical Research, National Hospital Organization Mie Hospital, Tsu, Mie 514-0125, Japan;
| | - Mark van der Linden
- National Reference Center for Streptococci, Department of Medical Microbiology, University Hospital RWTH Aachen, 52074 Aachen, Germany;
| | - Jennifer R. Verani
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (T.P.); (J.R.V.)
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), P.O. Box 606-00621 Nairobi, Kenya
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa; (J.K.); (A.v.G.)
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Braamfontein, Johannesburg 2000, South Africa
| | - Brita A. Winje
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, 0456 Oslo, Norway;
| | - Inci Yildirim
- Department of Pediatrics, Yale New Haven Children’s Hospital, New Haven, CT 06504, USA;
| | - Khalid Zerouali
- Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre, Casablanca 20250, Morocco;
- Department of Microbiology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca 20000, Morocco
| | - Kyla Hayford
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (M.K.H.); (M.G.Q.); (J.N.S.); (S.L.Z.); (L.L.H.); (K.H.)
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Walker JL, Grint DJ, Strongman H, Eggo RM, Peppa M, Minassian C, Mansfield KE, Rentsch CT, Douglas IJ, Mathur R, Wong AYS, Quint JK, Andrews N, Bernal JL, Scott JA, Ramsay M, Smeeth L, McDonald HI. UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records. BMC Public Health 2021; 21:484. [PMID: 33706738 PMCID: PMC7948667 DOI: 10.1186/s12889-021-10427-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/11/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Characterising the size and distribution of the population at risk of severe COVID-19 is vital for effective policy and planning. Older age, and underlying health conditions, are associated with higher risk of death from COVID-19. This study aimed to describe the population at risk of severe COVID-19 due to underlying health conditions across the United Kingdom. METHODS We used anonymised electronic health records from the Clinical Practice Research Datalink GOLD to estimate the point prevalence on 5 March 2019 of the at-risk population following national guidance. Prevalence for any risk condition and for each individual condition is given overall and stratified by age and region with binomial exact confidence intervals. We repeated the analysis on 5 March 2014 for full regional representation and to describe prevalence of underlying health conditions in pregnancy. We additionally described the population of cancer survivors, and assessed the value of linked secondary care records for ascertaining COVID-19 at-risk status. RESULTS On 5 March 2019, 24.4% of the UK population were at risk due to a record of at least one underlying health condition, including 8.3% of school-aged children, 19.6% of working-aged adults, and 66.2% of individuals aged 70 years or more. 7.1% of the population had multimorbidity. The size of the at-risk population was stable over time comparing 2014 to 2019, despite increases in chronic liver disease and diabetes and decreases in chronic kidney disease and current asthma. Separately, 1.6% of the population had a new diagnosis of cancer in the past 5 y. CONCLUSIONS The population at risk of severe COVID-19 (defined as either aged ≥70 years, or younger with an underlying health condition) comprises 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals. Our national estimates broadly support the use of Global Burden of Disease modelled estimates in other countries. We provide age- and region- stratified prevalence for each condition to support effective modelling of public health interventions and planning of vaccine resource allocation. The high prevalence of health conditions among older age groups suggests that age-targeted vaccination strategies may efficiently target individuals at higher risk of severe COVID-19.
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Affiliation(s)
- Jemma L Walker
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Daniel J Grint
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Helen Strongman
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Rosalind M Eggo
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Maria Peppa
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Caroline Minassian
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Kathryn E Mansfield
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | | | - Ian J Douglas
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Rohini Mathur
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Angel Y S Wong
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | | | - Nick Andrews
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Jamie Lopez Bernal
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - J Anthony Scott
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Mary Ramsay
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Liam Smeeth
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Helen I McDonald
- NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
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Virk A, Bella Jalloh M, Koedoyoma S, Smalle IO, Bolton W, Scott JA, Brown J, Jayne D, Ensor T, King R. What factors shape surgical access in West Africa? A qualitative study exploring patient and provider experiences of managing injuries in Sierra Leone. BMJ Open 2021; 11:e042402. [PMID: 33649054 PMCID: PMC8098971 DOI: 10.1136/bmjopen-2020-042402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Surgical access is central to universalising health coverage, yet 5 billion people lack timely access to safe surgical services. Surgical need is particularly acute in post conflict settings like Sierra Leone. There is limited understanding of the barriers and opportunities at the service delivery and community levels. Focusing on fractures and wound care which constitute an enormous disease burden in Sierra Leone as a proxy for general surgical need, we examine provider and patient perceived factors impeding or facilitating surgical care in the post-Ebola context of a weakened health system. METHODS Across Western Area Urban (Freetown), Bo and Tonkolili districts, 60 participants were involved in 38 semistructured interviews and 22 participants in 5 focus group discussions. Respondents included surgical providers, district-level policy-makers, traditional healers and patients. Data were thematically analysed, combining deductive and inductive techniques to generate codes. RESULTS Interacting demand-side and supply-side issues affected user access to surgical services. On the demand side, high cost of care at medical facilities combined with the affordability and convenient mode of payment to the traditional health practitioners hindered access to the medical facilities. On the supply side, capacity shortages and staff motivation were challenges at facilities. Problems were compounded by patients' delaying care mainly spurred by sociocultural beliefs in traditional practice and economic factors, thereby impeding early intervention for patients with surgical need. In the absence of formal support services, the onus of first aid and frontline trauma care is borne by lay citizens. CONCLUSION Within a resource-constrained context, supply-side strengthening need accompanying by demand-side measures involving community and traditional actors. On the supply side, non-specialists could be effectively utilised in surgical delivery. Existing human resource capacity can be enhanced through better incentives for non-physicians. Traditional provider networks can be deployed for community outreach. Developing a lay responder system for first-aid and front-line support could be a useful mechanism for prompt clinical intervention.
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Affiliation(s)
- Amrit Virk
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Mohamed Bella Jalloh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Songor Koedoyoma
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Isaac O Smalle
- Department of Surgery, College of Medicine, University of Sierra Leone, Freetown, Sierra Leone
- Department of Global Health, King's College, London, UK
| | | | - J A Scott
- School of Medicine, University of Leeds, Leeds, UK
| | - Julia Brown
- School of Medicine, University of Leeds, Leeds, UK
| | - David Jayne
- School of Medicine, University of Leeds, Leeds, UK
| | - Tim Ensor
- School of Medicine, University of Leeds, Leeds, UK
| | - Rebecca King
- School of Medicine, University of Leeds, Leeds, UK
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Scott JA, Barry PJ, Jones AM, Athwal VS. Management of superior mesenteric venous thrombus in cystic fibrosis related liver disease. Paediatr Respir Rev 2020; 35:106-108. [PMID: 32798114 DOI: 10.1016/j.prrv.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
Abdominal pain is a common feature in patients with cystic fibrosis (CF) and CF related liver disease (CFLD). Superior mesenteric venous (SMV) thrombosis is an uncommon but important cause of abdominal pain. Management strategies are complicated by an underlying prothrombotic state and increased risk of bleeding from complications of CF and CFLD. This review addresses clinical presentation, detection and management options of an acute SMV thrombus in the context of CF.
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Affiliation(s)
- J A Scott
- Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK; Divsion of Diabetes, Endocrine and Gastroenterology, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
| | - P J Barry
- Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK
| | - A M Jones
- Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK
| | - V S Athwal
- Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK; Divsion of Diabetes, Endocrine and Gastroenterology, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
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McDonald HI, Tessier E, White JM, Woodruff M, Knowles C, Bates C, Parry J, Walker JL, Scott JA, Smeeth L, Yarwood J, Ramsay M, Edelstein M. Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32431288 PMCID: PMC7238742 DOI: 10.2807/1560-7917.es.2020.25.19.2000848] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [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] [Indexed: 01/27/2023]
Abstract
Using electronic health records, we assessed the early impact of coronavirus disease (COVID-19) on routine childhood vaccination in England by 26 April 2020. Measles-mumps-rubella vaccination counts fell from February 2020, and in the 3 weeks after introduction of physical distancing measures were 19.8% lower (95% confidence interval: −20.7 to −18.9) than the same period in 2019, before improving in mid-April. A gradual decline in hexavalent vaccination counts throughout 2020 was not accentuated by physical distancing.
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Affiliation(s)
- Helen I McDonald
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Elise Tessier
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom
| | - Joanne M White
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom
| | - Matthew Woodruff
- The Phoenix Partnership (TPP) (Leeds) Ltd, Leeds, United Kingdom
| | | | - Chris Bates
- The Phoenix Partnership (TPP) (Leeds) Ltd, Leeds, United Kingdom
| | - John Parry
- The Phoenix Partnership (TPP) (Leeds) Ltd, Leeds, United Kingdom
| | - Jemma L Walker
- Statistics, Modelling and Economics Department, Public Health England, Colindale, United Kingdom.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - J Anthony Scott
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Liam Smeeth
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Joanne Yarwood
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Mary Ramsay
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Michael Edelstein
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
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7
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Boundy-Mills K, McCluskey K, Elia P, Glaeser JA, Lindner DL, Nobles DR, Normanly J, Ochoa-Corona FM, Scott JA, Ward TJ, Webb KM, Webster K, Wertz JE. Preserving US microbe collections sparks future discoveries. J Appl Microbiol 2019; 129:162-174. [PMID: 31758754 PMCID: PMC7383923 DOI: 10.1111/jam.14525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/27/2019] [Revised: 09/26/2019] [Accepted: 11/20/2019] [Indexed: 11/28/2022]
Abstract
Collections of micro‐organisms are a crucial element of life science research infrastructure but are vulnerable to loss and damage caused by natural or man‐made disasters, the untimely death or retirement of personnel, or the loss of research funding. Preservation of biological collections has risen in priority due to a new appreciation for discoveries linked to preserved specimens, emerging hurdles to international collecting and decreased funding for new collecting. While many historic collections have been lost, several have been preserved, some with dramatic rescue stories. Rescued microbes have been used for discoveries in areas of health, biotechnology and basic life science. Suggestions for long‐term planning for microbial stocks are listed, as well as inducements for long‐term preservation.
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Affiliation(s)
- K Boundy-Mills
- Phaff Yeast Culture Collection, Food Science and Technology, University of California Davis, Davis, CA, USA
| | - K McCluskey
- Department of Plant Pathology, Fungal Genetics Stock Center, Kansas State University, Manhattan, KS, USA
| | - P Elia
- Soybean Genomics and Improvement Laboratory, USDA-ARS Rhizobium Germplasm Resource Collection, Beltsville, MD, USA
| | - J A Glaeser
- Center for Forest Mycology Research, USDA-Forest Service, Northern Research Station, Madison, WI, USA
| | - D L Lindner
- Center for Forest Mycology Research, USDA-Forest Service, Northern Research Station, Madison, WI, USA
| | - D R Nobles
- UTEX Culture Collection of Algae, The University of Texas at Austin, Austin, TX, USA
| | - J Normanly
- Department of Biochemistry and Molecular Biology, University of Massachusetts, Amherst, MA, USA
| | - F M Ochoa-Corona
- National Institute for Microbial Forensics & Food and Agricultural Biosecurity, Oklahoma State University, Stillwater, OK, USA
| | - J A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - T J Ward
- USDA-Agricultural Research Service, Peoria, IL, USA
| | - K M Webb
- Soil Management and Sugar Beet Research Unit, USDA-ARS, Fort Collins, CO, USA
| | - K Webster
- Department of Biochemistry and Molecular Biology, University of Massachusetts, Amherst, MA, USA.,Institute of Applied Life Sciences, University of Massachusetts, Amherst, MA, USA
| | - J E Wertz
- E. coli Genetic Stock Center, Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
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8
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Abstract
Breastfeeding is important for health and development. Yet, the interaction between breastfeeding duration and usage of fluoridated water on caries experience has not been investigated. This study examined exposure to fluoridation as an effect modifier of the association between breastfeeding duration and caries. The 2012 to 2014 national population-based study of Australian children involved parental questionnaires and oral epidemiological assessment. Children were grouped by parent-reported breastfeeding duration into minimal (none or <1 mo), breastfed for 1 to <6 mo, breastfed for 6 to 24 mo, and sustained (>24 mo). Residential history and main water source used for the first 2 y of life were collected to group children into exposed (WF) and nonexposed (NF) to fluoridation. Socioeconomic status, infant formula feeding, and sugar-sweetened beverage (SSB) consumption data were collected. The prevalence and severity of caries in children aged 5 to 6 y were primary outcomes. Multivariable regression models with robust error estimation were generated to compute prevalence ratios (PRs) and mean ratios (MRs) for 3 breastfeeding groups against the reference (breastfed for 6-24 mo). Of the 5- to 6-y-old children, 2,721 were in the WF and 1,737 were in the NF groups. The groups had comparable distributions of socioeconomic factors, infant formula feeding, and SSB consumption. There were U-shape distributions of caries experience among breastfeeding groups, being more pronounced among NF children. Among NF children, the minimal and sustained breastfeeding groups had significantly higher PR (1.4 [1.1-1.9] and 1.8 [1.4-2.4]) and MR (2.1 [1.4-3.3] and 2.4 [1.4-4.1]) than the reference group. However, among the WF children, this association between breastfeeding duration and caries attenuated after adjustment for other factors. The study contributes evidence of a nonlinear (U-shape) association between breastfeeding duration and dental caries. Early life exposure to fluoridated drinking water attenuated the potential cariogenic effect of both lack of and sustained breastfeeding.
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Affiliation(s)
- D H Ha
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - A J Spencer
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - K G Peres
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia.,2 School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia
| | | | - J A Scott
- 4 School of Public Health, Curtin University, Perth, Australia
| | - L G Do
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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9
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Miliku K, Robertson B, Sharma AK, Subbarao P, Becker AB, Mandhane PJ, Turvey SE, Lefebvre DL, Sears MR, Bode L, Azad MB, Anand SS, Azad M, Becker AB, Befus AD, Brauer M, Brook JR, Chen E, Cyr M, Daley D, Dell SD, Denburg JA, Duan Q, Eiwegger T, Grasemann H, HayGlass K, Hegele RG, Holness DL, Hystad P, Kobor M, Kollman TR, Kozyrskyj AL, Laprise C, Lou WYW, Macri J, Miller G, Moraes TJ, Ramsey C, Ratjen F, Sandford A, Scott JA, Scott J, Silverman F, Simons E, Takaro T, Tebbutt S, To T. Human milk oligosaccharide profiles and food sensitization among infants in the CHILD Study. Allergy 2018; 73:2070-2073. [PMID: 29775217 DOI: 10.1111/all.13476] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- K. Miliku
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION) Children's Hospital Research Institute of Manitoba Winnipeg MB Canada
- Department of Pediatrics and Child Health University of Manitoba Winnipeg MB Canada
- The Generation R Study Group Departments of Pediatrics and Epidemiology Erasmus University Medical Center Rotterdam Rotterdam The Netherlands
| | - B. Robertson
- Department of Pediatrics and Larsson‐Rosenquist Foundation Mother‐Milk‐Infant Center of Research Excellence University of California San Diego La Jolla CA USA
| | - A. K. Sharma
- George & Fay Yee Centre for Healthcare Innovation University of Manitoba Winnipeg MB Canada
| | - P. Subbarao
- Departments of Pediatrics & Physiology University of Toronto Toronto ON Canada
| | - A. B. Becker
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION) Children's Hospital Research Institute of Manitoba Winnipeg MB Canada
- Department of Pediatrics and Child Health University of Manitoba Winnipeg MB Canada
| | - P. J. Mandhane
- Department of Pediatrics University of Alberta Edmonton AB Canada
| | - S. E. Turvey
- Department of Pediatrics University of British Columbia Vancouver BC Canada
| | - D. L. Lefebvre
- Department of Medicine McMaster University Hamilton ON Canada
| | - M. R. Sears
- Department of Medicine McMaster University Hamilton ON Canada
| | - L. Bode
- Department of Pediatrics and Larsson‐Rosenquist Foundation Mother‐Milk‐Infant Center of Research Excellence University of California San Diego La Jolla CA USA
| | - M. B. Azad
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION) Children's Hospital Research Institute of Manitoba Winnipeg MB Canada
- Department of Pediatrics and Child Health University of Manitoba Winnipeg MB Canada
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10
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Pulker CE, Trapp GSA, Scott JA, Pollard CM. What are the position and power of supermarkets in the Australian food system, and the implications for public health? A systematic scoping review. Obes Rev 2018; 19:198-218. [PMID: 29193744 DOI: 10.1111/obr.12635] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/31/2017] [Accepted: 09/22/2017] [Indexed: 12/01/2022]
Abstract
Supermarkets have been described as having unprecedented and disproportionate power in the food system. This scoping review synthesized the literature that describes the position and power of supermarkets in the Australian food system, and the implications for public health. A systematic search of peer-reviewed and grey literature identified 68 documents that described supermarket power. Implications for public health were also recorded. Data revealed that supermarkets hold a powerful position in the Australian food system, acting as the primary gatekeepers. Supermarkets have obtained instrumental, structural and discursive power from many sources that overlap and reinforce each other. Few positive public health impacts of supermarket power were identified, providing many opportunities for improvement in the domains of food governance, the food system and public health nutrition. There is very little public health research examining the impact of supermarket power in Australia. More research is needed, and examination of supermarket own brands is of particular importance owing to their pivotal role as a source of power and their potential to improve public health outcomes, such as obesity.
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Affiliation(s)
- C E Pulker
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - G S A Trapp
- Telethon Kids Institute, Subiaco, Western Australia, Australia.,Centre for the Built Environment and Health, The University of Western Australia, Crawley, Western Australia, Australia.,School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - J A Scott
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - C M Pollard
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,Department of Health in Western Australia, Perth, Western Australia, Australia
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11
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Verani JR, Baqui AH, Broome CV, Cherian T, Cohen C, Farrar JL, Feikin DR, Groome MJ, Hajjeh RA, Johnson HL, Madhi SA, Mulholland K, O'Brien KL, Parashar UD, Patel MM, Rodrigues LC, Santosham M, Scott JA, Smith PG, Sommerfelt H, Tate JE, Victor JC, Whitney CG, Zaidi AK, Zell ER. Case-control vaccine effectiveness studies: Data collection, analysis and reporting results. Vaccine 2017; 35:3303-3308. [PMID: 28442230 PMCID: PMC7008029 DOI: 10.1016/j.vaccine.2017.04.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/10/2017] [Accepted: 04/12/2017] [Indexed: 12/25/2022]
Abstract
The case-control methodology is frequently used to evaluate vaccine effectiveness post-licensure. The results of such studies provide important insight into the level of protection afforded by vaccines in a 'real world' context, and are commonly used to guide vaccine policy decisions. However, the potential for bias and confounding are important limitations to this method, and the results of a poorly conducted or incorrectly interpreted case-control study can mislead policies. In 2012, a group of experts met to review recent experience with case-control studies evaluating vaccine effectiveness; we summarize the recommendations of that group regarding best practices for data collection, analysis, and presentation of the results of case-control vaccine effectiveness studies. Vaccination status is the primary exposure of interest, but can be challenging to assess accurately and with minimal bias. Investigators should understand factors associated with vaccination as well as the availability of documented vaccination status in the study context; case-control studies may not be a valid method for evaluating vaccine effectiveness in settings where many children lack a documented immunization history. To avoid bias, it is essential to use the same methods and effort gathering vaccination data from cases and controls. Variables that may confound the association between illness and vaccination are also important to capture as completely as possible, and where relevant, adjust for in the analysis according to the analytic plan. In presenting results from case-control vaccine effectiveness studies, investigators should describe enrollment among eligible cases and controls as well as the proportion with no documented vaccine history. Emphasis should be placed on confidence intervals, rather than point estimates, of vaccine effectiveness. Case-control studies are a useful approach for evaluating vaccine effectiveness; however careful attention must be paid to the collection, analysis and presentation of the data in order to best inform evidence-based vaccine policies.
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Affiliation(s)
- Jennifer R Verani
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.
| | - Abdullah H Baqui
- International Center for Maternal and Newborn Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Claire V Broome
- Rollins School of Public Health Emory University, 1518 Clifton Rd, Atlanta, GA, USA
| | - Thomas Cherian
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, 1 Modderfontein Rd, Sandringham, Johannesburg, South Africa
| | - Jennifer L Farrar
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | - Daniel R Feikin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA; International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Michelle J Groome
- Respiratory and Meningeal Pathogens Unit, University of Witwatersrand, Richard Ward, 1 Jan Smuts Ave, Braamfontein, Johannesburg, South Africa
| | - Rana A Hajjeh
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | - Hope L Johnson
- Monitoring & Evaluation, Policy & Performance, GAVI Alliance, Chemin des Mines 2, 1202 Geneva, Switzerland
| | - Shabir A Madhi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, 1 Modderfontein Rd, Sandringham, Johannesburg, South Africa; Respiratory and Meningeal Pathogens Unit, University of Witwatersrand, Richard Ward, 1 Jan Smuts Ave, Braamfontein, Johannesburg, South Africa
| | - Kim Mulholland
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Katherine L O'Brien
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Umesh D Parashar
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | - Manish M Patel
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | - Laura C Rodrigues
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Mathuram Santosham
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - J Anthony Scott
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK; KEMRI-Wellcome Trust Research Programme, PO Box 230-80108, Kilifi, Kenya
| | - Peter G Smith
- MRC Tropical Epidemiology Group, London School of Tropical Medicine and Hygiene, London, UK
| | - Halvor Sommerfelt
- Centre of Intervention Science in Maternal and Child Health and Centre for International Health, University of Bergen, PO Box 7800, Bergen, Norway; Department of International Public Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway
| | - Jacqueline E Tate
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | | | - Cynthia G Whitney
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | | | - Elizabeth R Zell
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
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12
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Verani JR, Baqui AH, Broome CV, Cherian T, Cohen C, Farrar JL, Feikin DR, Groome MJ, Hajjeh RA, Johnson HL, Madhi SA, Mulholland K, O'Brien KL, Parashar UD, Patel MM, Rodrigues LC, Santosham M, Scott JA, Smith PG, Sommerfelt H, Tate JE, Victor JC, Whitney CG, Zaidi AK, Zell ER. Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls. Vaccine 2017; 35:3295-3302. [PMID: 28442231 PMCID: PMC7007298 DOI: 10.1016/j.vaccine.2017.04.037] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/10/2017] [Accepted: 04/12/2017] [Indexed: 01/01/2023]
Abstract
Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under ‘real world’ conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential.
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Affiliation(s)
- Jennifer R Verani
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA.
| | - Abdullah H Baqui
- International Center for Maternal and Newborn Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Claire V Broome
- Rollins School of Public Health Emory University, 1518 Clifton Rd, Atlanta, GA, USA
| | - Thomas Cherian
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, 1 Modderfontein Road, Sandringham, Johannesburg, South Africa
| | - Jennifer L Farrar
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Daniel R Feikin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA; International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Michelle J Groome
- Respiratory and Meningeal Pathogens Unit, University of Witwatersrand, Richard Ward, 1 Jan Smuts Ave, Braamfontein, Johannesburg, South Africa
| | - Rana A Hajjeh
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Hope L Johnson
- Monitoring & Evaluation, Policy & Performance, GAVI Alliance, Chemin des Mines 2, 1202 Geneva, Switzerland
| | - Shabir A Madhi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, 1 Modderfontein Road, Sandringham, Johannesburg, South Africa; Respiratory and Meningeal Pathogens Unit, University of Witwatersrand, Richard Ward, 1 Jan Smuts Ave, Braamfontein, Johannesburg, South Africa
| | - Kim Mulholland
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Katherine L O'Brien
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Umesh D Parashar
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Manish M Patel
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Laura C Rodrigues
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Mathuram Santosham
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - J Anthony Scott
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK; KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Peter G Smith
- MRC Tropical Epidemiology Group, London School of Tropical Medicine and Hygiene, London, UK
| | - Halvor Sommerfelt
- Centre of Intervention Science in Maternal and Child Health and Centre for International Health, University of Bergen, P.O. Box 7800, Bergen, Norway; Department of International Public Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway
| | - Jacqueline E Tate
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | | | - Cynthia G Whitney
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | | | - Elizabeth R Zell
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
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13
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Azad MB, Konya T, Persaud RR, Guttman DS, Chari RS, Field CJ, Sears MR, Mandhane PJ, Turvey SE, Subbarao P, Becker AB, Scott JA, Kozyrskyj AL. Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. BJOG 2015; 123:983-93. [PMID: 26412384 DOI: 10.1111/1471-0528.13601] [Citation(s) in RCA: 375] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Dysbiosis of the infant gut microbiota may have long-term health consequences. This study aimed to determine the impact of maternal intrapartum antibiotic prophylaxis (IAP) on infant gut microbiota, and to explore whether breastfeeding modifies these effects. DESIGN Prospective pregnancy cohort of Canadian infants born in 2010-2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Study. SETTING General community. SAMPLE Representative sub-sample of 198 healthy term infants from the CHILD Study. METHODS Maternal IAP exposures and birth method were documented from hospital records and breastfeeding was reported by mothers. Infant gut microbiota was characterised by Illumina 16S rRNA sequencing of faecal samples at 3 and 12 months. MAIN OUTCOME MEASURES Infant gut microbiota profiles. RESULTS In this cohort, 21% of mothers received IAP for Group B Streptococcus prophylaxis or pre-labour rupture of membranes; another 23% received IAP for elective or emergency caesarean section (CS). Infant gut microbiota community structures at 3 months differed significantly with all IAP exposures, and differences persisted to 12 months for infants delivered by emergency CS. Taxon-specific composition also differed, with the genera Bacteroides and Parabacteroides under-represented, and Enterococcus and Clostridium over-represented at 3 months following maternal IAP. Microbiota differences were especially evident following IAP with emergency CS, with some changes (increased Clostridiales and decreased Bacteroidaceae) persisting to 12 months, particularly among non-breastfed infants. CONCLUSIONS Intrapartum antibiotics in caesarean and vaginal delivery are associated with infant gut microbiota dysbiosis, and breastfeeding modifies some of these effects. Further research is warranted to explore the health consequences of these associations. TWEETABLE ABSTRACT Maternal #antibiotics during childbirth alter the infant gut #microbiome.
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Affiliation(s)
- M B Azad
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.,Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - T Konya
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - R R Persaud
- College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada
| | - D S Guttman
- Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, ON, Canada
| | - R S Chari
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
| | - C J Field
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - M R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - P J Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - S E Turvey
- Department of Pediatrics, Child & Family Research Institute, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - P Subbarao
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - A B Becker
- Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - J A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - A L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Behbod B, Sordillo JE, Hoffman EB, Datta S, Webb TE, Kwan DL, Kamel JA, Muilenberg ML, Scott JA, Chew GL, Platts-Mills TAE, Schwartz J, Coull B, Burge H, Gold DR. Asthma and allergy development: contrasting influences of yeasts and other fungal exposures. Clin Exp Allergy 2015; 45:154-63. [PMID: 25200568 DOI: 10.1111/cea.12401] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 07/19/2014] [Accepted: 08/05/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Infancy is a developmental stage with heightened susceptibility to environmental influences on the risk of chronic childhood disease. Few birth cohort studies have detailed measures of fungal diversity data in infants' bedrooms, limiting the potential to measure long-term associations of these complex exposures with development of asthma or allergy. OBJECTIVE We evaluated the relation of home fungal levels in infancy to repeated measures of wheeze and development of asthma and rhinitis by age 13, and sensitization by age 12 years. METHODS In the Epidemiology of Home Allergens and Asthma prospective birth cohort study, we recruited 408 children with family history of allergic disease or asthma. When children were aged 2-3 months, we measured culturable fungi in bedroom air and dust, and in outdoor air. Main outcomes included ascertainment of symptoms/disease onset by questionnaire from birth through age 13. We estimated hazard ratios and, for wheeze and sensitization, odds ratios for an interquartile increase in log-transformed fungal concentrations, adjusting for other outcome predictors and potential confounders. RESULTS Elevated levels of yeasts in bedroom floor dust were associated with reduced: i) wheeze at any age; ii) fungal sensitization; and iii) asthma development by age 13 (hazard ratio (HR) = 0.86; 95% confidence interval (CI), [0.75 to 0.98]). Outdoor airborne Cladosporium and dustborne Aspergillus predicted increased rhinitis. Risk of fungal sensitization by age 12, in response to environmental Alternaria and Aspergillus, was elevated in children with a maternal history of fungal sensitization. CONCLUSIONS AND CLINICAL RELEVANCE Despite the irritant and allergenic properties of fungi, early-life elevated dust yeast exposures or their components may be protective against allergy and asthma in children at risk for these outcomes. Ascertainment of fungal components associated with immunoprotective effects may have therapeutic relevance for asthma.
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Affiliation(s)
- B Behbod
- Harvard School of Public Health, Boston, MA, USA
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15
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Scott JA, Palmer EL. Radiology reports: a quantifiable and objective textual approach. Clin Radiol 2015; 70:1185-91. [PMID: 26169580 DOI: 10.1016/j.crad.2015.06.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/20/2015] [Accepted: 06/05/2015] [Indexed: 11/25/2022]
Abstract
AIM To examine the feasibility of using automated lexical analysis in conjunction with machine learning to create a means of objectively characterising radiology reports for quality improvement. MATERIALS AND METHODS Twelve lexical parameters were quantified from the collected reports of four radiologists. These included the number of different words used, number of sentences, reading grade, readability, usage of the passive voice, and lexical metrics of concreteness, ambivalence, complexity, passivity, embellishment, communication and cognition. Each radiologist was statistically compared to the mean of the group for each parameter to determine outlying report characteristics. The reproducibility of these parameters in a given radiologist's reporting style was tested by using only these 12 parameters as input to a neural network designed to establish the authorship of 60 unknown reports. RESULTS Significant differences in report characteristics were observed between radiologists, quantifying and characterising deviations of individuals from the group reporting style. The 12 metrics employed in a neural network correctly identified the author in each of 60 unknown reports tested, indicating a robust parametric signature. CONCLUSION Automated and quantifiable methods can be used to analyse reporting style and provide impartial and objective feedback as well as to detect and characterise significant differences from the group. The parameters examined are sufficiently specific to identify the authors of reports and can potentially be useful in quality improvement and residency training.
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Affiliation(s)
- J A Scott
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - E L Palmer
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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16
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Manns MP, Fried MW, Zeuzem S, Jacobson IM, Forns X, Poordad F, Peeters M, Fu M, Lenz O, Ouwerkerk-Mahadevan S, Jessner W, Scott JA, Kalmeijer R, De La Rosa G, Sinha R, Beumont-Mauviel M. Simeprevir with peginterferon/ribavirin for treatment of chronic hepatitis C virus genotype 1 infection: pooled safety analysis from Phase IIb and III studies. J Viral Hepat 2015; 22:366-75. [PMID: 25363449 DOI: 10.1111/jvh.12346] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/03/2014] [Indexed: 12/12/2022]
Abstract
This pooled analysis of five Phase IIb and III studies evaluated the safety and tolerability of simeprevir, a once daily, oral hepatitis C virus (HCV) NS3/4A protease inhibitor. Data were summarised for patients who received simeprevir 150 mg once daily (n = 924) or placebo (n = 540) plus pegylated interferon-α/ribavirin for 12 weeks. During the first 12 weeks of treatment, few patients discontinued simeprevir or placebo due to adverse events (AEs) (both 2.2%). Pruritus (23.8% vs 17.4%), rash (any; 22.9% vs 16.7%) and photosensitivity (3.2% vs 0.6%) [Correction added on 16 January 2015, after first online publication: In the above sentence, the values in 'Photosensitivity' were previously incorrect and have now been changed to 3.2% vs 0.6%.] were more prevalent in the simeprevir vs the placebo groups. Most AEs were grade 1/2 (72.4% for simeprevir vs 71.3% for placebo). All grade 3/4 AEs occurred in <5.0% of patients, except neutropenia (9.8% vs 7.6%). Overall incidence of neutropenia was similar (17.3% vs 15.7%). Incidence of anaemia was 13.2% for simeprevir vs 10.9% for placebo, and incidence of increased bilirubin was 8.4% vs 2.8%. Bilirubin increases were mild-to-moderate and transient without concurrent transaminase increases or association with hepatic injury. Safety and tolerability did not vary with METAVIR score, although increased bilirubin and anaemia were more frequent in simeprevir-treated patients with METAVIR F4 (increased bilirubin, 13.0% vs 3.3%; anaemia, 19.0% vs 14.8%). Serious AEs were infrequent (2.1% for simeprevir vs 3.0% for placebo). No deaths were reported during the first 12 weeks of treatment. Patient-reported fatigue and other outcomes were comparable for both groups, but were of shorter duration for simeprevir due to the use of response-guided therapy. Simeprevir is well tolerated in HCV genotype 1-infected patients.
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Affiliation(s)
- M P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
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17
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Moraes TJ, Lefebvre DL, Chooniedass R, Becker AB, Brook JR, Denburg J, HayGlass KT, Hegele RG, Kollmann TR, Macri J, Mandhane PJ, Scott JA, Subbarao P, Takaro TK, Turvey SE, Duncan JD, Sears MR, Befus AD. The Canadian healthy infant longitudinal development birth cohort study: biological samples and biobanking. Paediatr Perinat Epidemiol 2015; 29:84-92. [PMID: 25405552 DOI: 10.1111/ppe.12161] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND It is hypothesised that complex interactions between genetic and environmental factors give rise to allergy and asthma in childhood. The Canadian Healthy Infant Longitudinal Development (CHILD) study was designed to explore these factors. METHODS CHILD is a longitudinal, general population birth cohort study following infants from mid-pregnancy to age 5 years. Over this time period, biological samples, questionnaires, clinical measures and environmental data are collected. RESULTS A total of 3624 families have been recruited, and many thousands of samples and questionnaires have been collected, annotated, and archived. This report outlines the rationale and methodology for collecting and storing diverse biological samples from parents and children in this study, and the mechanisms for their release for analyses. CONCLUSIONS The CHILD sample and data repository is a tremendous current and future resource and will provide a wealth of information not only informing studies of asthma and allergy, but also potentially in many other aspects of health relevant for Canadian infants and children.
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Affiliation(s)
- T J Moraes
- Physiology and Experimental Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada; Department of Paediatrics, University of Toronto, Toronto, ON, Canada
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18
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Affiliation(s)
- Alexander M Aiken
- London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK.
| | | | - J Anthony Scott
- London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shaheen Mehtar
- Unit for Infection Prevention and Control, Division of Community Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Didier Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Hajo Grundmann
- Department of Medical Microbiology, University of Groningen, University Medical Centre, Groningen, Netherlands
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19
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Satzke C, Turner P, Virolainen-Julkunen A, Adrian PV, Antonio M, Hare KM, Henao-Restrepo AM, Leach AJ, Klugman KP, Porter BD, Sá-Leão R, Scott JA, Nohynek H, O'Brien KL. Standard method for detecting upper respiratory carriage of Streptococcus pneumoniae: updated recommendations from the World Health Organization Pneumococcal Carriage Working Group. Vaccine 2014; 32:165-79. [PMID: 24331112 DOI: 10.1016/j.vaccine.2013.08.062] [Citation(s) in RCA: 318] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 07/25/2013] [Accepted: 08/23/2013] [Indexed: 11/29/2022]
Abstract
In 2003 the World Health Organization (WHO) convened a working group and published a set of standard methods for studies measuring nasopharyngeal carriage of Streptococcus pneumoniae (the pneumococcus). The working group recently reconvened under the auspices of the WHO and updated the consensus standard methods. These methods describe the collection, transport and storage of nasopharyngeal samples, as well as provide recommendations for the identification and serotyping of pneumococci using culture and non-culture based approaches. We outline the consensus position of the working group, the evidence supporting this position, areas worthy of future research, and the epidemiological role of carriage studies. Adherence to these methods will reduce variability in the conduct of pneumococcal carriage studies undertaken in the context of pneumococcal vaccine trials, implementation studies, and epidemiology studies more generally so variability in methodology does not confound the interpretation of study findings.
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Affiliation(s)
- Catherine Satzke
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Centre for International Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, Australia.
| | - Paul Turner
- Microbiology Department, Angkor Hospital for Children, Siem Reap, Kingdom of Cambodia; Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
| | - Anni Virolainen-Julkunen
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
| | - Peter V Adrian
- MRC/Wits Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Kim M Hare
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | | | - Amanda J Leach
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Keith P Klugman
- Rollins School of Public Health, Emory University, Atlanta, GA, USA; Respiratory and Meningeal Pathogens Research Unit, University of Witwatersrand, Johannesburg, South Africa
| | - Barbara D Porter
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Raquel Sá-Leão
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - J Anthony Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; London School of Hygiene & Tropical Medicine, London, UK
| | - Hanna Nohynek
- Vaccine Programme Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Katherine L O'Brien
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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20
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Konya T, Koster B, Maughan H, Escobar M, Azad MB, Guttman DS, Sears MR, Becker AB, Brook JR, Takaro TK, Kozyrskyj AL, Scott JA. Associations between bacterial communities of house dust and infant gut. Environ Res 2014; 131:25-30. [PMID: 24637181 DOI: 10.1016/j.envres.2014.02.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 01/14/2014] [Accepted: 02/19/2014] [Indexed: 06/03/2023]
Abstract
The human gut is host to a diverse and abundant community of bacteria that influence health and disease susceptibility. This community develops in infancy, and its composition is strongly influenced by environmental factors, notably perinatal anthropogenic exposures such as delivery mode (Cesarean vs. vaginal) and feeding method (breast vs. formula); however, the built environment as a possible source of exposure has not been considered. Here we report on a preliminary investigation of the associations between bacteria in house dust and the nascent fecal microbiota from 20 subjects from the Canadian Healthy Infant Longitudinal Development (CHILD) Study using high-throughput sequence analysis of portions of the 16S rRNA gene. Despite significant differences between the dust and fecal microbiota revealed by Nonmetric Multidimensional Scaling (NMDS) analysis, permutation analysis confirmed that 14 bacterial OTUs representing the classes Actinobacteria (3), Bacilli (3), Clostridia (6) and Gammaproteobacteria (2) co-occurred at a significantly higher frequency in matched dust-stool pairs than in randomly permuted pairs, indicating an association between these dust and stool communities. These associations could indicate a role for the indoor environment in shaping the nascent gut microbiota, but future studies will be needed to confirm that our findings do not solely reflect a reverse pathway. Although pet ownership was strongly associated with the presence of certain genera in the dust for dogs (Agrococcus, Carnobacterium, Exiguobacterium, Herbaspirillum, Leifsonia and Neisseria) and cats (Escherichia), no clear patterns were observed in the NMDS-resolved stool community profiles as a function of pet ownership.
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Affiliation(s)
- T Konya
- Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Canada
| | - B Koster
- Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Canada
| | - H Maughan
- Department of Cell and Systems Biology, University of Toronto, Canada
| | - M Escobar
- Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Canada
| | - M B Azad
- Department of Pediatrics, University of Alberta, Canada
| | - D S Guttman
- Department of Cell and Systems Biology, University of Toronto, Canada
| | - M R Sears
- Department of Medicine, McMaster University, Canada
| | | | - J R Brook
- Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Canada; Environment Canada, Canada
| | - T K Takaro
- Faculty of Health Science, Simon Fraser University, Canada
| | - A L Kozyrskyj
- Department of Pediatrics, University of Alberta, Canada
| | - J A Scott
- Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Canada.
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21
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Macfarlane JG, Ruchaud-Sparagano MH, Scott JA, Bulmer DA, Khan CMA, Simpson AJ. P142 Src kinase inhibition attenuates neutrophil degranulation without impairing bacterial killing: a possible therapeutic strategy for acute lung injury? Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.292] [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: 11/04/2022]
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22
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Levine OS, O'Brien KL, Deloria-Knoll M, Murdoch DR, Feikin DR, DeLuca AN, Driscoll AJ, Baggett HC, Brooks WA, Howie SRC, Kotloff KL, Madhi SA, Maloney SA, Sow S, Thea DM, Scott JA. The Pneumonia Etiology Research for Child Health Project: a 21st century childhood pneumonia etiology study. Clin Infect Dis 2012; 54 Suppl 2:S93-101. [PMID: 22403238 PMCID: PMC3297546 DOI: 10.1093/cid/cir1052] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Pneumonia Etiology Research for Child Health (PERCH) project is a 7-country, standardized, comprehensive evaluation of the etiologic agents causing severe pneumonia in children from developing countries. During previous etiology studies, between one-quarter and one-third of patients failed to yield an obvious etiology; PERCH will employ and evaluate previously unavailable innovative, more sensitive diagnostic techniques. Innovative and rigorous epidemiologic and analytic methods will be used to establish the causal association between presence of potential pathogens and pneumonia. By strategic selection of study sites that are broadly representative of regions with the greatest burden of childhood pneumonia, PERCH aims to provide data that reflect the epidemiologic situation in developing countries in 2015, using pneumococcal and Haemophilus influenzae type b vaccines. PERCH will also address differences in host, environmental, and/or geographic factors that might determine pneumonia etiology and, by preserving specimens, will generate a resource for future research and pathogen discovery.
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Affiliation(s)
- Orin S Levine
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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23
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Grant LR, Hammitt LL, Murdoch DR, O'Brien KL, Scott JA. Procedures for collection of induced sputum specimens from children. Clin Infect Dis 2012; 54 Suppl 2:S140-5. [PMID: 22403228 PMCID: PMC3297553 DOI: 10.1093/cid/cir1069] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 12/22/2011] [Indexed: 12/17/2022] Open
Abstract
In most settings, sputum is not routinely collected for microbiological diagnosis from children with lower respiratory disease. To evaluate whether it is feasible and diagnostically useful to collect sputum in the Pneumonia Etiology Research for Child Health (PERCH) study, we reviewed the literature on induced sputum procedures. Protocols for induced sputum in children were collated from published reports and experts on respiratory disease and reviewed by an external advisory group for recommendation in the PERCH study. The advisory group compared 6 protocols: 4 followed a nebulization technique using hypertonic saline, and 2 followed a chest or abdomen massage technique. Grading systems for specimen quality were evaluated. Collecting sputum from children with lower respiratory tract illness is feasible and is performed around the world. An external advisory group recommended that sputum be collected from children hospitalized with severe and very severe pneumonia who participate in the PERCH study provided no contraindications exist. PERCH selected the nebulization technique using hypertonic saline.
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Affiliation(s)
- Lindsay R Grant
- Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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24
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Summerbell RC, Gueidan C, Schroers HJ, de Hoog GS, Starink M, Rosete YA, Guarro J, Scott JA. Acremonium phylogenetic overview and revision of Gliomastix, Sarocladium, and Trichothecium. Stud Mycol 2011; 68:139-62. [PMID: 21523192 PMCID: PMC3065988 DOI: 10.3114/sim.2011.68.06] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Over 200 new sequences are generated for members of the genus
Acremonium and related taxa including ribosomal small subunit
sequences (SSU) for phylogenetic analysis and large subunit (LSU) sequences
for phylogeny and DNA-based identification. Phylogenetic analysis reveals that
within the Hypocreales, there are two major clusters containing
multiple Acremonium species. One clade contains Acremonium
sclerotigenum, the genus Emericellopsis, and the genus
Geosmithia as prominent elements. The second clade contains the
genera Gliomastixsensu stricto and Bionectria. In
addition, there are numerous smaller clades plus two multi-species clades, one
containing Acremonium strictum and the type species of the genus
Sarocladium, and, as seen in the combined SSU/LSU analysis, one
associated subclade containing Acremonium breve and related species
plus Acremonium curvulum and related species. This sequence
information allows the revision of three genera. Gliomastix is
revived for five species, G. murorum, G. polychroma, G. tumulicola, G.
roseogrisea, and G. masseei. Sarocladium is extended to
include all members of the phylogenetically distinct A. strictum
clade including the medically important A. kiliense and the
protective maize endophyte A. zeae. Also included in
Sarocladium are members of the phylogenetically delimited
Acremonium bacillisporum clade, closely linked to the A.
strictum clade. The genus Trichothecium is revised following the
principles of unitary nomenclature based on the oldest valid anamorph or
teleomorph name, and new combinations are made in Trichothecium for
the tightly interrelated Acremonium crotocinigenum, Spicellum
roseum, and teleomorph Leucosphaerinaindica. Outside
the Hypocreales, numerous Acremonium-like species fall into
the Plectosphaerellaceae, and A. atrogriseum falls into the
Cephalothecaceae.
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Affiliation(s)
- R C Summerbell
- Sporometrics, Inc. 219 Dufferin Street, Suite 20C, Toronto, Ont., Canada M6K 1Y9
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25
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Abstract
AIM To determine the effect of mothers receiving health promotion material and education antenatally and/or postnatally on breastfeeding outcomes in Perth, Western Australia. METHODS A 12-month longitudinal study was conducted in two public maternity hospitals in Perth, Western Australia, between 2002 and 2003. Data were collected on a consecutive sample 587 mothers. RESULTS The results showed that mothers who received an individual consultation or were involved in a discussion on breastfeeding antenatally with hospital staff were approximately 55% less likely to cease fully breastfeeding (HR 0.44; 95% CI 0.24-0.88) before 6 months, and 50% less likely to cease any breastfeeding before 12 months postnatally (HR 0.51; 95% CI 0.28-0.92). In the postnatal period, mothers who received instruction on positioning and attachment of the infant to the breast while in hospital were approximately 30% less likely to cease fully breastfeeding before 6 months (HR 0.66; 95% CI 0.45-0.99). CONCLUSION The results of this study suggest a positive association between receiving individualized breastfeeding information in both the antenatal and postnatal period, and breastfeeding outcomes.
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Affiliation(s)
- P K Pannu
- School of Public Health, Curtin University of Technology, Perth, WA, Australia
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26
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Chapman SJ, Khor CC, Vannberg FO, Rautanen A, Walley A, Segal S, Moore CE, Davies RJO, Day NP, Peshu N, Crook DW, Berkley JA, Williams TN, Scott JA, Hill AVS. Common NFKBIL2 polymorphisms and susceptibility to pneumococcal disease: a genetic association study. Crit Care 2010; 14:R227. [PMID: 21171993 PMCID: PMC3220025 DOI: 10.1186/cc9377] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 11/12/2010] [Accepted: 12/20/2010] [Indexed: 11/15/2022]
Abstract
Introduction Streptococcus pneumoniae remains a major global health problem and a leading cause of death in children worldwide. The factors that influence development of pneumococcal sepsis remain poorly understood, although increasing evidence points towards a role for genetic variation in the host's immune response. Recent insights from the study of animal models, rare human primary immunodeficiency states, and population-based genetic epidemiology have focused attention on the role of the proinflammatory transcription factor NF-κB in pneumococcal disease pathogenesis. The possible role of genetic variation in the atypical NF-κB inhibitor IκB-R, encoded by NFKBIL2, in susceptibility to invasive pneumococcal disease has not, to our knowledge, previously been reported upon. Methods An association study was performed examining the frequencies of nine common NFKBIL2 polymorphisms in two invasive pneumococcal disease case-control groups: European individuals from hospitals in Oxfordshire, UK (275 patients and 733 controls), and African individuals from Kilifi District Hospital, Kenya (687 patients with bacteraemia, of which 173 patients had pneumococcal disease, together with 550 controls). Results Five polymorphisms significantly associated with invasive pneumococcal disease susceptibility in the European study, of which two polymorphisms also associated with disease in African individuals. Heterozygosity at these loci was associated with protection from invasive pneumococcal disease (rs760477, Mantel-Haenszel 2 × 2 χ2 = 11.797, P = 0.0006, odds ratio = 0.67, 95% confidence interval = 0.53 to 0.84; rs4925858, Mantel-Haenszel 2 × 2 χ2 = 9.104, P = 0.003, odds ratio = 0.70, 95% confidence interval = 0.55 to 0.88). Linkage disequilibrium was more extensive in European individuals than in Kenyans. Conclusions Common NFKBIL2 polymorphisms are associated with susceptibility to invasive pneumococcal disease in European and African populations. These findings further highlight the importance of control of NF-κB in host defence against pneumococcal disease.
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Affiliation(s)
- Stephen J Chapman
- The Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK.
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27
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Weinberger DM, Harboe ZB, Sanders EAM, Ndiritu M, Klugman KP, Rückinger S, Dagan R, Adegbola R, Cutts F, Johnson HL, O'Brien KL, Scott JA, Lipsitch M. Association of serotype with risk of death due to pneumococcal pneumonia: a meta-analysis. Clin Infect Dis 2010; 51:692-9. [PMID: 20715907 DOI: 10.1086/655828] [Citation(s) in RCA: 253] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The 92 capsular serotypes of Streptococcus pneumoniae differ greatly in nasopharyngeal carriage prevalence, invasiveness, and disease incidence. There has been some debate, though, regarding whether serotype independently affects the outcome of invasive pneumococcal disease (IPD). Published studies have shown variable results with regard to case-fatality ratios for specific serotypes and the role of host factors in affecting these relationships. We evaluated whether risk of death due to IPD is a stable serotype-associated property across studies and then compared the pooled effect estimates with epidemiologic and biological correlates. METHODS We performed a systematic review and meta-analysis of serotype-specific disease outcomes for patients with pneumonia and meningitis. Study-specific estimates of risk of death (risk ratio [RR]) were pooled from 9 studies that provided serotype-specific data on pneumonia and meningitis using a random-effects method with serotype 14 as the reference. Pooled RRs were compared with RRs from adults with low comorbidity scores to evaluate potential confounding by host factors. RESULTS Significant differences were found in the RR estimates among serotypes in patients with bacteremic pneumonia. Overall, serotypes 1, 7F, and 8 were associated with decreased RRs, and serotypes 3, 6A, 6B, 9N, and 19F were associated with increased RRs. Outcomes among meningitis patients did not differ significantly among serotypes. Serotypes with increased RRs had a high carriage prevalence, had low invasiveness, and were more heavily encapsulated in vitro. CONCLUSIONS These results suggest that IPD outcome, like other epidemiologic measures, is a stable serotype-associated property.
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Affiliation(s)
- Daniel M Weinberger
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA.
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Corbett-Detig J, Habas PA, Scott JA, Kim K, Rajagopalan V, McQuillen PS, Barkovich AJ, Glenn OA, Studholme C. 3D global and regional patterns of human fetal subplate growth determined in utero. Brain Struct Funct 2010; 215:255-63. [PMID: 21046152 PMCID: PMC3041913 DOI: 10.1007/s00429-010-0286-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [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: 05/28/2010] [Accepted: 10/06/2010] [Indexed: 12/13/2022]
Abstract
The waiting period of subplate evolution is a critical phase for the proper formation of neural connections in the brain. During this time, which corresponds to 15 to 24 postconceptual weeks (PCW) in the human fetus, thalamocortical and cortico-cortical afferents wait in and are in part guided by molecules embedded in the extracellular matrix of the subplate. Recent advances in fetal MRI techniques now allow us to study the developing brain anatomy in 3D from in utero imaging. We describe a reliable segmentation protocol to delineate the boundaries of the subplate from T2-W MRI. The reliability of the protocol was evaluated in terms of intra-rater reproducibility on a subset of the subjects. We also present the first 3D quantitative analyses of temporal changes in subplate volume, thickness, and contrast from 18 to 24 PCW. Our analysis shows that firstly, global subplate volume increases in proportion with the supratentorial volume; the subplate remained approximately one-third of supratentorial volume. Secondly, we found both global and regional growth in subplate thickness and a linear increase in the median and maximum subplate thickness through the waiting period. Furthermore, we found that posterior regions--specifically the occipital pole, ventral occipito-temporal region, and planum temporale--of the developing brain underwent the most statistically significant increases in subplate thickness. During this period, the thickest region was the developing somatosensory/motor cortex. The subplate growth patterns reported here may be used as a baseline for comparison to abnormal fetal brain development.
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Affiliation(s)
- J Corbett-Detig
- Biomedical Image Computing Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143-0628, USA.
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Khor CC, Vannberg FO, Chapman SJ, Guo H, Wong SH, Walley AJ, Vukcevic D, Rautanen A, Mills TC, Chang KC, Kam KM, Crampin AC, Ngwira B, Leung CC, Tam CM, Chan CY, Sung JJ, Yew WW, Toh KY, Tay SK, Kwiatkowski D, Lienhardt C, Hien TT, Day NP, Peshu N, Marsh K, Maitland K, Scott JA, Williams TN, Berkley JA, Floyd S, Tang NL, Fine PE, Goh DL, Hill AV. CISH and susceptibility to infectious diseases. N Engl J Med 2010; 362:2092-101. [PMID: 20484391 PMCID: PMC3646238 DOI: 10.1056/nejmoa0905606] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The interleukin-2-mediated immune response is critical for host defense against infectious pathogens. Cytokine-inducible SRC homology 2 (SH2) domain protein (CISH), a suppressor of cytokine signaling, controls interleukin-2 signaling. METHODS Using a case-control design, we tested for an association between CISH polymorphisms and susceptibility to major infectious diseases (bacteremia, tuberculosis, and severe malaria) in blood samples from 8402 persons in Gambia, Hong Kong, Kenya, Malawi, and Vietnam. We had previously tested 20 other immune-related genes in one or more of these sample collections. RESULTS We observed associations between variant alleles of multiple CISH polymorphisms and increased susceptibility to each infectious disease in each of the study populations. When all five single-nucleotide polymorphisms (SNPs) (at positions -639, -292, -163, +1320, and +3415 [all relative to CISH]) within the CISH-associated locus were considered together in a multiple-SNP score, we found an association between CISH genetic variants and susceptibility to bacteremia, malaria, and tuberculosis (P=3.8x10(-11) for all comparisons), with -292 accounting for most of the association signal (P=4.58x10(-7)). Peripheral-blood mononuclear cells obtained from adult subjects carrying the -292 variant, as compared with wild-type cells, showed a muted response to the stimulation of interleukin-2 production--that is, 25 to 40% less CISH expression. CONCLUSIONS Variants of CISH are associated with susceptibility to diseases caused by diverse infectious pathogens, suggesting that negative regulators of cytokine signaling have a role in immunity against various infectious diseases. The overall risk of one of these infectious diseases was increased by at least 18% among persons carrying the variant CISH alleles.
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Affiliation(s)
- Chiea C. Khor
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
- Host Susceptibility to Infection program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | | | | | - Haiyan Guo
- Host Susceptibility to Infection program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Sunny H. Wong
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
| | - Andrew J. Walley
- Section of Genomic Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Damjan Vukcevic
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
| | - Anna Rautanen
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
| | - Tara C. Mills
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
| | - Kwok-Chiu Chang
- Department of Health, Tuberculosis and Chest Sevice ,Hong Kong SAR, China
| | - Kai-Man Kam
- Public Health Laboratory Center, Department of Health, Hong Kong SAR Government, China
| | | | | | - Chi-Chiu Leung
- Department of Health, Tuberculosis and Chest Sevice ,Hong Kong SAR, China
| | - Cheuk-Ming Tam
- Department of Health, Tuberculosis and Chest Sevice ,Hong Kong SAR, China
| | - Chiu-Yeung Chan
- Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Joseph J.Y. Sung
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Wai Yew
- Tuberculosis and Chest Unit, Grantham Hospital, Hospital Authority, Hong Kong SAR, China
| | - Kai-Yee Toh
- Host Susceptibility to Infection program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Stacey K.H. Tay
- Department of Paediatrics, Children’s Medical Institute, National Universityc Health System and National University of Singapore
| | - Dominic Kwiatkowski
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
- MRC Laboratories, P.O. Box 273, The Gambia
| | | | - Tran-Tinh Hien
- Center for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Vietnam
| | - Nicholas P. Day
- Center for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Vietnam
| | - Nobert Peshu
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya
| | - Kevin Marsh
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya
- Department of Paediatrics and Wellcome Trust Centre for Clinical Tropical Medicine, Faculty of Medicine, Imperial College, Norfolk Place, London, W2 1PG, UK
| | - Kathryn Maitland
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya
- Department of Paediatrics and Wellcome Trust Centre for Clinical Tropical Medicine, Faculty of Medicine, Imperial College, Norfolk Place, London, W2 1PG, UK
| | - J. Anthony Scott
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya
- Centre for Clinical Vaccinology & Tropical Medciine, University of Oxford, UK
| | - Thomas N. Williams
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya
- Centre for Clinical Vaccinology & Tropical Medciine, University of Oxford, UK
| | - James A. Berkley
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya
- Centre for Clinical Vaccinology & Tropical Medciine, University of Oxford, UK
| | - Sian Floyd
- Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine
| | - Nelson L.S. Tang
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory of Genetics of Disease Susceptibility, Li Ka Shing Institute of Health Sciences, The Chinese Unviersity of Hong Kong, Hong Kong SAR, China
| | - Paul E.M. Fine
- Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine
| | - Denise L.M. Goh
- Host Susceptibility to Infection program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Department of Paediatrics, Children’s Medical Institute, National Universityc Health System and National University of Singapore
| | - Adrian V.S. Hill
- The Wellcome Trust Centre for Human Genetics, University of Oxford, UK
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Chapman SJ, Khor CC, Vannberg FO, Rautanen A, Segal S, Moore CE, Davies RJO, Day NP, Peshu N, Crook DW, Berkley JA, Williams TN, Scott JA, Hill AVS. NFKBIZ polymorphisms and susceptibility to pneumococcal disease in European and African populations. Genes Immun 2009; 11:319-25. [PMID: 19798075 DOI: 10.1038/gene.2009.76] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The proinflammatory transcription factor nuclear factor-kappaB (NF-kappaB) has a central role in host defence against pneumococcal disease. Both rare mutations and common polymorphisms in the NFKBIA gene encoding the NF-kappaB inhibitor, IkappaB-alpha, associate with susceptibility to bacterial disease, but the possible role of polymorphisms within the related IkappaB-zeta gene NFKBIZ in the development of invasive pneumococcal disease (IPD) has not been reported previously. To investigate this further, we examined the frequencies of 22 single-nucleotide polymorphisms spanning NFKBIZ in two case-control studies, comprising UK Caucasian (n=1008) and Kenyan (n=723) individuals. Nine polymorphisms within a single UK linkage disequilibrium (LD) block and all four polymorphisms within the equivalent, shorter Kenyan LD block displayed either a significant association with IPD or a trend towards association. For each polymorphism, heterozygosity was associated with protection from IPD when compared with the combined homozygous states (for example, for rs600718, Mantel-Haenszel 2 x 2 chi(2)=7.576, P=0.006, odds ratio (OR)=0.67, 95% confidence interval (95% CI) for OR: 0.51-0.88; for rs616597, Mantel-Haenszel 2 x 2 chi(2)=8.715, P=0.003, OR=0.65, 95% CI: 0.49-0.86). We conclude that multiple NFKBIZ polymorphisms associate with susceptibility to IPD in humans. The study of multiple populations may aid in fine mapping of associations within extensive regions of strong LD ('transethnic mapping').
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Affiliation(s)
- S J Chapman
- Immunity and Inflammation, The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
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Saldanha R, Manno M, Saleh M, Ewaze JO, Scott JA. The influence of sampling duration on recovery of culturable fungi using the Andersen N6 and RCS bioaerosol samplers. Indoor Air 2008; 18:464-72. [PMID: 18761682 DOI: 10.1111/j.1600-0668.2008.00547.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
UNLABELLED The influence of sampling duration on recovery of culturable fungi was compared using the Andersen N6 and the Reuter Centrifugal Sampler (RCS). Samplers were operated side-by-side, collecting 15 samples each of incrementally increasing duration (1-15 min). From 270 samples collected, 26 fungal genera were recovered. Species of Alternaria, Aspergillus, Cladosporium, Epicoccum, Penicillium and Ulocladium were most frequent. Data adjusted to CFU/m3 were fitted to a Poisson regression model with a logarithmic link function and evaluated for the impact of sampling time on qualitative and quantitative recovery of fungi, both as individual taxa and in aggregate according to xerotolerance. Significant differences between the two samplers were observed for xerotolerant and normotolerant moulds, as well as Aspergillus spp. and Cladosporium spp. With the exception of Cladosporium spp., overall recoveries were higher with the RCS. When the Andersen N6 was used, the recovered levels of Cladosporium spp. and unidentified yeasts were reduced significantly at sampling times over 6 min. Similarly, when the RCS was used, recovery of Aspergillus spp., Penicillium spp., Ulocladium spp., unidentified yeasts, and low water activity fungi declined significantly at sampling times over 6 min. PRACTICAL IMPLICATIONS Currently, the industry-wide trend for viable air sampling in indoor environmental investigations is to use sampling times between 2 and 4 min in duration. Our results support the routine use of a 6-min sampling time where low spore loads are expected, resulting in improved limits of detection.
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Affiliation(s)
- R Saldanha
- Golder Associates Ltd, Toronto, ON, Canada
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Kaufman DJ, Katsanis SH, Javitt GH, Murphy JA, Scott JA, Hudson KL. Carrier screening for cystic fibrosis in US genetic testing laboratories: a survey of laboratory directors. Clin Genet 2008; 74:367-73. [PMID: 18700896 DOI: 10.1111/j.1399-0004.2008.01070.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Initial guidelines for cystic fibrosis (CF) carrier screening were issued in 2001 by the American College of Medical Genetics and the American College of Obstetricians and Gynecologists and updated in 2004. It is unknown how these guidelines have influenced laboratory practice. This study examined the uptake of two components of these guidelines for CF screening in genetic testing laboratories. A survey of directors of US genetic testing laboratories was conducted. Of 190 respondents, 178 answered questions about CF testing. Nearly half (49%) performed some type of DNA testing for CF; most of these (92%) performed CF carrier screening. Ten percent used a 23-mutation panel for CF screening. The results of 5T tests were reported as a reflex test by 79% of laboratories, while 8% always returned 5T results and 7% never returned them. Seven percent of laboratories adopted both guidelines, 80% adopted one of the two guidelines, and 13% had not adopted either recommendation, suggesting that factors other than clinical guidelines may influence laboratories' CF screening practices. Further studies are needed to determine whether the adoption of CF screening guidelines has significant clinical or economic effects on population-based CF screening programs.
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Affiliation(s)
- D J Kaufman
- Genetics and Public Policy Center, Berman Institute of Bioethics, Johns Hopkins University, Washington, DC, USA.
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Abstract
OBJECTIVE To validate a five-item, semi-quantitative, short food frequency questionnaire (SFFQ) designed to estimate daily legume consumption over a week, against results obtained from 7-day food diaries (7-day FD). DESIGN Participants completed a 7-day FD and at the end of this period completed the SFFQ, to indicate the number of times they ate five legume-containing dishes in the previous week and what size portion of each dish they consumed. Daily legume intake (g day(-1)) was calculated for both methods and participants were classified into tertiles of intake for each method. SUBJECTS/SETTING Fifty-one healthy females aged 25-55 years, employed at the University of Glasgow, Scotland, UK between May 2003 and December 2004. RESULTS The two methods produced a similar mean intake of legumes [SFFQ: 14.8 (95% CI: 9.9-19.8) versus 7-day FD: 14.9 (95% CI: 9.3-20.6) g day(-1)] and the Pearson's correlation coefficient was 0.353 (P = 0.038). Exact agreement within tertiles and gross misclassification were 54.9% and 9.8% respectively. The weighted kappa statistic indicated fair agreement between the two methods (kappa = 0.262). CONCLUSIONS The SFFQ is an acceptable instrument for estimating legume consumption over a week and can be used to rank individuals according to the intake of this food group in similar nutrition intervention studies.
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Affiliation(s)
- A Papadaki
- Preventive Medicine and Nutrition Clinic, Department of Social Medicine, University of Crete, Greece.
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Abstract
OBJECTIVE To document patterns of measured weight and waist circumference (WC) change and the increase in overweight and obesity over a 9-year period. SUBJECTS/METHODS A total of 1044 subjects from two age-defined cohorts aged 39 and 59 in 1991. Height, weight and WC were measured in 1991, 1995 and 2000 and body mass index (BMI) was calculated. Pattern of weight and WC change was studied over approximately 9 years. RESULTS The prevalence of overweight and obesity increased markedly and the younger cohort showed greater increases in weight and WC than the older cohort. There was no significant difference in mean BMI and/or mean 9-year weight change between men and women in either age cohort, and mean weight gain was similar for all occupational groups. Only 20% of subjects maintained a stable weight (+/-2 kg), while 42.2 and 17.6% gained greater than 5 and 10 kg over the 9-year period, respectively. The rate of weight gain appeared to be relatively steady over the 9 years among younger subjects but declined in the older subjects in the second half of the observation period. CONCLUSIONS Health promotion strategies to prevent weight gain need to be population-based, targeting all social and age groups, but particularly those in their early middle-age.
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Affiliation(s)
- M Ebrahimi-Mameghani
- Department of Nutrition, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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McKellar G, Morrison E, McEntegart A, Hampson R, Tierney A, Mackle G, Scoular J, Scott JA, Capell HA. A pilot study of a Mediterranean-type diet intervention in female patients with rheumatoid arthritis living in areas of social deprivation in Glasgow. Ann Rheum Dis 2007; 66:1239-43. [PMID: 17613557 PMCID: PMC1955146 DOI: 10.1136/ard.2006.065151] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats has been associated with health benefits, including improved cardiovascular profile and benefit in RA. OBJECTIVE To overcome obstacles to healthy eating by a community-based intervention promoting a Mediterranean-type diet in patients with RA living in socially deprived areas of Glasgow. METHODS 130 female patients with RA aged 30-70 years (median 55), disease duration 8 years were recruited from three hospital sites. The intervention group (n = 75) attended weekly 2-hour sessions for 6 weeks in the local community, including hands-on cooking classes backed up with written information. The control group (n = 55) were given dietary written information only. Both groups completed food frequency questionnaires (FFQs), and clinical and laboratory measures were assessed at baseline, 3 and 6 months. RESULTS Significant benefit was shown in the intervention group compared with controls for patient global assessment at 6 months (p = 0.002), pain score at 3 and 6 months (p = 0.011 and 0.049), early morning stiffness at 6 months (p = 0.041) and Health Assessment Questionnaire score at 3 months (p = 0.03). Analysis of the FFQs showed significant increases in weekly total fruit, vegetable and legume consumption and improvement in the ratio of monounsaturated:saturated fat intake and systolic BP in the intervention group only. The cooking classes were positively received by patients and tutors; cost/patient for the 6 week course was 84 pounds (124 euro). CONCLUSIONS Results demonstrate that a 6 week intervention can improve consumption of healthier foods. If implemented more widely it may prove a popular, inexpensive and useful adjunct to other RA treatment.
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Affiliation(s)
- G McKellar
- Glasgow Royal Infirmary Castle Street, G4 0SF Glasgow, UK.
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Synnott K, Bogue J, Edwards CA, Scott JA, Higgins S, Norin E, Frias D, Amarri S, Adam R. Parental perceptions of feeding practices in five European countries: an exploratory study. Eur J Clin Nutr 2007; 61:946-56. [PMID: 17228346 DOI: 10.1038/sj.ejcn.1602604] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To gain an insight into parental perceptions of infant feeding practices in five European countries. DESIGN An exploratory investigation using focus group discussions. Various aspects addressed included social and cultural setting for the consumption of food, infant feeding practice and behaviour, consumer health awareness and sources of information, and attitudes towards a healthy infant diet. SETTING Focus group participants were recruited from centres in five countries, Germany, Italy, Scotland, Spain and Sweden, with three focus groups being conducted in each centre. SUBJECTS A total of 108 parents with infants up to the age of 12 months participated in focus group discussions across these centres. METHODS Focus groups were conducted with participants from centres in five countries. RESULTS The majority of parents in this study chose to initiate breastfeeding and prepare infant food at home. Parents did not strictly adhere to infant feeding guidelines when introducing complementary foods into their infant's diets. There were cross-cultural differences in sources of information on infant feeding practice with the paediatrician in Germany, Italy and Spain. The health visitor in Scotland and the child welfare clinics in Sweden were the most popular sources. CONCLUSIONS A number of cultural differences and similarities in attitudes towards infant feeding practice were revealed. This makes European wide approaches to promoting healthy infant feeding difficult as different infant feeding practices are influenced not only by parental perceptions but also by advice from health professionals and feeding guidelines. Further data need to be available on parents' attitudes and beliefs towards infant feeding practice to investigate further the rationale for differing beliefs and attitudes towards infant feeding practice. SPONSORSHIP EU Fifth Framework QLRT 2002 02606.
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Affiliation(s)
- K Synnott
- Department of Food Business and Development, University College Cork, Cork, Ireland
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Binns CW, Win NN, Zhao Y, Scott JA. Trends in the expression of breastmilk 1993-2003. Breastfeed Rev 2006; 14:5-9. [PMID: 17190014] [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: 05/13/2023]
Abstract
The expression of breastmilk is an important strategy to enable mothers to continue exclusive breastfeeding. In some situations, for health or convenience, expressed breastmilk is required and infants fed this way still fall within the definition of exclusive breastfeeding. The aim of this study was to document the changes in rates of breastmilk expression between the first Perth Infant Feeding Study (PIFS I) in 1992-03 and PIFS II in 2002-03. The proportion of mothers expressing breastmilk peaked in the first six weeks, at 38% for PIFS I and 69% for PIFS II. The proportion of mothers who had expressed breastmilk had almost doubled in the decade between studies. The proportion of mothers expressing declined to about 28% of mothers at 22 weeks for PIFS II and slightly less in PIFS I. Breastmilk expression is a very useful skill to allow mothers to exclusively breastfeed until six months and should be taught to all mothers.
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Affiliation(s)
- C W Binns
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
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Nwagwu CI, Mathews MS, Scott JA, Denardo AJ, Horner TG. Ruptured Giant Basilar Artery Aneurysm in a Comatose Adolescent: Successful Obliteration Using Intraoperative SSEP, BAER, and MEP Monitoring. A Case Report. Interv Neuroradiol 2006; 12:237-44. [PMID: 20569577 DOI: 10.1177/159101990601200306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 08/15/2006] [Indexed: 11/17/2022] Open
Abstract
SUMMARY Giant basilar aneurysms are infrequently seen in children. We present the endovascular management of an adolescent who presented comatose with pinpoint pupils due to a ruptured giant basilar trunk aneurysm. A noncontrast head CT disclosed a large prepontine lesion with brainstem hemorrhage. Catheter angiography showed a 4.5 cm irregular, fusiform basilar trunk aneurysm. With SSEP, BAER, and MEP monitoring, the patient underwent bilateral temporary vertebral artery occlusion, followed by GDC embolization of the aneurysm. Postprocedure internal carotid angiograms showed adequate blood supply to the basilar apex via patent posterior communicating arteries. On postprocedure day two, the patient was following commands. The remainder of his hospital course was uneventful. Postoperative angiograms showed no residual filling of the aneurysm. At 12 months the patient was neurologically intact and at baseline function as an honor student and follow-up angiogram showed persistent occlusion of the aneurysm from the circulation. Successful endovascular treatment has been considered a less invasive and safer alternative to surgical management of some complex vascular lesions. While most reports on reversing basilar artery flow have been carried out in awake patients with neurological examinations, this is not possible in a patient presenting in a comatose state. This report suggests that SSEPs, BAERs and MEP may be of use in such patients in safely carrying out basilar artery occlusion.
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Affiliation(s)
- C I Nwagwu
- Department of Neurosurgery, University of California (Irvine), Orange, California -
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Abstract
An understanding of how fatigue cracks grow in bone is of importance as fatigue is thought to be the main cause of clinical stress fractures. This study presents new results on the fatigue-crack growth behavior of small surface cracks (approximately 75-1000 microm in size) in human cortical bone, and compares their growth rates with data from other published studies on the behavior of both surface cracks and many millimeter, through-thickness large cracks. Results are obtained with a cyclically loaded cantilever-beam geometry using optical microscopy to examine for crack growth after every 100-500 cycles. Based on the current and previous results, small fatigue cracks appear to become more resistant to fatigue-crack growth with crack extension, analogous to the way the fracture resistance of cortical bone increases with crack growth. Mechanistically, a theory attributing such behavior to the development of bridges in the wake of the crack with crack growth is presented. The existence of such bridges is directly confirmed using optical microscopy.
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Affiliation(s)
- J J Kruzic
- Department of Mechanical Engineering, Oregon State University, Corvallis, OR 97331, USA
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Levine OS, O'Brien KL, Knoll M, Adegbola RA, Black S, Cherian T, Dagan R, Goldblatt D, Grange A, Greenwood B, Hennessy T, Klugman KP, Madhi SA, Mulholland K, Nohynek H, Santosham M, Saha SK, Scott JA, Sow S, Whitney CG, Cutts F. Pneumococcal vaccination in developing countries. Lancet 2006; 367:1880-2. [PMID: 16765742 DOI: 10.1016/s0140-6736(06)68703-5] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Orin S Levine
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Abstract
The Internet offers a promising medium for delivering nutrition education. This study aimed to evaluate user perceptions and usage patterns of an innovative healthy eating website promoting the Mediterranean diet. The website was evaluated over a 6-month period by female employees of University of Glasgow, aged 25-55 years. User satisfaction with the website was evaluated using a triangulation approach, including website visit counts, questionnaires (31 participants) and focus group interviews (18 participants). Although login frequency decreased over the 6-month study, questionnaires revealed that most sections of the website were viewed as being very helpful and the majority of participants perceived the overall website to be extremely interesting, informative, novel, trustworthy, easy to understand, useful, user-friendly, attractive and encouraging. The recipes section was the most visited and lack of time was the main barrier to using the website on a weekly basis, as recommended. The results of the questionnaires were confirmed by measures of website usage and the feedback provided by the focus group interviews. Several features that would improve the website, such as increased interactivity, nutritional analysis and fruit and vegetable serving content of recipes and more regular updates, were identified from the interviews and will inform future refinements of the website.
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Affiliation(s)
- A Papadaki
- Human Nutrition Section, Division of Developmental Medicine, Faculty of Medicine, University of Glasgow, Glasgow Royal Infirmary, UK
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Molassiotis A, Ozden G, Platin N, Scott JA, Pud D, Fernandez-Ortega P, Milovics L, Panteli V, Gudmundsdottir G, Browall M, Madsen E, Patiraki E, Kearney N. Complementary and alternative medicine use in patients with head and neck cancers in Europe. Eur J Cancer Care (Engl) 2006; 15:19-24. [PMID: 16441673 DOI: 10.1111/j.1365-2354.2005.00615.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to examine the patterns of complementary and alternative medicine (CAM) use in a sample of head and neck cancer patients, forming part of a larger study. A cross-sectional survey design was used collecting data through a descriptive 27-item questionnaire in nine countries in Europe. The participants were 75 patients with head and neck cancers. The prevalence rate of CAM use was 22.7%. The most common therapies used were herbal medicine (47%), medicinal teas (23.5%), use of vitamins/minerals (11.8%) and visualization (11.8%). Use of CAM dramatically increased after the diagnosis with cancer (i.e. eightfold increase in the use of herbs). A profile of CAM users was not evident in this sample. Patients used CAM for a variety of reasons together, with counteracting the ill effects from cancer and its treatment being the most common one. Information about CAM was obtained mostly from friends and family. As one in five head and neck cancer patients use CAM it is important that clinicians explore practices with their patients, improve communication about CAM with them and assist those who want to use CAM in using appropriate and safe therapies.
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Affiliation(s)
- A Molassiotis
- School of Nursing, University of Manchester, Manchester, UK.
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Scott JA, Kearney N, Hummerston S, Molassiotis A. Use of complementary and alternative medicine in patients with cancer: a UK survey. Eur J Oncol Nurs 2005; 9:131-7. [PMID: 15944106 DOI: 10.1016/j.ejon.2005.03.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 03/22/2005] [Indexed: 11/26/2022]
Abstract
Over the past decade Complementary and Alternative Medicine (CAM) use in the UK has increased dramatically. However, little research appears to exist regarding its use in patients diagnosed with cancer. The study was descriptive using a survey design. Questionnaire data was collected from 127 adult patients with a diagnosis of cancer from both Scotland and England. CAM use was reported by 29% of the sample. The use of relaxation, meditation and the use of medicinal teas were the most frequently used therapies. Findings suggest that CAM use within patients diagnosed with cancer in the UK has increased which has implications for patient and health care professional education.
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Affiliation(s)
- J A Scott
- Department of Nursing and Midwifery, University of Stirling, Stirling, Scotland FK9 4LA, UK.
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Abstract
AIM To report updated rates of breastfeeding in Perth through 2002/3 and to compare them to those from 1992/3. METHODS DESIGN A 12-mo longitudinal study. SETTING Two public maternity hospitals in Perth, Australia. SUBJECTS Eligible mothers of healthy newborn infants delivered between mid-September 2002 and mid-July 2003. INTERVENTIONS All eligible mothers were asked to participate in a 12-mo longitudinal study of infant feeding. While in hospital, participating mothers completed a questionnaire that included questions on how they were feeding their newborn. MAIN OUTCOMES MEASURES Prevalence of ever breastfeeding, and breastfeeding at discharge. RESULTS A total of 587 mothers, or 55% of those eligible, participated in the study. At hospital discharge, 93.8% of mothers in 2002/3 were breastfeeding compared with 83.8% in 1992/3. Significant increases were observed across all socio-demographic groups, with the biggest increase seen amongst younger mothers and those born outside of Australia. The national target of having in excess of 90% of mothers breastfeeding at discharge from hospital has been achieved in Perth. The challenge for health professionals and the community is to help maintain and further improve these breastfeeding practices.
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Affiliation(s)
- K I Graham
- School of Medicine, Curtin University of Technology, Perth, Western Australia, Australia.
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Molassiotis A, Fernández-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AMA, Platin N, Kearney N, Patiraki E. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005; 16:655-63. [PMID: 15699021 DOI: 10.1093/annonc/mdi110] [Citation(s) in RCA: 687] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients across a number of European countries. METHODS A descriptive survey design was developed. Fourteen countries participated in the study and data was collected through a descriptive questionnaire from 956 patients. RESULTS Data suggest that CAM is popular among cancer patients with 35.9% using some form of CAM (range among countries 14.8% to 73.1%). A heterogeneous group of 58 therapies were identified as being used. Herbal medicines and remedies were the most commonly used CAM therapies, together with homeopathy, vitamins/minerals, medicinal teas, spiritual therapies and relaxation techniques. Herbal medicine use tripled from use before diagnosis to use since diagnosis with cancer. Multivariate analysis suggested that the profile of the CAM user was that of younger people, female and with higher educational level. The source of information was mainly from friends/family and the media, while physicians and nurses played a small part in providing CAM-related information. The majority used CAM to increase the body's ability to fight cancer or improve physical and emotional well-being, and many seemed to have benefited from using CAM (even though the benefits were not necessarily related to the initial reason for using CAM). Some 4.4% of patients, however, reported side-effects, mostly transient. CONCLUSIONS It is imperative that health professionals explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
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Affiliation(s)
- A Molassiotis
- School of Nursing, University of Manchester, Manchester, UK.
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Abstract
Azure dye-impregnated sheep's wool keratin (keratin azure) was incorporated in a high pH medium and overlaid on a keratin-free basal medium. The release and diffusion of the azure dye into the lower layer indicated production of keratinase. Fifty-eight fungal taxa, including 49 members of the Arthrodermataceae, Gymnoascaceae and Onygenaceae (Order Onygenales), were assessed for keratin degradation using this method. The results were comparable to measures of keratin utilization reported in studies using tests based on the perforation or erosion of human hair in vitro.
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Affiliation(s)
- J A Scott
- Department of Public Health Sciences/Gage Occupational and Environmental Health Unit, University of Toronto, Toronto, ON, Canada
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Abstract
BACKGROUND The reasons for mis-reporting food consumption warrant investigation. OBJECTIVE To document intention to mis-report food consumption and its associations with psychological measures in women. DESIGN A total of 184 female volunteers aged 18-65 years, comprising 50 seeking help in primary care to lose weight with a body mass index (BMI) >/=30 kg m(-2) (obese-clinical group) and 134 nurses (nonclinical groups) (BMI <25 kg m(-2), n = 52; BMI 25-29.9 kg m(-2), n = 45; BMI >/=30 kg m(-2), n = 37) were studied. A questionnaire was administered containing three psychological tests (self-esteem, psychological well-being and Stunkard's three-factor eating questionnaire) and new items to address food intake mis-reporting. RESULTS Overall, 68% of participants declared an inclination to mis-report (64% nonclinical, 78% clinical). Inclination to under-report was 29, 33 and 51% in the three nonclinical groups; and 46% among the obese clinical patients. Among the same groups, inclination to over-report were 39, 29, 11 and 32%. After adjusting for social deprivation and BMI, women inclined to mis-report had higher hunger (P = 0.008) and disinhibition (P = 0.005) scores than those intending to report accurately. These variables were associated with current dieting, frequency of dieting, self-reported bingeing and dissatisfaction with body weight. CONCLUSIONS These findings indicate that intentional under-reporting and over-reporting of food consumption are common in women of all BMI categories and are associated with eating behaviour. Current dieting, frequency of dieting in the past, self-reported bingeing and dissatisfaction with body weight seem to mediate this relationship.
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Affiliation(s)
- J J Lara
- Department of Human Nutrition, University of Glasgow, Glasgow, UK
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Abidov A, Hachamovitch R, Friedman JD, Hayes SW, Kang X, Cohen I, Germano G, Berman DS, Kjaer A, Cortsen A, Federspiel M, Hesse B, Holm S, O’Connor M, Dhalla AK, Wong MY, Wang WQ, Belardinelli L, Therapeutics CV, Epps A, Dave S, Brewer K, Chiaramida S, Gordon L, Hendrix GH, Feng B, Pretorius PH, Bruyant PP, Boening G, Beach RD, Gifford HC, King MA, Fessler JA, Hsu BL, Case JA, Gegen LL, Hertenstein GK, Cullom SJ, Bateman TM, Akincioglu C, Abidov A, Nishina H, Kavanagh P, Kang X, Aboul-Enein F, Yang L, Hayes S, Friedman J, Berman D, Germano G, Santana CA, Rivero A, Folks RD, Grossman GB, Cooke CD, Hunsche A, Faber TL, Halkar R, Garcia EV, Hansen CL, Silver S, Kaplan A, Rasalingam R, Awar M, Shirato S, Reist K, Htay T, Mehta D, Cho JH, Heo J, Dubovsky E, Calnon DA, Grewal KS, George PB, Richards DR, Hsi DH, Singh N, Meszaros Z, Thomas JL, Reyes E, Loong CY, Latus K, Anagnostopoulos C, Underwood SR, Kostacos EJ, Araujo LI, Kostacos EJ, Araujo LI, Lewin HC, Hyun MC, DePuey EG, Tanaka H, Chikamori T, Igarashi Y, Harafuji K, Usui Y, Yanagisawa H, Hida S, Yamashina A, Nasr HA, Mahmoud SA, Dalipaj MM, Golanowski LN, Kemp RAD, Chow BJ, Beanlands RS, Ruddy TD, Michelena HI, Mikolich BM, McNelis P, Decker WAV, Stathopoulos I, Duncan SA, Isasi C, Travin MI, Kritzman JN, Ficaro EP, Corbett JR, Allison JS, Weinsaft JW, Wong FJ, Szulc M, Okin PM, Kligfield P, Harafuji K, Chikamori T, Igarashi Y, Tanaka H, Usui Y, Yanagisawa H, Hida S, Ishimaru S, Yamashima A, Giedd KN, Bergmann SR, Shah S, Emmett L, Allman KC, Magee M, Van Gaal W, Kritharides L, Freedman B, Abidov A, Gerlach J, Akincioglu C, Friedman J, Kavanagh P, Miranda R, Germano G, Berman DS, Hayes SW, Damera N, Lone B, Singh R, Shah A, Yeturi S, Prasad Y, Blum S, Heller EN, Bhalodkar NC, Koutelou M, Kollaros N, Theodorakos A, Manginas A, Leontiadis E, Kouzoumi A, Cokkinos D, Mazzanti M, Marini M, Cianci G, Perna GP, Pai M, Greenberg MD, Liu F, Frankenberger O, Kokkinos P, Hanumara D, Goheen E, Wu C, Panagiotakos D, Fletcher R, Greenberg MD, Liu F, Frankenberger O, Kokkinos P, Hanumara D, Goheen E, Rodriguez OJ, Iyer VN, Lue M, Hickey KT, Blood DK, Bergmann SR, Bokhari S, Chareonthaitawee P, Christensen SD, Allen JL, Kemp BJ, Hodge DO, Ritman EL, Gibbons RJ, Smanio P, Riva G, Rodriquez F, Tricoti A, Nakhlawi A, Thom A, Pretorius PH, King MA, Dahlberg S, Leppo J, Slomka PJ, Nishina H, Berman DS, Akincioglu C, Abidov A, Friedman JD, Hayes SW, Germano G, Petrovici R, Husain M, Lee DS, Nanthakumar K, Iwanochko RM, Brunken RC, DiFilippo F, Neumann DR, Bybel B, Herrington B, Bruckbauer T, Howe C, Lohmann K, Hayden C, Chatterjee C, Lathrop B, Brunken RC, Chen MS, Lohmann KA, Howe WC, Bruckbauer T, Kaczur T, Bybel B, DiFilippo FP, Druz RS, Akinboboye OA, Grimson R, Nichols KJ, Reichek N, Ngai K, Dim R, Ho KT, Pary S, Ahmed SU, Ahlberg A, Cyr G, Vitols PJ, Mann A, Alexander L, Rosenblatt J, Mieres J, Heller GV, Ahmed SU, Ahlberg AW, Cyr G, Navare S, O’Sullivan D, Heller GV, Chiadika S, Lue M, Blood DK, Bergmann SR, Bokhari S, Heston TF, Heller GV, Cerqueira MD, Jones PG, Bryngelson JR, Moutray KL, Gegen LL, Hertenstein GK, Moser K, Case JA, Zellweger MJ, Burger PC, Pfisterer ME, Mueller-Brand J, Kang WJ, Lee BI, Lee DS, Paeng JC, Lee JS, Chung JK, Lee MC, To BN, O’Connell WJ, Botvinick EH, Duvall WL, Croft LB, Einstein AJ, Fisher JE, Haynes PS, Rose RK, Henzlova MJ, Prasad Y, Vashist A, Blum S, Sagar P, Heller EN, Kuwabara Y, Nakayama K, Tsuru Y, Nakaya J, Shindo S, Hasegawa M, Komuro I, Liu YH, Wackers F, Natale D, DePuey G, Taillefer R, Araujo L, Kostacos E, Allen S, Delbeke D, Anstett F, Kansal P, Calvin JE, Hendel RC, Gulati M, Pratap P, Takalkar A, Kostacos E, Alavi A, Araujo L, Melduni RM, Duncan SA, Travin MI, Isasi CR, Rivero A, Santana C, Esiashvili S, Grossman G, Halkar R, Folks RD, Garcia EV, Su H, Dobrucki LW, Chow C, Hu X, Bourke BN, Cavaliere P, Hua J, Sinusas AJ, Spinale FG, Sweterlitsch S, Azure M, Edwards DS, Sudhakar S, Chyun DA, Young LH, Inzucchi SE, Davey JA, Wackers FJ, Noble GL, Navare SM, Calvert J, Hussain SA, Ahlberg AM, Katten DM, Boden WE, Heller GV, Shaw LJ, Yang Y, Antunes A, Botelho MF, Gomes C, de Lima JJP, Silva ML, Moreira JN, Simões S, GonÇalves L, Providência LA, Elhendy A, Bax JJ, Schinkel AF, Valkema R, van Domburg RT, Poldermans D, Arrighi J, Lampert R, Burg M, Soufer R, Veress AI, Weiss JA, Huesman RH, Gullberg GT, Moser K, Case JA, Loong CY, Prvulovich EM, Reyes E, Aswegen AV, Anagnostopoulos C, Underwood SR, Htay T, Mehta D, Sun L, Lacy J, Heo J, Brunken RC, Kaczur T, Jaber W, Ramakrishna G, Miller TD, O’connor MK, Gibbons RJ, Bural GG, Mavi A, Kumar R, El-Haddad G, Srinivas SM, A Alavi, El-Haddad G, Alavi A, Araujo L, Thomas GS, Johnson CM, Miyamoto MI, Thomas JJ, Majmundar H, Ryals LA, Ip ZTK, Shaw LJ, Bishop HA, Carmody JP, Greathouse WG, Yanagisawa H, Chikamori T, Tanaka H, Usui Y, Igarashi U, Hida S, Morishima T, Tanaka N, Takazawa K, Yamashina A, Diedrichs H, Weber M, Koulousakis A, Voth E, Schwinger RHG, Mohan HK, Livieratos L, Gallagher S, Bailey DL, Chambers J, Fogelman I, Sobol I, Barst RJ, Nichols K, Widlitz A, Horn E, Bergmann SR, Chen J, Galt JR, Durbin MK, Ye J, Shao L, Garcia EV, Mahenthiran J, Elliott JC, Jacob S, Stricker S, Kalaria VG, Sawada S, Scott JA, Aziz K, Yasuda T, Gewirtz H, Hsu BL, Moutray K, Udelson JE, Barrett RJ, Johnson JR, Menenghetti C, Taillefer R, Ruddy T, Hachamovitch R, Jenkins SA, Massaro J, Haught H, Lim CS, Underwood R, Rosman J, Hanon S, Shapiro M, Schweitzer P, VanTosh A, Jones S, Harafuji K, Giedd KN, Johnson NP, Berliner JI, Sciacca RR, Chou RL, Hickey KT, Bokhari SS, Rodriguez O, Bokhari S, Moser KW, Moutray KL, Koutelou M, Theodorakos A, Kollaros N, Manginas A, Leontiadis E, Cokkinos D, Mazzanti M, Marini M, Cianci G, Perna GP, Nanasato M, Fujita H, Toba M, Nishimura T, Nikpour M, Urowitz M, Gladman D, Ibanez D, Harvey P, Floras J, Rouleau J, Iwanochko R, Pai M, Guglin ME, Ginsberg FL, Reinig M, Parrillo JE, Cha R, Merhige ME, Watson GM, Oliverio JG, Shelton V, Frank SN, Perna AF, Ferreira MJ, Ferrer-Antunes AI, Rodrigues V, Santos F, Lima J, Cerqueira MD, Magram MY, Lodge MA, Babich JW, Dilsizian V, Line BR, Bhalodkar NC, Lone B, Singh R, Prasad Y, Yeturi S, Blum S, Heller EN, Rodriguez OJ, Skerrett D, Charles C, Shuster MD, Itescu S, Wang TS, Bruyant PP, Pretorius PH, Dahlberg S, King MA, Petrovici R, Iwanochko RM, Lee DS, Emmett L, Husain M, Hosokawa R, Ohba M, Kambara N, Tadamura E, Kubo S, Nohara R, Kita T, Thompson RC, McGhie AI, O’Keefe JH, Christenson SD, Chareonthaitawee P, Kemp BJ, Jerome S, Russell TJ, Lowry DR, Coombs VJ, Moses A, Gottlieb SO, Heiba SI, Yee G, Coppola J, Elmquist T, Braff R, Youssef I, Ambrose JA, Abdel-Dayem HM, Canto J, Dubovsky E, Scott J, Terndrup TE, Faber TL, Folks RD, Dim UR, Mclaughlin J, Pollepalle D, Schapiro W, Wang Y, Akinboboye O, Ngai K, Druz RS, Polepalle D, Phippen-Nater B, Leonardis J, Druz R. Abstracts of original contributions ASNC 2004 9th annual scientific session September 3-–October 3, 2004 New York, New York. J Nucl Cardiol 2004. [DOI: 10.1007/bf02974964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Binns CW, Scott JA. Can we make hospitals and the community baby friendly? Acta Paediatr 2003; 92:646-7. [PMID: 12856970] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
There is an increasing trend in midwifery towards shorter hospitalization, and in a world where 24-48 h will be the norm, the challenge for the baby-friendly hospital in the new century will be to establish community support services for all mothers and to make all of our hospitals and communities "Baby and breastfeeding friendly".
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Affiliation(s)
- C W Binns
- School of Public Health, Curtin University of Technology, Perth, Western Australia.
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