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Burchell D, Coleman T, Travers R, Aversa I, Schmid E, Coulombe S, Wilson C, Woodford MR, Davis C. 'I don't want to have to teach every medical provider': barriers to care among non-binary people in the Canadian healthcare system. Cult Health Sex 2024; 26:61-76. [PMID: 37173293 DOI: 10.1080/13691058.2023.2185685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/24/2023] [Indexed: 05/15/2023]
Abstract
It is well-known that trans and non-binary individuals experience worse health outcomes due to experiences of violence and discrimination. For this reason, accessible healthcare for trans and non-binary people is crucial. There is a lack of Canadian literature on the experiences of non-binary people within the healthcare system. This study sought to understand barriers to healthcare among non-binary people living in a mid-sized urban/rural region of Canada. Interviews were conducted between November 2019 to March 2020 with 12 non-binary individuals assigned female at birth, living in Waterloo Region, Ontario, Canada, as a part of a larger qualitative study exploring experiences within the community, healthcare and employment. Three broad themes were developed: erasure, barriers to access to healthcare, and assessing whether (or not) to come out. Sub-themes included institutional erasure, informational erasure, general healthcare barriers, medical transition healthcare barriers, anticipated discrimination, and assessing safety. Policy and institutional changes are needed to increase the safety and accessibility of healthcare services to non-binary individuals.
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Affiliation(s)
- Drew Burchell
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Todd Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Isabella Aversa
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Emily Schmid
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Simon Coulombe
- Département des relations industrielles, Université Laval, Québec City, QC, Canada
| | - Ciann Wilson
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Michael R Woodford
- Faculty of Social Work, Wilfrid Laurier University, Kitchener, ON, Canada
| | - Charlie Davis
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
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2
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Fante-Coleman T, Wilson CL, Cameron R, Coleman T, Travers R. ‘Getting shut down and shut out’: Exploring ACB patient perceptions on healthcare access at the physician-patient level in Canada. Int J Qual Stud Health Well-being 2022; 17:2075531. [PMID: 35585792 PMCID: PMC9132487 DOI: 10.1080/17482631.2022.2075531] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The experiences of African, Caribbean and Black (ACB) Canadians are seldom explored in the Canadian context. Family physicians act as a gateway to the rest of the healthcare system and are necessary to provide proper patient care. However, Canada’s history with colonialism may impact the socio-cultural context in which patients receive care. Method 41 participants from Waterloo Region, Ontario, were engaged in eight focus groups to discuss their experiences in the healthcare system. Data were analysed following thematic analysis. Results Style of care, racism and discrimination and a lack of cultural competence hindered access. oor Inadequate cultural competence was attributed to western and biomedical approaches, poor understanding of patients’ context, physicians failing to address specific health concerns, and racism and discrimination. Participants highlighted that the two facilitators to care were having an ACB family physician and fostering positive relationships with physicians. Conclusion Participants predominantly expressed dissatisfaction in physicians’ approaches to care, which were compounded by experiences of racism and discrimination. Findings demonstrate how ACB patients are marginalized and excluded from the healthcare syste Iimplications for better access to care included utilizing community healthcare centres, increasing physicians’ capacity around culturally inclusive care, and increasing access to ACB physicians.
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Affiliation(s)
- Tiyondah Fante-Coleman
- Access and Equity Research Lab1, Department of Psychology2, Department of Health Sciences4 Wilfrid Laurier University, Waterloo, Ontario, Canada
- Dalla Lana School of Public Health5 University of Toronto, Toronto, Ontario, Canada
- Black Health Alliance, Toronto, Ontario, Canada
| | - Ciann L. Wilson
- Access and Equity Research Lab1, Department of Psychology2, Department of Health Sciences4 Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo and Area, Kitchener, Ontario, Canada
| | - Todd Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
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3
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Truong P, Walsh E, Scott VP, Coleman T, Tilvawala G, Friend J. Non-Nutritive Suckling System for Real-Time Characterization of Intraoral Vacuum Profile in Full Term Neonates. IEEE J Transl Eng Health Med 2022; 11:107-115. [PMID: 36619906 PMCID: PMC9815562 DOI: 10.1109/jtehm.2022.3231788] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
Infant breastfeeding diagnostics remain subjective due to the absence of instrumentation to objectively measure and understand infant oral motor skills and suckling characteristics. Qualitative diagnostic exams, such as the digital suck assessment which relies upon a clinician's gloved finger inserted into the infant's mouth, produce a diversity of diagnoses and intervention pathways due to their subjective nature. In this paper, we report on the design of a non-nutritive suckling (NNS) system which quantifies and analyzes quantitative intraoral vacuum and sucking patterns of full-term neonates in real time. In our study, we evaluate thirty neonate suckling profiles to demonstrate the technical and clinical feasibility of the system. We successfully extract the mean suck vacuum, maximum suck vacuum, frequency, burst duration, number of sucks per burst, number of sucks per minute, and number of bursts per minute. In addition, we highlight the discovery of three intraoral vacuum profile shapes that are found to be correlated to different levels of suckling characteristics. These results establish a framework for future studies to evaluate oromotor dysfunction that affect the appearance of these signals based on established normal profiles. Ultimately, with the ability to easily and quickly capture intraoral vacuum data, clinicians can more accurately perform suckling assessments to provide timely intervention and assist mothers and infants towards successful breastfeeding outcomes.
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Affiliation(s)
- Phuong Truong
- Medically Advanced Devices LaboratoryDepartment of Mechanical and Aerospace Engineering, Jacobs School of Engineering and Department of SurgerySchool of Medicine, University of California at San Diego San Diego La Jolla CA 92093 USA
| | - Erin Walsh
- Center for Voice and SwallowingDepartment of Otolaryngology, School of MedicineUniversity of California at San Diego San Diego CA 92122 USA
| | - Vanessa P Scott
- Department of Pediatrics, School of MedicineUniversity of California at San Diego San Diego CA 92103 USA
| | - Todd Coleman
- Department of BioengineeringStanford University Stanford CA 94305 USA
| | - Gopesh Tilvawala
- Medically Advanced Devices LaboratoryDepartment of Mechanical and Aerospace Engineering, Jacobs School of Engineering and Department of SurgerySchool of Medicine, University of California at San Diego San Diego La Jolla CA 92093 USA
| | - James Friend
- Medically Advanced Devices LaboratoryDepartment of Mechanical and Aerospace Engineering, Jacobs School of Engineering and Department of SurgerySchool of Medicine, University of California at San Diego San Diego La Jolla CA 92093 USA
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Tassiopoulos K, Travers R, Cameron R, Coulombe S, Davis CE, Wilson CL, Woodford MR, Coleman T. Knowledge of viral load, PrEP, and HIV-related sexual risk among men who have sex with men in the Waterloo region. The Canadian Journal of Human Sexuality 2022. [DOI: 10.3138/cjhs.2021-0054] [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: 12/13/2022]
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) remain most disproportionately affected by HIV in Canada. HIV-related sexual risk behaviours have been linked to high HIV risk among GBMSM, but prior research has not focused on knowledge of viral load, and the risk it presents for HIV acquisition. The purpose of this study was to explore the relationship between HIV-related sexual risk behaviour and knowledge of viral load among GBMSM. A cross-sectional survey was conducted using a convenience sample of individuals age 16 and older who self-identified as LGBTQ and lived, worked, or resided in the Waterloo region, an urban-rural area in southwestern Ontario ( N = 526). Responses were analyzed from those identifying as GBMSM ( N = 269). Logistic regression models were created to explore sociodemographic, outness, social support, and HIV-related sexual risk variables associated with knowledge of viral load. Multivariable regression models were built to explore the same associations while controlling for confounders. HIV risk was not associated with knowledge of viral load in bivariate or multivariable analyses. Point estimates for low/negligible (odds ratio [OR] 1.10; 95% CI 0.46–2.51) and high risk (OR 1.88; 95% CI 0.68–5.20) suggest trends of higher knowledge with increased HIV risk. Men who engage in sexual risk behaviour may have increased sexual health literacy and awareness of biomedical interventions (e.g., pre-exposure prophylaxis, or PrEP) that reduce HIV risk. Policies are needed that promote acceptance of sexual orientation, improve awareness and access to PrEP, and ensure optimal delivery of HIV education to at-risk groups prior to engagement in higher risk activities.
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Affiliation(s)
- Karina Tassiopoulos
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo, Kitchener, Ontario, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Charlie E. Davis
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ciann L. Wilson
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Michael R. Woodford
- Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - Todd Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
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Bick D, Bishop J, Coleman T, Dean S, Edwards E, Frawley H, Gkini E, Hay-Smith J, Hemming K, Jones E, Oborn E, Pearson M, Salmon V, Webb S, MacArthur C. Antenatal preventative pelvic floor muscle exercise intervention led by midwives to reduce postnatal urinary incontinence (APPEAL): protocol for a feasibility and pilot cluster randomised controlled trial. Pilot Feasibility Stud 2022; 8:231. [PMID: 36273227 PMCID: PMC9588215 DOI: 10.1186/s40814-022-01185-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022] Open
Abstract
Background Antenatal pelvic floor muscle exercises (PFME) in women without prior urinary incontinence (UI) are effective in reducing postnatal UI; however, UK midwives often do not provide advice and information to women on undertaking PFME, with evidence that among women who do receive advice, many do not perform PFME. Methods The primary aim of this feasibility and pilot cluster randomised controlled trial is to provide a potential assessment of the feasibility of undertaking a future definitive trial of a midwifery-led antenatal intervention to support women to perform PFME in pregnancy and reduce UI postnatally. Community midwifery teams in participating NHS sites comprise trial clusters (n = 17). Midwives in teams randomised to the intervention will be trained on how to teach PFME to women and how to support them in undertaking PFME in pregnancy. Women whose community midwifery teams are allocated to control will receive standard antenatal care only. All pregnant women who give birth over a pre-selected sample month who receive antenatal care from participating community midwifery teams (clusters) will be sent a questionnaire at 10–12 weeks postpartum (around 1400–1500 women). Process evaluation data will include interviews with midwives to assess if the intervention could be implemented as planned. Interviews with women in both trial arms will explore their experiences of support from midwives to perform PFME during pregnancy. Data will be stored securely at the Universities of Birmingham and Exeter. Results will be disseminated through publications aimed at maternity service users, clinicians, and academics and inform a potential definitive trial of effectiveness. The West Midlands–Edgbaston Research Ethics Committee approved the study protocol. Discussion Trial outcomes will determine if criteria to progress to a definitive cluster trial are met. These include women’s questionnaire return rates, prevalence of UI, and other health outcomes as reported by women at 10–12 weeks postpartum. Progress to a definitive trial however is likely to be prevented in the UK context by new perinatal pelvic health service, although this may be possible elsewhere. Trial registration 10.1186/ISRCTN10833250. Registered 09/03/2020
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Affiliation(s)
- D Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7AL, UK.
| | - J Bishop
- University of Birmingham, Birmingham, UK
| | - T Coleman
- University of Leicester, Leicester, UK
| | - S Dean
- University of Exeter, Exeter, UK
| | - E Edwards
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - H Frawley
- University of Melbourne, Melbourne, Australia
| | - E Gkini
- University of Birmingham, Birmingham, UK
| | | | - K Hemming
- University of Birmingham, Birmingham, UK
| | - E Jones
- University of Birmingham, Birmingham, UK
| | - E Oborn
- University of Warwick, Coventry, UK
| | | | - V Salmon
- University of Exeter, Exeter, UK
| | - S Webb
- Royal College of Midwives, London, UK
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Tassiopoulos K, Travers R, Cameron R, Coulombe S, Davis CE, Wilson CL, Woodford MR, Coleman T. Knowledge of viral load, PrEP, and HIV-related sexual risk among men who have sex with men in the Waterloo region. The Canadian Journal of Human Sexuality 2022. [DOI: 10.3138/cjhs.2022-0054] [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: 11/06/2022]
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) remain most disproportionately affected by HIV in Canada. HIV-
related sexual risk behaviours have been linked to high HIV risk among GBMSM, but prior research has not focused on knowledge of viral load, and the risk it presents for HIV acquisition. The purpose of this study was to explore the relationship between HIV-related sexual risk behaviour and knowledge of viral load among GBMSM. A cross-sectional survey was conducted using a convenience sample of individuals age 16 and older who self-identified as LGBTQ and lived, worked, or resided in the Waterloo region, an urban-rural area in southwestern Ontario ( N = 526). Responses were analyzed from those identifying as GBMSM ( N = 269). Logistic regression models were created to explore sociodemographic, outness, social support, and HIV-related sexual risk variables associated with knowledge of viral load. Multivariable regression models were built to explore the same associations while controlling for confounders. HIV risk was not associated with knowledge of viral load in bivariate or multivariable analyses. Point estimates for low/negligible (odds ratio [OR] 1.10; 95% CI 0.46–2.51) and high risk (OR 1.88; 95% CI 0.68–5.20) suggest trends of higher knowledge with increased HIV risk. Men who engage in sexual risk behaviour may have increased sexual health literacy and awareness of biomedical interventions (e.g., pre-exposure prophylaxis, or PrEP) that reduce HIV risk. Policies are needed that promote acceptance of sexual orientation, improve awareness and access to PrEP, and ensure optimal delivery of HIV education to at-risk groups prior to engagement in higher risk activities.
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Affiliation(s)
- Karina Tassiopoulos
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo, Kitchener, Ontario, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Charlie E. Davis
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ciann L. Wilson
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Michael R. Woodford
- Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - Todd Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
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7
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Cox E, Warren T, Khan M, Wilson C, Cameron R, Davis C, Coleman T, Steffler J, Coulombe S, Woodford M. Experiences of discrimination and its impacts on well-being among racialised LGBTQ+ newcomers living in Waterloo region, Ontario, Canada. Health Soc Care Community 2022; 30:e2980-e2988. [PMID: 35146827 DOI: 10.1111/hsc.13743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/05/2022] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
Discrimination (i.e. racism, homo/bi/transphobia) at both the individual and systemic levels may negatively impact the well-being of racialised LGBTQ+ newcomers living in Waterloo Region, Ontario, Canada. Current research about the experiences of LGBTQ+ newcomers focuses predominantly on homogeneous samples of gay men living in large metropolitan city centres. The present study aims to extend the current literature by exploring the experiences of discrimination and its impacts on well-being among racialised LGBTQ+ newcomers living in a small urban area and representing a variety of intersecting identities (i.e. ethno-racial background, LGBTQ+ identity, newcomer status). Using a qualitative method, 10 individuals were invited to complete a semistructured interview between fall 2019 and summer 2020 about their experiences of discrimination in Waterloo Region, and how such experiences impact their well-being. Using an intersectional lens, a thematic analysis revealed that racialised LGBTQ+ newcomers experienced discrimination before and after settlement in Waterloo Region. Prior to settlement, participants spoke predominantly about experiences of homo/biphobia and the associated feelings of internalised oppression. Alternatively, upon settling in Waterloo Region, experiences of discrimination were predominantly racism, and, in particular, systemic racism, which manifested as an inability to access adequate services and a lack of representation in various spaces throughout Waterloo Region. These results extend previous research by identifying the service barriers experienced by racialised LGBTQ+ newcomers living in a small urban area and can be used to inform best practices for addressing these barriers in Waterloo Region and other small urban areas with similar demographics. Implications and limitations are discussed.
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Affiliation(s)
- Emily Cox
- Wilfrid Laurier University (WLU), Waterloo, Ontario, Canada
| | - Teneile Warren
- Wilfrid Laurier University (WLU), Waterloo, Ontario, Canada
| | - Maryam Khan
- Wilfrid Laurier University (WLU), Waterloo, Ontario, Canada
| | - Ciann Wilson
- Wilfrid Laurier University (WLU), Waterloo, Ontario, Canada
| | - Ruth Cameron
- The AIDS Committee of Cambridge, Kitchener, Waterloo & Area (ACCKWA), Kitchener, Canada
| | | | - Todd Coleman
- Wilfrid Laurier University (WLU), Waterloo, Ontario, Canada
| | | | - Simon Coulombe
- Wilfrid Laurier University (WLU), Waterloo, Ontario, Canada
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Bu Y, Prince J, Mojtahed H, Kimball D, Shah V, Coleman T, Sarkar M, Rao R, Huang M, Schwindt P, Borna A, Lerman I. Peripheral Nerve Magnetoneurography With Optically Pumped Magnetometers. Front Physiol 2022; 13:798376. [PMID: 35370794 PMCID: PMC8975546 DOI: 10.3389/fphys.2022.798376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
Electrodiagnosis is routinely integrated into clinical neurophysiology practice for peripheral nerve disease diagnoses, such as neuropathy, demyelinating disorders, nerve entrapment/impingement, plexopathy, or radiculopathy. Measured with conventional surface electrodes, the propagation of peripheral nerve action potentials along a nerve is the result of ionic current flow which, according to Ampere’s Law, generates a small magnetic field that is also detected as an “action current” by magnetometers, such as superconducting quantum interference device (SQUID) Magnetoencephalography (MEG) systems. Optically pumped magnetometers (OPMs) are an emerging class of quantum magnetic sensors with a demonstrated sensitivity at the 1 fT/√Hz level, capable of cortical action current detection. But OPMs were ostensibly constrained to low bandwidth therefore precluding their use in peripheral nerve electrodiagnosis. With careful OPM bandwidth characterization, we hypothesized OPMs may also detect compound action current signatures consistent with both Sensory Nerve Action Potential (SNAP) and the Hoffmann Reflex (H-Reflex). In as much, our work confirms OPMs enabled with expanded bandwidth can detect the magnetic signature of both the SNAP and H-Reflex. Taken together, OPMs now show potential as an emerging electrodiagnostic tool.
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Affiliation(s)
- Yifeng Bu
- Jacobs School of Engineering, Electrical and Computer Engineering, University of California San Diego, San Diego, CA, United States
| | - Jacob Prince
- Jacobs School of Engineering, Electrical and Computer Engineering, University of California San Diego, San Diego, CA, United States
| | - Hamed Mojtahed
- Jacobs School of Engineering, Electrical and Computer Engineering, University of California San Diego, San Diego, CA, United States
| | - Donald Kimball
- Jacobs School of Engineering, Electrical and Computer Engineering, University of California San Diego, San Diego, CA, United States
| | | | - Todd Coleman
- Department of Bioengineering, Stanford University, Stanford, CA, United States
| | - Mahasweta Sarkar
- Electrical and Computer Engineering Department, San Diego State University, Stanford, CA, United States
| | - Ramesh Rao
- Jacobs School of Engineering, Electrical and Computer Engineering, University of California San Diego, San Diego, CA, United States
| | - Mingxiong Huang
- Department of Radiology, Radiology Imaging Laboratory, University of California San Diego, San Diego, CA, United States
| | - Peter Schwindt
- Quantum Information Sciences, Sandia National Laboratories, Albuquerque, NM, United States
| | - Amir Borna
- Quantum Information Sciences, Sandia National Laboratories, Albuquerque, NM, United States
| | - Imanuel Lerman
- Jacobs School of Engineering, Electrical and Computer Engineering, University of California San Diego, San Diego, CA, United States
- Department of Anesthesiology, Center for Pain Medicine, University of California San Diego, San Diego, CA, United States
- Veterans Health Administration, VA San Diego, Center for Stress and Mental Health, San Diego, CA, United States
- *Correspondence: Imanuel Lerman,
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Coleman T, Sarian A, Grad S. Re: Subramanian and Kumar. Vaccination rates and COVID-19 cases. Eur J Epidemiol 2021; 36:1245-1246. [PMID: 34951675 PMCID: PMC8703207 DOI: 10.1007/s10654-021-00821-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/02/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Todd Coleman
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada.
| | - Alik Sarian
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Stephanie Grad
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada
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Abstract
BACKGROUND Previous Canadian studies have identified problems regarding health care access for transgender (trans) and nonbinary people, but all-ages national data have been lacking. This study describes access to care among trans and nonbinary people in Canada, and compares health care access across provinces or regions. METHODS We conducted a bilingual, multimode cross-sectional survey (Trans PULSE Canada) from July 26 to Oct. 1, 2019. We recruited trans and nonbinary people aged 14 years and older using convenience sampling. We assessed 5 outcomes: having a primary care provider, having a primary care provider with whom the respondent was comfortable discussing trans health issues, past-year unmet health care need, medical gender affirmation status, and being on a wait-list to access gender-affirming medical care. Average marginal predictions were estimated from multivariable logistic regression models with multiply imputed data. RESULTS The survey included 2873 participants, and 2217 surveys were analyzed after exclusions. Of the 2217 trans and nonbinary respondents, most had a primary care provider (n = 1803; 81.4%, 95% confidence interval [CI] 79.8%-83.0%), with model-predicted probabilities from 52.1% (95% CI 20.2%-84.1%) in the territories to 92.9% (95% CI 83.5%-100.0%) in Newfoundland and Labrador. Of the respondents, 52.3% (n = 1150; 95% CI 50.3%-54.2%) had a primary care provider with whom they were comfortable discussing trans health issues, and 44.4% (n = 978; 95% CI 42.3%-46.4%) reported an unmet health care need. Among participants who needed gender-affirming medical treatment (n = 1627), self-defined treatment completion ranged from an estimated 16.8% (95% CI 0.6%-32.5%) in Newfoundland and Labrador to 59.1% (95% CI 52.5%-65.6%) in Quebec. Of those who needed but had not completed gender-affirming care at the time of the study (n = 1046), 40.7% (n = 416; 95% CI 37.8%-43.6%) were on a wait-list, most often for surgery. These outcomes, with the exception of having a provider with whom one is comfortable discussing trans issues, varied significantly by province or region (p < 0.05). INTERPRETATION Participants reported considerable unmet needs or delays in primary, general and gender-affirming care, with significant regional variation. Our results indicate that, despite efforts toward equity in access to care for trans and nonbinary people in Canada, inequities persist.
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Affiliation(s)
- Ayden I Scheim
- Department of Epidemiology and Biostatistics (Scheim), Dornsife School of Public Health, Drexel University, Philadelphia, Pa.; Li Ka Shing Knowledge Institute (Scheim), St. Michael's Hospital, Toronto, Ont.; Department of Health Sciences (Coleman), Wilfrid Laurier University, Waterloo, Ont.; School of Public Health & Social Policy (Lachowsky), Faculty of Human and Social Development, University of Victoria, Victoria, BC; Department of Epidemiology and Biostatistics (Bauer), Schulich School of Medicine & Dentistry, Western University, London, Ont.
| | - Todd Coleman
- Department of Epidemiology and Biostatistics (Scheim), Dornsife School of Public Health, Drexel University, Philadelphia, Pa.; Li Ka Shing Knowledge Institute (Scheim), St. Michael's Hospital, Toronto, Ont.; Department of Health Sciences (Coleman), Wilfrid Laurier University, Waterloo, Ont.; School of Public Health & Social Policy (Lachowsky), Faculty of Human and Social Development, University of Victoria, Victoria, BC; Department of Epidemiology and Biostatistics (Bauer), Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Nathan Lachowsky
- Department of Epidemiology and Biostatistics (Scheim), Dornsife School of Public Health, Drexel University, Philadelphia, Pa.; Li Ka Shing Knowledge Institute (Scheim), St. Michael's Hospital, Toronto, Ont.; Department of Health Sciences (Coleman), Wilfrid Laurier University, Waterloo, Ont.; School of Public Health & Social Policy (Lachowsky), Faculty of Human and Social Development, University of Victoria, Victoria, BC; Department of Epidemiology and Biostatistics (Bauer), Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Greta R Bauer
- Department of Epidemiology and Biostatistics (Scheim), Dornsife School of Public Health, Drexel University, Philadelphia, Pa.; Li Ka Shing Knowledge Institute (Scheim), St. Michael's Hospital, Toronto, Ont.; Department of Health Sciences (Coleman), Wilfrid Laurier University, Waterloo, Ont.; School of Public Health & Social Policy (Lachowsky), Faculty of Human and Social Development, University of Victoria, Victoria, BC; Department of Epidemiology and Biostatistics (Bauer), Schulich School of Medicine & Dentistry, Western University, London, Ont
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Ussher M, Best C, Lewis S, McKell J, Coleman T, Cooper S, Orton S, Bauld L. Financial Incentives for Preventing Postpartum return to Smoking (FIPPS): study protocol for a three-arm randomised controlled trial. Trials 2021; 22:512. [PMID: 34340694 PMCID: PMC8327045 DOI: 10.1186/s13063-021-05480-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/28/2021] [Accepted: 07/22/2021] [Indexed: 02/08/2023] Open
Abstract
Background Financial incentives are an effective way of helping women to stop smoking during pregnancy. Unfortunately, most women who stop smoking at this time return to smoking within 12 months of the infant’s birth. There is no evidence for interventions that are effective at preventing postpartum smoking relapse. Financial incentives provided after the birth may help women to sustain cessation. This randomised controlled trial will assess the effectiveness and cost-effectiveness of financial incentives to help women who are abstinent from smoking at end-of-pregnancy to avoid return to smoking up to 12 months postpartum. Methods This is a UK-based, multi-centre, three-arm, superiority, parallel group, individually randomised controlled trial, with 1:1:1 allocation. It will compare the effectiveness of two financial incentive interventions with each other (one intervention for up to 3 months postpartum offering up to £120 of incentives (£60 for the participant and £60 for a significant other support); the other for up to 12 months postpartum with up to £300 of incentives (£240 for the participant and £60 for a significant other support) and with a no incentives/usual care control group. Eligible women will be between 34 weeks gestation and 2 weeks postpartum, abstinent from smoking for at least 4 weeks, have an expired carbon monoxide (CO) reading < 4 parts per million (ppm), aged at least 16 years, intend remaining abstinent from smoking after the birth and able to speak and read English. The primary outcome is self-reported, lapse-free, smoking abstinence from the last quit attempt in pregnancy until 12 months postpartum, biochemically validated by expired CO and/or salivary cotinine or anabasine. Outcomes will be analysed by intention-to-treat and regression models used to compare the proportion of abstinent women between the two intervention groups and between each intervention group and the control group. An economic evaluation will assess the cost-effectiveness of offering incentives and a qualitative process evaluation will examine barriers and facilitators to trial retention, effectiveness and implementation. Discussion This pragmatic randomised controlled trial will test whether offering financial incentives is effective and cost-effective for helping women to avoid smoking relapse during the 12 months after the birth of their baby. Trial registration International Standard Randomised Controlled Trial Number 55218215. Registered retrospectively on 5th June 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05480-6.
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Affiliation(s)
- M Ussher
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK. .,Population Health Research Institute, St George's, University of London, SW17 ORE, London, UK.
| | - C Best
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK
| | - S Lewis
- Division of Epidemiology and Public Health, Medical School, University of Nottingham, Nottingham, NG7 2UH, UK
| | - J McKell
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK
| | - T Coleman
- Division of Primary Care, Medical School, University of Nottingham, Nottingham, NG7 2UH, UK
| | - S Cooper
- Division of Primary Care, Medical School, University of Nottingham, Nottingham, NG7 2UH, UK
| | - S Orton
- Division of Primary Care, Medical School, University of Nottingham, Nottingham, NG7 2UH, UK
| | - L Bauld
- Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
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Bowker K, Lewis S, Phillips L, Orton S, Ussher M, Naughton F, Bauld L, Coleman T, Sinclair L, McRobbie H, Khan A, Cooper S. Pregnant women's use of e-cigarettes in the UK: a cross-sectional survey. BJOG 2021; 128:984-993. [PMID: 33012050 DOI: 10.1111/1471-0528.16553] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To estimate prevalence of vaping in pregnancy. Compare characteristics and attitudes between exclusive smokers and vapers, and between exclusive vapers and dual users (smoke and vape). DESIGN Cross-sectional survey. SETTING Hospitals across England and Scotland. POPULATION Pregnant women attending antenatal clinics in 2017. METHODS Women at 8-24 weeks' gestation completed screening questions about their smoking and vaping. Current or recent ex-smokers and/or vapers completed a full detailed survey about vaping and smoking. MAIN OUTCOME MEASURES The prevalence of vaping, characteristics and attitudes of women who vape and/or smoke. RESULTS Of 3360 pregnant women who completed screening questions, 515 (15.3%, 95% CI 14.1-16.6) were exclusive smokers, 44 (1.3%, 95% CI 1.0-1.8) exclusive vapers and 118 (3.5%, 95% CI 2.9-4.2) dual users. In total, 867 (25.8%) women completed the full survey; compared with smokers (n = 434), vapers (n = 140) were more likely to hold higher educational qualifications (odds ratio [OR) 1.51, 95% CI 1.01-2.25). Compared with exclusive vapers (n = 33), dual users (n = 107) were younger (OR 0.91 95% CI 0.85-0.98) and less likely to hold high qualifications (OR 0.43, 95% CI 0.20-0.96). Compared with smokers, dual users were more likely to be planning to quit smoking (OR 2.27, 95% CI 1.24-4.18). Compared with smokers, vapers were more likely to think vaping was safer than smoking (78.6% versus 36.4%). CONCLUSIONS One in 20 pregnant women report vaping, and most also smoke. Dual users are more motivated towards stopping smoking than smokers. Where women have tried but cannot stop smoking, clinicians could encourage them to consider vaping for smoking cessation. TWEETABLE EXTRACT One in 20 women report vaping during pregnancy but of those that do vape, most also smoke, despite having intentions to quit.
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Affiliation(s)
- K Bowker
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - L Phillips
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Orton
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - M Ussher
- Population Health Research Institute, St George's, University of London, London, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - F Naughton
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - L Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - T Coleman
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - L Sinclair
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - H McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - A Khan
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Cooper
- Division of Primary Care Research and UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK
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Ragonetti T, Coleman T, Travers R, Tran B, Coulombe S, Wilson C, Woodford MR, Davis C, Cameron R. Factors associated with interest in and knowledge of pre-exposure prophylaxis (PrEP) among gay, bisexual, and other men who have sex with men (GBMSM) in the Region of Waterloo, Ontario, Canada: Insights from the OutLook Study. The Canadian Journal of Human Sexuality 2020. [DOI: 10.3138/cjhs.2019-0060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pre-exposure prophylaxis (PrEP) is an effective HIV-prevention tool for gay, bisexual, and other men who have sex with men (GBMSM), a group known to be disproportionately affected by HIV/AIDS. We aimed to identify sociodemographic, psychosocial, and health factors associated with awareness of PrEP or interest in PrEP among GBMSM in a mid-sized Canadian city, where PrEP availability is arguably more scarce compared to larger metropolitan regions. The OutLook Study was a comprehensive online survey of LGBTQ health and well-being that collected data from sexual minorities aged 16+ in the Region of Waterloo, Ontario, Canada. Participants were cisgender MSM with an unknown or negative HIV status (n = 203). Bivariate logistic regression was performed to analyze factors associated with both awareness of PrEP and interest in PrEP. Multivariate logistic regression explored sexual behaviours in the past 12 months while controlling for sociodemographic and psychosocial variables. Increasing number of sexual partners (OR: 1.10; 95% CI: 1.03–1.53) was significantly associated with interest in PrEP and lifetime experiences of homophobia remained significant from the bivariate model (ORs ranged from 1.11–1.12). Since GBMSM with low educational attainment were shown to have less knowledge about PrEP, educational campaigns could be targeted in high schools rather than colleges, universities, and trade schools. Prevention initiatives should be aimed at places where single or non-monogamous GBMSM frequent due to these men being disproportionately affected by HIV/AIDS. These findings provide insights for potential interventions targeting MSM from mid-sized cities.
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Affiliation(s)
- Tom Ragonetti
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Todd Coleman
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Robb Travers
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Billy Tran
- Department of Health Sciences, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Simon Coulombe
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Ciann Wilson
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Michael R. Woodford
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, ON
| | - Charlie Davis
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
| | - Ruth Cameron
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, ON
- AIDS Committee of Cambridge, Kitchener, Waterloo, and Area, Kitchener, ON
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Lerman I, Bu T, Huang M, Wu V, Coleman T. Non‐invasive Targeted Gastric Vagal Complex Stimulation: Preliminary in Human Cutaneous Measures of Gastric Slow Wave Function. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.09477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Winberg C, Coleman T, Woodford MR, McKie RM, Travers R, Renn KA. Hearing "That's So Gay" and "No Homo" on Campus and Substance Use Among Sexual Minority College Students. J Homosex 2018; 66:1472-1494. [PMID: 30475157 DOI: 10.1080/00918369.2018.1542208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sexual orientation microaggressions are common on college campuses and can contribute to negative outcomes; yet little is known about their relationship with substance use outcomes. Among a convenience sample of cisgender sexual minority college students (n= 574; 57.0% female, 24.9% people of color, 50.7% gay/lesbian; 72.4% public school) from 37 states (67.8% Midwest), this analysis investigates the association between hearing "that's so gay" and "no homo" on campus and hazardous alcohol use and the frequency of illicit drug use. Using multivariable regression analyses, the commonly heard phrases "that's so gay" and "no homo" were each found to significantly increase the risk for hazardous drinking and the frequency of drug use among students. Efforts should be made to create more welcoming campus climates for sexual minority students by reducing the use of these microaggressions and, in the meantime, offering supports to mitigate their harmful effects.
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Affiliation(s)
- Carter Winberg
- a Faculty of Medicine , University of Toronto , Toronto , Ontario , Canada
| | - Todd Coleman
- b Department of Health Sciences, Faculty of Science , Wilfrid Laurier University , Waterloo , Canada
| | - Michael R Woodford
- c Lyle S. Hallman Faculty of Social Work , Wilfrid Laurier University , Kitchener , Canada
| | - Raymond M McKie
- d School of Psychology, Faculty of Social Sciences , University of Ottawa , Ottawa , Ontario , Canada
| | - Robb Travers
- b Department of Health Sciences, Faculty of Science , Wilfrid Laurier University , Waterloo , Canada
| | - Kristen A Renn
- e College of Education , Michigan State University , East Lansing , Michigan , USA
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16
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Adam BD, Hart TA, Mohr J, Coleman T, Vernon J. HIV-related syndemic pathways and risk subjectivities among gay and bisexual men: a qualitative investigation. Cult Health Sex 2017; 19:1254-1267. [PMID: 28394721 DOI: 10.1080/13691058.2017.1309461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Life history interviews were conducted with 40 gay and bisexual men to identify modes of syndemic experience and risk practice. Out of the interview narratives emerged one major and two minor modes of developmental pathway whereby syndemic conditions are navigated and expressed: (1) a combination of adverse childhood events with later episodes of depression and/or substantial substance use; (2) personal disruption that led to periods of depression and anxiety associated with the stresses of migration; and (3) a disorientation and an unravelling of life trajectory in the transition from family of origin to college or work. Risk practices fell into three high-risk modes: active and frequent engagement in condomless sex; unassertive deferment to a partner's initiation of condomless sex; and episodic risk combined with a risk reduction strategy. Three low risk modes were also identified: no recent condomlessness but multiple risk history in interview; a trajectory over time from high to low risk; and consistent low risk practice. These different modes of syndemic experience and risk management may have implications for identification of the effective HIV prevention tools that work best for different sets of men.
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Affiliation(s)
- Barry D Adam
- a Department of Sociology, Anthropology and Criminology , University of Windsor , Windsor , Canada
| | - Trevor A Hart
- b Department of Psychology , Ryerson University , Toronto , Canada
| | - Jack Mohr
- c Canadian Treatment Action Council , Toronto , Canada
| | - Todd Coleman
- d Health Sciences , Wilfrid Laurier University , Waterloo , Canada
| | - Julia Vernon
- b Department of Psychology , Ryerson University , Toronto , Canada
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Vaz LR, Coleman T, Fahy SJ, Cooper S, Bauld L, Szatkowski L, Leonardi-Bee J. Factors associated with the effectiveness and reach of NHS stop smoking services for pregnant women in England. BMC Health Serv Res 2017; 17:545. [PMID: 28789643 PMCID: PMC5549362 DOI: 10.1186/s12913-017-2502-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 08/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The UK National Health Service provides Stop Smoking Services for pregnant women (SSSP) but there is a lack of evidence concerning how these are best organised. This study investigates influences on services' effectiveness and also on their propensity to engage pregnant smokers with support in stopping smoking. METHODS Survey data collected from 121/141 (86%) of SSSP were augmented with data from Hospital Episode Statistics and the 2011 UK National Census. 'Reach' or propensity to engage smokers with support was defined as the percentage of pregnant smokers setting a quit date with SSSP support, and 'Effectiveness' as the percentage of women who set a quit date who also reported abstinence at four weeks later. A bivariate (i.e. two outcome variable) response Markov Chain Monte Carlo model was used to identify service-level factors associated with the Reach and Effectiveness of SSSP. RESULTS Beta coefficients represent a percentage change in Reach and Effectiveness by the covariate. Providing the majority of one-to-one contacts in a clinic rather than at home increased both Reach (%) (β: 6.97, 95% CI: 3.34, 10.60) and Effectiveness (%) (β: 7.37, 95% CI: 3.03, 11.70). Reach of SSSP was also increased when the population served was more deprived (β for increase in Reach with a one unit increase in IMD score: 0.55, 95% CI: 0.25, 0.85), had a lower proportion of people with dependent children (β: -2.52, 95% CI: -3.82, -1.22), and a lower proportion of people in managerial or professional occupations (β: -0.31, 95% CI: -0.59, -0.03). The Effectiveness of SSSP was decreased in those areas that had a greater percentage of people >16 years with no educational qualifications (β: -0.51, 95% CI: -0.95, -0.07). CONCLUSIONS To engage pregnant smokers and to encourage them to quit, it may be more efficient for SSSP support to be focussed around clinics, rather than women's homes. Reach of SSSP is inversely associated with disadvantage and efforts should be made to contact these women as they are less likely to achieve abstinence in the short and longer term.
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Affiliation(s)
- L R Vaz
- UK Centre for Tobacco and Alcohol Studies, Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2RD, UK.
| | - T Coleman
- UK Centre for Tobacco and Alcohol Studies, Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2RD, UK
| | - S J Fahy
- UK Centre for Tobacco and Alcohol Studies, Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2RD, UK
| | - S Cooper
- UK Centre for Tobacco and Alcohol Studies, Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2RD, UK
| | - L Bauld
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, FK9 4LA, UK
| | - L Szatkowski
- UK Centre for Tobacco and Alcohol Studies, Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2RD, UK.,UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building 2, Hucknall Road, Nottingham, NG5 1PB, UK
| | - J Leonardi-Bee
- UK Centre for Tobacco and Alcohol Studies, Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2RD, UK.,UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building 2, Hucknall Road, Nottingham, NG5 1PB, UK
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Oppong BA, Dash C, Li Y, Makambi K, Coleman T, Adams-Campbell L. Abstract P5-10-10: Predictors of breast density among Black and Hispanic women presenting for mammographic screening. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-10-10] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Increased breast density has been associated with elevated breast cancer risk and complicating mammographic interpretation. Although previous studies have investigated population variations in breast density, Black and Hispanic women are often underrepresented in these analyses. Moreover, it is unclear how breast density differs between these ethnicities. We report on the mammographic density distribution of Black and Hispanic women having breast cancer screening at the Capital Breast Care Center (CBCC) and analyze factors associated with high breast density.
Methods: Retrospective data from electronic medical records at a population-based mammography screening center were abstracted. From 2010 to 2014, data from women undergoing their first breast cancer screening were reviewed. Patient demographics including race, age at screening, education and menopausal status were abstracted in addition to body mass index (BMI) and Breast Imaging-Reporting and Data System (BI-RADS) density category:1- “fatty”, 2- “scattered fibroglandular densities”, 3- “heterogeneously dense” and 4- “extremely dense”. Logistic regression was used to investigate factors associated with breast density.
Results: Density categorization was recorded for 1747 women over the five-year period, with 855 (49%) Black and 892 (51%) Hispanic. Patient characteristics associated with high density (categories 3 and 4) were younger age, Hispanic ethnicity, nulliparity, premenopausal status, and BMI < 30 kg/m2. On multivariate logistic regression, Hispanic ethnicity, premenopausal status, and BMI < 30 kg/m2 were predictive of high mammographic density.
Conclusion: In a sample of women presenting for mammographic screening at CBCC, Hispanic women were more likely to have higher breast density compared to Black women. After controlling for ethnicity, postmenopausal and obese women were less likely to have dense breasts. Additional investigation is needed to further study the impact of obesity on breast density in underserved minority women.
Citation Format: Oppong BA, Dash C, Li Y, Makambi K, Coleman T, Adams-Campbell L. Predictors of breast density among Black and Hispanic women presenting for mammographic screening [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-10-10.
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Affiliation(s)
- BA Oppong
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - C Dash
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - Y Li
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - K Makambi
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - T Coleman
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - L Adams-Campbell
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
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Chowdhury S, Burris H, Patel M, Infante J, Jones S, Voskoboynik M, Parry K, Elvin P, Coleman T, Gardner H, Lyne P, Arkenau H. A phase I dose escalation, safety and pharmacokinetic (PK) study of AZD5312 (IONIS-ARRx), a first-in-class Generation 2.5 antisense oligonucleotide targeting the androgen receptor (AR). Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33031-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
We propose an approach for learning latent directed polytrees as long as there exists an appropriately defined discrepancy measure between the observed nodes. Specifically, we use our approach for learning directed information polytrees where samples are available from only a subset of processes. Directed information trees are a new type of probabilistic graphical models that represent the causal dynamics among a set of random processes in a stochastic system. We prove that the approach is consistent for learning minimal latent directed trees. We analyze the sample complexity of the learning task when the empirical estimator of mutual information is used as the discrepancy measure.
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Affiliation(s)
- Jalal Etesami
- Department of Industrial and Enterprise Systems Engineering, Coordinated Science Laboratory, University of Illinois at Urbana Champaign, Urbana, IL 61801, U.S.A.
| | - Negar Kiyavash
- Department of Industrial and Enterprise Systems Engineering, Coordinated Science Laboratory, and Department of Electrical and Computer Engineering, University of Illinois at Urbana Champaign, Urbana, IL 61801, U.S.A.
| | - Todd Coleman
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, U.S.A.
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Dhalwani NN, Szatkowski L, Coleman T, Fiaschi L, Tata LJ. Maternal Smoking, Nicotine Replacement Therapy in Pregnancy and Stillbirth: A Population-based Study using United Kingdom Primary Care Data. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.253] [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: 11/13/2022] Open
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22
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Dhalwani NN, Szatkowski L, Coleman T, Fiaschi L, Tata LJ. Maternal Smoking, Nicotine Replacement Therapy in Pregnancy and Congenital Anomalies in offspring: A Population-based Study using the United Kingdom Primary Care Data. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.252] [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: 11/13/2022] Open
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Jones R, Cheung A, Coleman T, Ballard P, D'Cruz C, Schuller A, Frigault M, Gu Y, Sai Y, Weiguo S, Ren Y, Qing W, Lindbom L, Petersson K. 392 Using modelling & simulation to integrate mouse PK–PD-efficacy with preliminary human PK data to inform the Phase II doses and schedule for the experimental c-Met inhibitor AZD6094 (Volitinib). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70518-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lengerke C, Fernandez-Capetillo O, Tolic-Norrelykke I, Barna M, Coleman T, Zamboni D. When the going gets tough: scientists' personal challenges. Cell 2014; 159:225-6. [PMID: 25436265 DOI: 10.1016/j.cell.2014.09.034] [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: 10/24/2022]
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Tappin DM, Bauld L, Purves D, Boyd K, Sinclair L, MacAskill S, McKell J, Friel B, McConnachie A, Coleman T. Cessation in Pregnancy Incentives Trial (CPIT): A phase II trial in Scotland 2011-2013. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku163.071] [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: 11/13/2022] Open
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26
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Snow J, Coleman T, Goodale M. Real-world size improves object recognition in visual form agnosia. J Vis 2014. [DOI: 10.1167/14.10.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Coleman T, Skiba R, Carroll A, Turek S, Berryhill M, Snow J. Bringing the 'real-world' into cognitive science: real objects are more memorable than pictures. J Vis 2014. [DOI: 10.1167/14.10.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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He B, Coleman T, Genin GM, Glover G, Hu X, Johnson N, Liu T, Makeig S, Sajda P, Ye K. Grand challenges in mapping the human brain: NSF workshop report. IEEE Trans Biomed Eng 2013; 60:2983-92. [PMID: 24108705 DOI: 10.1109/tbme.2013.2283970] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This report summarizes the outcomes of the NSF Workshop on Mapping and Engineering the Brain, held at Arlington, VA, during August 13-14, 2013. Three grand challenges were identified, including high spatiotemporal resolution neuroimaging, perturbation-based neuroimaging, and neuroimaging in naturalistic environments. It was highlighted that each grand challenge requires groundbreaking discoveries, enabling technologies, appropriate knowledge transfer, and multi- and transdisciplinary education and training for success.
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Dhalwani NN, Tata LJ, Coleman T, Szatkowski L. OP09 Prescribing of Nicotine Replacement Therapy in and Around Pregnancy in the UK – A Population Based Study using Primary Care Data. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Coleman T, Chamberlain C, Davey MA, Cooper SE, Leonardi-Bee J. Efficacy of nicotine replacement therapy in pregnancy. BJOG 2013; 120:373-4. [DOI: 10.1111/1471-0528.12064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2012] [Indexed: 11/30/2022]
Affiliation(s)
- T Coleman
- Division of Primary Care; University of Nottingham; Nottingham; UK
| | - C Chamberlain
- International Public Health Unit; Department of Epidemiology and Preventive Medicine; Monash University; Prahran; Vic.; Australia
| | - M-A Davey
- Mother and Child Health Research; La Trobe University; Melbourne; Vic.; Australia
| | - SE Cooper
- Division of Primary Care; University of Nottingham; Nottingham; UK
| | - J Leonardi-Bee
- Division of Epidemiology and Public Health; University of Nottingham; Nottingham; UK
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Arizumi N, Coleman T, DeVille L. Emergence of direction- and orientation-selectivity and othercomplex structures from stochastic neuronal networks evolving under STDP. BMC Neurosci 2011. [PMCID: PMC3240537 DOI: 10.1186/1471-2202-12-s1-p68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hong B, Mace M, Crowder R, Coleman T, He W, Szczepanski F, Feczko J, Lyzak J. Metastatic breast cancer detection and therapy monitoring using folate-targeting flow cytometry. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.23] [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] [Indexed: 11/20/2022] Open
Abstract
23 Background: Circulating tumor cell (CTC) has emerged as a valuable surrogate tumor marker for cancer diagnosis, prognosis, therapy personalization, and drug discovery. To identify CTCs, EpCAM and/or cytokeratin have been commonly used; however, their expression may diminish for subgroups of breast cancers or during epithelial-mesenchymal transition. A unique approach by targeting folate receptor (FR) on CTCs overcomes the limitation. Cancer cells overexpress FR with high affinity (KD=0.1 nM) to internalize high levels of folate for rapid growth. FR is also found upregulated in most cancers, while at very low levels in normal tissues. Methods: A flow cytometry based in-vitro CTC assay kit (OncoIVDx) was developed by IV Diagnostics Inc to specifically enumerate CTCs which overexpress FRs. 20 mL of 9 metastatic breast cancer (MBC) patients' peripheral blood was collected using CellSave tube before and after the treatment in midst of therapy. CTCs were tagged by fluorescently labeled folate conjugate, while leukocytes were counterstained by anti-CD45. To absolutely count the rare CTCs, a fluorescent bead was added serving internal control. Results: Table. Conclusions: No obvious shift in dot plots was found for patients' leucocytes compared to those in normal sample. Tumor size, histologic grade, nodal involvement and lymphovascular invasion (LVI) did not display a significant association with CTC presence, although more positive nodes with identified LVI might indicate an unfavorable increase in CTC counts. CTC presence was found associated with serum marker CA27.29. A score of 30 and less correlated with CTC response to the treatment. Chemotherapy alone or in combination with hormone therapy did not correlate with the change in CTC counts after treatment, except for hormone therapy alone. Unfavorable progression of cancers could be predicated for the patients with approximately 25 and more CTCs. We would like to thank NIH/NCI for SBIR phase I grant (1R43CA13789301A1). [Table: see text]
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Affiliation(s)
- B. Hong
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - M. Mace
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - R. Crowder
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - T. Coleman
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - W. He
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - F. Szczepanski
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - J. Feczko
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
| | - J. Lyzak
- IVDiagnostics, West lafayette, IN; Alverno Clinical Laboratory, Hammond, IN; Purdue University North Central, Valparaiso, IN; IVDiagnostics, Valparaiso, IN; Porter Hospital, Valparaiso, IN
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Haslam IS, Wright JA, O'Reilly DA, Sherlock DJ, Coleman T, Simmons NL. Intestinal ciprofloxacin efflux: the role of breast cancer resistance protein (ABCG2). Drug Metab Dispos 2011; 39:2321-8. [PMID: 21930826 DOI: 10.1124/dmd.111.038323] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Intestinal secretory movement of the fluoroquinolone antibiotic, ciprofloxacin, may limit its oral bioavailability. Active ATP-binding cassette (ABC) transporters such as breast cancer resistance protein (BCRP) have been implicated in ciprofloxacin transport. The aim of this study was to test the hypothesis that BCRP alone mediates intestinal ciprofloxacin secretion. The involvement of ABC transport proteins in ciprofloxacin secretory flux was investigated with the combined use of transfected cell lines [bcrp1/BCRP-Madin-Darby canine kidney II (MDCKII) and multidrug resistance-related protein 4 (MRP4)-human embryonic kidney (HEK) 293] and human intestinal Caco-2 cells, combined with pharmacological inhibition using 3-(6-isobutyl-9-methoxy-1,4-dioxo-1,2,3,4,6, 7,12,12a-octahydropyrazino[1',2':1,6]pyrido[3,4-b]indol-3-yl)-propionic acid tert-butyl ester (Ko143), cyclosporine, 3-[[3-[2-(7-chloroquinolin-2-yl)vinyl]phenyl]-(2-dimethylcarbamoylethylsulfanyl)methylsulfanyl] propionic acid (MK571), and verapamil as ABC-selective inhibitors. In addition, the regional variation in secretory capacity was investigated using male Han Wistar rat intestine mounted in Ussing chambers, and the first indicative measurements of ciprofloxacin transport by ex vivo human jejunum were made. Active, Ko143-sensitive ciprofloxacin secretion was observed in bcrp1-MDCKII cell layers, but in low-passage (BCRP-expressing) Caco-2 cell layers only a 54% fraction was Ko143-sensitive. Ciprofloxacin accumulation was lower in MRP4-HEK293 cells than in the parent line, indicating that ciprofloxacin is also a substrate for this transporter. Ciprofloxacin secretion by Caco-2 cell layers was not inhibited by MK571. Secretory flux showed marked regional variability in the rat intestine, increasing from the duodenum to peak in the ileum. Ciprofloxacin secretion was present in human jejunum and was reduced by Ko143 but showed marked interindividual variability. Ciprofloxacin is a substrate for human and rodent BCRP. An additional pathway for ciprofloxacin secretion exists in Caco-2 cells, which is unlikely to be MRP(4)-mediated. BCRP is likely to be the dominant transport mechanism for ciprofloxacin efflux in both rat and human jejunum.
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Affiliation(s)
- I S Haslam
- AstraZeneca, Discovery DMPK, Macclesfield, Cheshire, United Kingdom.
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Abstract
Carcinomatous meningitis due to bladder cancer is a rare entity reported only in case reports. Optimal therapy is thus poorly defined with earlier cases reporting an unsuccessful outcome. Here we report a case of late carcinomatous meningitis secondary to transitional cell carcinoma (TCC) of the bladder occurring in a patient in complete remission. He was successfully treated with intrathecal methotrexate and whole brain irradiation and experienced prolonged survival after treatment. With modern chemotherapy increasing complete remissions and survival rates in patients with TCC, more and more patients are being reported with carcinomatous meningitis. We raise the question of whether central nervous system prophylaxis should be considered in patients with TCC achieving a complete remission to chemotherapy in the metastatic setting.
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Affiliation(s)
- S Tadepalli
- Department of Hematology and Oncology, Georgia Health Sciences University, Augusta, Ga., USA
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Kim DH, Lu N, Ma R, Kim YS, Kim RH, Wang S, Wu J, Won SM, Tao H, Islam A, Yu KJ, Kim TI, Chowdhury R, Ying M, Xu L, Li M, Chung HJ, Keum H, McCormick M, Liu P, Zhang YW, Omenetto FG, Huang Y, Coleman T, Rogers JA. Epidermal Electronics. Science 2011; 333:838-43. [PMID: 21836009 DOI: 10.1126/science.1206157] [Citation(s) in RCA: 1890] [Impact Index Per Article: 145.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Dae-Hyeong Kim
- Department of Materials Science and Engineering, Beckman Institute for Advanced Science and Technology, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Ma R, Kim DH, McCormick M, Coleman T, Rogers J. A stretchable electrode array for non-invasive, skin-mounted measurement of electrocardiography (ECG), electromyography (EMG) and electroencephalography (EEG). Annu Int Conf IEEE Eng Med Biol Soc 2011; 2010:6405-8. [PMID: 21096704 DOI: 10.1109/iembs.2010.5627315] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper reports a class of stretchable electrode array capable of intimate, conformal integration onto the curvilinear surfaces of skin on the human body. The designs employ conventional metallic conductors but in optimized mechanical layouts, on soft, thin elastomeric substrates. These devices exhibit an ability to record spontaneous EEG activity even without conductive electrolyte gels, with recorded alpha rhythm responses that are 40% stronger than those collected using conventional tin electrodes and gels under otherwise similar conditions. The same type of device can also measure high quality ECG and EMG signals. The results suggest broad utility for skin-mounted measurements of electrical activity in the body, with advantages in signal levels, wearability and modes of integration compared to alternatives.
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Affiliation(s)
- Rui Ma
- Coordinated Science Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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Prosser JD, Bhatt N, Coleman T, Jackson L. Case Report of Periocular Merkel Cell Carcinoma Treated with Primary Concomitant Chemotherapy and Radiation, and Review of the Literature Regarding Its Use. Laryngoscope 2011; 120 Suppl 4:S177. [DOI: 10.1002/lary.21641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Coleman T, Agboola S, Leonardi-Bee J, Taylor M, McEwen A, McNeill A. Relapse prevention in UK Stop Smoking Services: current practice, systematic reviews of effectiveness and cost-effectiveness analysis. Health Technol Assess 2010; 14:1-152, iii-iv. [DOI: 10.3310/hta14490] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- T Coleman
- University of Nottingham, Division of Primary Care, Nottingham, UK
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Shoeman R, Redfield B, Coleman T, Greene RC, Smith AA, Brot N, Weissbach H. Regulation of methionine synthesis in Escherichia coli: Effect of metJ gene product and S-adenosylmethionine on the expression of the metF gene. Proc Natl Acad Sci U S A 2010; 82:3601-5. [PMID: 16593564 PMCID: PMC397833 DOI: 10.1073/pnas.82.11.3601] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The regulation of the expression of the Escherichia coli metF gene, which codes for 5,10-methylenetet-rahydrofolate reductase (EC 1.1.99.15), has been investigated by using a simplified DNA-directed in vitro system that measures the formation of the first dipeptide (fMet-Ser) of the gene product. The synthesis of fMet-Ser directed by a plasmid containing the metF gene is specifically inhibited by metJ protein (repressor protein). S-Adenosylmethionine enhances the inhibition by the metJ protein of metF gene expression. The inhibition by the metJ protein is at the level of transcription and the results suggest that S-adenosylmethionine is functioning as an allosteric effector.
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Affiliation(s)
- R Shoeman
- Roche Institute of Molecular Biology, Roche Research Center, Nutley, NJ 07110
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Coleman T. Adding live, reactive telephone counselling to self-help literature does not increase smoking cessation. ACTA ACUST UNITED AC 2010; 15:53-4. [DOI: 10.1136/ebm1054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Szatkowski L, Coleman T, Lewis S, McNeill A. Can national smoking prevalence be monitored using primary care medical records data? J Epidemiol Community Health 2009. [DOI: 10.1136/jech.2009.096719w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Al-Abed Y, Metz C, Cheng KF, Aljabari B, Linge H, Ochani M, Lin X, Pavlov V, Coleman T, Tracey K, Miller EJ. Discovery of a natural antagonist of macrophage migration inhibitory factor. Crit Care 2009. [PMCID: PMC2776225 DOI: 10.1186/cc8108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
OBJECTIVE To determine the effects of environmental tobacco smoke (ETS) exposure on birth outcomes. DESIGN A systematic review and meta-analysis was performed in accordance with MOOSE guidelines. MEDLINE, EMBASE, CINAHL and LILACS (up to October 2007), were searched and also reviews and reference lists from publications, with no language restrictions. Pooled mean differences and odds ratios (ORs) with 95% confidence intervals were estimated using data extracted from papers, based on random effect models. SETTING Comparative epidemiological studies. PATIENTS Pregnant women or women who have given birth. EXPOSURES Maternal exposure to ETS during pregnancy. MAIN OUTCOME MEASURES Mean birth weight and proportion of premature infants. RESULTS 58 studies were included; 53 used cohort designs, 23 ascertaining ETS exposure prospectively and 30 retrospectively; 5 used case-control designs. In prospective studies, ETS exposure was associated with a 33 g (95% CI 16 to 51) reduction in mean birth weight, and in retrospective studies a 40 g (95% CI 26 to 54) reduction. ETS exposure was also associated with an increased risk of low birth weight (birth weight <2500 g; prospective studies: OR 1.32, 95% CI 1.07 to 1.63; retrospective studies: OR 1.22, 95% CI 1.08 to 1.37). The risk of small for gestational age (<10th centile) birth was significantly associated with ETS exposure only in retrospective studies (OR 1.21, 95% CI 1.06 to 1.37). There was no effect of ETS exposure on gestational age. CONCLUSIONS Exposure of non-smoking pregnant women to ETS reduces mean birth weight by 33 g or more, and increases the risk of birth weight below 2500 g by 22%, but has no clear effect on gestation or the risk of being small for gestational age.
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Affiliation(s)
- J Leonardi-Bee
- Dr J Leonardi-Bee, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, Nottingham NG5 1PB, UK;
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Haslam IS, Jones K, Coleman T, Simmons NL. Induction of P-glycoprotein expression and function in human intestinal epithelial cells (T84). Biochem Pharmacol 2008; 76:850-61. [PMID: 18703021 DOI: 10.1016/j.bcp.2008.07.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 07/14/2008] [Accepted: 07/15/2008] [Indexed: 11/28/2022]
Abstract
Intestinal induction of Pgp is known to limit the oral availability of certain drug compounds and give rise to detrimental drug-drug interactions. We have investigated the induction of P-glycoprotein (Pgp; MDR1) activity in a human intestinal epithelial cell line (T84) following pre-exposure to a panel of drug compounds, reported to be Pgp substrates, inhibitors or inducers. Human MDR1-transfected MDCKII epithelial monolayers were used to assess Pgp substrate interactions and inhibition of digoxin secretion by the selected drug compounds. The T84 cell line was used to assess induction of Pgp-mediated digoxin secretion following pre-exposure to the same compounds. Changes in gene expression (MDR1, MRP2, PXR and CAR) were determined by quantitative RT-PCR. Net transepithelial digoxin secretion was increased (1.3 fold, n=6, P<0.05) following pre-exposure to the PXR activator hyperforin (100nM, 72h), as was MDR1 mRNA expression (3.0 fold, n=4, P<0.05). A number of Pgp substrates (quinidine, amprenavir, irinotecan, topotecan, atorvastatin and erythromycin) induced net digoxin secretion, as did the non-Pgp substrate artemisinin. Various non-Pgp substrates demonstrated inhibition of digoxin secretion (verapamil, mifepristone, clotrimazole, mevastatin, diltiazem and isradipine) but did not induce Pgp-mediated digoxin secretion. Of the compounds that increased Pgp secretion, quinidine, topotecan, atorvastatin and amprenavir pre-exposure also elevated MDR1 mRNA levels, whereas erythromycin, irinotecan and artemisinin displayed no change in transcript levels. This indicates possible post-translational regulation of digoxin secretion. Finally, a strong correlation between drug modulation of MRP2 and PXR mRNA expression levels was evident.
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Affiliation(s)
- I S Haslam
- Epithelial Research Group, Institute for Cell and Molecular Biosciences, University of Newcastle Upon Tyne, Medical School, Newcastle Upon Tyne NE24HH, UK
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El Geneidy MM, Lewis G, Dainer P, Terris MK, Brown J, Coleman T. Factors predicting a response to anti-androgen withdrawal maneuvers in prostate cancer patients failing combined androgen blockade. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Haslam IS, Jones K, Coleman T, Simmons NL. Rifampin and digoxin induction of MDR1 expression and function in human intestinal (T84) epithelial cells. Br J Pharmacol 2008; 154:246-55. [PMID: 18332862 DOI: 10.1038/bjp.2008.69] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Oral drug bioavailability is limited by intestinal expression of P-glycoprotein (MDR1, Pgp, ABCB1) whose capacity is regulated via nuclear receptors e.g. the pregnane X receptor (PXR, SXR, NR1I2). In order to study dynamic regulation of MDR1 transport capacity we have identified the T84 epithelial cell-line as a model for human intestine co-expressing MDR1 with PXR. The ability of rifampin, a known PXR agonist and digoxin, a model MDR1 substrate, to regulate MDR1 expression and transport activity has been tested, in these T84 cells. EXPERIMENTAL APPROACH Transport was assayed by bi-directional [(3)H]-digoxin transepithelial fluxes across epithelial layers of T84 cells seeded onto permeable filter supports following pre-exposure to rifampin and digoxin. Quantitative real-time PCR, Western blotting and immunocytochemistry were used to correlate induction of MDR1 transcript and protein levels with transport activity. KEY RESULTS Rifampin exposure (10 microM, 72 hours) increased MDR1 transcript levels (3.4 fold), MDR1 total protein levels (4.4 fold), apical MDR1 protein (2.7 fold) and functional activity of MDR1 (1.2 fold). Pre-incubation with digoxin (1 microM, 72 hours) potently induced MDR1 transcript levels (92 fold), total protein (7 fold), apical MDR1 protein (4.7 fold) and functional activity (1.75 fold). Whereas PXR expression was increased by rifampin incubation (2 fold), digoxin reduced PXR expression (0.3 fold). CONCLUSIONS AND IMPLICATIONS Chronic digoxin pre-treatment markedly upregulates MDR1 expression and secretory capacity of T84 epithelia. Digoxin-induced changes in MDR1 levels are distinct from PXR-mediated changes resulting from rifampin exposure.
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Affiliation(s)
- I S Haslam
- Epithelial Research Group, Institute for Cell and Molecular Biosciences, University of Newcastle Upon Tyne, Medical School, Newcastle Upon Tyne, UK
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Wilson A, Sinfield P, Rodgers S, Hammersley V, Coleman T. Drugs to support smoking cessation in UK general practice: are evidence based guidelines being followed? Qual Saf Health Care 2007; 15:284-8. [PMID: 16885254 PMCID: PMC2564020 DOI: 10.1136/qshc.2005.017673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Prescribing drugs to support smoking cessation is one of the most cost effective interventions in primary care, but there is evidence they are underused. Little is known about how far guidelines have been adopted. AIMS To examine the context in which nicotine replacement therapy (NRT) and bupropion are prescribed in UK general practice and whether guidelines are being followed. DESIGN Patient questionnaire survey. SETTING Twenty five general practices from the Trent Focus Collaborative Research Network in South Yorkshire and East Midlands, UK. METHODS Participating practices posted a questionnaire to up to 40 patients prescribed NRT and bupropion respectively in the previous 3-9 months. RESULTS The response rate for people prescribed NRT was 44.7% (323/723) and for bupropion 42.5% (77/181). Patients reported initiating the prescription request in 258 cases (65%), whereas GPs were reported as suggesting it in 49 (12%), smoking cessation services (SCS) in 38 (10%), and practice nurses in 36 (9%). Of those who could recall the content of the consultation in which NRT or bupropion was prescribed, 191 (79%) reported receiving advice on treatment use and 209 (68%) were encouraged to set a quit date. Follow up by SCS was recommended to 186 (64%) and practice follow up was offered to 212 (63%), but 41 (15%) reported no offer of follow up support. CONCLUSIONS The majority of patients reported receiving advice and follow up in line with guidelines. However, relatively few prescriptions were suggested by GPs or practice nurses and, in a significant minority of cases, neither follow up by the practice nor additional support from SCS was recommended. More active implementation of guidelines could increase the impact of general practice on the prevalence of smoking.
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Affiliation(s)
- A Wilson
- Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.
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Lesko SM, Coleman T. The Effect of Age on the Treatment of Stage III Colorectal Cancer. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s107-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
OBJECTIVE To compare the characteristics of smokers who do and do not receive smoking cessation treatment in primary care. DESIGN Prospective cohort study using practices registered with the pilot QRESEARCH database. SETTING 156,550 patients aged 18 years and over from 39 general practices located within four strategic health authorities, representing the former Trent Region, UK. SUBJECTS Patients registered with practices between 1 April 2001 and 31 March 2003 aged 18 years and over who were identified as smokers before the two year study period. OUTCOME Prescription for smoking cessation treatment (nicotine replacement therapy (NRT) or bupropion) in the two year study period. VARIABLES Age, sex, deprivation score, co-morbidity. RESULTS Of the 29,492 patients recorded as current smokers at the start of the study period 1892 (6.4%) were given prescriptions for smoking cessation treatment during the subsequent two years. Of these, 1378 (72.8%) were given NRT alone, 406 (21.5%) bupropion alone, and 108 (5.7%) both treatments. Smokers were more likely to receive smoking cessation treatment if they lived in the most deprived areas (odds ratio (OR) for the most relative to the least deprived fifth, adjusted for sex, age, and co-morbidity, 1.50, 95% confidence interval (CI) 1.26 to 1.78), and if they were aged 25-74 years compared to 18-24 years or 75 and over. Smokers with co-morbidity were also more likely to receive smoking cessation treatment. Smokers were less likely to receive smoking cessation treatment if they were male (adjusted OR 0.68, 95% CI 0.62 to 0.75). CONCLUSION The low proportion of smokers being prescribed these products strongly suggests that a major public health opportunity to prevent smoking related illness is being missed.
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Affiliation(s)
- A Wilson
- Department of Health Sciences, University of Leicester, Leicester LE5 4PW, UK.
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