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Desikan SK, Brahmbhatt B, Patel J, Kankaria A, Anagnostakos J, Dux M, Beach K, Gray VL, McDonald T, Crone C, Sikdar S, Sorkin JD, Lal BK. Cognitive impairment in asymptomatic carotid artery stenosis is associated with abnormal segments in the Circle of Willis. J Vasc Surg 2024:S0741-5214(24)01085-1. [PMID: 38710420 DOI: 10.1016/j.jvs.2024.04.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/11/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Our group has previously demonstrated that patients with asymptomatic carotid artery stenosis (ACAS) demonstrate cognitive impairment. One proposed mechanism for cognitive impairment in patients with ACAS is cerebral hypoperfusion due to flow-restriction. We tested whether the combination of a high-grade carotid stenosis and inadequate cross-collateralization in the Circle of Willis (CoW) resulted in worsened cognitive impairment. METHODS Twenty-four patients with high-grade (≥70% diameter-reducing) ACAS underwent carotid duplex ultrasound, cognitive assessment, and 3D time-of-flight magnetic resonance angiography (MRA). The cognitive battery consisted of nine neuropsychological tests assessing four cognitive domains: learning and recall, attention and working memory, motor and processing speed, and executive function. Raw cognitive scores were converted into standardized T-scores. A structured interpretation of the MRA images was performed with each segment of the CoW categorized as being either normal or abnormal. Abnormal segments of the CoW were defined as segments characterized as narrowed or occluded due to congenital aplasia or hypoplasia, or acquired atherosclerotic stenosis or occlusion. Linear regression was used to estimate the association between the number of abnormal segments in the CoW, and individual cognitive domain scores. Significance was set to p<0.05. RESULTS The mean age of the patients was 66.1 + 9.6 (mean + SD) years and 79.2% (n=19) were male. A significant negative association was found between the number of abnormal segments in the CoW and cognitive scores in the learning and recall (β = -6.5, p = 0.01), and attention and working memory (β = -7.0, p = 0.02) domains. There was a trend suggesting a negative association in the motor and processing speed (β = -2.4, p = 0.35) and executive function (β = -4.5, p = 0.06) domains that did not reach significance. CONCLUSION In patients with high-grade ACAS, the concomitant presence of increasing occlusive disease in the CoW correlates with worse cognitive function. This association was significant in the learning and recall and attention and working memory domains. While motor and processing speed and executive function also declined numerically with increasing abnormal segments in the CoW, the relationship was not significant. Since flow restriction at a carotid stenosis compounded by inadequate collateral compensation across a diseased CoW worsens cerebral perfusion, our findings support the hypothesis that cerebral hypoperfusion underlies the observed cognitive impairment in patients with ACAS.
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Affiliation(s)
- S K Desikan
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - B Brahmbhatt
- Department of Bioengineering, George Mason University, Fairfax, VA, USA
| | - J Patel
- Radiology Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - A Kankaria
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - J Anagnostakos
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - M Dux
- Neuropsychology Section, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - K Beach
- D. Eugene Strandness Vascular Laboratory, Department of Surgery, University of Washington, Seattle, WA, USA
| | - V L Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - T McDonald
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - C Crone
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - S Sikdar
- Department of Bioengineering, George Mason University, Fairfax, VA, USA
| | - J D Sorkin
- Baltimore VA Geriatric Research, Education and Clinical Center, Baltimore, MD, USA; Department of Medicine, Division of Gerontology and Palliative Care, University of Maryland School of Medicine, Baltimore, MD, USA
| | - B K Lal
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA.
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McDonald T, Debbarma A, Whaley C, Reid R, Dowd B. Barriers primary care clinic leaders face to improving value in a consumer choice health plan design. Health Aff Sch 2023; 1:qxad065. [PMID: 38756360 PMCID: PMC10986225 DOI: 10.1093/haschl/qxad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 05/18/2024]
Abstract
Primary care clinics are a frequent focus of policy initiatives to improve the value of health care; yet, it is unclear whether they have the ability or incentive to take on the additional tasks that these initiatives ask of them. This paper reports on a qualitative study assessing barriers that clinic leaders face to reducing cost within a tiered cost-sharing commercial health insurance benefit design that gives both consumers and clinics a strong incentive to reduce cost. We conducted semi-structured interviews of clinical and operational leaders at a diverse set of 12 Minnesota primary care clinics and identified 6 barriers: insufficient information on drivers of cost; clinics controlling a portion of spending; patient preference for higher cost specialists; administrative challenges; limited resources; and misalignment of incentives. We discuss approaches to reducing these barriers and opportunities to implement them.
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Affiliation(s)
- Tim McDonald
- Pardee RAND Graduate School, Arlington, VA, United States
| | - Arindam Debbarma
- University of Minnesota School of Public Health, Minneapolis, MN, United States
| | | | - Rachel Reid
- RAND Corporation, Santa Monica, CA, United States
| | - Bryan Dowd
- University of Minnesota School of Public Health, Minneapolis, MN, United States
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3
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Homaira N, Strachan R, Quinn H, Beggs S, Bhuiyan M, Bowen A, Fawcett LK, Gilbert GL, Lambert SB, Macartney K, Marshall HS, Martin AC, McCallum G, McCullagh A, McDonald T, Selvadurai H, McIntyre P, Oftadeh S, Ranganathan S, Saunders T, Suresh S, Wainwright C, Wilson A, Wong M, Jaffe A, Snelling T. Erratum to "Real world impact of 13vPCV in preventing invasive pneumococcal pneumonia in Australian children: A national study" [Vaccine 41(1) (2023) 85-91]. Vaccine 2023; 41:6401-6402. [PMID: 37625991 DOI: 10.1016/j.vaccine.2023.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Affiliation(s)
- Nusrat Homaira
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia.
| | - Roxanne Strachan
- Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | - Helen Quinn
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia
| | - Sean Beggs
- Paediatric Department, Royal Hobart Hospital, Hobart, TAS, Australia; School of Medicine, University of Tasmania, Tasmania, Australia
| | - Mejbah Bhuiyan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Asha Bowen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Laura K Fawcett
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | | | - Stephen B Lambert
- Centre for Infectious Diseases-Public Health, Institute of Clinical Pathology and Medical Research, Westmead, NSW, Australia; Children's Health Queensland, Queensland Paediatric Infectious Diseases Laboratory, Brisbane, Queensland, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia; UQ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen S Marshall
- Women's and Children's Health Network, North Adelaide, SA, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Andrew C Martin
- Department of General Paediatrics, Perth's Children Hospital, Perth, Western Australia, Australia
| | - Gabrielle McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Angela McCullagh
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | | | - Hiran Selvadurai
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peter McIntyre
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia; Women's and Children's Health, University of Otago-Dunedin Campus, Dunedin, New Zealand
| | - Shahin Oftadeh
- Pneumococcal Reference Laboratory, Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Thomas Saunders
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sadasivam Suresh
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia; Respiratory and Sleep Medicine, Children's Health Queensland Hospital and Health Service , Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Claire Wainwright
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia; Respiratory and Sleep Medicine, Children's Health Queensland Hospital and Health Service , Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Angela Wilson
- Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Melanie Wong
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Adam Jaffe
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | - Tom Snelling
- Faculty of Medicine and Health School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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4
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Knaul FM, Arreola-Ornelas H, Touchton M, McDonald T, Blofield M, Avila Burgos L, Gómez-Dantés O, Kuri P, Martinez-Valle A, Méndez-Carniado O, Nargund RS, Porteny T, Sosa-Rubí SG, Serván-Mori E, Symes M, Vargas Enciso V, Frenk J. Setbacks in the quest for universal health coverage in Mexico: polarised politics, policy upheaval, and pandemic disruption. Lancet 2023; 402:731-746. [PMID: 37562419 DOI: 10.1016/s0140-6736(23)00777-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 08/12/2023]
Abstract
2023 marks the 20-year anniversary of the creation of Mexico's System of Social Protection for Health and the Seguro Popular, a model for the global quest to achieve universal health coverage through health system reform. We analyse the success and challenges after 2012, the consequences of reform ageing, and the unique coincidence of systemic reorganisation during the COVID-19 pandemic to identify strategies for health system disaster preparedness. We document that population health and financial protection improved as the Seguro Popular aged, despite erosion of the budget and absent needed reforms. The Seguro Popular closed in January, 2020, and Mexico embarked on a complex, extensive health system reorganisation. We posit that dismantling the Seguro Popular while trying to establish a new programme in 2020-21 made the Mexican health system more vulnerable in the worst pandemic period and shows the precariousness of evidence-based policy making to political polarisation and populism. Reforms should be designed to be flexible yet insulated from political volatility and constructed and managed to be structurally permeable and adaptable to new evidence to face changing health needs. Simultaneously, health systems should be grounded to withstand systemic shocks of politics and natural disasters.
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Affiliation(s)
- Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Fundación Mexicana para la Salud, Mexico City, Mexico; Tómatelo a Pecho, Mexico City, Mexico
| | - Hector Arreola-Ornelas
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Fundación Mexicana para la Salud, Mexico City, Mexico; Tómatelo a Pecho, Mexico City, Mexico; Institute for Obesity Research and School of Government and Public Transformation, Tecnológico de Monterrey, Nuevo León, México
| | - Michael Touchton
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Department of Political Science, College of Arts, and Sciences, University of Miami, Coral Gables, FL, USA.
| | - Tim McDonald
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; RAND Corporation, Santa Monica, CA, USA
| | - Merike Blofield
- Department of Political Science, University of Hamburg, Hamburg, Germany
| | - Leticia Avila Burgos
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública de México, Cuernavaca, México
| | - Octavio Gómez-Dantés
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública de México, Cuernavaca, México
| | - Pablo Kuri
- Proyecto OriGen, Instituto Tecnológico y de Estudios Superiores de Monterrey, Nuevo León, México
| | - Adolfo Martinez-Valle
- Centro de Investigación en Políticas Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Renu Sara Nargund
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Vilcek Institute for Biomedical Sciences, New York University, New York, NY, USA
| | - Thalia Porteny
- Department of Health Policy and Management, Columbia University, New York, NY, USA
| | - Sandra Gabriela Sosa-Rubí
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública de México, Cuernavaca, México
| | - Edson Serván-Mori
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública de México, Cuernavaca, México
| | - Maya Symes
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Julio Frenk
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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5
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Homaira N, Strachan R, Quinn H, Beggs S, Bhuiyan M, Bowen A, Fawcett LK, Gilbert GL, Lambert SB, Macartney K, Marshall HS, Martin Md AC, McCallum G, McCullagh A, McDonald T, Selvadurai H, McIntyre P, Oftadeh S, Ranganathan PhD S, Saunders T, Suresh S, Wainwright C, Wilson A, Wong M, Jaffe A, Snelling T. Real world impact of 13vPCV in preventing invasive pneumococcal pneumonia in Australian children: A national study. Vaccine 2023; 41:85-91. [PMID: 36400662 DOI: 10.1016/j.vaccine.2022.11.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND We aimed to assess the direct protective effect of 13 valent pneumococcal conjugate vaccine (13vPCV) against invasive pneumococcal pneumonia (IPP; including pneumonia and empyema) in children using a nation-wide case-control study across 11 paediatric tertiary hospitals in Australia. METHODS Children < 18 years old admitted with pneumonia were eligible for enrolment. IPP was defined as Streptococcus pneumoniae (SP) cultured or detected by polymerase chain reaction (PCR) from blood or pleural fluid. Causative SP serotype (ST) was determined from blood or pleural fluid SP isolates by molecular methods in PCR positive specimens or else inferred from nasopharyngeal isolates. For each IPP case, 20 population controls matched by age and socio-economic status were sampled from the Australian Immunisation Register. Conditional logistic regression was used to estimate the adjusted odds ratio (aOR) of being fully vaccinated with 13vPCV (≥3 doses versus < 3 doses) among IPP cases compared to controls, adjusted for sex and Indigenous status. RESULTS From February 2015 to September 2018, we enrolled 1,168 children with pneumonia; 779 were 13vPCV-eligible and were individually matched to 15,580 controls. SP was confirmed in 195 IPP cases, 181 of whom had empyema. ST3 and ST19A were identified in 52% (102/195) and 11% (21/195) of IPP cases respectively. The aOR of being fully vaccinated with 13vPCV was 0.8 (95% CI 0.6-1.0) among IPP cases compared to matched controls. CONCLUSION We failed to identify a strong direct protective effect of 13vPCV against IPP among Australian children, where disease was largely driven by ST3.
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Affiliation(s)
- Nusrat Homaira
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia.
| | - Roxanne Strachan
- Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | - Helen Quinn
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia
| | - Sean Beggs
- Paediatric Department, Royal Hobart Hospital, Hobart, TAS, Australia; School of Medicine, University of Tasmania, Tasmania, Australia
| | - Mejbah Bhuiyan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Asha Bowen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Laura K Fawcett
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | | | - Stephen B Lambert
- Centre for Infectious Diseases-Public Health, Institute of Clinical Pathology and Medical Research, Westmead, NSW, Australia; Children's Health Queensland, Queensland Paediatric Infectious Diseases Laboratory, Brisbane, Queensland, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia; UQ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen S Marshall
- Women's and Children's Health Network, North Adelaide, SA, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Andrew C Martin Md
- Department of General Paediatrics, Perth's Children Hospital, Perth, Western Australia, Australia
| | - Gabrielle McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Angela McCullagh
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | | | - Hiran Selvadurai
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peter McIntyre
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia; Women's and Children's Health, University of Otago-Dunedin Campus, Dunedin, New Zealand
| | - Shahin Oftadeh
- Pneumococcal Reference Laboratory, Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia
| | - Sarath Ranganathan PhD
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Thomas Saunders
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sadasivam Suresh
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia; Respiratory and Sleep Medicine, Children's Health Queensland Hospital and Health Service , Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Claire Wainwright
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia; Respiratory and Sleep Medicine, Children's Health Queensland Hospital and Health Service , Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Angela Wilson
- Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Melanie Wong
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Adam Jaffe
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | - Tom Snelling
- Faculty of Medicine and Health School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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6
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Temple SEL, Ho G, Bennetts B, Boggs K, Vidic N, Mowat D, Christodoulou J, Schultz A, Gayagay T, Roscioli T, Zhu Y, Lunke S, Armstrong D, Harrison J, Kapur N, McDonald T, Selvadurai H, Tai A, Stark Z, Jaffe A. The role of exome sequencing in childhood interstitial or diffuse lung disease. Orphanet J Rare Dis 2022; 17:350. [PMID: 36085161 PMCID: PMC9463757 DOI: 10.1186/s13023-022-02508-1] [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: 04/29/2022] [Accepted: 09/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's interstitial and diffuse lung disease (chILD) is a complex heterogeneous group of lung disorders. Gene panel approaches have a reported diagnostic yield of ~ 12%. No data currently exist using trio exome sequencing as the standard diagnostic modality. We assessed the diagnostic utility of using trio exome sequencing in chILD. We prospectively enrolled children meeting specified clinical criteria between 2016 and 2020 from 16 Australian hospitals. Exome sequencing was performed with analysis of an initial gene panel followed by trio exome analysis. A subset of critically ill infants underwent ultra-rapid trio exome sequencing as first-line test. RESULTS 36 patients [median (range) age 0.34 years (0.02-11.46); 11F] were recruited from multiple States and Territories. Five patients had clinically significant likely pathogenic/pathogenic variants (RARB, RPL15, CTCF, RFXANK, TBX4) and one patient had a variant of uncertain significance (VIP) suspected to contribute to their clinical phenotype, with VIP being a novel gene candidate. CONCLUSIONS Trio exomes (6/36; 16.7%) had a better diagnostic rate than gene panel (1/36; 2.8%), due to the ability to consider a broader range of underlying conditions. However, the aetiology of chILD in most cases remained undetermined, likely reflecting the interplay between low penetrant genetic and environmental factors.
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Affiliation(s)
- Suzanna E L Temple
- Department of Clinical Genetics, Liverpool Hospital, Sydney, NSW, Australia. .,School of Women's and Children's Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia.
| | - Gladys Ho
- Sydney Genome Diagnostics, Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Disciplines of Child and Adolescent Health and Genomic Medicine, University of Sydney, Sydney, NSW, Australia
| | - Bruce Bennetts
- Sydney Genome Diagnostics, Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Disciplines of Child and Adolescent Health and Genomic Medicine, University of Sydney, Sydney, NSW, Australia
| | - Kirsten Boggs
- Australian Genomics Health Alliance, Melbourne, VIC, Australia.,Department of Clinical Genetics, Children's Hospital Westmead, Sydney, NSW, Australia.,Centre for Clinical Genetics, Sydney Children's Hospital Randwick, Sydney, NSW, Australia
| | - Nada Vidic
- School of Women's and Children's Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia.,Australian Genomics Health Alliance, Melbourne, VIC, Australia
| | - David Mowat
- School of Women's and Children's Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia.,Centre for Clinical Genetics, Sydney Children's Hospital Randwick, Sydney, NSW, Australia
| | - John Christodoulou
- Disciplines of Child and Adolescent Health and Genomic Medicine, University of Sydney, Sydney, NSW, Australia.,Australian Genomics Health Alliance, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - André Schultz
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia.,Department of Respiratory Medicine, Perth Children's Hospital, Nedlands, WA, Australia.,Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Australia
| | - Thet Gayagay
- Sydney Genome Diagnostics, Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Tony Roscioli
- Centre for Clinical Genetics, Sydney Children's Hospital Randwick, Sydney, NSW, Australia.,Randwick Genomics Laboratory, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia.,Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
| | - Ying Zhu
- Randwick Genomics Laboratory, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Sebastian Lunke
- Australian Genomics Health Alliance, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - David Armstrong
- Department of Paediatrics, Monash University, Clayton Rd, Clayton, VIC, Australia.,Department of Respiratory and Sleep Medicine, Monash Children's Hospital, Clayton Rd, Clayton, VIC, Australia
| | - Joanne Harrison
- University of Melbourne, Melbourne, VIC, Australia.,Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Nitin Kapur
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.,School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | | - Hiran Selvadurai
- Disciplines of Child and Adolescent Health and Genomic Medicine, University of Sydney, Sydney, NSW, Australia.,Children's Hospital Westmead, Sydney, NSW, Australia
| | - Andrew Tai
- Paediatric Respiratory and Sleep Department, Women's and Children's Hospital, Adelaide, SA, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Zornitza Stark
- Australian Genomics Health Alliance, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Adam Jaffe
- School of Women's and Children's Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia.,Department Respiratory and Sleep Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
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7
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Kelada L, Wakefield C, Vidic N, Armstrong DS, Bennetts B, Boggs K, Christodoulou J, Harrison J, Ho G, Kapur N, Lindsey-Temple S, McDonald T, Mowat D, Schultz A, Selvadurai H, Tai A, Jaffe A. Genomic testing for children with interstitial and diffuse lung disease (chILD): parent satisfaction, understanding and health-related quality of life. BMJ Open Respir Res 2022; 9:9/1/e001139. [PMID: 35190460 PMCID: PMC8862491 DOI: 10.1136/bmjresp-2021-001139] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Research is needed to determine best practice for genomic testing in the context of child interstitial or diffuse lung disease (chILD). We explored parent’s and child’s health-related quality of life (HRQoL), parents’ perceived understanding of a genomic testing study, satisfaction with information and the study and decisional regret to undertake genomic testing. Methods Parents of children with diagnosed or suspected chILD who were enrolled in a genomic sequencing study were invited to complete questionnaires pretesting (T1) and after receiving the result (T2). Results Parents’ (T1, n=19; T2, n=17) HRQoL was lower than population norms. Study satisfaction (T1) and perceived understanding (T2) were positively correlated (rs=0.68, p=0.014). Satisfaction with information (T1 and T2) and decisional regret (T2) were negatively correlated (T1 rs=−0.71, p=0.01; T2 rs=−0.56, p=0.03). Parents reported wanting more frequent communication with staff throughout the genomic sequencing study, and greater information about the confidentiality of test results. Conclusions Understanding of genomic testing, satisfaction with information and participation and decisional regret are inter-related. Pretest consultations are important and can allow researchers to explain confidentiality of data and the variable turnaround times for receiving a test result. Staff can also update parents when there will be delays to receiving a result.
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Affiliation(s)
- Lauren Kelada
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, New South Wales, Australia
| | - Claire Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, New South Wales, Australia
| | - Nada Vidic
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, New South Wales, Australia
| | - David S Armstrong
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Bruce Bennetts
- Discipline of Genetic Medicine and Discipline of Child & Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Genome Diagnostics, Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- KidGen Collaborative, Australian Genomics Health Alliance, Parkville, Victoria, Australia
| | - Kirsten Boggs
- Department of Clinical Genetics, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
- Mackenzie's Mission, Australian Genomics Health Alliance, Melbourne, Victoria, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - John Christodoulou
- Discipline of Genetic Medicine and Discipline of Child & Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Brain and Mitochondrial, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Joanne Harrison
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Respiratory and Sleep Medicine, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
- Division of Infection and Immunity, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
| | - Gladys Ho
- Discipline of Genetic Medicine and Discipline of Child & Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Genome Diagnostics, Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nitin Kapur
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Suzanna Lindsey-Temple
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, New South Wales, Australia
- Department of Clinical Genetics, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Tim McDonald
- Paediatrics, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - David Mowat
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, New South Wales, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - André Schultz
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Hiran Selvadurai
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Tai
- Respiratory and Sleep Medicine, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Adam Jaffe
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, New South Wales, Australia
- Respiratory Department, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
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8
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Knaul FM, Touchton M, Arreola-Ornelas H, Atun R, Anyosa RJCC, Frenk J, Martínez-Valle A, McDonald T, Porteny T, Sánchez-Talanquer M, Victora C. Punt Politics as Failure of Health System Stewardship: Evidence from the COVID-19 Pandemic Response in Brazil and Mexico. Lancet Reg Health Am 2021; 4:100086. [PMID: 34664040 PMCID: PMC8514423 DOI: 10.1016/j.lana.2021.100086] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 12/25/2022]
Abstract
We present a new concept, Punt Politics, and apply it to the COVID-19 non-pharmaceutical interventions (NPI) in two epicenters of the pandemic: Mexico and Brazil. Punt Politics refers to national leaders in federal systems deferring or deflecting responsibility for health systems decision-making to sub-national entities without evidence or coordination. The fragmentation of authority and overlapping functions in federal, decentralized political systems make them more susceptible to coordination problems than centralized, unitary systems. We apply the concept to pandemics, which require national health system stewardship, using sub-national NPI data that we developed and curated through the Observatory for the Containment of COVID-19 in the Americas to illustrate Punt Politics in Mexico and Brazil. Both countries suffer from protracted, high levels of COVID-19 mortality and inadequate pandemic responses, including little testing and disregard for scientific evidence. We illustrate how populist leadership drove Punt Politics and how partisan politics contributed to disabling an evidence-based response in Mexico and Brazil. These cases illustrate the combination of decentralization and populist leadership that is most conducive to punting responsibility. We discuss how Punt Politics reduces health system functionality, providing lessons for other countries and future pandemic responses, including vaccine rollout.
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Affiliation(s)
- Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA,Fundación Mexicana para la Salud, Mexico City, Mexico,Tómatelo a Pecho, Mexico City, Mexico
| | - Michael Touchton
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA,Department of Political Science, Institute for Advanced Studies of the Americas, University of Miami, Coral Gables, FL, USA,Corresponding author: Michael Touchton, University of Miami, Coral Gables, FL, USA
| | - Héctor Arreola-Ornelas
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA,Fundación Mexicana para la Salud, Mexico City, Mexico,Tómatelo a Pecho, Mexico City, Mexico
| | - Rifat Atun
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Renzo JC Calderon Anyosa
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA,School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | | | - Adolfo Martínez-Valle
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA,Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Tim McDonald
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA,RAND Corporation, Santa Monica, CA, USA
| | - Thalia Porteny
- Departments of Community Health and Occupational Therapy, Tufts University, Medford, MA, USA
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9
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McDonald T, White KM, Huang TY, Whaley CM, Dowd B. Clinic price reductions in a tiered total cost benefit design. Am J Manag Care 2021; 27:e316-e321. [PMID: 34533914 PMCID: PMC9940713 DOI: 10.37765/ajmc.2021.88744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To understand responses of primary care clinics to inclusion in a tiered total cost of care insurance benefit design. STUDY DESIGN We used a qualitative design beginning with longitudinal analysis of administrative data on consumer clinic choice, clinic tier placement, and clinic actions, followed by in-depth interviews with key informants from clinics, administering health plans, and program administrators. METHODS We collected data via semistructured interviews with purposively sampled key informants selected from clinics that prospectively reduced prices to move to, or remain in, a tier with lower cost sharing. Data from interview transcripts were coded using qualitative coding software and analyzed for thematic responses. RESULTS Our findings suggest that clinics respond to the incentives in the tiered cost-sharing benefit design. Two motivations cited by clinics are (1) concern over developing a reputation as a high-cost clinic and (2) concern about the possible loss of patients due to higher cost sharing. Some clinics have agreed to price reductions or risk-sharing arrangements to move to, or remain in, a tier with lower cost sharing. Clinic informants reported that price reductions alone are not scalable. They sought greater transparency in tier assignment and increased data sharing to help them reduce costly or unnecessary utilization. CONCLUSIONS Managers of primary care clinics respond to a tiered benefit design that holds them accountable for total cost of care. They respond by offering price discounts and expressing interest in reducing costly referrals and unnecessary use of services.
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Affiliation(s)
- Tim McDonald
- Pardee RAND Graduate School, 1776 Main St, Santa Monica, CA 90401.
| | | | | | | | - Bryan Dowd
- University of Minnesota, Minneapolis, MN
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10
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Bouchard DR, Olthuis JV, Bouffard-Levasseur V, Shannon C, McDonald T, Sénéchal M. Peer-led exercise program for ageing adults to improve physical functions - a randomized trial. Eur Rev Aging Phys Act 2021; 18:2. [PMID: 33573594 PMCID: PMC7879524 DOI: 10.1186/s11556-021-00257-x] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background A peer-led exercise program is one way to empower people sharing similar characteristics to encourage others to be active, but there is a lack of evidence that these programs have physical function and other benefits when delivered to ageing adults. Methods This randomized controlled trial lasting 12 weeks proposed an exercise peer-led program offered to 31 adults aged 50 and above, twice a week, by a trained leader of the same age from March to May 2019. The program was offered for free with limited space and equipment. Valid tests of physical function (e.g., 30-s chair stand, 6-min walk test) were used to assess the functional benefits. Psychosocial outcomes were assessed using self-reported questionnaires and metabolic outcomes via a fasted blood draw. Results A significant difference was found between pre-and post-values in most physical function tests in the intervention group (all p < 0.05). When adjusted for potential confounders, the intervention group was significantly associated with a more significant improvement on the chair stand test (ß = .26; p < 0.001; r2 = 0.26), the arm curl (ß = .29; p < 0.001; r2 = 0.49), as well as the 6-min walk test (ß = -.14; p < 0.001; r2 = 0.62) compared with the control group. Using repetitive measures generalized linear model, the interaction between the changes and the group was significant for all three tests. Benefits were also observed for participants’ stress level and perceived health in the intervention group compared to the control. Finally, no significant difference was observed between groups for metabolic health. Conclusions The current work suggests that a 12-week peer-led exercise program can improve physical function for adults age 50 and above. Trial registration NCT03799952(ClinicalTrials.gov) 12/20/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00257-x.
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Affiliation(s)
- D R Bouchard
- Cardiometabolic Exercise & Lifestyle Laboratory, Fredericton, NB, Canada. .,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada.
| | - J V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
| | - V Bouffard-Levasseur
- Secteur Éducation et kinésiologie, Université de Moncton, Fredericton, NB, Canada
| | - C Shannon
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada
| | - T McDonald
- Faculty of Law, University of New Brunswick, Fredericton, NB, Canada
| | - M Sénéchal
- Cardiometabolic Exercise & Lifestyle Laboratory, Fredericton, NB, Canada.,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada
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11
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Strachan R, Homaira N, Beggs S, Bhuiyan MU, Gilbert GL, Lambert SB, Macartney K, Marshall H, Martin AC, McCallum GB, McCullagh A, McDonald T, McIntyre P, Oftadeh S, Ranganathan S, Suresh S, Wainwright CE, Wilson A, Wong M, Snelling T, Jaffé A. Assessing the impact of the 13 valent pneumococcal vaccine on childhood empyema in Australia. Thorax 2021; 76:487-493. [PMID: 33504566 DOI: 10.1136/thoraxjnl-2020-216032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/04/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Empyema is a serious complication of pneumonia frequently caused by Streptococcus pneumoniae (SP). We assessed the impact of the 13-valent pneumococcal conjugate vaccine (13vPCV) on childhood pneumonia and empyema after inclusion in the Australian National Immunisation Program. METHODS For bacterial pneumonia and empyema hospitalisations, we ascertained incidence rates (IRs) using the National Hospital Morbidity Database International Statistical Classification of Disease discharge codes and relevant population denominators, and calculated incidence rate ratios (IRR) comparing the 13vPCV period (June 2012-May 2017) with the 7vPCV period (June 2007-May 2011). Blood and pleural fluid (PF) cultures and PF PCR of 401 children with empyema from 11 Australian hospitals during the 13vPCV period were compared with our previous study in the 7vPCV period. FINDINGS Across 7vPCV and 13vPCV periods, IRs per million children (95% CIs) were 1605 (1588 to 1621) and 1272 (1259 to 1285) for bacterial pneumonia, and 14.23 (12.67 to 15.79) and 17.89 (16.37 to 19.42) for empyema hospitalisations. IRRs were 0.79 (0.78 to 0.80) for bacterial pneumonia and 1.25 (1.09 to 1.44) for empyema. Of 161 empyema cases with SP serotypes, 147 (91.3%) were vaccine types. ST3 accounted for 76.4% of identified serotypes in the 13vPCV period, more than double than the 7vPCV period (p<0.001); ST19A decreased from 36.4% to 12.4%. No cases of ST1 empyema were identified in the 13vPCV period versus 14.5% in the 7vPCV period. INTERPRETATION 13vPCV resulted in a significant reduction in all-cause hospitalisations for bacterial pneumonia but empyema hospitalisations significantly increased, with emergence of pneumococcal ST3 as the dominant serotype in empyema. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trial Registry ACTRN 12614000354684.
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Affiliation(s)
- Roxanne Strachan
- Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Nusrat Homaira
- Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
| | - Sean Beggs
- Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia.,School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Mejbah U Bhuiyan
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Science, University of Western Australia, Crawley, Western Australia, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Gwendolyn L Gilbert
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephen B Lambert
- School of Medicine, University of Queensland, UQ Child Health Research Centre, Brisbane, Queensland, Australia.,Children's Health Queensland, Queensland Paediatric Infectious Diseases Laboratory, Brisbane, Queensland, Australia
| | - Kristine Macartney
- Infectious Diseases, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia
| | - Helen Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, Women's and Children's Health Network, North Adelaide, South Australia, Australia.,Child and Adolescent Health, Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
| | - Andrew C Martin
- Paediatrics, Princess Margaret Hospital For Children, Perth, Western Australia, Australia
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Angela McCullagh
- Respiratory and Sleep Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia.,Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Tim McDonald
- Paediatrics, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Peter McIntyre
- Infectious Diseases, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Women's and Children's Health, University of Otago-Dunedin Campus, Dunedin, New Zealand
| | - Shahin Oftadeh
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Wentworthville, New South Wales, Australia
| | - Sarath Ranganathan
- Paediatrics, The University of Melbourne Department of Paediatrics, Parkville, Victoria, Australia.,Infection and Immunology, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Sadasivam Suresh
- Department of Respiratory Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Claire E Wainwright
- Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Angela Wilson
- Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Melanie Wong
- Immunology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Thomas Snelling
- School of Women's and Children's Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam Jaffé
- Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
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Abstract
AIM To emphasize the role of history in shaping clinical nursing identity and opportunities, and encourage nurses' contribution to the story of contemporary clinical nursing. APPROACH Drawing upon history frameworks and approaches to history research, greater engagement of clinical nurses in recording nursing history is canvassed. A basic framework for developing historical research from practice narratives is suggested as a feasible option. OUTCOMES Topics identified: a) nurses' awareness of their history and nursing's professional standing; b) the importance of oral history in nursing development; and c) digital influences on history research and constructing historical narratives. CONCLUSION Clinical nurses' stories contribute to historical research. All nurses are responsible for gathering and distributing contemporary local narratives on clinical nursing. Oral history research provides a framework for nurses to record and share stories. IMPLICATIONS Recorded history can prevent nursing from being trivialized or misrepresented. Missing accounts of contemporary nursing create gaps in our narrative and risk future professional disempowerment.
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Affiliation(s)
- T McDonald
- International Nusing Review, International Council of Nurses, Yarrawarrah, NSW, Australia
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13
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Myngheer N, Allegaert K, Hattersley A, McDonald T, Kramer H, Ashcroft FM, Verhaeghe J, Mathieu C, Casteels K. Erratum. Fetal Macrosomia and Neonatal Hyperinsulinemic Hypoglycemia Associated With Transplacental Transfer of Sulfonylurea in a Mother With KCNJ11-Related Neonatal Diabetes. Diabetes Care 2014;37:3333-3335. Diabetes Care 2019; 42:1352. [PMID: 31221702 DOI: 10.2337/dc19-er07] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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14
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Starcevich LAH, McDonald T, Chung-MacCoubrey A, Heard A, Nesmith J, Philippi T. Correction to: Trend estimation for complex survey designs of water chemistry indicators from Sierra Nevada Lakes. Environ Monit Assess 2018; 190:664. [PMID: 30345470 PMCID: PMC6828488 DOI: 10.1007/s10661-018-7018-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The original version of this article contained a misaligned equation. The following equation replaces the online printed on the 5th page of the article.
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Affiliation(s)
- L A H Starcevich
- Western EcoSystems Technology, Inc., 2725 NW Walnut Blvd., Corvallis, 97330, USA.
| | - T McDonald
- Western EcoSystems Technology, Inc., 2725 NW Walnut Blvd., Corvallis, 97330, USA
| | - A Chung-MacCoubrey
- National Park Service Inventory and Monitoring Program, Klamath Network, 1250 Siskiyou Blvd, Ashland, OR, 97520, USA
| | - A Heard
- National Park Service Inventory and Monitoring Program, Sierra Nevada Network, 47050 Generals Highway, Three Rivers, CA, 93271, USA
| | - J Nesmith
- National Park Service Inventory and Monitoring Program, Sierra Nevada Network, 47050 Generals Highway, Three Rivers, CA, 93271, USA
| | - T Philippi
- National Park Service Inventory and Monitoring Division, c/o Cabrillo National Monument, 1800 Cabrillo Memorial Dr., San Diego, CA, 92106, USA
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15
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Thesing J, McDonald T, Hoehn S, Allegra P. 62 Patient Flow Improvements in a Rural Critical Access Hospital Reduces the Number of Patients Who Leave Without Being Seen. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Starcevich LAH, McDonald T, Chung-MacCoubrey A, Heard A, Nesmith J, Philippi T. Trend estimation for complex survey designs of water chemistry indicators from Sierra Nevada Lakes. Environ Monit Assess 2018; 190:596. [PMID: 30232629 PMCID: PMC6153522 DOI: 10.1007/s10661-018-6963-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/09/2018] [Accepted: 09/05/2018] [Indexed: 05/22/2023]
Abstract
Surveys for long-term monitoring programs managing natural resources often incorporate sampling design complexity. However, design weights are often ignored in trend models of data from complex sampling designs. Generalized random tessellation stratified samples of a simulated population of lakes are selected with various levels of survey design complexity, and three trend approaches are compared. We compare an unweighted trend model, linear regression models of the trend in design-based estimates of annual status, and a probability-weighted iterative generalized least squares (PWIGLS) approach with a linearization variance. The bias and confidence interval coverage of the trend estimate and the size and power of the trend test are used to evaluate weighted and unweighted approaches. We find that the unweighted approach often outperforms the other trend approaches by providing high power for trend detection and nominal confidence interval coverage of the true trend regression parameter. We also find that variance composition and revisit design structure affect the performance of the PWIGLS estimator. When a subpopulation exhibiting an extreme trend is sampled disproportionately to its occurrence in the population, the unweighted approach may produce biased estimates of trend with poor confidence interval coverage. We recommend considering variance composition and potential subpopulation trends when selecting sampling designs and trend analysis approaches.
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Affiliation(s)
- L A H Starcevich
- Western EcoSystems Technology, Inc., 2725 NW Walnut Blvd., Corvallis, 97330, USA.
| | - T McDonald
- Western EcoSystems Technology, Inc., 2725 NW Walnut Blvd., Corvallis, 97330, USA
| | - A Chung-MacCoubrey
- National Park Service Inventory and Monitoring Program, Klamath Network, 1250 Siskiyou Blvd, Ashland, OR, 97520, USA
| | - A Heard
- National Park Service Inventory and Monitoring Program, Sierra Nevada Network, 47050 Generals Highway, Three Rivers, CA, 93271, USA
| | - J Nesmith
- National Park Service Inventory and Monitoring Program, Sierra Nevada Network, 47050 Generals Highway, Three Rivers, CA, 93271, USA
| | - T Philippi
- National Park Service Inventory and Monitoring Division, c/o Cabrillo National Monument, 1800 Cabrillo Memorial Dr., San Diego, CA, 92106, USA
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Bell SC, Armstrong D, Harrington G, Jardine L, Divakaran R, Loff B, Middleton PG, McDonald T, Rowland K, Wishart M, Wood ME, Stuart RL. Work environment risks for health care workers with cystic fibrosis. Respirology 2018; 23:1190-1197. [PMID: 30215873 DOI: 10.1111/resp.13404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/22/2018] [Accepted: 08/21/2018] [Indexed: 01/06/2023]
Abstract
In Australia and New Zealand, >50% of people with cystic fibrosis (CF) are adults and many of these people are pursuing vocational training and undertaking paid employment. More than 6% of adults with CF are working in health care. There is limited guidance in literature to support health care workers with CF (HCWcf) in training and in employment to support safe practice and to provide protection for themselves and their patients from the acquisition of health care associated infection. A multidisciplinary team of CF and Infectious Disease Clinicians, Infection Prevention and Control Practitioners, HCWcf, academic experts in medical ethics and representatives from universities, appraised the available evidence on the risk posed to and by HCWcf. Specific recommendations were made for HCWcf, CF health care teams, hospitals and universities to support the safe practice and appropriate support for HCWcf.
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Affiliation(s)
- Scott C Bell
- Department of Thoracic Medicine, Adult Cystic Fibrosis Centre, The Prince Charles Hospital and QIMR Berghofer Medicine Research Institute, Brisbane, QLD, Australia
| | - David Armstrong
- Monash Children's Cystic Fibrosis Centre, Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | | | - Luke Jardine
- Department of Neonatology, Mater Mothers' Hospital, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - Bebe Loff
- Michael Kirby Centre for Public Health and Human Rights, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Peter G Middleton
- Department Respiratory and Sleep Medicine, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
| | - Tim McDonald
- Department of Paediatrics, Canberra Hospital, Canberra, ACT, Australia
| | - Karen Rowland
- Department of Infectious Disease, Calvary Hospital, Adelaide, SA, Australia
| | - Michael Wishart
- Department of Infection Control and Prevention, Holy Spirit Northside, Brisbane, QLD, Australia
| | - Michelle E Wood
- Department of Physiotherapy and Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Rhonda L Stuart
- Department of Infectious Diseases, Monash Health, Melbourne, VIC, Australia
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Helal NA, Osami A, Helmy A, McDonald T, Shaaban LA, Nounou MI. Non-viral gene delivery systems: hurdles for bench-to-bedside transformation. Pharmazie 2018; 72:627-693. [PMID: 29442038 DOI: 10.1691/ph.2017.7092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Biologist and Nobel Prize winner James Watson's quote, "We used to think that our fate was in our stars, but now we know that, in large measure, our fate is in our genes", represents the initial food for thought that revolutionized the way medications and active pharmaceutical ingredients are defined (Rocholl 1996). This fate engraved in the genetic material, as mentioned in Watson's quote, fueled a tremendous revolution wave in gene therapy. Gene therapy is a promising technology for treating genetic and acquired diseases by modulating the expression of a specific gene in the pathological cells. This is achieved by introducing a DNA sequence or other nucleic acid material or oligonucleotides to the target cell (Kay, 2011). Moreover, gene therapy contributes to correction of genetic defects, expression of therapeutic proteins, and inhibition of the synthesis of malignant proteins. In this review article, different non-viral gene delivery systems and their applications are discussed in detail. We reviewed and tabulated over 90 papers and 50 patents from 2006 to date discussing non-viral gene delivery technologies, innovation, and bench-to-bedside transformation. Furthermore, we are going to shed light on the lack of standardization in the design and characterization of non-viral gene delivery systems worldwide, which is a major concern in this research's field. This review would aid in getting an eagle eye view through non-viral gene delivery technologies during the past 20 years. Such a view, capturing the advances, the hurdles, and experimental details, would aid expert researchers in tuning their experimentation strategies and help newcomers better initially design their studies to generate solid and comprehensive results that can be reliable and reproducible.
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Curk T, McDonald T, Zazelenchuk D, Weidensaul S, Brinker D, Huy S, Smith N, Miller T, Robillard A, Gauthier G, Lecomte N, Therrien JF. Winter irruptive Snowy Owls (Bubo scandiacus) in North America are not starving. CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0278] [Citation(s) in RCA: 5] [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] [Indexed: 11/22/2022]
Abstract
Winter irruptions, defined as irregular massive movement of individuals over large distances, have been linked to food supply. Two hypotheses have been put forward: the “lack-of-food” suggests that a shortage of food forces individuals to leave their regular winter range and the “breeding output” suggests that unusually large food supplies during the preceding breeding season allows production of a large number of offspring dispersing in winter. According to the breeding output hypothesis, irruptive Snowy Owls (Bubo scandiacus (Linnaeus, 1758)) in eastern North America should not exhibit a lower body condition than individuals in regular wintering regions and individuals on the breeding grounds. Additionally, body condition of irruptive individuals should be unrelated to irruption intensity. Although body condition of juveniles was generally lower than that of adults and improved during the winter, we measured a fair body condition in both juvenile and adult irruptive Snowy Owls across North America. The results showed that Snowy Owls are not in a starving state during winter and that body condition of all age classes was not related to winter irruption intensity. Those results support the breeding output hypothesis suggesting that winter irruptions seem to be primarily the result of a large number of offspring produced when food availability on the breeding grounds is high.
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Affiliation(s)
- T. Curk
- Hawk Mountain Sanctuary, Orwigsburg, Pennsylvania, USA
- Max Planck Institute for Ornithology, Radolfzell, Germany
| | | | | | - S. Weidensaul
- Ned Smith Center for Nature and Art, Millersburg, Pennsylvania, USA
| | - D. Brinker
- Maryland Department of Natural Resources, Catonsville, Maryland, USA
| | - S. Huy
- Project Owlnet, Maryland, USA
| | - N. Smith
- Mass Audubon, Lincoln, Massachusetts, USA
| | - T. Miller
- Conservation Science Global, Inc., Cape May, New Jersey, USA
| | - A. Robillard
- Université Laval, Centre d’études nordiques, QC G1V 0A6, Canada
| | - G. Gauthier
- Université Laval, Centre d’études nordiques, QC G1V 0A6, Canada
| | - N. Lecomte
- Canada Research Chair in Polar and Boreal Ecology, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - J.-F. Therrien
- Hawk Mountain Sanctuary, Orwigsburg, Pennsylvania, USA
- Canada Research Chair in Polar and Boreal Ecology, Université de Moncton, Moncton, NB E1A 3E9, Canada
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Abstract
Abstract:Three alternative approaches to computerise primary health care services as provided in clinics in South Africa are compared. The first approach implements a system based on a head-count approach using a minimum set of indicators. This system resembles the current manual system of tally sheets. The second and third approaches implement computer systems based on patient records. The second approach is based on a very limited data set, and the third utilizes a comprehensive demographic and clinical data set. The three alternatives are compared with regard to practicality, flexibility, ease of use, accuracy and completeness of statistical reports, and time utilisation. It is concluded that the flexibility of a patientrecord approach, although more time consuming, is preferred. The second alternative is more feasible in a developing country with mostly computerilliterate nurses. Ways in which such a system can be implemented in an environment with limited hardware resources are also proposed.
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Wallace BP, Stacy BA, Rissing M, Cacela D, Garrison LP, Graettinger GD, Holmes JV, McDonald T, McLamb D, Schroeder B. Estimating sea turtle exposures to Deepwater Horizon oil. ENDANGER SPECIES RES 2017. [DOI: 10.3354/esr00728] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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23
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Bale SD, Goetz K, Harvey PR, Turin P, Bonnell JW, de Wit TD, Ergun RE, MacDowall RJ, Pulupa M, Andre M, Bolton M, Bougeret JL, Bowen TA, Burgess D, Cattell CA, Chandran BDG, Chaston CC, Chen CHK, Choi MK, Connerney JE, Cranmer S, Diaz-Aguado M, Donakowski W, Drake JF, Farrell WM, Fergeau P, Fermin J, Fischer J, Fox N, Glaser D, Goldstein M, Gordon D, Hanson E, Harris SE, Hayes LM, Hinze JJ, Hollweg JV, Horbury TS, Howard RA, Hoxie V, Jannet G, Karlsson M, Kasper JC, Kellogg PJ, Kien M, Klimchuk JA, Krasnoselskikh VV, Krucker S, Lynch JJ, Maksimovic M, Malaspina DM, Marker S, Martin P, Martinez-Oliveros J, McCauley J, McComas DJ, McDonald T, Meyer-Vernet N, Moncuquet M, Monson SJ, Mozer FS, Murphy SD, Odom J, Oliverson R, Olson J, Parker EN, Pankow D, Phan T, Quataert E, Quinn T, Ruplin SW, Salem C, Seitz D, Sheppard DA, Siy A, Stevens K, Summers D, Szabo A, Timofeeva M, Vaivads A, Velli M, Yehle A, Werthimer D, Wygant JR. The FIELDS Instrument Suite for Solar Probe Plus: Measuring the Coronal Plasma and Magnetic Field, Plasma Waves and Turbulence, and Radio Signatures of Solar Transients. Space Sci Rev 2016; 204:49-82. [PMID: 29755144 PMCID: PMC5942226 DOI: 10.1007/s11214-016-0244-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
NASA's Solar Probe Plus (SPP) mission will make the first in situ measurements of the solar corona and the birthplace of the solar wind. The FIELDS instrument suite on SPP will make direct measurements of electric and magnetic fields, the properties of in situ plasma waves, electron density and temperature profiles, and interplanetary radio emissions, amongst other things. Here, we describe the scientific objectives targeted by the SPP/FIELDS instrument, the instrument design itself, and the instrument concept of operations and planned data products.
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Affiliation(s)
- S D Bale
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - K Goetz
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - P R Harvey
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - P Turin
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J W Bonnell
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - T Dudok de Wit
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - R E Ergun
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - R J MacDowall
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Pulupa
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - M Andre
- Swedish Institute of Space Physics (IRF), Uppsala, Sweden
| | - M Bolton
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | | | - T A Bowen
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - D Burgess
- Astronomy Unit, Queen Mary, University of London, London, UK
| | - C A Cattell
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - B D G Chandran
- Department of Physics, University of New Hampshire, Durham, NH, USA
| | - C C Chaston
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - C H K Chen
- Department of Physics, Imperial College, London, UK
| | - M K Choi
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J E Connerney
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Cranmer
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - M Diaz-Aguado
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - W Donakowski
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J F Drake
- Department of Physics, University of Maryland, College Park, MD, USA
| | - W M Farrell
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - P Fergeau
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - J Fermin
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J Fischer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - N Fox
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - D Glaser
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - M Goldstein
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - D Gordon
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E Hanson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - S E Harris
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - L M Hayes
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J J Hinze
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - J V Hollweg
- Department of Physics, University of New Hampshire, Durham, NH, USA
| | - T S Horbury
- Department of Physics, Imperial College, London, UK
| | - R A Howard
- Space Science Division, Naval Research Laboratory, Washington, DC, USA
| | - V Hoxie
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - G Jannet
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - M Karlsson
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - J C Kasper
- University of Michigan, Ann Arbor, MI, USA
| | - P J Kellogg
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - M Kien
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - J A Klimchuk
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - S Krucker
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J J Lynch
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | | | - D M Malaspina
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - S Marker
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - P Martin
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | | | - J McCauley
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D J McComas
- Southwest Research Institute, San Antonio, TX, USA
| | - T McDonald
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | | | - M Moncuquet
- LESIA, Observatoire de Paris, Meudon, France
| | - S J Monson
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - F S Mozer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - S D Murphy
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Odom
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - R Oliverson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Olson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E N Parker
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | - D Pankow
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - T Phan
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E Quataert
- Astronomy Department, University of California, Berkeley, CA, USA
| | - T Quinn
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | | | - C Salem
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D Seitz
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D A Sheppard
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - A Siy
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - K Stevens
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - D Summers
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - A Szabo
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Timofeeva
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - A Vaivads
- Swedish Institute of Space Physics (IRF), Uppsala, Sweden
| | - M Velli
- Earth, Planetary, and Space Sciences, UCLA, Los Angelos, CA, USA
| | - A Yehle
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - D Werthimer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J R Wygant
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
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Abstract
BACKGROUND Families and nurses are important care-providers and proxies of older people. Their ability to assess the quality of life of elders in ways that align with how older people assess themselves has policy implications for allocating services and resources to older persons. AIM To investigate the alignment of perspectives of the quality of life held by older people, their families and nurses in China. METHODS Employing a survey design using concurrent EQ-5D-3L and WHOQOL-BREF surveys, responses from 72 matched stakeholder groups were compared and agreement tested using weighted kappa/one-way random intra-class correlations and paired Student's t-test. RESULTS On the more observable dimensions families and nurses were in close agreement with the older person in relation to quality of life reports. However, in the more subjective domains, family and especially nurses tended to estimate that the older person's suffering as more severe than they themselves thought. CONCLUSION The perspectives of older patients and their family are more closely aligned regarding the older person's quality of life than that of nurses caring for them, a finding inconsistent with international research. IMPLICATION FOR NURSING AND HEALTH POLICY The evidence suggests that nursing work assignment processes could influence the accuracy of nurses' perceptions of their patient's quality of life.
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Affiliation(s)
- W Wang
- HOPE School of Nursing, Wuhan University, Wuhan, China
| | - T McDonald
- HOPE School of Nursing, Wuhan University, Wuhan, China.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, New South Wales, Australia
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Mantel A, McDonald T, Goldsborough K, Pentland A, Chan J. 697 Prostaglandin D2-enhanced testosterone metabolism in human keratinocytes is mediated by reactive oxygen species. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gailey G, Sychenko O, McDonald T, Racca R, Rutenko A, Bröker K. Behavioural responses of western gray whales to a 4-D seismic survey off northeastern Sakhalin Island, Russia. ENDANGER SPECIES RES 2016. [DOI: 10.3354/esr00713] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Craig JR, McDonald T, Brewster CJ, Henman DJ. Increasing zinc via an inorganic source (ZnO) in high calcium finisher diets improves growth performance. Anim Prod Sci 2015. [DOI: 10.1071/anv55n12ab023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Myngheer N, Allegaert K, Hattersley A, McDonald T, Kramer H, Ashcroft FM, Verhaeghe J, Mathieu C, Casteels K. Fetal macrosomia and neonatal hyperinsulinemic hypoglycemia associated with transplacental transfer of sulfonylurea in a mother with KCNJ11-related neonatal diabetes. Diabetes Care 2014; 37:3333-5. [PMID: 25231897 PMCID: PMC5894804 DOI: 10.2337/dc14-1247] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Sulfonylureas (SUs) are effective at controlling glycemia in permanent neonatal diabetes mellitus (PNDM) caused by KCNJ11 (Kir6.2) mutations. RESEARCH DESIGN AND METHODS We report the case of a woman with PNDM who continued high doses of glibenclamide (85 mg/day) during her pregnancy. The baby was born preterm, and presented with macrosomia and severe hyperinsulinemic hypoglycemia requiring high-rate intravenous glucose infusion. RESULTS Postnatal genetic testing excluded a KCNJ11 mutation in the baby. Glibenclamide was detected in both the baby's blood and the maternal milk. CONCLUSIONS We hypothesize that high doses of glibenclamide in the mother led to transplacental passage of the drug and overstimulation of fetal β-cells, which resulted in severe hyperinsulinemic hypoglycemia in the neonate (who did not carry the mutation) and contributed to fetal macrosomia. We suggest that glibenclamide (and other SUs) should be avoided in mothers with PNDM if the baby does not carry the mutation or if prenatal screening has not been performed, while glibenclamide may be beneficial when the fetus is a PNDM carrier.
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Affiliation(s)
- Nele Myngheer
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Karel Allegaert
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | | | - Tim McDonald
- University of Exeter Medical School, Exeter, U.K
| | - Holger Kramer
- University Laboratory of Physiology, Oxford, Oxford, U.K
| | | | - Johan Verhaeghe
- Department of Obstetrics/Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Chantal Mathieu
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Kristina Casteels
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
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Abstract
BACKGROUND On 8 May 2013, the Chinese Nursing Association joined the International Council of Nurses. It is hoped that by sharing the history of nursing in China, scholars globally can incorporate into current thinking the challenges that Chinese nurses have faced in pursuing educational development and professional acknowledgement. AIM To review the history of nurse education in China between 1887 and 1949 and summarize events marking its development; and to provide historical references for considering contemporary nurse education and discipline development in China. METHODS Content analysis using bibliometric and historical research methods on available documentation sources. Milestone events were listed and their historical significance analysed. RESULTS Nurse education development during this period was affected by three major influences: (1) international nursing collaboration and involvement with Chinese nursing in China and abroad, (2) the determination of leaders to develop nursing as a unique and ethical profession, and (3) the pressure of war and civilian need on the focus of nursing development in China. CONCLUSION The development of nurse education in China occurred within an environment of social change, war and international collaboration. Throughout the Modern China period (1887-1949), nursing leadership has guided the growth of nurse education to be responsive to individual and community needs as well as ensuring nurse accountability for conduct and nursing practice. Contemporary Chinese nursing and education owes much to those throughout the Modern China period, who laid the foundations that support the current position and status of nursing. IMPLICATIONS FOR NURSING AND HEALTH POLICY The study displays the benefits and challenges of participation in policy and forums that help nurse scholars and practitioners understand the development of nurse education in China.
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Affiliation(s)
- Z Yan
- Nursing School of Second Military Medical University, Shanghai, China
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Hope SV, Jones AG, Goodchild E, Shepherd M, Besser REJ, Shields B, McDonald T, Knight BA, Hattersley A. Urinary C-peptide creatinine ratio detects absolute insulin deficiency in Type 2 diabetes. Diabet Med 2013; 30:1342-8. [PMID: 23659458 PMCID: PMC4154136 DOI: 10.1111/dme.12222] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/03/2013] [Accepted: 05/07/2013] [Indexed: 12/24/2022]
Abstract
AIMS To determine the prevalence and clinical characteristics of absolute insulin deficiency in long-standing Type 2 diabetes, using a strategy based on home urinary C-peptide creatinine ratio measurement. METHODS We assessed the urinary C-peptide creatinine ratios, from urine samples taken at home 2 h after the largest meal of the day, in 191 insulin-treated subjects with Type 2 diabetes (diagnosis age ≥45 years, no insulin in the first year). If the initial urinary C-peptide creatinine ratio was ≤0.2 nmol/mmol (representing absolute insulin deficiency), the assessment was repeated. A standardized mixed-meal tolerance test with 90-min stimulated serum C-peptide measurement was performed in nine subjects with a urinary C-peptide creatinine ratio ≤ 0.2 nmol/mmol (and in nine controls with a urinary C-peptide creatinine ratio >0.2 nmol/mmol) to confirm absolute insulin deficiency. RESULTS A total of 2.7% of participants had absolute insulin deficiency confirmed by a mixed-meal tolerance test. They were identified initially using urinary C-peptide creatinine ratio: 11/191 subjects (5.8%) had two consistent urinary C-peptide creatinine ratios ≤ 0.2 nmol/mmol; 9 of these 11 subjects completed a mixed-meal tolerance test and had a median stimulated serum C-peptide of 0.18 nmol/l. Five of these 9 had stimulated serum C-peptide <0.2 nmol/l and 9/9 subjects with urinary C-peptide creatinine ratio >0.2 had endogenous insulin secretion confirmed by the mixed-meal tolerance test. Compared with subjects with a urinary C-peptide creatinine ratio >0.2 nmol/mmol, those with confirmed absolute insulin deficiency had a shorter time to insulin treatment (median 2.5 vs. 6 years, P=0.005) and lower BMI (25.1 vs. 29.1 kg/m(2) , P=0.04). Two out of the five patients with absolute insulin deficiency were glutamic acid decarboxylase autoantibody-positive. CONCLUSIONS Absolute insulin deficiency may occur in long-standing Type 2 diabetes, and cannot be reliably predicted by clinical features or autoantibodies. Absolute insulin deficiency in Type 2 diabetes may increase the risk of hypoglycaemia and ketoacidosis, as in Type 1 diabetes. Its recognition should help guide treatment, education and management. The urinary C-peptide creatinine ratio is a practical non-invasive method to aid detection of absolute insulin deficiency, with a urinary C-peptide creatinine ratio > 0.2 nmol/mmol being a reliable indicator of retained endogenous insulin secretion.
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Affiliation(s)
- S. V. Hope
- Department of GeriatricsRoyal Devon and Exeter NHS Foundation TrustExeterUK
- NIHR Exeter Clinical Research FacilityExeterUK
| | - A. G. Jones
- NIHR Exeter Clinical Research FacilityExeterUK
| | | | - M. Shepherd
- NIHR Exeter Clinical Research FacilityExeterUK
| | | | - B. Shields
- NIHR Exeter Clinical Research FacilityExeterUK
| | - T. McDonald
- NIHR Exeter Clinical Research FacilityExeterUK
- Department of BiochemistryRoyal Devon and Exeter NHS Foundation TrustExeterUK
| | | | - A. Hattersley
- NIHR Exeter Clinical Research FacilityExeterUK
- Correspondence to: Andrew Hattersley. E‐mail:
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Smoot T, Pennau K, McDonald T, Brown C, Futran N, Dillon J. The Impact of Surgical Margins of Oral Squamous Cell Carcinoma on Local Recurrence and Disease-Specific Survival. J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.joms.2013.06.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Angstmann M, Angstmann TJ, McDonald T. Crisis? What crisis? Capitalising on increasing intern numbers in the ACT. Med J Aust 2013; 199:322. [DOI: 10.5694/mja13.10164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 05/25/2013] [Indexed: 11/17/2022]
Affiliation(s)
| | - Tobias J Angstmann
- Canberra Hospital and Health Services, ACT Government Health Directorate, Canberra, ACT
| | - Tim McDonald
- Canberra Hospital and Health Services, ACT Government Health Directorate, Canberra, ACT
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Robertson BL, Brown JA, McDonald T, Jaksons P. BAS: Balanced Acceptance Sampling of Natural Resources. Biometrics 2013; 69:776-84. [DOI: 10.1111/biom.12059] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 04/01/2013] [Accepted: 04/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- B. L. Robertson
- Department of Mathematics and Statistics; University of Canterbury; Private Bag 4800, Christchurch New Zealand
| | - J. A. Brown
- Department of Mathematics and Statistics; University of Canterbury; Private Bag 4800, Christchurch New Zealand
| | - T. McDonald
- Western EcoSystems Technology, Inc.; Cheyenne, Wyoming 82001 U.S.A
| | - P. Jaksons
- Department of Mathematics and Statistics; University of Canterbury; Private Bag 4800, Christchurch New Zealand
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35
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Strachan RE, Cornelius A, Gilbert GL, Gulliver T, Martin A, McDonald T, Nixon G, Roseby R, Ranganathan S, Selvadurai H, Smith G, Soto-Martinez M, Suresh S, Teoh L, Thapa K, Wainwright CE, Jaffé A. Pleural fluid nucleic acid testing enhances pneumococcal surveillance in children. Respirology 2012; 17:114-9. [PMID: 21848709 DOI: 10.1111/j.1440-1843.2011.02035.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND OBJECTIVE National surveillance of invasive pneumococcal disease (IPD) includes serotyping Streptococcus pneumoniae (SP) isolates from sterile site cultures. PCR is more sensitive and can identify more SP serotypes (STs) in culture-negative samples. The aim of this study was to determine whether enhanced surveillance of childhood empyema, using PCR, provides additional serotype information compared with conventional surveillance. METHODS Pleural fluid (PF) from children with empyema were cultured and tested by PCR to identify SP, targeting the autolysin gene (lytA). Multiplex PCR-based reverse line blot assay was used to identify SP STs. Corresponding IPD surveillance and serotype data were obtained from the National Notifiable Diseases Surveillance System (NNDSS). RESULTS Eighty-nine children with empyema, aged ≤16 years, were recruited between April 2008 and March 2009, inclusive. SP was isolated from 5/84 (5.9%) PF cultures and by PCR in 43/79 (54.4%) PF samples. Serotypes were unidentifiable in 15 samples. The frequency of six serotypes (or serotype pairs) identified in 28 samples, including one with two serotypes, were: ST1, n = 4/29 (13.8%); ST3, n = 9/29 (31.0%); ST19A, n = 12/29 (41.4%); ST7F/7A, n = 1/29 (3.4%); ST9V/9A, n = 1/29 (3.4%); ST22F/22A, n = 2/29 (6.9%). Over the same period, 361 IPD patients, aged 16 years or less, were notified to NNDSS. Among 331 serotypeable NNDSS isolates (71.5% from blood), the frequencies of ST1 and 3 were significantly lower than in PF samples: ST1, n = 8/331 (2.4%; P < 0.05); ST3, n = 13/331 (3.9%; P < 0.0001). CONCLUSIONS The use of PCR to identify and serotype SP in culture-negative specimens provides additive information.
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Affiliation(s)
- Roxanne E Strachan
- Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, Australia
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36
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Strachan RE, Cornelius A, Gilbert GL, Gulliver T, Martin A, McDonald T, Nixon GM, Roseby R, Ranganathan S, Selvadurai H, Smith G, Soto-Martinez M, Suresh S, Teoh L, Thapa K, Wainwright CE, Jaffe A. Bacterial causes of empyema in children, Australia, 2007-2009. Emerg Infect Dis 2011; 17:1839-45. [PMID: 22000353 PMCID: PMC3310657 DOI: 10.3201/eid1710.101825] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An increase in the incidence of empyema worldwide could be related to invasive pneumococcal disease caused by emergent nonvaccine replacement serotypes. To determine bacterial pathogens and pneumococcal serotypes that cause empyema in children in Australia, we conducted a 2-year study of 174 children with empyema. Blood and pleural fluid samples were cultured, and pleural fluid was tested by PCR. Thirty-two (21.0%) of 152 blood and 53 (33.1%) of 160 pleural fluid cultures were positive for bacteria; Streptococcus pneumoniae was the most common organism identified. PCR identified S. pneumoniae in 74 (51.7%) and other bacteria in 19 (13.1%) of 145 pleural fluid specimens. Of 53 samples in which S. pneumoniae serotypes were identified, 2 (3.8%) had vaccine-related and 51 (96.2%) had nonvaccine serotypes; 19A (n = 20; 36.4%), 3 (n = 18; 32.7%), and 1 (n = 8; 14.5%) were the most common. High proportions of nonvaccine serotypes suggest the need to broaden vaccine coverage.
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37
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Strachan RE, Cornelius A, Gilbert GL, Gulliver T, Martin A, McDonald T, Nixon GM, Roseby R, Ranganathan S, Selvadurai H, Smith G, Soto-Martinez M, Suresh S, Teoh L, Thapa K, Wainwright CE, Jaffé A. A bedside assay to detect streptococcus pneumoniae in children with empyema. Pediatr Pulmonol 2011; 46:179-83. [PMID: 20963842 DOI: 10.1002/ppul.21349] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 08/08/2010] [Accepted: 08/13/2010] [Indexed: 11/07/2022]
Abstract
BACKGROUND Empyema is a complication of pneumonia, commonly caused by Streptococcus pneumoniae. AIMS To validate the utility of an immunochromatographic test for the detection of S. pneumoniae antigen in the pleural fluid of children with empyema. METHODS Empyema patients had blood and pleural fluid cultured, and polymerase chain reaction (PCR) to detect the S. pneumoniae autolysin gene, lytA, in pleural fluid. Pleural fluid was tested using the Binax NOW S. pneumoniae antigen detection assay and compared with lytA PCR results and/or culture in blood or pleural fluid. RESULTS S. pneumoniae was detected by PCR in pleural fluid of 68 of 137 (49.6%) patients, by culture in 11 of 135 (8.1%) pleural specimens and 16 of 120 (13.3%) blood specimens. Pleural fluid Binax NOW testing from 130 patients demonstrated a sensitivity of 83.8% and specificity of 93.5% (positive predictive value of 93.4% and negative predictive value of 84.1%). CONCLUSIONS In pediatric empyema, high predictive values of pleural fluid Binax NOW S. pneumoniae antigen test suggest that this test may help rationalize antibiotic choice in these patients.
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Affiliation(s)
- Roxanne E Strachan
- Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, Australia
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Abstract
The Acquired Immune Deficiency Syndrome epidemic, caused by the Human Immunodeficiency Virus, is a global crisis which threatens development gains, economies, and societies. Within sub-Saharan Africa, where the epidemic began the earliest and the HIV prevalence is the highest, African countries have death rates not seen before. In South Africa the epidemic has a devastating impact which creates profound suffering on individuals and their families, and the impact on the socio-economic level is of great concern. The eradication of HIV/AIDS represents one of humanity’s greatest challenges, which requires co-operation and comprehensive collaboration between many different role players. In this endeavour clinical information plays a major role. To combat the effect of the disease, the Free State Department of Health started with the provisioning of antiretroviral therapy in the public health sector. The objective of this paper was to address the challenges they faced in order to develop and implement an information system to manage the rollout of antiretroviral treatment effectively. They started with a paper-based system to collect vital information. It was followed by a palm computer project that was initiated to electronically capture the data collected by the paper-based system. This system was then replaced by a comprehensive Hospital and Clinic Information System which was acquired and customised for the antiretroviral data collection process. Research partners developed a standalone antiretroviral data warehouse for collecting information associated with the monitoring and evaluation of the Free State antiretroviral and HIV/ AIDS treatment programme. The data warehouse successfully produced several management information reports to the antiretroviral management team. A need was identified to design a comprehensive antiretroviral data warehouse that will integrate data from several operational sources which are all associated with HIV/AIDS.
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Affiliation(s)
- J E Kotzé
- Department of Computer Science and Informatics, University of the Free State, Bloemfontein
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Craine N, Hickman M, Parry JV, Smith J, McDonald T, Lyons M. Characteristics of injecting drug users accessing different types of needle and syringe programme or using secondary distribution. J Public Health (Oxf) 2010; 32:328-35. [DOI: 10.1093/pubmed/fdp131] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Clewell A, McDonald T. Some Thoughts on Self-Sustainability in Restoration: A Response to Thomas B. Simpson. ECOL RESTOR 2010. [DOI: 10.3368/er.28.1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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41
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Brown M, Phillips CB, Ciszek K, Burton D, Attewell R, McDonald T, Dwan K. Children in the ACT with asthma--are they taking preventer medication according to guidelines? Aust Fam Physician 2010; 39:146-149. [PMID: 20369117] [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: 05/29/2023]
Abstract
AIM To ascertain whether children with asthma in the Australian Capital Territory were taking preventer medications in accordance with National Asthma Council Australia guidelines. METHODS Questionnaires were distributed to all parents who indicated in an ACT wide survey of school entry children in 2005 that their child had asthma (n=435), or experienced asthma symptoms/took asthma medication (n=501), exploring dose, frequency and mode of delivery of preventer their child was currently taking. RESULTS Data were available for 256 children (response rate 27%). Of the children with parent reported asthma (n=435) the response rate was 42%. Eighty-three (32%) children were currently taking preventers; complete medication details were provided for 60 children. A total of 32% of children on preventers were taking doses of preventers not in accordance with guidelines, while 80% of children were taking their medications at frequencies, or using delivery devices, not in accordance with guidelines. DISCUSSION This study suggests that home medical management of asthma with preventers for children may not be optimal.
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Affiliation(s)
- Maree Brown
- Community Asthma Support Service, ACT Health, Canberra, Australian Capital Territory.
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42
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Gagnon P, Tanyi J, Ku L, McDonald T, Holland J, Thomas C, Fuss M. Feasibility of Weekly Dose Mapping and Relevance to Adaptive Re-planning in Head and Neck IMRT. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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43
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McDonald T, Fuss M. STEREOTACTIC BODY RADIOTHERAPY AND HYPOFRACTIONATED RADIOTHERAPY FOR HEPATOCELLULAR CARCINOMA: SHORT-TERM OUTCOMES AND LIVER TOLERANCE. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72965-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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44
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Gagnon P, Tanyi J, Ku L, McDonald T, Holland J, Fuss M. DOSIMETRIC ANALYSIS OF WEEKLY ADAPTIVE HEAD & NECK IMRT USING A DEFORMABLE REGISTRATION ALGORITHM. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72657-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
OBJECTIVE Hajdu-Cheney syndrome (HCS), first described in 1948 by Hajdu and independently in 1965 by Cheney, is an extremely rare disorder characterized by severe and excessive bone resorption leading to osteoporosis, with a wide range of other systemic complications from connective tissue and bone dysplasia. Currently there are approximately 50 distinct cases reported in the literature. There have been several reports associating polycystic kidneys with HCS and several other connective tissue disorders, suggesting a possibility of a hyperproliferative component to the syndrome. No articles exist in the current literature describing a case of HCS with concurrent carcinoma. Here, we present a case of a 54-year-old nonimmune compromised woman with multiple stigmata of HCS and recently diagnosed anal squamous cell carcinoma. METHOD This is a case report of HCS and stage T3N0 squamous cell carcinoma of the anus. RESULTS This is the first report of a patient with HCS with malignancy. CONCLUSIONS We present a patient with HCS who developed anal squamous cell carcinoma. The mechanism of HCS, which is still unknown, may either make patients more susceptible to carcinoma or may just be a reflection of the normal incidence of anal squamous cell carcinoma given attributable risk factors.
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Affiliation(s)
- B R Page
- Radiation Medicine, Oregon Health and Science University, Portland, Oregon 97239-3098 , USA
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47
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Goodrich JM, Kerley LL, Smirnov EN, Miquelle DG, McDonald L, Quigley HB, Hornocker MG, McDonald T. Survival rates and causes of mortality of Amur tigers on and near the Sikhote-Alin Biosphere Zapovednik. J Zool (1987) 2008. [DOI: 10.1111/j.1469-7998.2008.00458.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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48
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Wood L, McDonald T, Roberts D, Han X, Hung A, Thomas C. Pelvic Irradiation Induces a Systemic TNF-α Response and Sickness Syndrome in Mice: Implications for Cancer Treatment Related Fatigue. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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49
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Hickman M, McDonald T, Judd A, Nichols T, Hope V, Skidmore S, Parry JV. Increasing the uptake of hepatitis C virus testing among injecting drug users in specialist drug treatment and prison settings by using dried blood spots for diagnostic testing: a cluster randomized controlled trial. J Viral Hepat 2008; 15:250-4. [PMID: 18086182 DOI: 10.1111/j.1365-2893.2007.00937.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The objective of this study was to assess whether introducing dried blood spot testing can increase hepatitis C virus (HCV) diagnostic testing. A cluster randomized controlled trial was conducted. Sites were matched into pairs, with one site in each pair randomly allocated to receive the intervention (training and use of dried blood spot). Data were collected from all sites for 6 months before and 6 months after the start of the intervention. The participants were 22 specialist drug clinics and six prisons in England and Wales. The main outcome measure of this study was percentage point difference in individuals tested for HCV (the difference between the percentage of patients tested 6 months after and 6 months before the introduction of dried blood spot tests). Before the trial, 8% of patients at control and intervention sites had been tested for HCV, with 16 sites testing less than 5% of their caseload. The average percentage point difference between intervention and control sites was 14.5% (95% CI 1.3-28%, paired t-test, P = 0.03); with 13 of the 14 pairs contributing to the positive effect of the intervention (Wilcoxon matched-pairs signed-rank-test, P = 0.002). The size of the difference between intervention and control sites varied considerably. The study provides preliminary supporting evidence that dried blood spot testing may increase the uptake of HCV diagnostic testing, by increasing the opportunity for patients to be offered testing. Additional trials with a larger number of sites are justified, ideally in the context of drug and treatment policies that gave clearer priority (and targets) to infection control and testing.
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Affiliation(s)
- M Hickman
- Department of Social Medicine, University of Bristol, Bristol, UK.
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50
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Higman K, Servatius C, Webber WL, McDonald T. Using the PACE EH model to mobilize communities to address local environmental health issues--a case study in Island County, Washington. J Environ Health 2007; 70:37-41, 63. [PMID: 17802815] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The Island County Environmental Health Initiative (ICEHI) is a demonstration project in the use of the Protocol for Assessing Community Excellence in Environmental Health (PACE EH) to build capacity in the 10 essential services of environmental health. The PACE EH methodology systematically applies the 10 essential services of environmental health through the completion of 13 tasks derived from a community-based environmental health assessment process. The ICEHI has successfully engaged community members, identified environmental health issues important to the community, and led to the implementation of action plans aimed at reducing environmental health risks through use of community resources. This paper describes the methodology utilized by the ICEHI to address locally important environmental health issues so that other local and state environmental health agencies may replicate the process in their communities.
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Affiliation(s)
- Keith Higman
- Island County Public Health, Coupeville, WA 98239, USA
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