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Gamlin CR, Schneider-Mizell CM, Mallory M, Elabbady L, Gouwens N, Williams G, Mukora A, Dalley R, Bodor A, Brittain D, Buchanan J, Bumbarger D, Kapner D, Kinn S, Mahalingam G, Seshamani S, Takeno M, Torres R, Yin W, Nicovich PR, Bae JA, Castro MA, Dorkenwald S, Halageri A, Jia Z, Jordan C, Kemnitz N, Lee K, Li K, Lu R, Macrina T, Mitchell E, Mondal SS, Mu S, Nehoran B, Popovych S, Silversmith W, Turner NL, Wong W, Wu J, Yu S, Berg J, Jarsky T, Lee B, Seung HS, Zeng H, Reid RC, Collman F, da Costa NM, Sorensen SA. Integrating EM and Patch-seq data: Synaptic connectivity and target specificity of predicted Sst transcriptomic types. bioRxiv 2023:2023.03.22.533857. [PMID: 36993629 PMCID: PMC10055412 DOI: 10.1101/2023.03.22.533857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Neural circuit function is shaped both by the cell types that comprise the circuit and the connections between those cell types 1 . Neural cell types have previously been defined by morphology 2, 3 , electrophysiology 4, 5 , transcriptomic expression 6-8 , connectivity 9-13 , or even a combination of such modalities 14-16 . More recently, the Patch-seq technique has enabled the characterization of morphology (M), electrophysiology (E), and transcriptomic (T) properties from individual cells 17-20 . Using this technique, these properties were integrated to define 28, inhibitory multimodal, MET-types in mouse primary visual cortex 21 . It is unknown how these MET-types connect within the broader cortical circuitry however. Here we show that we can predict the MET-type identity of inhibitory cells within a large-scale electron microscopy (EM) dataset and these MET-types have distinct ultrastructural features and synapse connectivity patterns. We found that EM Martinotti cells, a well defined morphological cell type 22, 23 known to be Somatostatin positive (Sst+) 24, 25 , were successfully predicted to belong to Sst+ MET-types. Each identified MET-type had distinct axon myelination patterns and synapsed onto specific excitatory targets. Our results demonstrate that morphological features can be used to link cell type identities across imaging modalities, which enables further comparison of connectivity in relation to transcriptomic or electrophysiological properties. Furthermore, our results show that MET-types have distinct connectivity patterns, supporting the use of MET-types and connectivity to meaningfully define cell types.
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Mahalingam G, Torres R, Kapner D, Trautman ET, Fliss T, Seshamani S, Perlman E, Young R, Kinn S, Buchanan J, Takeno MM, Yin W, Bumbarger DJ, Gwinn RP, Nyhus J, Lein E, Smith SJ, Reid RC, Khairy KA, Saalfeld S, Collman F, Macarico da Costa N. A scalable and modular automated pipeline for stitching of large electron microscopy datasets. eLife 2022; 11:76534. [PMID: 35880860 PMCID: PMC9427110 DOI: 10.7554/elife.76534] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/10/2022] [Indexed: 11/13/2022] Open
Abstract
Serial-section electronmicroscopy (ssEM) is themethod of choice for studyingmacroscopic biological samples at extremely high resolution in three dimensions. In the nervous system, nanometer-scale images are necessary to reconstruct dense neural wiring diagrams in the brain, so called connectomes. In order to use this data, consisting of up to 108 individual EM images, it must be assembled into a volume, requiring seamless 2D stitching from each physical section followed by 3D alignment of the stitched sections. The high throughput of ssEM necessitates 2D stitching to be done at the pace of imaging, which currently produces tens of terabytes per day. To achieve this, we present a modular volume assembly software pipeline ASAP (Assembly Stitching and Alignment Pipeline) that is scalable to datasets containing petabytes of data and parallelized to work in a distributed computational environment. The pipeline is built on top of the Render (27) services used in the volume assembly of the brain of adult Drosophilamelanogaster (30). It achieves high throughput by operating on themeta-data and transformations of each image stored in a database, thus eliminating the need to render intermediate output. ASAP ismodular, allowing for easy incorporation of new algorithms without significant changes in the workflow. The entire software pipeline includes a complete set of tools for stitching, automated quality control, 3D section alignment, and final rendering of the assembled volume to disk. ASAP has been deployed for continuous stitching of several large-scale datasets of the mouse visual cortex and human brain samples including one cubic millimeter of mouse visual cortex (28; 8) at speeds that exceed imaging. The pipeline also has multi-channel processing capabilities and can be applied to fluorescence and multi-modal datasets like array tomography.
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Affiliation(s)
| | - Russel Torres
- Allen Institute for Brain Science, Seattle, United States
| | - Daniel Kapner
- Allen Institute for Brain Science, Seattle, United States
| | - Eric T Trautman
- Scientific Computing, Janelia Research Campus, Ashburn, United States
| | - Tim Fliss
- Allen Institute for Brain Science, Seattle, United States
| | | | | | - Rob Young
- Allen Institute for Brain Science, Seattle, United States
| | - Samuel Kinn
- Allen Institute for Brain Science, Seattle, United States
| | - JoAnn Buchanan
- Allen Institute for Brain Science, Seattle, United States
| | - Marc M Takeno
- Allen Institute for Brain Science, Seattle, United States
| | - Wenjing Yin
- Allen Institute for Brain Science, Seattle, United States
| | | | - Ryder P Gwinn
- Epilepsy Surgery and Functional Neurosurgery, Swedish Neuroscience Institute, Seattle, United States
| | - Julie Nyhus
- Allen Institute for Brain Science, Seattle, United States
| | - Ed Lein
- Allen Institute for Brain Science, Seattle, United States
| | - Steven J Smith
- Allen Institute for Brain Science, Seattle, United States
| | - R Clay Reid
- Allen Institute for Brain Science, Seattle, United States
| | - Khaled A Khairy
- St. Jude Children's Research Hospital, Memphis, United States
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Abstract
Foreword The UK Department for International Development (DFID) is committed to investing in research to combat poverty, reduce high mortality and morbidity in resource poor contexts and support progress towards meeting the Millennium Development Goals. Research helps us to identify what works, what does not work and how to understand the local context when introducing new ways of working. There is no point doing research if the findings do not get into policy and practice. DFID strongly encourages all research programmes to consider research uptake activities as an integral part of the research. This special supplement draws on the work of the Sexual Health HIV Evidence into Practice (SHHEP) initiative. SHHEP is a collaboration across four DFID Research Programme Consortia (RPC) that undertake research and action on HIV and Sexual and Reproductive Health in resource poor contexts. Each consortium consists of 5 or more research, advocacy or service provider institutions from the south and the north working together over a five year period on critical areas of sexual and reproductive health. The essence of SHHEP is to share learning on research uptake and research engagement in Sexual and Reproductive Health, including HIV. The group has formulated a range of targeted mechanisms to communicate health research to different audiences and spearhead change, and were finalists for the British Medical Journal 2010 Getting Research into Practice (GRiP) prize. The papers in this special supplement focus on lesson learning on getting research into policy and practice. They highlight the range of methodologies and approaches researchers and communication specialists have used in different contexts to try to ensure research does not simply gather dust on library shelves but feeds into and is relevant to policy and practice in different contexts (for example South Africa, Swaziland, Tanzania, Uganda, Malawi, Ghana, Bangladesh) and on a diversity of topic areas (Gender based violence, sexualities, orphans and vulnerable children, HIV care and treatment including male circumcision, cotrimoxazole and links with nutrition). The work reported in this supplement provides examples of approaches that have been tried and from which other researchers can learn. They demonstrate that getting research into policy and practice is complex, dynamic and multi-faceted; and a wide range of context and issue specific conceptual and practical approaches have to be used. I hope that the innovative approaches and promising ways forward, presented in these papers, will inspire and motivate others. Professor Christopher Whitty Director Research and Evidence Division Department for International Development Dr Sue Kinn Head of Health Research Department for International Development
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Affiliation(s)
- C Whitty
- Director Research and Evidence Division, Department for International Development, 1 Palace Street, London SW1E 5HE
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Affiliation(s)
- F MacRae
- Greater Glasgow Primary Care NHS Trust, Glasgow
| | - R Lowrie
- Greater Glasgow Primary Care NHS Trust, Glasgow
| | - A MacLaren
- Greater Glasgow Primary Care NHS Trust, Glasgow
| | - S Kinn
- Glasgow Caledonian University, Glasgow
| | - A Fish
- Greater Glasgow Primary Care NHS Trust, Glasgow
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Kinn S, MacDonald C, Hinks S, Nandwani R, Ilett R, Shields N, Carr S, Bigrigg A. Client and staff views on facilities and services, before and after the convergence of sexual, reproductive and women's services. EUR J CONTRACEP REPR 2009. [DOI: 10.1080/ejc.8.2.65.74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
BACKGROUND Although recommendations about the treatment of obesity have been well documented, there is little research into how obese individuals view the outcomes of dietary treatment. It has been suggested that patient involvement in evaluating treatment outcomes may help target issues to assist with the ongoing improvement of dietetic services. The aim of this qualitative study was to collect patients' views on the dietetic service, the treatment outcomes in terms of lifestyle change and the impact that attending the dietetic service had on their lives in order to improve dietetic treatment, and to assist in the selection of appropriate outcome measurements in the future. METHODS Semi-structured interviews were conducted with 24 obese patients attending dietetic clinics in Ayrshire, West of Scotland for weight management (advice on healthy eating and physical activity to achieve an energy deficit). Patients' views were transcribed, grouped and coded using content analysis. RESULTS Views included the importance of attending the dietitian for support to achieve weight management and a need to 'feel accountable to someone'. Interviewees valued information provided regarding diet, physical activity, behavioural strategies and the risks of obesity. Patients described the impact of obesity on their lives and identified changes to their lifestyles and health since attending the dietitian. They also identified barriers to change, e.g. feeling frustrated and overwhelmed about the changes necessary. CONCLUSION This study extends the current knowledge of patients' views of their treatment outcomes, which may be important in helping dietitians devise appropriate patient-centred outcome measures. However, as this is a small sample, further long term research into a wider range of current and discharged patients' views is required.
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Affiliation(s)
- N Jones
- Biological and Biomedical Sciences, School of Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Brady M, Kinn S, O'Rourke K, Randhawa N, Stuart P. Preoperative fasting for preventing perioperative complications in children. ACTA ACUST UNITED AC 2006. [DOI: 10.1002/ebch.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
INTRODUCTION Current health policy stresses the need to take patients' views into account in the provision of health care, including involvement in the process of care and determining the outcome(s) of treatment. It is unclear whether patients undergoing dietary treatment have been consulted on their views. METHODS A literature review, searching electronic databases and hand searching dietetic journals, of dietary intervention research was carried out to identify if patients' views were sought in determining outcomes. RESULTS Searching uncovered a total of 28 papers reporting the results of studies of dietary interventions where patients views were sought in the measurement of outcome, however little detail was given about patient(s) involvement and whether the use of the measures influenced future care. FUTURE WORK Should address the issue of patient involvement in the determination of outcome and how this then influences future care.
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Affiliation(s)
- J A Jackson
- Department of Biological and Biomedical Sciences, School of Life Sciences, Glasgow Caledonian University, Glasgow, UK.
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Brady M, Kinn S, Stuart P. Preoperative fasting for preventing post-operative complications in children. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd003090.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
BACKGROUND Children, like adults, are required to fast before general anaesthesia with the aim of reducing the volume and acidity of their stomach contents. It is thought that fasting reduces the risk of regurgitation and aspiration of gastric contents during surgery. Recent developments have encouraged a shift from the standard 'nil-by-mouth-from-midnight' fasting policy to more relaxed regimens. Practice has been slow to change due to questions relating to the duration of a total fast, the type and amount of intake permitted. OBJECTIVES To systematically assess the effects of different fasting regimens (duration, type and volume of permitted intake) and the impact on perioperative complications and patient wellbeing (aspiration, regurgitation, related morbidity, thirst, hunger, pain, comfort, behaviour, nausea and vomiting) in children. SEARCH STRATEGY We searched Cochrane Wounds Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, the National Research Register, relevant conference proceedings and article reference lists and contacted experts. SELECTION CRITERIA Randomised and quasi randomised controlled trials of preoperative fasting regimens for children were identified. DATA COLLECTION AND ANALYSIS Data extraction and trial quality assessment was conducted independently by two authors. Trial authors were contacted for additional information including adverse events. MAIN RESULTS Forty-three randomised controlled comparisons (from 23 trials) involving 2350 children considered to be at normal risk of regurgitation or aspiration during anaesthesia. Only one incidence of aspiration and regurgitation was reported. Children permitted fluids up to 120 minutes preoperatively were not found to experience higher gastric volumes or lower gastric pH values than those who fasted. The children permitted fluids were also less thirsty and hungry, better behaved and more comfortable than those who fasted. Clear fluids preoperatively did not result in a clinically important difference in the children's gastric volume or pH. Evidence relating to the preoperative intake of milk was sparse. The volume of fluid permitted during the preoperative period did not appear to impact on children's intraoperative gastric volume or pH contents. AUTHORS' CONCLUSIONS There is no evidence that children who are not permitted oral fluids for more than six hours preoperatively benefit in terms of intraoperative gastric volume and pH over children permitted unlimited fluids up to two hours preoperatively. Children permitted fluids have a more comfortable preoperative experience in terms of thirst and hunger. This evidence applies only to children who are considered to be at normal risk of aspiration/regurgitation during anaesthesia.
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Affiliation(s)
- M Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK, G4 0BA.
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Abstract
OBJECTIVES To investigate the impact of a health adviser in genitourinary medicine as a training and support resource on the management of Chlamydia trachomatis in a large inner city health centre. METHODS A large, inner city health centre was selected at random for the intervention, with another selected as control. The health adviser offered support and training in the management of C trachomatis to clinical staff in the intervention health centre for 6 months. Data on testing activity were collected over the period of the intervention and during the equivalent period in the previous year. Data on partner notification activities were collected from case notes. RESULTS The research intervention was effective in increasing C trachomatis testing activity. However, the majority of tests were offered to women over 20 years of age and no increase in the proportion of positive results was observed. CONCLUSIONS The intervention was effective in increasing C trachomatis testing activity, but did not improve the overall detection rate. Health centre staff accommodated opportunistic testing for C trachomatis into existing healthcare practices, as opposed to introducing new screening systems designed to reach the target population.
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Affiliation(s)
- B Armstrong
- Nursing Research Initiative for Scotland, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
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Abstract
BACKGROUND Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents during surgery, thus reducing the risk of regurgitation/aspiration. Recent guidelines have recommended a shift in fasting policy from the standard 'nil by mouth from midnight' approach to more relaxed policies which permit a period of restricted fluid intake up to a few hours before surgery. The evidence underpinning these guidelines however, was scattered across a range of journals, in a variety of languages, used a variety of outcome measures and methodologies to evaluate fasting regimens that differed in duration and the type and volume of intake permitted during a restricted fasting period. Practice has been slow to change. OBJECTIVES To systematically review the effect of different preoperative fasting regimens (duration, type and volume of permitted intake) on perioperative complications and patient wellbeing (including aspiration, regurgitation and related morbidity, thirst, hunger, pain, nausea, vomiting, anxiety) in different adult populations. SEARCH STRATEGY Electronic databases, conference proceedings and reference lists from relevant articles were searched for studies of preoperative fasting in August 2003 and experts in the area were consulted. SELECTION CRITERIA Randomised controlled trials which compared the effect on postoperative complications of different preoperative fasting regimens on adults were included. DATA COLLECTION AND ANALYSIS Details of the eligible studies were independently extracted by two reviewers and where relevant information was unavailable from the text attempts were made to contact the authors. MAIN RESULTS Thirty eight randomised controlled comparisons (made within 22 trials) were identified. Most were based on 'healthy' adult participants who were not considered to be at increased risk of regurgitation or aspiration during anaesthesia. Few trials reported the incidence of aspiration/regurgitation or related morbidity but relied on indirect measures of patient safety i.e. intra-operative gastric volume and pH. There was no evidence that the volume or pH of participants' gastric contents differed significantly depending on whether the groups were permitted a shortened preoperative fluid fast or continued a standard fast. Fluids evaluated included water, coffee, fruit juice, clear fluids and other drinks (e.g. isotonic drink, carbohydrate drink). Participants given a drink of water preoperatively were found to have a significantly lower volume of gastric contents than the groups that followed a standard fasting regimen. This difference was modest and clinically insignificant. There was no indication that the volume of fluid permitted during the preoperative period (i.e. low or high) resulted in a difference in outcomes from those participants that followed a standard fast. Few trials specifically investigated the preoperative fasting regimen for patient populations considered to be at increased risk during anaesthesia of regurgitation/aspiration and related morbidity. REVIEWER'S CONCLUSIONS There was no evidence to suggest a shortened fluid fast results in an increased risk of aspiration, regurgitation or related morbidity compared with the standard 'nil by mouth from midnight' fasting policy. Permitting patients to drink water preoperatively resulted in significantly lower gastric volumes. Clinicians should be encouraged to appraise this evidence for themselves and when necessary adjust any remaining standard fasting policies (nil-by-mouth from midnight) for patients that are not considered 'at-risk' during anaesthesia.
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Affiliation(s)
- M Brady
- Nursing Research Initiative for Scotland, Cowcaddens Road, Glasgow, UK, G4 0BA
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Kinn S, MacDonald C, Hinks S, Nandwani R, Ilett R, Shields N, Carr S, Bigrigg A. Client and staff views on facilities and services, before and after the convergence of sexual, reproductive and women's services. EUR J CONTRACEP REPR 2003; 8:65-74. [PMID: 12831603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To evaluate client and staff views on existing facilities and services, before and after the convergence of sexual, reproductive and women's services. METHODS Evaluation involved questionnaire survey of clients and staff, one-to-one interviews with staff and review of routinely collected clinical activity data. RESULTS The integration of the three services led to a reduction in stigma associated with attending sexual health services. Despite some staff concerns, the number of men attending the services did not decrease. There was increased satisfaction with the new service, especially the quality of facilities. There were increased numbers of referrals between clinical services in the Sandyford Initiative. CONCLUSIONS Sexual, reproductive and women's services can be integrated to provide improved facilities for clients.
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Affiliation(s)
- S Kinn
- Nursing Research Initiative for Scotland, Glasgow Caledonian University, Glasgow, UK
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14
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Abstract
BACKGROUND Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents during surgery, thus reducing the risk of regurgitation/aspiration. Recent guidelines have recommended a shift in fasting policy from the standard 'nil by mouth from midnight' approach to more relaxed policies which permit a period of restricted fluid intake up to a few hours before surgery. The evidence underpinning these guidelines however, was scattered across a range of journals, in a variety of languages, used a variety of outcome measures and methodologies to evaluate fasting regimens that differed in duration and the type and volume of intake permitted during a restricted fasting period. Practice has been slow to change. OBJECTIVES To systematically review the effect of different preoperative fasting regimens (duration, type and volume of permitted intake) on perioperative complications and patient wellbeing (including aspiration, regurgitation and related morbidity, thirst, hunger, pain, nausea, vomiting, anxiety) in different adult populations. SEARCH STRATEGY Electronic databases, conference proceedings and reference lists from relevant articles were searched for studies of preoperative fasting in August 2003 and experts in the area were consulted. SELECTION CRITERIA Randomised controlled trials which compared the effect on postoperative complications of different preoperative fasting regimens on adults were included. DATA COLLECTION AND ANALYSIS Details of the eligible studies were independently extracted by two reviewers and where relevant information was unavailable from the text attempts were made to contact the authors. MAIN RESULTS Thirty eight randomised controlled comparisons (made within 22 trials) were identified. Most were based on 'healthy' adult participants who were not considered to be at increased risk of regurgitation or aspiration during anaesthesia. Few trials reported the incidence of aspiration/regurgitation or related morbidity but relied on indirect measures of patient safety i.e. intra-operative gastric volume and pH. There was no evidence that the volume or pH of participants' gastric contents differed significantly depending on whether the groups were permitted a shortened preoperative fluid fast or continued a standard fast. Fluids evaluated included water, coffee, fruit juice, clear fluids and other drinks (e.g. isotonic drink, carbohydrate drink). Participants given a drink of water preoperatively were found to have a significantly lower volume of gastric contents than the groups that followed a standard fasting regimen. This difference was modest and clinically insignificant. There was no indication that the volume of fluid permitted during the preoperative period (i.e. low or high) resulted in a difference in outcomes from those participants that followed a standard fast. Few trials specifically investigated the preoperative fasting regimen for patient populations considered to be at increased risk during anaesthesia of regurgitation/aspiration and related morbidity. REVIEWER'S CONCLUSIONS There was no evidence to suggest a shortened fluid fast results in an increased risk of aspiration, regurgitation or related morbidity compared with the standard 'nil by mouth from midnight' fasting policy. Permitting patients to drink water preoperatively resulted in significantly lower gastric volumes. Clinicians should be encouraged to appraise this evidence for themselves and when necessary adjust any remaining standard fasting policies (nil-by-mouth from midnight) for patients that are not considered 'at-risk' during anaesthesia.
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Affiliation(s)
- M Brady
- Nursing Research Initiative for Scotland, Cowcaddens Road, Glasgow, UK, G4 0BA
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Andrew N, Kinn S. Are nurses receptive to an evidence-based newsletter? Nurs Times 2001; 97:32-3. [PMID: 11966168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- N Andrew
- Department of Nursing and Community Health, Glasgow Caledonian University
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Scoular A, McCartney R, Kinn S, Carr S, Walker A. The 'real-world' impact of improved diagnostic techniques for Chlamydia trachomatis infection in Glasgow. Commun Dis Public Health 2001; 4:200-4. [PMID: 11732360] [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: 02/22/2023]
Abstract
In April 1997, the main chlamydia laboratory in Glasgow introduced ligase chain reaction (LCR) as its standard diagnostic test. The diagnostic effectiveness and health economic impact of introduction of LCR testing was assessed. Between April 1996 to March 2000, results of all chlamydia detection tests on genital specimens sent from general practitioners and the two main sexual healthcare providers (Genitourinary Medicine and Family Planning services) were reviewed. A preliminary economic assessment, inclusive of staff, reagents, consumables and laboratory overheads was conducted. Overall, testing activity increased four and a half times between 1996-97 and 1999-2000; the proportionate rise was greatest in general practice. Although chlamydia testing in both genders increased over the review period, testing activity rose disproportionately in women (59%, compared with a 31% increase in men). The overall Chlamydia trachomatis detection rate rose from 4.8% in 1996-97 to 7.8% in 1999-2000. Following introduction of LCR testing, an estimated additional 331 men and 844 women were diagnosed during the study period. The cost per additional diagnosis made was estimated at 162 Pounds for men and 263 Pounds for women. Substantial health gains are likely to be achieved, at both an individual and public health level, as a result of introduction of LCR testing for genital chlamydial infection.
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Affiliation(s)
- A Scoular
- Department of Genitourinary Medicine, The Sandyford Intiative, 2 Sandyford Place, Sauchiehall Street, Glasgow, G3 7NB.
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Abstract
It has been recognized that malnutrition in hospital is a serious problem that may go undetected. There is growing evidence that early nutritional support in high-risk patients helps reduce postoperative complications; however, malnutrition is often diagnosed only once it is well established. This study showed that, both retrospectively and prospectively; there were no formal nutritional assessments of patients in a high-dependency unit (HDU), that time to feeding was generally within the recommended 5-7 day postoperative period, and that the most common form of supplementary feeding was total parenteral nutrition (TPN). Prospectively, the choice of supplementary feeding was dependent on the type of surgery and the individual patient's condition. Since this study was completed, a dietician has been allocated to the HDU and carries out formal nutritional assessments on a daily basis. Further research is required to assess the impact of the dietician on patient nutrition.
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Affiliation(s)
- S Kinn
- Nursing Research Institute for Scotland, Glasgow Caledonian University, Glasgow, Scotland, UK
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Brady M, Kinn S, Stuart P. Preoperative fasting for preventing post-operative complications in children. Hippokratia 2001. [DOI: 10.1002/14651858.cd003090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Falls are a major cause of morbidity and mortality among older people. In an inpatient setting it has been suggested that the introduction of risk-assessment tools may be an important way of managing the issue. The study reported in this article was carried out in two stages. First, fall incidents were identified retrospectively using 'falls incident forms' and nursing notes, and the characteristics and management of patients who had fallen were compared with those who had not fallen. A risk-assessment tool and care plan were developed and evaluated prospectively. By analysing the data in stage one it was found that falls incidence reporting was poor and patients who had fallen had more evidence of previous falls than those who had not fallen. In stage two staff found the risk-assessment tool and care plan easy to complete; however, there was little documentation about whether any appropriate interventions, specific to the individuals' risk score, were carried out. Appropriate interventions identified on the risk-assessment tool were put into place inconsistently. As a result of this work the hospital has set up a multidisciplinary group to look at falls management.
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Affiliation(s)
- S Kinn
- Nursing Research Institute for Scotland, Glasgow Caledonian University
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Abstract
Emergency Nurse Practitioners (ENPs) are being used in an increasing proportion of A&E departments across England and Wales. This paper reports the findings of a postal survey sent to all (94) A&E departments in Scotland including the smaller GP run units. The aim of the study was to document the extent and nature of ENP services in Scotland. Nurses were found to be practising as ENPs in 47% of Scottish A&E departments. The majority (70%) of nurses practising as ENPs had been educated for the role on courses for ENPs. Nurses working as ENPs were being paid at all grades ranging from the lowest grade for a staff nurse (D-grade) through to H-grade. ENPs are practising in all types of A&E department. Most ENPs have been formally trained for the role, however huge variation exists in educational preparation and in remuneration for this expanded nursing role.
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Affiliation(s)
- M A Cooper
- Accident & Emergency, Glasgow Royal Infirmary 84 Castle Street, Glasgow, G4 0SF, UK
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Kinn S, Khuder SA, Bisesi MS, Woolley S. Evaluation of safety orientation and training programs for reducing injuries in the plumbing and pipefitting industry. J Occup Environ Med 2000; 42:1142-7. [PMID: 11125676 DOI: 10.1097/00043764-200012000-00004] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [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: 11/26/2022]
Abstract
Construction workers are at increased risk for fatal and non-fatal injuries. This study examined the effectiveness of employee orientation and training in reducing injuries among plumbers and pipefitters. We searched the Occupational Safety and Health Administration's "recordable" injury data and "documentable" safety and training records for six plumbing and pipefitting employers in northwestern Ohio. During the period 1996 to 1998, 133 injuries were recorded with the duration of 2,541,432 working hours. The most common types of injuries were cuts, lacerations, and abrasions. The majority of injuries resulted from workers being struck by objects. The injury rate was significantly higher for small companies and longer working hours. No difference was found between traveling and local workers. Seventy-five percent of workers received safety orientations on injury prevention. Among workers who received safety orientations, only 3.4% experienced injuries, compared with 11.1% of workers without orientations. Safety orientations were associated with a significant reduction in injuries (odds ratio, 0.23; 95% confidence interval, 0.15 to 0.35). Proper safety orientation and training could reduce the risks for occupational injuries in construction workers.
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Affiliation(s)
- S Kinn
- Medical College of Ohio, PO Box 10008, Toledo, OH 43699-0008, USA. skhuder@.mco.edu
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Affiliation(s)
- M Cooper
- A&E Department, Glasgow Royal Infirmary, North Glasgow University Hospitals NHS Trust
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23
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Abstract
Many clinical nurses feel that academic research frequently lacks credibility and relevance to them in clinical practice, as much of the published nursing research has focused on nursing theory or other nursing academic issues. For practitioners, research credibility is about whether the project is attempting to answer a practice-based question and whether the results are communicated in an understandable way.
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Affiliation(s)
- J Curzio
- Nursing Research Initiative for Scotland (NRIS), Glasgow Caledonian University
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24
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Kinn S, Macnaughton J, Noone A, Scoular A. Chlamydia trachomatis in primary care: knowledge and practice in Glasgow. Br J Gen Pract 2000; 50:214-5. [PMID: 10750232 PMCID: PMC1313654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
A recent Department of Health report recommended the establishment of a selective screening programme for Chlamydia trachomatis infection. We report a survey which suggests that primary care clinicians may not yet be prepared for this task.
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Affiliation(s)
- S Kinn
- Department of General Practice, University of Glasgow.
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25
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26
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Abstract
The aim of this paper is to start a debate about ethical issues associated with the practice of clinical audit. This is an area that has not received much consideration. The role of clinical audit is to raise general clinical standards. The ethical issues of clinical audit may have far-reaching consequences for clinicians, patients, health care providers and purchasers. Guidance is required to provide consistency in approach so that those involved in clinical audit, at whatever level, can be confident that they are following good practice. Clinicians and managers often think of good practice as being a technical matter. The main point of this paper is to bring out important ethical dimensions to good practice.
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Affiliation(s)
- S Kinn
- Glasgow Caledonian University, Scotland
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27
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Abstract
Information Management and Technology (IM&T) is assuming a greater role within the modern NHS and there is an increasing need for members of the medical, and other health care, professions to receive appropriate training and education in these areas. Over half the Postgraduate Deans, Regional Advisers in General Practice and the Medical Royal Colleges have made a conscious decision to supply training in IM&T-related areas. These courses are open to a wide range of health care professionals. However, the number of reported places is not adequate for the large number of people who require the training. Less than half the organizations employed staff with a remit to provide training but over half provided courses in collaboration with educational establishments. As the medical undergraduate curriculum changes and incorporates training in computer skills, the links between the postgraduate institutions and medical schools must be fostered and developed. This will lead to increasing opportunities for health professionals both in the range of subjects and the number of places available.
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Affiliation(s)
- S Kinn
- Scottish Clinical Audit Resource Centre, University of Glasgow, UK
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28
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Affiliation(s)
- S Kinn
- Scottish Clinical Audit Resource Centre, Glasgow University
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29
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Jones R, Kinn S, Grainger F. Medical informatics. BMJ 1995; 310:601. [PMID: 7888958 PMCID: PMC2548973 DOI: 10.1136/bmj.310.6979.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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30
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Abstract
Nurses are probably more aware of clinical audit now than at any time in history, but what do they actually know about it? Aware that for many, the words cause unnecessary fear and anxiety, the author has set out a simple guide to audit. The information in the article is based on a successful series of workshops on clinical audit she and her colleagues ran for nurses in the Greater Glasgow area.
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Kinn S, Jones R. Continuing education in health informatics in the UK: the need for learning materials. Medinfo 1995; 8 Pt 2:1260-1264. [PMID: 8591422] [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: 05/22/2023]
Abstract
The case for education in health informatics for all practitioners as well as information specialists has been well recognized [1]. Changes are occurring in the undergraduate medical curriculum in the UK. This can be seen by the general moves towards computer-based teaching in higher education and the recommendations for the new medical undergraduate curriculum by the General Medical Council (GMC). A survey of undergraduate students has shown that there is an increasing level of computer literacy [2]. We need, therefore, to concentrate on postgraduate education. In the UK, postgraduate and continuing education is organized under the auspices of Regional Postgraduate Deans, Regional Advisors in General Practice, and the educational initiatives of the Professional Royal Colleges. Educational guidelines for information management for undergraduates have been described [3] and these guidelines apply to practitioners as well. The main problems in postgraduate education are the scale of the task, the staff, facilities, and teaching materials available. Basic computer literacy will enable practitioners to make use of computers in their own environment and access the "information superhighway" via the Internet. When this becomes a reality, there will be a need for suitable teaching materials to be made available. The accessibility of these materials raises questions about credit for authorship and the production of flexible packages that can be used by different individuals with their own needs in mind. We have a number of educational materials, at different stages of development, that are described here in the hope that we may collaborate in the exchange of teaching materials.
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Affiliation(s)
- S Kinn
- Department of Postgraduate Medical Education, Glasgow University, Scotland, UK
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32
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Jones R, Kinn S. Global public health and the information superhighway. Doctors and students need computer training. BMJ 1994; 309:736-7. [PMID: 7950531 PMCID: PMC2540823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Kinn S, Semple E, Gregson K, Hillan E. Practical audit workshops for nurses. J Adv Nurs 1994; 20:517-20. [PMID: 7963058 DOI: 10.1111/j.1365-2648.1994.tb02389.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Six practical audit workshops were run for nurses working in the Greater Glasgow Health Board. Between 15 and 25 nurses came for a morning session and returned 6 weeks later for an afternoon session. The participants came from all grades, specialties and units across the health board. The morning session included a basic introduction to the principles and stages of the audit cycle and information on different audit methods. The majority of the time was devoted to small group discussions where individuals were able to develop their own ideas for audit projects relevant to their working situations. Together with one of the organizers, the members of the groups helped each other in the design of the different projects. Almost 65% of attenders (78 out of 122) returned 6 weeks later for the afternoon session and most had begun an audit project in the time interval. These projects were at various stages around the audit cycle. The afternoon sessions started with a talk by a nurse involved in an audit project, followed by the participants returning to their small groups to discuss the successes and problems involved in their own audits. The groups provided further support and advice based on a wide range of different experiences during the intervening time. The projects carried out were impressive both in the quality and the variety of topics covered. Ninety per cent of those attending felt that the knowledge gained from the exercise was of practical use in their own working environment. A measure of the success of the workshops was that several of the later afternoon talks were given by nurses who had attended the earlier workshops.
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Affiliation(s)
- S Kinn
- Department of Postgraduate Medical Education, University of Glasgow, Scotland
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