191 results on '"London, DR"'
Search Results
2. Sleep apnoea: clinical importance and facilities for investigation and treatment in the UK. Addendum to the 1993 Royal College of Physicians Sleep Apnoea report
- Author
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Gibson, GJ, Douglas, NJ, Stradling, JR, London, DR, and Semple, SJ
- Subjects
nervous system diseases ,respiratory tract diseases - Abstract
The potential importance of the obstructive sleep apnoea syndrome (OSA) has been recognized only in the last few years. Epidemiological studies suggest that symptomatic OSA occurs in 1-2% of middle-aged men and in approximately half that number of women. The relation of OSA to vascular disease is uncertain and the main indication for treatment is the relief of disabling sleepiness. Two recent evidence based analyses have produced diametrically opposed conclusions on the efficacy of treatment with nasal continuous positive airway pressure (CPAP). However, recent controlled studies confirm the overwhelming clinical experience of benefit. Facilities for the investigation and treatment of patients with OSA in the UK are subject to severe financial constraints and the availability of CPAP treatment lags markedly behind that in other countries for which data are available.
- Published
- 2016
3. ORAL PERFORMANCE OF ÌRÈGÚN MUSIC IN YAGBALAND, KOGI STATE, NIGERIA: AN OVERVIEW
- Author
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Management of the Federal College of Education, Okene, Centre for African Studies, SOAS, University of London, Dr. Daramola, M. Professor Femi Adedeji, management of Obafemi Awolowo University, Stephen, Titus Olusegun; Department of Music, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria, Management of the Federal College of Education, Okene, Centre for African Studies, SOAS, University of London, Dr. Daramola, M. Professor Femi Adedeji, management of Obafemi Awolowo University, and Stephen, Titus Olusegun; Department of Music, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
- Abstract
Performance is one of the major arts in most African countries. Among the Yoruba in Nigeria several genre of oral performance has been researched and documented. These include the ijala, iwi, oriki ekun iyawo, Iyere Ifa, iwure , among others. However, very little attention and studies have been committed to oral performance of Ìrègún chants and songs in Yagbaland. This paper, therefore, focuses on the evaluation of oral performance of Ìrègún chants and songs among Yagba people in Kogi State, located in North central of Nigeria. Primary data were collected through 3 In-depth and 3 Key Informant interviews of leaders and members of Ìrègún musical groups. In addition to 3 Participant Observation and 3 Non-Participant Observation methods from Yagba-West, Yagba-East and Mopamuro Local Government Areas of Kogi State, music recordings, photographs of Ìrègún performances, and 6 chants were purposefully sampled. Secondary data were collected through library, archival and Internet sources. Although closely interwoven, Ìrègún performance is structured into preparation, actual and post-performance activities. While chanting, singing, playing of musical instruments and dancing forms the performance dimensions. Iregun music serves as veritable mirror and cultural preserver in Yagba communities. ORAL PERFORMANCE OF ÌRÈGÚN MUSIC IN YAGBALAND, KOGI STATE, NIGERIA: AN OVERVIEW
- Published
- 2015
4. Sleep apnoea: Clinical importance and facilities for investigation and treatment in the UK
- Author
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Gibson, G, Douglas, N, Stradling, JR, London, DR, and Semple, S
- Subjects
nervous system diseases ,respiratory tract diseases - Abstract
The potential importance of the obstructive sleep apnoea syndrome (OSA) has been recognised only in the last few years. Epidemiological studies suggest that symptomatic OSA occurs in 1-2% of middle-aged men and in approximately half that number of women. The relation of OSA to vascular disease is uncertain and the main indication for treatment is the relief of disabling sleepiness. Two recent evidence based analyses have produced diametrically opposed conclusions on the efficacy of treatment with nasal continuous positive airway pressure (CPAP). However, recent controlled studies confirm the overwhelming clinical experience of benefit. Facilities for the investigation and treatment of patients with OSA in the UK are subject to severe financial constraints and the availability of CPAP treatment lags markedly behind that in other countries for which data are available.
- Published
- 1998
5. Specialist training in the UK
- Author
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Alberti, KGMM, primary and London, DR, additional
- Published
- 1997
- Full Text
- View/download PDF
6. Who's treating depression?
- Author
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London, Dr.
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Depression, Mental -- Diagnosis ,Depression, Mental -- Care and treatment ,Depression, Mental -- Evaluation ,Medical screening -- Evaluation - Abstract
Depression screening is becoming a mainstay in general medical evaluations, and this is a positive development, considering its prevalence and power. Depression is one of the four leading causes of [...]
- Published
- 2007
7. Cardiovascular effects of single oral doses of the new beta- adrenoceptor blocking agents betaxolol (SL 75212) in healthy volunteers.
- Author
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Cadigan, PJ, London, DR, Pentecost, BL, Bianchetti, G, Gomeni, R, Kilborn, JR, and Morselli, PL
- Abstract
1 The effects of betaxolol (SL 75212), a new beta-adrenoceptor blocking agent, on the cardiovascular response to exercise have been studied in six normal subjects after placebo and single oral doses of 5, 10, 20 and 40 mg given double-blind in a randomized sequence. 2 All doses reduced exercise heart rate, with a significant reduction persisting to 23 h after doses of 20 mg and 40 mg. Systolic blood pressure on exercise was reduced after all doses, with a reduction continuing to 23 h after doses of 10 mg and above. 3 The mean elimination half-life of SL 75212 was 17.5 +/- 3.9 h. The plasma clearance ranged from 0.15- 0.48 1 kg-1 h-1 and the volume of distribution from 5.8-13 1 kg-1. 4 There was a significant correlation between the peak blood levels and change in exercise heart rate (r = 0.53, P less than 0.05) and between the area under the blood concentration curve and the effect of the exercise heart rate (r = 0.55, P less than 0.01). [ABSTRACT FROM AUTHOR]
- Published
- 1980
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8. IN VITRO SYNTHESIS OF STEROIDS BY A FEMINISING ADRENOCORTICAL CARCINOMA: EFFECT OF PROLACTIN AND OTHER PROTEIN HORMONES
- Author
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London Dr, W. R. Butt, Cowley Th, Griffiths K, H. Roberts, David S. Millington, and M. P. Golder
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endocrine system ,medicine.medical_specialty ,Chromatography, Gas ,Endocrinology, Diabetes and Metabolism ,Adrenal Gland Neoplasms ,Radioimmunoassay ,Estrone ,Adrenocorticotropic hormone ,Peptide hormone ,Biology ,Gas Chromatography-Mass Spectrometry ,chemistry.chemical_compound ,Endocrinology ,Adrenocorticotropic Hormone ,Culture Techniques ,Internal medicine ,medicine ,Humans ,Adrenocortical carcinoma ,Gonadal Steroid Hormones ,Testosterone ,Aged ,General Medicine ,medicine.disease ,Adrenal Cortex Neoplasms ,Prolactin ,Culture Media ,chemistry ,Female ,Cyclase activity ,hormones, hormone substitutes, and hormone antagonists ,Adenylyl Cyclases ,Hormone - Abstract
The study describes the effects of ACTH, prolactin and other protein hormones on the synthesis and secretion of steroid hormones by tissue from a feminising adrenocortical carcinoma removed from a post-menopausal female. Steroid production by the tissue was determined by high resolution-mass fragmentography and by radioimmunoassay. Prolactin and ACTH stimulated the synthesis of estrogens by the tissue whereas GH, LH and ACTH were more effective than prolactin in stimulating androgen synthesis. The effect of protein hormones, other than ACTH, on adenylate cyclase activity of this tumour tissue indicated a lack of specificity of the membrane receptor sites.Experiments in vitro on tissue from a feminizing adrenocortical carcinoma removed from a postmenopausal patient are described. Portions of the adrenal tumor were cultured. The effects of ACTH, prolactin, and other protein hormones on the synthesis and secretion of steroid hormones by the cultured tissue were studied. Steroids were extracted from the culture medium with ethyl acetate. Steroid production was determined by high resolution-mass fragmentography and by radioimmunoassay. Results suggest that in vitro neither growth hormone (GH) nor luteinizing hormone (LH), at the concentrations used, effectively stimulated the synthesis and secretion of estradiol-17beta by the adrenal tumor tissue. However, ACTH and prolactin with insulin, appearing to influence the action of both these hormones, stimulated the output of estradiol-17beta. Steroid was being synthesized during the 3-day culture period. The tumor tissue actively synthesized and secreted into the medium estrone as well as estradiol-17beta under the influence of ACTH and prolactin with insulin. Data also suggest that LH and GH were capable of influencing the synthesis and secretion of androstenedione by the tissue explants. No DNA sulphate was present in the media from the tumor tissue cultures before or after incubation with either ACTH or prolactin. Results from studies with normal adrenal tissue in culture indicated that DNA sulphate, DHA, and androstenedione were present in the culture medium after 3 days' incubation. In this report the concentration of endogenous estrone relative to estradiol-17beta and estradiol was found to be high. The effect of protein hormones, other than ACTH, on adenylate cyclase activity of this tumor tissue indicated a lack of specificity of the membrane receptor sites. High resolution-mass fragmentography had greater specificity than radioimmunoassay.
- Published
- 1976
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9. Control by insulin of protein synthesis in muscle
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London Dr
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medicine.medical_specialty ,Cell Membrane Permeability ,medicine.medical_treatment ,Glycine ,Biological Transport, Active ,Muscle Proteins ,Medicine (miscellaneous) ,Ribosome ,Ouabain ,RNA, Transfer ,Leucine ,Internal medicine ,Insulin receptor substrate ,medicine ,Protein biosynthesis ,Animals ,Insulin ,Amino Acids ,chemistry.chemical_classification ,Carbon Isotopes ,Alanine ,Nutrition and Dietetics ,Chemistry ,Muscles ,Sodium ,Stimulation, Chemical ,Rats ,Amino acid ,Endocrinology ,Ribosomes ,medicine.drug - Published
- 1972
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10. A Simple Procedure for the Radioimmunoassay of 17α-Hydroxyprogesterone in Serum: Comparison with an Immunological Purification Technique
- Author
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Davila, Norma, Rudd, BT, Morris, R, Kandeel, F, Bodden, Jane, and London, DR
- Abstract
A simple radioimmunoassay for the measurement of 17α-hydroxyprogesterone in 0·1–0·25 ml serum is described. An antibody prepared against 17α-hydroxyprogesterone 3(O-carboxymethyl)-oxime-BSA as immunogen was used. A correlation of the 17α-hydroxyprogesterone concentration found in the serum of normal subjects and of patients with that obtained by a more complex immunological purification method was good (r = 0·924, p < 0·001). Accuracy, precision, and specificity were acceptable with the simple method. Normal values for infants, children, and adults have been established, and the individual concentrations of 17α-hydroxyprogesterone in the serum of patients with congenital adrenal hyperplasia were well separated from normal values.
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- 1980
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11. Birth order and risk of hepatocellular carcinoma in chronic carriers of hepatitis B virus: a case-control study in The Gambia
- Author
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Harr Freeya Njai, Ramou Njie, Ousman Nyan, Christian Bottomley, Maud Lemoine, Gibril Ndow, Yusuke Shimakawa, Lamin Bojang, Umberto D'Alessandro, Andrew J. Hall, Mark Thursz, Makie Taal, Abdoulie Jatta, Saydiba Tamba, Department of Infectious Disease Epidemiology [London] (IDE), Faculty of Epidemiology and Population Health [London], London School of Hygiene and Tropical Medicine (LSHTM)-London School of Hygiene and Tropical Medicine (LSHTM), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Medical Research Council Unit The Gambia (MRC), Imperial College London, Ministry of Health and Social Welfare [Banjul, The Gambia] (MOHSW), Edward Francis Small Teaching Hospital [Banjul, Gambia] (EFSTH), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), This work was supported by the European Commission's Seventh Framework Programme (grant 265994, PROLIFICA)., The authors thank MRC Unit, The Gambia, the Gambia National Cancer Registry, the Gambia Government and the Imperial College London which supported the study. The authors also thank Dr Debbie Garside and Prof Simon‐Taylor Robinson at the Imperial College London, Dr Abubacarr Kambi, Dr Louise Sarr, Mr Famara Bojang, Ms Deboh Jallow, Mr Sheriff Koley, Ms Yamundow‐Jallow Samba, Mr Alagie Sanneh, Mr Demba Sonko and Ms Mavis Foster‐Nyarko at MRC Unit, The Gambia., European Project: 265994,EC:FP7:HEALTH,FP7-AFRICA-2010,PROLIFICA(2011), and Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)
- Subjects
Male ,HBsAg ,MESH: Logistic Models ,carcinoma ,medicine.disease_cause ,MESH: Aged, 80 and over ,MESH: Pregnancy ,Pregnancy ,Risk Factors ,MESH: Risk Factors ,Medicine ,2. Zero hunger ,Aged, 80 and over ,MESH: Aged ,education.field_of_study ,MESH: Middle Aged ,Obstetrics ,MESH: Birth Order ,Liver Neoplasms ,MESH: Carrier State / virology ,Hepatitis B ,Middle Aged ,MESH: Case-Control Studies ,MESH: Infant ,3. Good health ,MESH: Infectious Disease Transmission, Vertical ,Birth order ,MESH: Hepatitis B virus ,Hepatocellular carcinoma ,Carrier State ,Female ,Gambia ,Adult ,medicine.medical_specialty ,Hepatitis B virus ,Carcinoma, Hepatocellular ,MESH: Hepatitis B Surface Antigens / genetics ,MESH: Gambia / epidemiology ,Population ,MESH: Hepatitis B, Chronic / epidemiology ,Hepatitis B, Chronic ,hepatocellular ,vertical ,MESH: Hepatitis B Vaccines / therapeutic use ,Humans ,MESH: Carrier State / epidemiology ,Hepatitis B Vaccines ,MESH: Carcinoma, Hepatocellular / epidemiology ,education ,birth order ,Aged ,Hepatitis B Surface Antigens ,MESH: Humans ,Hepatology ,business.industry ,MESH: Liver Neoplasms / epidemiology ,MESH: Hepatitis B, Chronic / transmission ,Case-control study ,Infant ,MESH: Adult ,Odds ratio ,infectious disease transmission ,medicine.disease ,Infectious Disease Transmission, Vertical ,digestive system diseases ,MESH: Male ,Logistic Models ,Case-Control Studies ,Immunology ,Africa ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,MESH: Female - Abstract
International audience; Background & aims: Early age at infection with Hepatitis B virus (HBV) increases the risk of chronic infection. Moreover, early HBV infection may further independently increase the risk of hepatocellular carcinoma (HCC) beyond its effect on chronicity.Methods: The distribution of birth order, a proxy for mode and timing of HBV transmission, was compared in The Gambia between hepatitis B surface antigen (HBsAg)-positive HCC cases recruited from hospitals (n = 72) and two HBsAg-positive control groups without HCC: population-based controls from a community HBV screening (n = 392) and hospital-based controls (n = 63).Results: HCC risk decreased with increasing birth order in the population-based case-control analysis. Using first birth order as the reference, the odds ratios were 0.52 (95% CI: 0.20-1.36), 0.52 (0.17-1.56), 0.57 (0.16-2.05) and 0.14 (0.03-0.64) for second, third, fourth and greater than fourth birth order respectively (P = 0.01). A similar inverse association was observed in the hospital-based case-control comparison (P = 0.04).Conclusions: Compared to controls, HCC cases had earlier birth order, a proxy for young maternal age and maternal HBV viraemia at birth. This finding suggests that in chronic HBV carriers perinatal mother-to-infant transmission may increase HCC risk more than horizontal transmission. Providing HBV vaccine within 24 h of birth to interrupt perinatal transmission might reduce the incidence of HCC in The Gambia.
- Published
- 2015
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12. ORAL PERFORMANCE OF ÌRÈGÚN MUSIC IN YAGBALAND, KOGI STATE, NIGERIA: AN OVERVIEW
- Author
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Titus Olusegun Stephen and Management of the Federal College of Education, Okene, Centre for African Studies, SOAS, University of London, Dr. Daramola, M. Professor Femi Adedeji, management of Obafemi Awolowo University
- Subjects
Literature ,business.industry ,media_common.quotation_subject ,Iregun music, performance, Yagbaland, Chants and Songs ,Yoruba ,lcsh:A ,Musical ,Participant observation ,Chants and Songs ,Musicology, African Musicology ,The arts ,language.human_language ,Visual arts ,Iregun music ,Oríkì ,State (polity) ,Local government ,Yagbaland ,language ,Singing ,lcsh:General Works ,business ,Psychology ,performance ,media_common - Abstract
Performance is one of the major arts in most African countries. Among the Yoruba in Nigeria several genre of oral performance has been researched and documented. These include the ijala, iwi, oriki ekun iyawo, Iyere Ifa, iwure , among others. However, very little attention and studies have been committed to oral performance of Ìrègún chants and songs in Yagbaland. This paper, therefore, focuses on the evaluation of oral performance of Ìrègún chants and songs among Yagba people in Kogi State, located in North central of Nigeria. Primary data were collected through 3 In-depth and 3 Key Informant interviews of leaders and members of Ìrègún musical groups. In addition to 3 Participant Observation and 3 Non-Participant Observation methods from Yagba-West, Yagba-East and Mopamuro Local Government Areas of Kogi State, music recordings, photographs of Ìrègún performances, and 6 chants were purposefully sampled. Secondary data were collected through library, archival and Internet sources. Although closely interwoven, Ìrègún performance is structured into preparation, actual and post-performance activities. While chanting, singing, playing of musical instruments and dancing forms the performance dimensions. Iregun music serves as veritable mirror and cultural preserver in Yagba communities. ORAL PERFORMANCE OF ÌRÈGÚN MUSIC IN YAGBALAND, KOGI STATE, NIGERIA: AN OVERVIEW
- Published
- 2015
- Full Text
- View/download PDF
13. Evidence-Based Review of Randomized Controlled Trials of Interventions for the Management of Behavioral Issues in Individuals With Moderate to Severe Traumatic Brain Injury.
- Author
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MacKenzie HM, Flores-Sandoval C, Bateman EA, McIntyre A, Barua U, Mehta S, Bayley M, and Teasell R
- Subjects
- Humans, Brain Injuries, Traumatic therapy, Randomized Controlled Trials as Topic
- Abstract
Objective: To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for the management of behavioral issues post moderate to severe traumatic brain injury (MSTBI), as part of an extensive database that has been conceptualized as a living systematic review., Methods: Systematic searches were conducted in MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO, up to and including December 2022, for articles published in the English language, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of RCT was assessed using the Physiotherapy Evidence Database (PEDro) scale, and level of evidence was assigned using a modified Sackett scale., Results: Forty-six RCTs examining interventions and outcome measures related to behavioral issues post-MSTBI were included. These studies collectively enrolled 3,267 participants. The majority of RCTs were conducted in the United States (n = 27; 58.7%) and 28 (60.9%) were conducted after 2010. Of these, 27 RCTs examined non-pharmacological interventions and 19 examined pharmacological interventions. Effective pharmacological treatments included amantadine and dexmedetomidine. Effective non-pharmacological interventions included sensory stimulation in the acute phase, anger self-management programs, peer mentoring, problem-solving, and emotional regulation. Psychotherapy showed conflicting evidence., Conclusion: This evidence-based review provides a comprehensive overview of the research landscape of RCTs addressing behavior post-MSTBI. The findings from these RCTs may be valuable for health care professionals, researchers, and policymakers involved in the field of TBI and behavior., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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14. Psychosocial and Support Needs of the Main Caregiver for Adolescents and Young Adults Undergoing Treatment for Cancer.
- Author
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Pettitt NJ, Petrella AR, Neilson S, Topping A, and Taylor RM
- Abstract
Background: Family relationships and social networks are critically important to adolescents and young adults (AYAs) with cancer, impacting their experience and well-being throughout the cancer trajectory. A cancer diagnosis impacts the development of independence and an adult identity, which can present challenges to psychosocial well-being needs and relationships between caregivers and AYAs., Objective: The aim of this study was to explore the psychosocial and support needs of the main caregivers of AYAs., Methods: This is a secondary analysis of the BRIGHTLIGHT caregiver survey, exploring items pertaining to support offered/engaged with, appraisal of helpfulness, and caregivers' emotional and psychological distress experience. Descriptive statistics, a correlational analysis, and a 1-way analysis of variance were conducted., Results: There were 518 caregiver responses (62%). Over half received information about their caregiving needs, with the majority finding this very/fairly helpful. Most (80%) of those who had not received the information would have valued it. High levels of negative emotional and psychological well-being were reported, with 91% feeling depressed or anxious since the AYAs' diagnosis and 41% always/often experiencing these feelings. Total distress was associated with being younger, a parent, female, and unemployed, and earning a below-average income., Conclusions: The needs of caregivers are broad and multidimensional; however, some characteristics were associated with higher distress. When caregiver-specific information was provided by healthcare professionals, it was well received., Implications for Practice: Healthcare professionals should consider caregivers' needs individually and provide/signpost to support. Caregivers need to be involved in designing and implementing future research, given the heterogeneity of needs identified., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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15. Help-seeking for Intimate Partner Violence and Abuse: Experiences of Serving and Ex-serving UK Military Personnel.
- Author
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Lane R, Alves-Costa F, Gribble R, Taylor A, Howard LM, Fear NT, and MacManus D
- Abstract
Purpose: Intimate Partner Violence and Abuse (IPVA) is as a major health concern globally. The prevalence of IPVA perpetration and victimisation has been found to be higher in military compared to civilian populations. Of concern, help-seeking for other psychosocial difficulties among military communities has been shown to be both limited and challenging, and military personnel could face additional or amplified barriers to help-seeking for IPVA than their civilian counterparts. This study aimed to use qualitative methods to explore the experiences of, and barriers to, help-seeking for IPVA victimisation and perpetration among UK military personnel., Methods: Thematic analysis was conducted on 40 one-to-one semi-structured interviews with military personnel (29 male, 11 female)., Results: Four superordinate themes were derived, thematically organised according to different levels of the social ecological model: Military cultural factors; Support service factors; Interpersonal factors ; and Individual factors. At a military cultural level, participants described difficulties in help-seeking for IPVA resulting from widespread stigma and hypermasculine attitudes in military communities, minimisation of violence, perceived pressure from chain of command, and fear of consequences of reporting. At a support-service level, participants' negative views or experiences and lack of awareness of services were also significant in deterring help-seeking. At an interpersonal level, participants recounted how relationships with military colleagues, their partner and their family could be both instrumental or a hindrance to help-seeking for IPVA. At an individual level, lack of insight into IPVA and different forms of abuse were suggested through minimisation of violence and described to contribute to delay in help-seeking. Shame, compounded by multi-layered stigma present at each social ecological model level, was a key reason for delaying or avoiding help-seeking., Conclusions: The findings indicate the added challenges in help-seeking for IPVA experienced by military personnel and highlight a need for a whole systems approach to improve the provision of support for IPVA in the military serving and ex-serving community to instil meaningful change., Competing Interests: Conflicts of InterestNo conflicts of interest to declare., (© The Author(s) 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
- Published
- 2023
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16. Deep Intronic FGF14 GAA Repeat Expansion in Late-Onset Cerebellar Ataxia.
- Author
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Pellerin D, Danzi MC, Wilke C, Renaud M, Fazal S, Dicaire MJ, Scriba CK, Ashton C, Yanick C, Beijer D, Rebelo A, Rocca C, Jaunmuktane Z, Sonnen JA, Larivière R, Genís D, Molina Porcel L, Choquet K, Sakalla R, Provost S, Robertson R, Allard-Chamard X, Tétreault M, Reiling SJ, Nagy S, Nishadham V, Purushottam M, Vengalil S, Bardhan M, Nalini A, Chen Z, Mathieu J, Massie R, Chalk CH, Lafontaine AL, Evoy F, Rioux MF, Ragoussis J, Boycott KM, Dubé MP, Duquette A, Houlden H, Ravenscroft G, Laing NG, Lamont PJ, Saporta MA, Schüle R, Schöls L, La Piana R, Synofzik M, Zuchner S, and Brais B
- Subjects
- Humans, Australia, Canada, Friedreich Ataxia genetics, Friedreich Ataxia pathology, Cerebellar Ataxia genetics, Cerebellar Ataxia pathology, Introns genetics, DNA Repeat Expansion genetics
- Abstract
Background: The late-onset cerebellar ataxias (LOCAs) have largely resisted molecular diagnosis., Methods: We sequenced the genomes of six persons with autosomal dominant LOCA who were members of three French Canadian families and identified a candidate pathogenic repeat expansion. We then tested for association between the repeat expansion and disease in two independent case-control series - one French Canadian (66 patients and 209 controls) and the other German (228 patients and 199 controls). We also genotyped the repeat in 20 Australian and 31 Indian index patients. We assayed gene and protein expression in two postmortem cerebellum specimens and two induced pluripotent stem-cell (iPSC)-derived motor-neuron cell lines., Results: In the six French Canadian patients, we identified a GAA repeat expansion deep in the first intron of FGF14 , which encodes fibroblast growth factor 14. Cosegregation of the repeat expansion with disease in the families supported a pathogenic threshold of at least 250 GAA repeats ([GAA]
≥250 ). There was significant association between FGF14 (GAA)≥250 expansions and LOCA in the French Canadian series (odds ratio, 105.60; 95% confidence interval [CI], 31.09 to 334.20; P<0.001) and in the German series (odds ratio, 8.76; 95% CI, 3.45 to 20.84; P<0.001). The repeat expansion was present in 61%, 18%, 15%, and 10% of French Canadian, German, Australian, and Indian index patients, respectively. In total, we identified 128 patients with LOCA who carried an FGF14 (GAA)≥250 expansion. Postmortem cerebellum specimens and iPSC-derived motor neurons from patients showed reduced expression of FGF14 RNA and protein., Conclusions: A dominantly inherited deep intronic GAA repeat expansion in FGF14 was found to be associated with LOCA. (Funded by Fondation Groupe Monaco and others.)., (Copyright © 2022 Massachusetts Medical Society.)- Published
- 2023
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17. Intimate Partner Violence and Abuse: A Qualitative Exploration of UK Military Personnel and Civilian Partner Experiences.
- Author
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Lane R, Gribble R, Alves-Costa F, Taylor A, Howard LM, Fear NT, and MacManus D
- Abstract
Purpose: The prevalence of Intimate Partner Violence and Abuse (IPVA) perpetration and victimisation has been found to be higher in serving and ex-serving military samples compared to civilians. Despite this, there is a lack of qualitative research exploring the IPVA experiences of couples in which one or both partners are serving or have served in the military. This qualitative study aimed to explore IPVA experiences within the UK military community from the perspective of serving and ex-serving military personnel and civilian partners of UK military personnel., Method: One-to-one telephone interviews were conducted with 40 serving and ex-serving military personnel (29 male, 11 female) and 25 female civilian partners. Data was analysed using thematic analysis., Results: Four superordinate themes were derived: (1) patterns and directions of IPVA, (2) types of IPVA, (3) perceived drivers of IPVA and (4) perceived impact of IPVA. The findings point to frequent bidirectional abuse in part driven by poor communication and emotion regulation, whilst also highlighting the experiences of severe IPVA victimisation of civilian partners by military personnel motivated by power and control. Perceived drivers of both IPVA perpetration and victimisation include military factors borne of military culture or training, alcohol and mental health difficulties., Conclusion: These results highlight the role of cultural norms, as well as the role of emotion dysregulation, poor communication skills and mental health difficulties in explaining and perpetuating abuse within ecological theoretical frameworks of violence among couples within which one or both partners are serving or ex-serving military personnel., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© The Author(s) 2022.)
- Published
- 2022
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18. Relationship conflict and partner violence by UK military personnel following return from deployment in Iraq and Afghanistan.
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Lane R, Short R, Jones M, Hull L, Howard LM, Fear NT, and MacManus D
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- Afghanistan, Child, Cohort Studies, Female, Humans, Iraq, Iraq War, 2003-2011, Male, Risk Factors, Violence psychology, Alcoholism epidemiology, Intimate Partner Violence, Military Personnel psychology
- Abstract
Purpose: Risk of violence by UK military personnel, both towards non-family and family, has been found to be higher post-deployment. However, no UK research to date has attempted to examine relationship conflict and intimate partner violence (IPV) in this period. This study estimated the prevalence of and risk factors for post-deployment relationship conflict and partner violence in UK military personnel., Methods: We utilised data on military personnel who had deployed to Iraq and/or Afghanistan (n = 5437), drawn from a large cohort study into the health and well-being of UK military personnel., Results: 34.7% reported relationship conflict (arguing with partner) and 3.4% reported perpetrating physical IPV post-deployment. Males were more likely than females to report relationship conflict. There were similar rates of self-reported physical IPV perpetration among males and females. Among our male sample, factors associated with both relationship conflict and physical IPV perpetration post-deployment included being in the Army compared with the Royal Air Force, higher levels of childhood adversity, higher levels of military trauma exposure and recent mental health and alcohol misuse problems. Being over 40 at time of deployment (vs being under 25) and having deployed in a combat role were also associated with relationship conflict, but not physical IPV perpetration., Conclusions: Deployment-related variables and mental health and alcohol misuse problems were found to be key factors associated with post-deployment relationship conflict and IPV. Services providing health or welfare support to military personnel must collaborate with mental health services and consider history of deployment, and particularly deployment-related trauma, in their assessments to improve identification and management of intimate partner violence and abuse in military communities., (© 2022. The Author(s).)
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- 2022
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19. Neuromodulation Using Computer-Altered Music to Treat a Ten-Year-Old Child Unresponsive to Standard Interventions for Functional Neurological Disorder.
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Rajabalee N, Kozlowska K, Lee SY, Savage B, Hawkes C, Siciliano D, Porges SW, Pick S, and Torbey S
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- Child, Computers, Humans, Conversion Disorder, Music
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- 2022
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20. Intimate partner violence and abuse experience and perpetration in UK military personnel compared to a general population cohort: A cross-sectional study.
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MacManus D, Short R, Lane R, Jones M, Hull L, Howard LM, and Fear NT
- Abstract
Background: Research exploring prevalence of, and factors associated with, increased risk of experiencing or perpetrating Intimate Partner Violence and Abuse (IPVA) in military communities is limited. This study aimed to describe IPVA prevalence in a military sample, explore the role of military-specific risk factors, and draw comparisons with a general population cohort., Methods: We utilised data from a sample of military personnel participating in a cohort study of the health and wellbeing of UK military personnel who reported having an intimate relationship in the previous 12 months ( n = 5557). To allow for comparison with civilian populations, participants from a general population cohort study in England ( n = 6075) were matched on age and sex to the military cohort ( n = 8093)., Findings: The 12-month prevalences of IPVA experience and perpetration in the military sample were 12.80% (95% CI 11.72-13.96%) and 9.40% (8.45-10.45%), respectively. Factors associated with both increased IPVA experience and perpetration included childhood adversity, relationship dissatisfaction, military trauma, and recent mental health and alcohol misuse problems. Compared to the civilian cohort, adjusted odds (95% CI) of IPVA experience and perpetration were higher in the military: 2.94 (2.15-4.01) and 3.41 (1.79-6.50), respectively., Interpretation: This study found higher prevalences of IPVA experience and perpetration in the military compared to the general population cohort and highlighted both non-military and military factors associated with increased risk of both. Relationship dissatisfaction, military trauma and mental health difficulties mark key areas for IPVA prevention and management efforts to target., Funding: Funded by the UK Ministry of Defence and National Institute of Health Research., Competing Interests: DM was funded by a research fellowship from the National Institute of Health Research. NF, MJ and LH were funded by the UK Ministry of Defence for the duration of the study reported in this manuscript. NF is a specialist academic member of the independent group advising NHS Digital on the release of patient data. LMH is part funded by the UK Research and Innovation Violence, Abuse and Mental Health Network., (© 2022 Published by Elsevier Ltd.)
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- 2022
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21. Fertility and Pregnancy Outcomes after Robotic-assisted Laparoscopic Myomectomy in a Canadian Cohort.
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Hur C and Falcone T
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- Canada, Female, Fertility, Humans, Pregnancy, Pregnancy Outcome, Laparoscopy, Robotic Surgical Procedures adverse effects, Uterine Myomectomy adverse effects, Uterine Neoplasms surgery
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- 2022
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22. What Are Work-Related Predictors of Post-COVID-19 Home and Family Work Roles? A Cross-Sectional Survey.
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Dabbagh A, Seens H, Fraser J, and MacDermid JC
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- Cross-Sectional Studies, Employment, Humans, SARS-CoV-2, Surveys and Questionnaires, COVID-19
- Abstract
Objective: To determine the extent to which pre-and post-COVID-19 work-related factors can explain post-COVID-19 home and family work roles., Methods: This study was a cross-sectional survey. The primary outcome measure was the Home and Family Work Roles Questionnaire. Descriptive statistical methods and multiple regression analyses were run. The significant predictors were further probed in a one-way analysis of covariance (ANCOVA) model with a Tukey posthoc correction., Results: In our sample of 1447 participants, the two significant predictors of post-COVID-19 home and family work roles were pre-pandemic paid job status (F [3, 1401] = 5.66, P < 0.001), and pre-COVID-19 home and family work roles (F [1, 1401] = 2509.26, P < 0.001)., Conclusion: Greater pre-pandemic home and family role responsibilities, full-time and part-time employment pre-COVID-19 were associated with greater post-COVID-19 home and family responsibilities., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)
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- 2022
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23. Could Anti-inflammatory Interventions Earlier in Development Confer Primary Prevention of Psychiatric Disorders?
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Malys MK and Mondelli V
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- Anti-Inflammatory Agents, Humans, Primary Prevention, Mental Disorders prevention & control
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- 2022
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24. Rosacea and Diet: What is New in 2021?
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Searle T, Ali FR, Carolides S, and Al-Niaimi F
- Abstract
Objective: Rosacea is a common inflammatory cutaneous condition with a complex yet unknown etiopathogenesis. Diet and certain food items are known to trigger or worsen rosacea symptoms, but conflicting and often inconsistent advice is given to patients regarding this link. We provide an up-to-date literature review on the relationship between rosacea and diet., Methods: Using the keywords "alcohol," "diet," "flushing," "food," "inflammation," "rosacea," "skin-gut axis" and "spice" we systemically searched the databases PubMed, MEDLINE and EMBASE for English-language articles in July 2020., Results: The most frequently reported triggers implicated in rosacea include alcohol, spicy food, cinnamaldehyde-containing foods (e.g., tomatoes, citrus fruits, chocolate), hot drinks, and histamine-rich foods (e.g., aged cheese, wine, processed meats). Some food items appear to play a protective role, such as omega-3, which appears to protect against ocular rosacea. The relationship between certain food items and the subtype of rosacea is varied, with inconsistent results shown in the few studies that examined this. As an example, alcohol worsens flushing and fatty food triggers both erythematotelangiectatatic and phymatous rosacea in susceptible individuals., Conclusion: While several food types appear to be associated with exacerbation of rosacea, there are no recommendations that can be applied to all patients. Further studies are needed to examine the exact link between diet and rosacea subtypes., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2021. Matrix Medical Communications. All rights reserved.)
- Published
- 2021
25. The Role of Facets of Job Satisfaction in the National and Socioeconomic Differences in Overall Job Satisfaction: A Comparison Between Studies of Civil Servants in Great Britain and Japan.
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Tatsuse T, Sekine M, Yamada M, Cable N, Chandola T, and Marmot MG
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- Humans, Japan, Socioeconomic Factors, Surveys and Questionnaires, United Kingdom, Job Satisfaction
- Abstract
Objective: To explore national and socioeconomic differences in overall job satisfaction, we examined whether those differences can be explained by what job-related factors., Methods: Our datasets for this study are from the Whitehall II study and the Japan Civil Servant Study. Of the participants who were 5540 cases, with 3250 people from Great Britain and 2290 from Japan., Results: The odds ratio for job dissatisfaction was more than double in Japan compared with Britain. However, after adjusting the related factors-especially the facets of job satisfaction variables-the difference was reversed. Also, regarding the occupational differences, lower occupational grades had lower risks of overall job dissatisfaction, after adjusting for related factors., Conclusions: The national and socioeconomic differences in overall job satisfaction were strongly related to facets of job satisfaction rather than job stress factors., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 American College of Occupational and Environmental Medicine.)
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- 2021
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26. The BRIGHTLIGHT National Survey of the Impact of Specialist Teenage and Young Adult Cancer Care on Caregivers' Information and Support Needs.
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Martins A, Alvarez-Galvez J, Fern LA, Vindrola-Padros C, Barber JA, Gibson F, Whelan JS, and Taylor RM
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- Adaptation, Psychological, Adolescent, Adult, Cohort Studies, Cost of Illness, England, Humans, Male, Middle Aged, Needs Assessment, Neoplasms rehabilitation, Surveys and Questionnaires, Young Adult, Caregivers psychology, Health Services Needs and Demand statistics & numerical data, Neoplasms psychology, Quality of Life psychology
- Abstract
Background: Teenage and young adult cancer services in England are centralized in 13 principal treatment centers (TYA-PTC). These "specialist services" are designed to support caregivers as well as young people., Objectives: To evaluate whether caregivers of young people with cancer had fewer unmet information and support needs if they had all/some care in a TYA-PTC., Methods: Participants in a cohort study of young people with cancer nominated their main carer to complete the BRIGHTLIGHT Carer Questionnaire, completed 6 months after diagnosis. Comparisons were made according to where young people's care was delivered: all, some, or no care in a TYA-PTC. Principal components analysis reduced the questionnaire to 5 dimensions, which were used as dependent variables in subsequent regression analysis., Results: Four hundred seventy-six responses of 514 returned questionnaires (92%) were included in the analysis. The majority of caregivers were white, middle-aged, married/cohabiting mothers. Adjusted analysis indicated caregivers who had all/some care in a TYA-PTC had more satisfaction with support and also with services specifically provided for carers. Those who had some TYA-PTC care had greater satisfaction with information but less opportunity to be involved in decisions., Conclusions: Caregivers of young people who had no TYA-PTC care have the most unmet information and support needs., Implications for Practice: Nurses outside of the TYA-PTC need to be supported by the TYA-PTC in providing information/support for caregivers. When a young person is receiving care in multiple hospitals, nurses need to optimize opportunities for caregivers to be involved in decision making., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2021
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27. Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis.
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Salazar de Pablo G, De Micheli A, Solmi M, Oliver D, Catalan A, Verdino V, Di Maggio L, Bonoldi I, Radua J, Baccaredda Boy O, Provenzani U, Ruzzi F, Calorio F, Nosari G, Di Marco B, Famularo I, Montealegre I, Signorini L, Molteni S, Filosi E, Mensi M, Balottin U, Politi P, Shin JI, Correll CU, Arango C, and Fusar-Poli P
- Subjects
- Adolescent, Anxiety, Anxiety Disorders, Humans, Outcome Assessment, Health Care, Psychotherapy, Stress Disorders, Post-Traumatic
- Abstract
Background: Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention)., Methods: We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number., Results: 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features., Conclusion: Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes., (Copyright © 2021 President and Fellows of Harvard College.)
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- 2021
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28. Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial.
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Zhou Q, Shi X, Saravelos S, Huang X, Zhao Y, Huang R, Xia E, and Li TC
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- Adult, China, Cross-Linking Reagents chemistry, Cross-Linking Reagents therapeutic use, Dissection, Double-Blind Method, Female, Gynatresia drug therapy, Gynatresia surgery, Humans, Hyaluronic Acid chemistry, Hydrogels chemistry, Hydrogels therapeutic use, Polysaccharides chemistry, Postoperative Complications prevention & control, Pregnancy, Recurrence, Tissue Adhesions surgery, Uterine Diseases surgery, Hyaluronic Acid therapeutic use, Hysteroscopy adverse effects, Hysteroscopy methods, Polysaccharides therapeutic use, Tissue Adhesions prevention & control, Uterine Diseases drug therapy
- Abstract
Study Objective: To investigate auto-cross-linked hyaluronic acid gel for the prevention of intrauterine adhesion (IUA) recurrence after hysteroscopic adhesiolysis., Design: A single-center, double-blinded randomized controlled trial., Setting: A tertiary university hospital., Patients: Two hundred seventy-two patients with moderate-to-severe (American Fertility Society [AFS] score ≥5) IUAs underwent hysteroscopic adhesiolysis., Interventions: The patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel after surgery (treatment group) or standard care only (control group). All patients had second-look hysteroscopy at 4 weeks and hormonal therapy for 2 cycles after surgery., Measurements and Main Results: Two hundred sixty patients were eligible and randomized; 245 patients successfully completed the study (n = 122 in treatment group, and n = 123 in control group). The primary outcome measure was IUA recurrence at second-look hysteroscopy. The secondary outcome measures included an improvement in the AFS score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median AFS score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in the menstrual pattern at 3-month follow-up (87.7% vs 76.4%), in the treatment and control groups, respectively., Conclusion: The application of auto-cross-linked hyaluronic acid gel did not seem to improve IUA recurrence after hysteroscopic adhesiolysis., (Copyright © 2020 AAGL. Published by Elsevier Inc. All rights reserved.)
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- 2021
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29. Sleep Quality Among Teenagers and Young Adults With Cancer.
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Fortmann J, Fisher A, Hough R, Gregory A, and Pugh G
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- Adolescent, Cancer Survivors statistics & numerical data, Cross-Sectional Studies, Female, Humans, Male, United Kingdom epidemiology, Young Adult, Cancer Survivors psychology, Neoplasms therapy, Sleep, Sleep Wake Disorders epidemiology
- Abstract
Background: Teenagers and young adults (TYAs) with cancer are known to suffer poor sleep quality and sleep disturbances; understanding the level of burden is essential to improving patient outcomes via supportive care interventions., Objectives: To compare sleep quality and the prevalence of sleep disturbances among TYA cancer patients, TYA survivors, and general population TYAs with no history of cancer., Methods: Teenager and young adult patients receiving active cancer treatment (n = 70), TYA cancer survivors (n = 151), and general population TYAs (n = 324) aged between 13 and 24 years completed the Pittsburgh Sleep Quality Index. Analyses of covariance were used to investigate potential group differences. Age at survey diagnosis, gender, ethnicity, and health status were included as covariates., Results: 84.29% of TYA patients, 62.91% of TYA cancer survivors, and 65.12% of general population TYAs reported Pittsburgh Sleep Quality Index scores greater than 5, suggesting clinically significant sleep disorders. Teenager and young adult patients reported significantly poorer global sleep quality compared with TYA survivors (mean difference, 0.99; 95% confidence interval, 0.03-1.96; P = .044) and general population TYAs (mean difference, 1.34; 95% confidence interval, 0.26-2.41; P = .009). Teenager and young adult patients and survivors reported significantly poorer sleep latency (P = .003 for TYA patients, P = .035 for TYA survivors off treatment) and habitual sleep efficiency (P < .001 for TYA patients, P = .014 for TYA survivors) than general population controls., Conclusions: The significant differences observed suggest young people with cancer, particularly those on treatment, may benefit from specialized sleep interventions., Implications for Practice: Efforts to ensure health professionals have the knowledge and skills to provide advice about sleep to young people with cancer are needed.
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- 2021
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30. Impact of Increasing Comorbidity Burden on Resource Utilization in Patients With Proximal Humerus Fractures.
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London DA, Cagle PJ, Parsons BO, Galatz LM, Anthony SG, Zubizarreta N, Mazumdar M, and Poeran J
- Subjects
- Aged, Arthroplasty, Replacement, Shoulder economics, Cohort Studies, Comorbidity, Conservative Treatment economics, Costs and Cost Analysis, Female, Fracture Fixation, Internal economics, Hemiarthroplasty economics, Hospitalization economics, Humans, Male, Open Fracture Reduction economics, Shoulder Fractures epidemiology, Cost of Illness, Drug Utilization economics, Drug Utilization statistics & numerical data, Patient Acceptance of Health Care statistics & numerical data, Shoulder Fractures economics, Shoulder Fractures surgery
- Abstract
Introduction: Proximal humerus fractures (PHF) are a common upper extremity fracture in the elderly cohort. An aging and more comorbid cohort, along with recent trends of increased operative intervention, suggests that there could be an increase in resource utilization caring for these patients. We sought to quantify these trends and quantify the impact that comorbidity burden has on resource utilization., Methods: Data on 83,975 patients with PHFs were included from the Premier Healthcare Claims database (2006 to 2016) and stratified by Deyo-Charlson index. Multivariable models assessed associations between Deyo-Charlson comorbidities and resource utilization (length and cost of hospitalization, and opioid utilization in oral morphine equivalents [OME]) for five treatment modalities: (1) open reduction internal fixation (ORIF), (2) closed reduction internal fixation (CRIF), (3) hemiarthroplasty, (4) reverse total shoulder arthroplasty, and (5) nonsurgical treatment (NST). We report a percentage change in resource utilization associated with an increasing comorbidity burden., Results: Overall distribution of treatment modalities was (proportion in percent/median length of stay/cost/opioid utilization): ORIF (19.1%/2 days/$11,183/210 OME), CRIF (1.1%/4 days/$11,139/220 OME), hemiarthroplasty (10.7%/3 days/$17,255/275 OME), reverse total shoulder arthroplasty (6.4%/3 days/$21,486/230 OME), and NST (62.7%/0 days/$1,269/30 OME). Patients with an increased comorbidity burden showed a pattern of (1) more pronounced relative increases in length of stay among those treated operatively (65.0% for patients with a Deyo-Charlson index >2), whereas (2) increases in cost of hospitalization (60.1%) and opioid utilization (37.0%) were more pronounced in the NST group., Discussion: In patients with PHFs, increased comorbidity burden coincides with substantial increases in resource utilization in patients receiving surgical and NSTs. Combined with known increases in operative intervention, trends in increased comorbidity burden may have profound effects on the cohort level and resource utilization for those with PHFs, especially because the use of bundled payment strategies for fractures increases., Level of Evidence: Level III.
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- 2020
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31. Preschool respiratory hospital admissions following infant bronchiolitis: a birth cohort study.
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Skirrow H, Wincott T, Cecil E, Bottle A, Costelloe C, and Saxena S
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- Bronchiolitis diagnosis, Child Health Services, Child, Preschool, Cohort Studies, Databases, Factual, England epidemiology, Female, Humans, Infant, Infant, Newborn, Male, Retrospective Studies, Risk Factors, State Medicine, Bronchiolitis epidemiology, Hospitalization
- Abstract
Background: Bronchiolitis causes significant infant morbidity worldwide from hospital admissions. However, studies quantifying the subsequent respiratory burden in children under 5 years are lacking., Objective: To estimate the risk of subsequent respiratory hospital admissions in children under 5 years in England following bronchiolitis admission in infancy., Design: Retrospective population-based birth cohort study., Setting: Public hospitals in England., Patients: We constructed a birth cohort of 613 377 infants born between 1 April 2007 and 31 March 2008, followed up until aged 5 years by linking Hospital Episode Statistics admissions data., Methods: We compared the risk of respiratory hospital admission due to asthma, wheezing and lower and upper respiratory tract infections (LRTI and URTI) in infants who had been admitted for bronchiolitis with those who had not, using Cox proportional hazard regression. We adjusted hazard ratios (HR) for known respiratory illness risk factors including living in deprived households, being born preterm or with a comorbid condition., Results: We identified 16 288/613 377 infants (2.7%) with at least one admission for bronchiolitis. Of these, 21.7% had a further respiratory hospital admission by age 5 years compared with 8% without a previous bronchiolitis admission (HR (adjusted) 2.82, 95% CI 2.72 to 2.92). The association was greatest for asthma (HR (adjusted) 4.35, 95% CI 4.00 to 4.73) and wheezing admissions (HR (adjusted) 5.02, 95% CI 4.64 to 5.44), but were also significant for URTI and LRTI admissions., Conclusions: Hospital admission for bronchiolitis in infancy is associated with a threefold to fivefold risk of subsequent respiratory hospital admissions from asthma, wheezing and respiratory infections. One in five infants with bronchiolitis hospital admissions will have a subsequent respiratory hospital admission by age 5 years., Competing Interests: Competing interests: HS reports personal fees from StGilesMedical, outside the submitted work; TW and EC have nothing to disclose. AB reports grants from Dr Foster, grants from Medtronic, outside the submitted work; CC has nothing to disclose. SS reports grants from NIHR career development fellowship, during the conduct of the study., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2019
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32. Mechanisms of Action and Outcomes for Students in Recovery Colleges.
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Toney R, Elton D, Munday E, Hamill K, Crowther A, Meddings S, Taylor A, Henderson C, Jennings H, Waring J, Pollock K, Bates P, and Slade M
- Subjects
- Humans, Interpersonal Relations, Mental Health Services, Outcome and Process Assessment, Health Care, Power, Psychological, Psychiatric Rehabilitation methods, Schizophrenia rehabilitation, Students, Universities
- Abstract
Objective: Recovery colleges are widespread, with little empirical research on how they work and the outcomes they produce. This study aimed to coproduce a change model characterizing mechanisms of action (how they work) and outcomes (their impact) for mental health service users who attend recovery colleges., Methods: A systematized review identified all publications about recovery colleges. Inductive collaborative data analysis of 10 key publications by academic researchers and coresearchers with lived experience informed a theoretical framework for mechanisms of action and student outcomes, which was refined through deductive analysis of 34 further publications. A change model was coproduced and refined through stakeholder interviews (N=33)., Results: Four mechanisms of action for recovery colleges were identified: empowering environment (safety, respect, and supporting choices), enabling different relationships (power, peers, and working together), facilitating personal growth (for example, coproduced learning, strengths, and celebrating success), and shifting the balance of power through coproduction and reducing power differentials. Outcomes were change in the student (for example, self-understanding and self-confidence) and changes in the student's life (for example, occupational, social, and service use). A coproduced change model mapping mechanisms of action to outcomes was created., Conclusions: Key features differentiate recovery colleges from traditional services, including an empowering environment, enabling relationships, and growth orientation. Service users who lack confidence, those with whom services struggle to engage, those who will benefit from exposure to peer role models, and those lacking social capital may benefit most. As the first testable characterization of mechanisms and outcomes, the change model allows formal evaluation of recovery colleges.
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- 2018
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33. Predicting Barriers to Treatment for Depression in a U.S. National Sample: A Cross-Sectional, Proof-of-Concept Study.
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Chekroud AM, Foster D, Zheutlin AB, Gerhard DM, Roy B, Koutsouleris N, Chandra A, Esposti MD, Subramanyan G, Gueorguieva R, Paulus M, and Krystal JH
- Subjects
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Depressive Disorder diagnosis, Female, Humans, Logistic Models, Male, Middle Aged, Primary Health Care, Proof of Concept Study, Psychotherapy, Sampling Studies, Self-Assessment, Surveys and Questionnaires, United States, Young Adult, Depressive Disorder therapy, Health Services Accessibility statistics & numerical data, Patient Acceptance of Health Care psychology, Treatment Refusal psychology
- Abstract
Objective: Even though safe and effective treatments for depression are available, many individuals with a diagnosis of depression do not obtain treatment. This study aimed to develop a tool to identify persons who might not initiate treatment among those who acknowledge a need., Methods: Data were aggregated from the 2008-2014 U.S. National Survey on Drug Use and Health (N=391,753), including 20,785 adults given a diagnosis of depression by a health care provider in the 12 months before the survey. Machine learning was applied to self-report survey items to develop strategies for identifying individuals who might not get needed treatment., Results: A derivation cohort aggregated between 2008 and 2013 was used to develop a model that identified the 30.6% of individuals with depression who reported needing but not getting treatment. When applied to independent responses from the 2014 cohort, the model identified 72% of those who did not initiate treatment (p<.01), with a balanced accuracy that was also significantly above chance (71%, p<.01). For individuals who did not get treatment, the model predicted 10 (out of 15) reasons that they endorsed as barriers to treatment, with balanced accuracies between 53% and 65% (p<.05 for all)., Conclusions: Considerable work is needed to improve follow-up and retention rates after the critical initial meeting in which a patient is given a diagnosis of depression. Routinely collected information about patients with depression could identify those at risk of not obtaining needed treatment, which may inform the development and implementation of interventions to reduce the prevalence of untreated depression.
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- 2018
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34. A Systematic, Thematic Review of Social and Occupational Factors Associated With Psychological Outcomes in Healthcare Employees During an Infectious Disease Outbreak.
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Brooks SK, Dunn R, Amlôt R, Rubin GJ, and Greenberg N
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- Health Personnel education, Humans, Occupational Health, Professional Role psychology, Psychological Distance, Quarantine psychology, Social Isolation, Social Support, Disease Outbreaks, Health Personnel psychology, Occupational Exposure, Severe Acute Respiratory Syndrome epidemiology, Severe Acute Respiratory Syndrome psychology, Workplace psychology
- Abstract
Objective: To conduct a systematic literature review to identify social and occupational factors affecting the psychological wellbeing of healthcare workers involved in the severe acute respiratory syndrome (SARS) crisis., Methods: Four literature databases were searched and data extracted from relevant papers., Results: Eighteen thousand five papers were found and 22 included in the review. The psychological impact of SARS on employees appeared to be associated with occupational role; training/preparedness; high-risk work environments; quarantine; role-related stressors; perceived risk; social support; social rejection/isolation; and impact of SARS on personal or professional life., Conclusions: To minimize the psychological impact of future outbreaks of infectious diseases, healthcare workers should be prepared for the potential psychological impact; employers should encourage a supportive environment in the workplace and ensure that support is in place for those most at risk, for example, those with the most patient contact.
- Published
- 2018
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35. A Scoring System for Assessing Learning Progression of Dental Students' Clinical Skills Using Haptic Virtual Workstations.
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Ria S, Cox MJ, Quinn BF, San Diego JP, Bakir A, and Woolford MJ
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- Dental Cavity Preparation standards, Education, Dental standards, Humans, User-Computer Interface, Clinical Competence standards, Educational Measurement methods, Students, Dental
- Abstract
The aim of this study was to develop and test a scoring system to assess the learning progression of novice dental students using haptic virtual workstations. For the study, 101 first-year dental students at a UK dental school conducted one practice task (task 1) and four simulated cavity removal tasks (tasks 2-5) of increasing difficulty over two laboratory sessions in 2015. Performance data on the students' attempts were recorded as haptic technology-enhanced learning (hapTEL) log-files showing the percentage of caries, healthy tissue, and pulp removed. On-screen results were photographed and submitted by the students to the tutors. A scoring system named the Accuracy of Caries Excavation (ACE) score was devised to score these results and achieve an even distribution of scores and a calculated combined score. A total of 127 individual logged attempts by 80% of the students over sessions 1 and 2 were recorded and submitted to the tutors. The mean ACE scores for both sessions for tasks 2 through 5 were 9.2, 11.6, 6.4, and 4.9, respectively; for Session 2 (tasks 3-5), scores were 12.4, 6.7, and 5.0, respectively (p<0.001). The average performance on task 3, which was attempted in similar numbers during both sessions, improved from the first to the second session (8.14 vs. 12.38; p=0.009). Using the HapTEL system in a first-year BDS curriculum improved the students' performance of simulated cavity preparation after practicing over two sessions. Use of the ACE scoring system enabled tutors to make consistent assessments across a large student cohort and provided an objective method of formative assessment.
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- 2018
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36. Positive Changes Experienced After a First Episode of Psychosis: A Systematic Review.
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Jordan G, MacDonald K, Pope MA, Schorr E, Malla AK, and Iyer SN
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- Humans, Early Medical Intervention statistics & numerical data, Mental Health Services statistics & numerical data, Posttraumatic Growth, Psychological, Psychotic Disorders epidemiology, Psychotic Disorders psychology, Psychotic Disorders rehabilitation
- Abstract
Objective: Although the negative consequences associated with first-episode psychosis (FEP) have been well investigated, relatively less is known about positive changes that people may experience after FEP. Existing literature is disparate and in need of synthesis. Such a synthesis can inform the design of mental health services that foster strengths, hope, and optimism. The objective of this study was to synthesize the literature on how positive change is experienced after FEP by affected persons and their families and friends and to delineate the individual, social, and structural factors facilitating positive change., Methods: A librarian-assisted systematic review of quantitative, qualitative, and mixed-methods studies published in English between 1970 and 2015 was conducted. Articles identified from three databases (PubMed, PsycINFO, and Embase) and through additional search strategies were screened. Results sections were open coded and analyzed by using thematic synthesis., Results: Of the 2,777 studies identified, 40 were retained. The synthesis of findings showed that after FEP, service users and their families and friends experienced positive changes at the individual (for example, more insight and clarity), interpersonal (for example, improved relationships), and spiritual levels (for example, greater religiosity). In addition to being facilitated by mental health services, these positive changes were enabled by personal (for example, motivation), social (for example, family support), and spiritual (for example, prayer) factors., Conclusions: Suffering is a core experience of FEP from which a range of positive changes can follow among service users and their families and friends. It may be beneficial for mental health services to specifically strive to promote these positive changes.
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- 2018
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37. Training the Frontline Workforce to Deliver Evidence-Based Therapy to People With Psychosis: Challenges in the GOALS Study.
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Garety PA, Craig TKJ, Iredale CH, Basit N, Fornells-Ambrojo M, Halkoree R, Jolley S, Landau S, McCrone P, Tunnard C, Zala D, and Waller H
- Subjects
- Adult, Cognitive Behavioral Therapy methods, Evidence-Based Practice methods, Feasibility Studies, Humans, Implementation Science, Cognitive Behavioral Therapy education, Community Mental Health Services methods, Evidence-Based Practice education, Health Personnel education, Inservice Training methods, Psychotic Disorders therapy
- Abstract
Improving access to psychotherapies in psychosis requires workforce expansion in resource-challenged systems. The GOALS feasibility randomized controlled trial assessed training and implementation of an evidence-based intervention by frontline workers, targeting recovery goals. Training uptake and therapy fidelity were good. Case managers with crisis management responsibilities were less likely than clinical assistants to deliver therapy. Participants receiving "sufficient therapy" achieved goals, but therapy was usually provided by clinical assistants. This is consistent with implementation science principles, that training must be combined with supportive organizational structures, such as by focusing on roles that already include therapy delivery or developing stronger organizational supports for case managers.
- Published
- 2018
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38. The upgoing thumb sign: An interobserver/intraobserver reliability study.
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Abootalebi S, Azarpazhooh MR, Sposato L, and Hachinski V
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Background: The upgoing thumb sign as a subtle clinical finding of upper motor neuron involvement has been frequently reported in patients with TIAs and minor strokes. This study was designed to show the method of examination and interpretation and the interobserver/intraobserver reliability., Methods: The thumb sign was elicited in TIA/minor strokes or stroke mimics. After obtaining the participant's permission, the examinations were recorded. Two independent neurologists reviewed all patients for the possibility of an upgoing thumb sign. After 1 hour education about the definition of an upgoing thumb sign to a group of stroke fellows, nurse practitioners, and a research secretary, the videos were reviewed and the participants rated the thumb sign independently. The intraobserver reliability was assessed after 3 months by rating the same videos., Results: The interobserver reliability among 9 raters showed an overall agreement of 0.83 and fixed-marginal kappa of 0.66. The same videos were reviewed by the observers after 3 months with a similar level of agreement (percent of overall agreement 0.84, fixed-marginal kappa 0.66) and a substantial to almost perfect level of intraobserver concordance (mean 0.86; SD 0.08; median 0.90; interquartile range 25-75, 0.8, 0.95)., Conclusions: The upgoing thumb sign is a subtle upper limb neurologic finding, with a high level of interobserver and intraobserver reliability. The test is easy to perform and can be interpreted accurately.
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- 2017
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39. Learning to Overcome Hierarchical Pressures to Achieve Safer Patient Care: An Interprofessional Simulation for Nursing, Medical, and Physician Assistant Students.
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Reeves SA, Denault D, Huntington JT, Ogrinc G, Southard DR, and Vebell R
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- Curriculum, Education, Medical organization & administration, Education, Nursing organization & administration, Humans, Learning, Nursing Education Research, Nursing Evaluation Research, Physician Assistants education, Students, Medical psychology, Students, Nursing psychology, Communication, Interprofessional Relations, Patient Safety, Patient Simulation, Students, Health Occupations psychology
- Abstract
To positively impact patient safety, the Institute of Medicine, as well as the Quality and Safety Education for Nurses initiative, has recommended clinician training in structured communication techniques. Such techniques are particularly useful in overcoming hierarchical barriers in health care settings. This article describes an interprofessional simulation program to teach structured communication techniques to preprofessional nursing, medical, and physician assistant students. The teaching and evaluation plans are described to aid replication.
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- 2017
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40. Hyperventilation-Induced Non-epileptic Seizures in an Adolescent Boy with Pediatric Medical Traumatic Stress.
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Chandra P, Kozlowska K, Cruz C, Baslet GC, Perez DL, and Garralda ME
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- Adolescent, Humans, Hyperventilation complications, Male, Seizures etiology, Conversion Disorder diagnosis, Hyperventilation diagnosis, Seizures diagnosis, Stress Disorders, Traumatic diagnosis
- Published
- 2017
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41. Carrots and Sticks on Opposite Sides of the Atlantic: Integration Incentives for People With Serious Mental Illness in England.
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Ramanuj PP, Breslau J, Strathdee G, Spaeth-Rublee B, and Pincus HA
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- England, Humans, United States, Delivery of Health Care, Integrated organization & administration, Mental Disorders therapy, Mental Health Services organization & administration
- Abstract
Integrating care pathways between primary and specialist mental health care is seen as integral to improving the health of people with mental illness. Multiple integration initiatives have been implemented, but few have tried to integrate care for people with serious mental illness. This column describes two such initiatives in the United States and in England. The two schemes are compared according to the population they target, payment mechanisms, accountability structures, service delivery, outcomes, and lessons learned.
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- 2017
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42. Developing and Implementing a Simulated Electronic Medication Administration Record for Undergraduate Nursing Education: Using Sociotechnical Systems Theory to Inform Practice and Curricula.
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Booth RG, Sinclair B, Brennan L, and Strudwick G
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- Education, Nursing, Baccalaureate, Humans, Nursing Informatics, Patient Safety, Students, Nursing, Curriculum, Medical Order Entry Systems, Medication Errors prevention & control, Simulation Training methods, Systems Theory
- Abstract
Knowledge and skills related to medication administration are a fundamental element of nursing education. With the increased use of electronic medication administration technology in practice settings where nurses work, nursing educators need to consider how best to implement these forms of technology into clinical simulation. This article describes the development of a simulated electronic medication administration system, including the use of sociotechnical systems theory to inform elements of the design, implementation, and testing of the system. Given the differences in the medication administration process and workflow generated by electronic medication administration technology, nursing educators should explore sociotechnical theory as a potentially informative lens from which to plan and build curricula related to simulation activities involving clinical technology.
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- 2017
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43. Schizophrenia on YouTube.
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Nour MM, Nour MH, Tsatalou OM, and Barrera A
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- Humans, Internet standards, Video Recording standards, Education, Medical, Internet statistics & numerical data, Psychotic Disorders physiopathology, Schizophrenia physiopathology, Video Recording statistics & numerical data
- Abstract
Objective: YouTube ( www.youtube.com ) is the most popular video-sharing Web site on the Internet and is used by medical students as a source of information regarding mental health conditions, including schizophrenia. The accuracy and educational utility of schizophrenia presentations on YouTube are unknown. The purpose of this study was to analyze the accuracy of depictions of psychosis in the context of a diagnosis of schizophrenia (referred to in this article as "acute schizophrenia") on YouTube and to assess the utility of these videos as educational tools for teaching medical students to recognize the clinical features of acute schizophrenia., Methods: YouTube was searched for videos purporting to show acute schizophrenia. Eligible videos were independently rated by two consultant psychiatrists on two separate occasions 22 days apart for diagnostic accuracy, psychopathology, and educational utility., Results: Videos (N=4,200) were assessed against predefined inclusion and exclusion criteria. The majority were not eligible for further analysis, mostly because they did not claim to show a patient with schizophrenia (74%) or contained duplicated content (11%). Of 35 videos that met the eligibility and adequacy criteria, only 12 accurately depicted acute schizophrenia. Accurate videos were characterized by persecutory delusions (83%), inappropriate affect (75%), and negative symptoms (83%). Despite the fact that 83% of accurate videos were deemed to have good educational utility compared with 15% of inaccurate videos, accurate and inaccurate videos had similar view counts (290,048 versus 186,124)., Conclusions: Schizophrenia presentations on YouTube offer a distorted picture of the condition.
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- 2017
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44. A Genome-Wide Association Meta-Analysis of Attention-Deficit/Hyperactivity Disorder Symptoms in Population-Based Pediatric Cohorts.
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Middeldorp CM, Hammerschlag AR, Ouwens KG, Groen-Blokhuis MM, Pourcain BS, Greven CU, Pappa I, Tiesler CMT, Ang W, Nolte IM, Vilor-Tejedor N, Bacelis J, Ebejer JL, Zhao H, Davies GE, Ehli EA, Evans DM, Fedko IO, Guxens M, Hottenga JJ, Hudziak JJ, Jugessur A, Kemp JP, Krapohl E, Martin NG, Murcia M, Myhre R, Ormel J, Ring SM, Standl M, Stergiakouli E, Stoltenberg C, Thiering E, Timpson NJ, Trzaskowski M, van der Most PJ, Wang C, Nyholt DR, Medland SE, Neale B, Jacobsson B, Sunyer J, Hartman CA, Whitehouse AJO, Pennell CE, Heinrich J, Plomin R, Smith GD, Tiemeier H, Posthuma D, and Boomsma DI
- Subjects
- Adolescent, Attention Deficit Disorder with Hyperactivity psychology, Case-Control Studies, Child, Cohort Studies, Female, Genetics, Population methods, Genome-Wide Association Study, Humans, Male, Attention Deficit Disorder with Hyperactivity genetics
- Abstract
Objective: The aims of this study were to elucidate the influence of common genetic variants on childhood attention-deficit/hyperactivity disorder (ADHD) symptoms, to identify genetic variants that explain its high heritability, and to investigate the genetic overlap of ADHD symptom scores with ADHD diagnosis., Method: Within the EArly Genetics and Lifecourse Epidemiology (EAGLE) consortium, genome-wide single nucleotide polymorphisms (SNPs) and ADHD symptom scores were available for 17,666 children (<13 years of age) from nine population-based cohorts. SNP-based heritability was estimated in data from the three largest cohorts. Meta-analysis based on genome-wide association (GWA) analyses with SNPs was followed by gene-based association tests, and the overlap in results with a meta-analysis in the Psychiatric Genomics Consortium (PGC) case-control ADHD study was investigated., Results: SNP-based heritability ranged from 5% to 34%, indicating that variation in common genetic variants influences ADHD symptom scores. The meta-analysis did not detect genome-wide significant SNPs, but three genes, lying close to each other with SNPs in high linkage disequilibrium (LD), showed a gene-wide significant association (p values between 1.46 × 10(-6) and 2.66 × 10(-6)). One gene, WASL, is involved in neuronal development. Both SNP- and gene-based analyses indicated overlap with the PGC meta-analysis results with the genetic correlation estimated at 0.96., Conclusion: The SNP-based heritability for ADHD symptom scores indicates a polygenic architecture, and genes involved in neurite outgrowth are possibly involved. Continuous and dichotomous measures of ADHD appear to assess a genetically common phenotype. A next step is to combine data from population-based and case-control cohorts in genetic association studies to increase sample size and to improve statistical power for identifying genetic variants., Competing Interests: Dr. Hudziak has received grant or research support from the National Institutes of Health, the National Institute of Mental Health, the National Institute of Diabetes and Digestive and Kidney Disease, and the state of Vermont. His primary appointment is with the University of Vermont. He has additional appointments with Erasmus University in Rotterdam, Netherlands, Washington University School of Medicine in St. Louis, Missouri, and the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. Drs. Middeldorp, Groen-Blokhuis, St Pourcain, Greven, Pappa, Tiesler, Nolte, Ebejer, Zhao, Davies, Ehli, Evans, Guxens, Hottenga, Jugessur, Kemp, Martin, Myhre, Ormel, Ring, Standl, Stergiakouli, Stoltenberg, Thiering, Timpson, Trzaskowski, van der Most, Nyholt, Medland, Neale, Jacobsson, Sunyer, Hartman, Whitehouse, Pennell, Heinrich, Plomin, Smith, Tiemeier, Posthuma, Boomsma, Ms. Hammerschlag, Mr. Ouwens, Mr. Ang, Ms. Vilor-Tejedor, Mr. Bacelis, Ms. Fedko, Ms. Krapohl, Mr. Murcia, and Ms. Wang report no biomedical financial interests or potential conflicts of interest., (Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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45. Mapping Adolescent Cancer Services: How Do Young People, Their Families, and Staff Describe Specialized Cancer Care in England?
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Vindrola-Padros C, Taylor RM, Lea S, Hooker L, Pearce S, Whelan J, and Gibson F
- Subjects
- Adolescent, England, Female, Humans, Male, Medical Oncology methods, Pediatrics methods, Pediatrics standards, Qualitative Research, Young Adult, Family psychology, Medical Oncology standards, Neoplasms therapy, Quality of Health Care standards, Survivors psychology
- Abstract
Background: Specialized cancer services for adolescents and young adults (AYAs) are being developed in a number of countries to address the particular needs of this population. However, the evidence base to inform service design and associated care delivery is inadequate., Objective: The aim of this study was to undertake a mapping study to identify the main components of AYA cancer care to be studied further to reflect the range of approaches to service delivery currently provided in England., Methods: Semistructured interviews were conducted with young people, their family members, and staff in 11 AYA principal treatment centers. Using different levels of extraction, these data were drawn together to illuminate the main components of AYA cancer care and the range of approaches to service delivery., Results: Young people, family members, and staff consistently identified and valued similar areas of AYA cancer care: caring and supportive staff, activities designed for AYAs, and an environment that feels like home., Conclusion: The mapping exercise successfully informed the selection of 4 sites for an in-depth case study. The main components of specialized AYA care have been described., Implications for Practice: This description can assist clinical teams interested in developing or refining their approach to AYA cancer care. It could also offer a way to agree priorities, based on the key components young people consider as being essential for their care, and facilitate services to benchmark against these key components, and it could also go some way to address international AYA goals to support global change to reduce the current disparities in care.
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- 2016
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46. Prison and Community Populations at Ultra-High Risk of Psychosis: Differences and Challenges for Service Provision.
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Jarrett M, Jamieson-Craig TK, Forrester A, McGuire P, Badger S, Fusar-Poli P, Byrne M, Williams P, and Valmaggia LR
- Subjects
- Adult, Humans, London epidemiology, Male, Mental Health Services, Psychotic Disorders diagnosis, Young Adult, Prisoners statistics & numerical data, Psychotic Disorders epidemiology, Residence Characteristics statistics & numerical data
- Abstract
Objective: The aim of the study was to explore the feasibility of expanding a community service for early detection of psychosis into a local London prison for men in the United Kingdom., Methods: All new receptions to a local prison for men in South London were approached for routine screening. Those who met criteria for being at ultra-high-risk of psychosis were compared with a help-seeking sample from the community who met the same criteria. Clinical and sociodemographic characteristics were compared to determine whether the prison and community populations had similar profiles and mental health needs., Results: Of 891 prisoners screened, 44 (5%) met criteria for being at ultra-high risk of psychosis. The community sample consisted of 42 participants. Compared with the community group, prison participants had lower scores on almost all symptom measures, were less likely to have remained in school and completed exams, and were more likely to be in short-term accommodations and to be of black race-ethnicity. Lifetime use of illicit drugs was similar between the groups, but recent use was much higher in the prison group., Conclusions: Expanding community services into custodial settings should take into account the different environment and needs of the prisoner population. Specifically, early detection and intervention services should target a broad range of mental health problems rather than psychosis alone.
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- 2016
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47. Emotional Impairment and Persistent Upregulation of mGlu5 Receptor following Morphine Abstinence: Implications of an mGlu5-MOPr Interaction.
- Author
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Zanos P, Georgiou P, Gonzalez LR, Hourani S, Chen Y, Kitchen I, Kieffer BL, Winsky-Sommerer R, and Bailey A
- Subjects
- Animals, Behavior, Animal drug effects, Brain metabolism, Male, Mice, Mice, Knockout, Morphine pharmacology, Up-Regulation drug effects, Emotions drug effects, Morphine adverse effects, Receptor, Metabotropic Glutamate 5 metabolism, Receptors, Opioid, mu genetics, Substance Withdrawal Syndrome metabolism
- Abstract
Background: A difficult problem in treating opioid addicts is the maintenance of a drug-free state because of the negative emotional symptoms associated with withdrawal, which may trigger relapse. Several lines of evidence suggest a role for the metabotropic glutamate receptor 5 in opioid addiction; however, its involvement during opioid withdrawal is not clear., Methods: Mice were treated with a 7-day escalating-dose morphine administration paradigm. Following withdrawal, the development of affective behaviors was assessed using the 3-chambered box, open-field, elevated plus-maze and forced-swim tests. Metabotropic glutamate receptor 5 autoradiographic binding was performed in mouse brains undergoing chronic morphine treatment and 7 days withdrawal. Moreover, since there is evidence showing direct effects of opioid drugs on the metabotropic glutamate receptor 5 system, the presence of an metabotropic glutamate receptor 5/μ-opioid receptor interaction was assessed by performing metabotropic glutamate receptor 5 autoradiographic binding in brains of mice lacking the μ-opioid receptor gene., Results: Withdrawal from chronic morphine administration induced anxiety-like, depressive-like, and impaired sociability behaviors concomitant with a marked upregulation of metabotropic glutamate receptor 5 binding. Administration of the metabotropic glutamate receptor 5 antagonist, 3-((2-Methyl-4-thiazolyl)ethynyl)pyridine, reversed morphine abstinence-induced depressive-like behaviors. A brain region-specific increase in metabotropic glutamate receptor 5 binding was observed in the nucleus accumbens shell, thalamus, hypothalamus, and amygdala of μ-opioid receptor knockout mice compared with controls., Conclusions: These results suggest an association between metabotropic glutamate receptor 5 alterations and the emergence of opioid withdrawal-related affective behaviors. This study supports metabotropic glutamate receptor 5 system as a target for the development of pharmacotherapies for the treatment of opioid addiction. Moreover, our data show direct effects of μ-opioid receptor system manipulation on metabotropic glutamate receptor 5 binding in the brain., (© The Author 2016. Published by Oxford University Press on behalf of CINP.)
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- 2016
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48. Healthcare Professionals' Knowledge of Family Psychosocial Problems in Pediatric Cancer: A Pilot Study.
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Barrera M, Rokeach A, Yogalingam P, Hancock K, Johnston DL, Cataudella D, Cassidy M, Punnett AS, and Shama W
- Subjects
- Adolescent, Child, Female, Humans, Male, Pediatrics methods, Pilot Projects, Psychometrics, Reproducibility of Results, Family psychology, Knowledge, Neoplasms psychology, Patient-Centered Care methods, Pediatrics standards
- Abstract
Background: Best practice guidelines for the treatment of cancer now advocate for a child- and family-centered model of care and a psychosocial model of risk prevention. However, healthcare professionals (HCPs) report a number of barriers preventing the implementation of psychosocial care, including an absence of tools to help identify psychosocial problems within the family., Objectives: The aims of this study are to (1) explore the psychometric properties of the Psychosocial Care Checklist (PCCL) and (2) test if the PCCL can differentiate the degree to which HCPs are aware of psychosocial problems within the family (patient, siblings, parents) of a child with cancer., Methods: Thirty-seven HCPs caring for a child with cancer completed the PCCL at time 1 (2-4 weeks after diagnosis) and 29 HCPs completed the PCCL at time 2 (2-3 weeks after)., Results: The PCCL had strong test-retest reliability for all domains (α > .60) and strong internal consistency for the total PCCL (α = .91). Interrater reliability was moderate for the oncologist-nurse dyad with regard to sibling knowledge (r = 0.56) and total psychosocial knowledge (r = 0.65). Social workers were significantly more knowledgeable than both nurses and oncologists about total family problems (P = .01) and sibling problems (P = .03)., Conclusions: Preliminary findings suggest that the PCCL has adequate test-retest reliability and validity and is useful in differentiating the degree to which HCPs are aware of psychosocial problems within the family, with social workers being the most knowledgeable., Implications for Practice: Using the PCCL may help HCPs to identify psychosocial problems within the family and appropriately allocate psychosocial resources.
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- 2016
- Full Text
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49. Development of a Core Curriculum Framework in Cariology for U.S. Dental Schools.
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Fontana M, Guzmán-Armstrong S, Schenkel AB, Allen KL, Featherstone J, Goolsby S, Kanjirath P, Kolker J, Martignon S, Pitts N, Schulte A, Slayton RL, Young D, and Wolff M
- Subjects
- Clinical Decision-Making, Dental Caries prevention & control, Education, Dental organization & administration, Humans, Risk Assessment, United States, Competency-Based Education organization & administration, Curriculum, Dental Caries therapy, Schools, Dental organization & administration
- Abstract
Maintenance of health and preservation of tooth structure through risk-based prevention and patient-centered, evidence-based disease management, reassessed at regular intervals over time, are the cornerstones of present-day caries management. Yet management of caries based on risk assessment that goes beyond restorative care has not had a strong place in curriculum development and competency assessment in U.S. dental schools. The aim of this study was to develop a competency-based core cariology curriculum framework for use in U.S. dental schools. The Section on Cariology of the American Dental Education Association (ADEA) organized a one-day consensus workshop, followed by a meeting program, to adapt the European Core Cariology Curriculum to the needs of U.S. dental education. Participants in the workshop were 73 faculty members from 35 U.S., three Canadian, and four international dental schools. Representatives from all 65 U.S. dental schools were then invited to review and provide feedback on a draft document. A recommended competency statement on caries management was also developed: "Upon graduation, a dentist must be competent in evidence-based detection, diagnosis, risk assessment, prevention, and nonsurgical and surgical management of dental caries, both at the individual and community levels, and be able to reassess the outcomes of interventions over time." This competency statement supports a curriculum framework built around five domains: 1) knowledge base; 2) risk assessment, diagnosis, and synthesis; 3) treatment decision making: preventive strategies and nonsurgical management; 4) treatment decision making: surgical therapy; and 5) evidence-based cariology in clinical and public health practice. Each domain includes objectives and learning outcomes.
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- 2016
50. A Systematic Review of Suicidality in People with Intellectual Disabilities.
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Dodd P, Doherty A, and Guerin S
- Subjects
- Humans, Intellectual Disability epidemiology, Suicide statistics & numerical data
- Abstract
Background: Suicidality in people with intellectual disability has not been extensively researched., Aim: To identify the nature of the research that has actually been conducted on this topic., Method: A search of research databases was conducted according to predefined criteria. Key information was extracted and rated for methodological merit., Results: Twenty-four studies met the inclusion criteria for this systematic review. The aspects of suicidality investigated, which varied among studies, included suicidal attempts, behavior, ideation, and completed suicide. Thirteen studies highlighted risk factors for suicidality in this population. The most frequently noted risk factors were a concurrent mental health difficulty and the level of intellectual disability. Eight studies referred to people with intellectual disabilities' understanding of the concept of death or suicide. Various methodological issues were identified in the studies included., Conclusions: In what we believe to be first systematic review of suicidality in people with intellectual disabilities, it was apparent that well-designed, standardized research studies on the topic are scarce. There is consequently limited evidence to guide prevention and intervention strategies for suicidality in this population.
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- 2016
- Full Text
- View/download PDF
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