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3. Can building a community of practice improve pharmacovigilance in low-resource settings?

Author

Walker, RJ, Allen, E, and Lang, T

Subjects
Public health, Pharmacovigilance, Medicine, Communities of practice
Abstract

Undertaking effective drug safety monitoring can be particularly challenging in Low-Resource Settings (LRSs) due to a lack of infrastructure, weak regulatory systems and poor access to training and education. Having identified that more could be done to provide or draw together existing free or low-cost resources, Global Pharmacovigilance (GPV), an online platform dedicated to pharmacovigilance activities in LRSs was launched on The Global Health Network (TGHN) in mid-2016. This action research project sought to investigate whether GPV’s membership could be harnessed to work together in a Community of Practice (CoP) on specific challenges facing pharmacovigilance in LRSs, and to assess the impact of the CoP outcomes on the work of those engaged in pharmacovigilance activities in LRSs. Participants were invited to work together to develop relevant training, guidance, tools and/or resources to address the challenges identified, using the online environment as the workspace for discussions, networking and dissemination of outputs. Following the emergence of the COVID-19 pandemic during the course of this research, and given its significant impact upon health systems globally, it was deemed essential to ensure that pharmacovigilance stakeholders in LRSs had the capacity to address both the exacerbated pre-existing and novel challenges that they were facing. The focus of the research was accordingly contextualised to focus on the greatest challenges facing pharmacovigilance in LRSs during the COVID-19 pandemic. Adopting an action research mixed methods approach, this project built upon on a rapid consensus-gathering methodology developed by TGHN, which had been implemented successfully to address wider COVID-19 research priorities and iteratively drive the improvement of knowledge, skills and methods gaps in the field of Global Health. This began with a novel, hybrid knowledge synthesis strategy to identify published literature and existing training and education resources relevant to pharmacovigilance in LRSs. Consensus-gathering activities began with an online survey of GPV members, to identify highly-ranked areas for pharmacovigilance improvement in LRSs during the pandemic. Survey development included the implementation and assessment of a novel, hybrid validity testing methodology. A virtual open workshop was then hosted to share the survey findings with the CoP, invite further discussion on the results, and to reach consensus on the highest priorities at that time. Two international virtual working groups were then formed, each focussing on one of the highest priorities identified in the consensus-gathering activities. These working group were supported by GPV to work together to facilitate the development of (or provision of, if already available elsewhere) pharmacovigilance resources to address the priorities identified. A significant number of challenges to the conduct of pharmacovigilance in LRSs were identified. The highest priorities for pharmacovigilance in LRSs during the COVID-19 pandemic included ensuring the safe use of medical interventions in vulnerable populations (particularly children and pregnant women), improving communication between pharmacovigilance stakeholders, and increasing local agency of local pharmacovigilance data. The CoP model represented an effective strategy for fostering collaboration and enabling knowledge exchange and generation amongst pharmacovigilance stakeholders in LRSs. In addition, the CoP approach facilitated the successful identification of the highest priorities for pharmacovigilance in LRSs during the COVID-19 pandemic, where tools, education and guidance were needed. Whilst the implementation and impact of resources to address these challenges was not assessed, the CoP model was shown to provide an effective platform for the collaborative, community-led development of such resources through the conception of clear and ambitious intervention proposals by highly-engaged working group members. A knowledge community approach was found to offers an effective strategy for guiding improvements to pharmacovigilance activities in LRSs. The democratic, participant-led methodology provides direct solutions to many of the challenges facing pharmacovigilance in these regions, through the creation of inter-organisational and international networks, the holistic approach to participant contribution, and the collaborative approach to resource sharing and development. The adoption of a knowledge community approach either as the core element of pharmacovigilance capacity building initiatives, or as supporting element to guide such initiatives, has the potential to greatly improve pharmacovigilance capacity in LRSs, and reduce the inequities amongst pharmacovigilance stakeholders around the globe.

Published
2023

5. Supplemental Material, sj-pdf-1-ptd-10.1177_08968608221132647 - Long-term impact of early non-infectious complications at the initiation of peritoneal dialysis

Author

Chan, R, Walker, RJ, Samaranayaka, A, and Schollum, JBW

Subjects
Medicine
Abstract

Supplemental Material, sj-pdf-1-ptd-10.1177_08968608221132647 for Long-term impact of early non-infectious complications at the initiation of peritoneal dialysis by R Chan, RJ Walker, A Samaranayaka and JBW Schollum in Peritoneal Dialysis International

Published
2022
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7. Effects of allopurinol on the progression of chronic kidney disease

Author

Badve, SV, Pascoe, EM, Tiku, A, Boudville, N, Brown, FG, Cass, A, Clarke, P, Dalbeth, N, Day, RO, De Zoysa, JR, Douglas, B, Faull, R, Harris, DC, Hawley, CM, Jones, GRD, Kanellis, J, Palmer, SC, Perkovic, V, Rangan, GK, Reidlinger, D, Robison, L, Walker, RJ, Walters, G, Johnson, DW, Badve, SV, Pascoe, EM, Tiku, A, Boudville, N, Brown, FG, Cass, A, Clarke, P, Dalbeth, N, Day, RO, De Zoysa, JR, Douglas, B, Faull, R, Harris, DC, Hawley, CM, Jones, GRD, Kanellis, J, Palmer, SC, Perkovic, V, Rangan, GK, Reidlinger, D, Robison, L, Walker, RJ, Walters, G, and Johnson, DW

Abstract

BACKGROUND: Elevated serum urate levels are associated with progression of chronic kidney disease. Whether urate-lowering treatment with allopurinol can attenuate the decline of the estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease who are at risk for progression is not known. METHODS: In this randomized, controlled trial, we randomly assigned adults with stage 3 or 4 chronic kidney disease and no history of gout who had a urinary albumin: creatinine ratio of 265 or higher (with albumin measured in milligrams and creatinine in grams) or an eGFR decrease of at least 3.0 ml per minute per 1.73 m2 of body-surface area in the preceding year to receive allopurinol (100 to 300 mg daily) or placebo. The primary outcome was the change in eGFR from randomization to week 104, calculated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. RESULTS: Enrollment was stopped because of slow recruitment after 369 of 620 intended patients were randomly assigned to receive allopurinol (185 patients) or placebo (184 patients). Three patients per group withdrew immediately after randomization. The remaining 363 patients (mean eGFR, 31.7 ml per minute per 1.73 m2; median urine albumin: creatinine ratio, 716.9; mean serum urate level, 8.2 mg per deciliter) were included in the assessment of the primary outcome. The change in eGFR did not differ significantly between the allopurinol group and the placebo group (-3.33 ml per minute per 1.73 m2 per year [95% confidence interval {CI}, -4.11 to -2.55] and -3.23 ml per minute per 1.73 m2 per year [95% CI, -3.98 to -2.47], respectively; mean difference, -0.10 ml per minute per 1.73 m2 per year [95% CI, -1.18 to 0.97]; P = 0.85). Serious adverse events were reported in 84 of 182 patients (46%) in the allopurinol group and in 79 of 181 patients (44%) in the placebo group. CONCLUSIONS: In patients with chronic kidney disease and a high risk of progression, urate-lowering treatment with a

Published
2020

8. Spironolactone mitigates, but does not reverse, the progression of renal fibrosis in a transgenic hypertensive rat

Author

Leader, CJ, Kelly, DJ, Sammut, IA, Wilkins, GT, Walker, RJ, Leader, CJ, Kelly, DJ, Sammut, IA, Wilkins, GT, and Walker, RJ

Abstract

Hypertension plays an important role in the development and progression of chronic kidney disease. Studies to date, with mineralocorticoid receptor antagonists (MRA), have demonstrated varying degrees of results in modifying the development of renal fibrosis. This study aimed to investigate whether treatment with a MRA commenced following the establishment of hypertension, a situation more accurately representing the clinical setting, modified the progression of renal fibrosis. Using male Cyp1a1Ren2 rats (n = 28), hypertension was established by addition of 0.167% indole‐3‐carbinol (w/w) to the rat chow, for 2 weeks prior to treatment. Rats were then divided into normotensive, hypertensive (H), or hypertensive with daily oral spironolactone treatment (H + SP) (human equivalent dose 50 mg/day). Physiological data and tissue were collected after 4 and 12 weeks for analysis. After 4 weeks, spironolactone had no demonstrable effect on systolic blood pressure (SBP), proteinuria, or macrophage infiltration in the renal cortex. However, glomerulosclerosis and renal cortical fibrosis were significantly decreased. Following 12 weeks of spironolactone treatment, SBP was lowered (not back to normotensive levels), proteinuria was reduced, and the progression of glomerulosclerosis and renal cortical fibrosis was significantly blunted. This was associated with a significant reduction in macrophage and myofibroblast infiltration, as well as CTGF and pSMAD2 expression. In summary, in a model of established hypertension, spironolactone significantly blunted the progression of renal fibrosis and glomerulosclerosis, and downregulated the renal inflammatory response, which was associated with reduced proteinuria, despite only a partial reduction in systolic blood pressure. This suggests a blood pressure independent effect of MRA on renal fibrosis.

Published
2020

9. Can we IMPROVE cardiovascular outcomes through phosphate lowering in CKD? Rationale and protocol for the IMpact of Phosphate Reduction on Vascular End-points in Chronic Kidney Disease (IMPROVE-CKD) study

Author

Lioufas, N, Toussaint, ND, Pedagogos, E, Elder, G, Badve, SV, Pascoe, E, Valks, A, Hawley, C, Block, GA, Boudville, NC, Campbell, K, Cameron, JD, Chen, SSM, Faull, RJ, Holt, SG, Hooi, LS, Jackson, D, Jardine, MJ, Johnson, DW, Kerr, PG, Lau, KK, Morrish, A, Perkovic, V, Polkinghorne, KR, Pollock, CA, Reidlinger, D, Robison, L, Smith, ER, Walker, RJ, Wang, AYM, Lioufas, N, Toussaint, ND, Pedagogos, E, Elder, G, Badve, SV, Pascoe, E, Valks, A, Hawley, C, Block, GA, Boudville, NC, Campbell, K, Cameron, JD, Chen, SSM, Faull, RJ, Holt, SG, Hooi, LS, Jackson, D, Jardine, MJ, Johnson, DW, Kerr, PG, Lau, KK, Morrish, A, Perkovic, V, Polkinghorne, KR, Pollock, CA, Reidlinger, D, Robison, L, Smith, ER, Walker, RJ, and Wang, AYM

Abstract

Introduction Patients with chronic kidney disease (CKD) are at heightened cardiovascular risk, which has been associated with abnormalities of bone and mineral metabolism. A deeper understanding of these abnormalities should facilitate improved treatment strategies and patient-level outcomes, but at present there are few large, randomised controlled clinical trials to guide management. Positive associations between serum phosphate and fibroblast growth factor 23 (FGF-23) and cardiovascular morbidity and mortality in both the general and CKD populations have resulted in clinical guidelines suggesting that serum phosphate be targeted towards the normal range, although few randomised and placebo-controlled studies have addressed clinical outcomes using interventions to improve phosphate control. Early preventive measures to reduce the development and progression of vascular calcification, left ventricular hypertrophy and arterial stiffness are crucial in patients with CKD. Methods and analysis We outline the rationale and protocol for an international, multicentre, randomised parallel-group trial assessing the impact of the non-calcium-based phosphate binder, lanthanum carbonate, compared with placebo on surrogate markers of cardiovascular disease in a predialysis CKD population - the IM pact of P hosphate R eduction O n V ascular E nd-points (IMPROVE)-CKD study. The primary objective of the IMPROVE-CKD study is to determine if the use of lanthanum carbonate reduces the burden of cardiovascular disease in patients with CKD stages 3b and 4 when compared with placebo. The primary end-point of the study is change in arterial compliance measured by pulse wave velocity over a 96-week period. Secondary outcomes include change in aortic calcification and biochemical parameters of serum phosphate, parathyroid hormone and FGF-23 levels. Ethics and dissemination Ethical approval for the IMPROVE-CKD trial was obtained by each local Institutional Ethics Committee for all 17 partic

Published
2019

10. Crystal structure and surface characteristics of Sr-doped GdBaCo2O6−δ double perovskites : oxygen evolution reaction and conductivity

Author

Skinner, SJ, Ryan, MP, Pramana, S, Cavallaro, A, Li, C, Handoko, A, Chan, KW, Walker, RJ, Regoutz, A, Herrin, J, Yeo, BS, Payne, DJ, Kilner, JA, Earth Observatory of Singapore, Kaust UK Ltd, and Engineering & Physical Science Research Council (EPSRC)

Subjects
Technology, Conductivity, Science & Technology, SPECTROSCOPY, Energy & Fuels, REFINEMENT, STABILITY, Chemistry, Physical, Materials Science, Materials Science, Multidisciplinary, ENERGY ION-SCATTERING, DIFFUSION, Chemistry, ELECTROCATALYSIS, BOND-VALENCE PARAMETERS, Physical Sciences, Crystal Structure, OXIDES, Science::Chemistry [DRNTU], FUEL-CELL CATHODES, NEUTRON POWDER-DIFFRACTION
Abstract

A cheap and direct solution towards engineering better catalysts through identification of novel materials is required for a sustainable energy system. Perovskite oxides have emerged as potential candidates to replace the less economically attractive Pt and IrO2 water splitting catalysts. In this work, excellent electrical conductivity (980 S cm 1) was found for the double perovskite of composition GdBa0.6Sr0.4Co2O6 d which is consistent with a better oxygen evolution reaction activity with the onset polarisation of 1.51 V with respect to a reversible hydrogen electrode (RHE). GdBa1 xSrxCo2O6 d with increasing Sr content was found to crystallise in the higher symmetry tetragonal P4/mmm space group in comparison with the undoped GdBaCo2O6 d which is orthorhombic (Pmmm), and yields higher oxygen uptake, accompanied by higher Co oxidation states. This outstanding electrochemical performance is explained by the wider carrier bandwidth, which is a function of Co–O–Co buckling angles and Co–O bond lengths. Furthermore the higher oxygen evolution activity was observed despite the formation of non-lattice oxides (mainly hydroxide species) and enrichment of alkaline earth ions on the surface. Published version

Published
2018

11. Coherent anti‐Stokes Raman scattering (CARS) spectroscopy in Caenorhabditis elegans and Globodera pallida: evidence for an ivermectin‐activated decrease in lipid stores

Author

Smus, JP, Ludlow, E, Dallière, N, Luedtke, S, Monfort, T, Lilley, C, Urwin, P, Walker, RJ, O'Connor, V, Holden-Dye, L, and Mahajan, S

Abstract

BACKGROUND: Macrocyclic lactones are arguably the most successful chemical class with efficacy against parasitic nematodes. Here we investigated the effect of the macrocyclic lactone ivermectin on lipid homeostasis in the plant parasitic nematode Globodera pallida and provide new insight into its mode of action. RESULTS: A non-invasive, non-destructive, label-free and chemically selective technique called Coherent anti-Stokes Raman scattering (CARS) spectroscopy was used to study lipid stores in G. pallida. We optimised the protocol using the free-living nematode Caenorhabditis elegans and then used CARS to quantify lipid stores in the pre-parasitic, non-feeding J2 stage of G. pallida. This revealed a concentration of lipid stores in the posterior region of J2s within 24 hours of hatching which decreased to undetectable levels over the course of 28 days. We tested the effect of ivermectin on J2 viability and lipid stores. Within 24 hours ivermectin paralysed J2s. Counter-intuitively, over the same time-course ivermectin increased the rate of depletion of J2 lipid, suggesting in ivermectin-treated J2s there is a disconnection between the energy requirements for motility and metabolic rate. This decrease in lipid stores would be predicted to negatively impact on J2 infective potential. CONCLUSION: These data suggest that the benefit of macrocyclic lactones as seed treatments may be underpinned by a multilevel effect involving both neuromuscular inhibition and acceleration of lipid metabolism.

Published
2017

12. Axion searches with the EDELWEISS-II experiment

Author

Armengaud, E, Arnaud, Q, Augier, C, Benoit, A, Berge, L, Bergmann, T, Bluemer, J, Broniatowski, A, Brudanin, V, Camus, P, Cazes, A, Censier, B, Chapellier, M, Charlieux, F, Couedo, F, Coulter, P, Cox, GA, de Boissiere, T, De Jesus, M, Dolgorouky, Y, Drillien, AA, Dumoulin, L, Eitel, K, Filosofov, D, Fourches, N, Gascon, J, Gerbier, G, Gros, M, Hehn, L, Henry, S, Herve, S, Heuermann, G, Holtzer, N, Humbert, V, Juillard, A, Kefelian, C, Kleifges, M, Kluck, H, Kozlov, V, Kraus, H, Kudryavtsev, VA, Le Sueur, H, Mancuso, M, Marrache-Kikuchi, C, Marnieros, S, Menshikov, A, Navick, X-F, Nones, C, Olivieri, E, Pari, P, Paul, B, Piro, MC, Rigaut, O, Robinson, M, Rozov, S, Sanglard, V, Schmidt, B, Siebenborn, B, Tcherniakhovski, D, Tenconi, M, Vagneron, L, Walker, RJ, Weber, M, Yakushev, E, Zhang, X, Collaboration, EDELWEISS, Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Institut de Physique Nucléaire de Lyon (IPNL), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), CSNSM INSTR, Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), CSNSM PS1, Centre de Spectrométrie Nucléaire et de Spectrométrie de Masse (CSNSM), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11)-Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Souterrain de Modane (LSM - UMR 6417), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), EDELWEISS, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])

Subjects
axions, Cosmology and Nongalactic Astrophysics (astro-ph.CO), Solar neutrino, BOUNDS, Dark matter, FOS: Physical sciences, GERMANIUM DETECTORS, EDELWEISS, 01 natural sciences, 7. Clean energy, Nuclear physics, High Energy Physics - Phenomenology (hep-ph), dark matter experiments DARK-MATTER, 0103 physical sciences, CP INVARIANCE, 010306 general physics, Axion, Physics, dark matter detectors, Solar energetic particles, 010308 nuclear & particles physics, Astronomy and Astrophysics, CRYOGENIC DETECTORS, Baryon, High Energy Physics - Phenomenology, SOLAR AXIONS, [PHYS.HPHE]Physics [physics]/High Energy Physics - Phenomenology [hep-ph], INTERLEAVED ELECTRODES, Neutrino, Lepton, Astrophysics - Cosmology and Nongalactic Astrophysics
Abstract

We present new constraints on the couplings of axions and more generic axion-like particles using data from the EDELWEISS-II experiment. The EDELWEISS experiment, located at the Underground Laboratory of Modane, primarily aims at the direct detection of WIMPs using germanium bolometers. It is also sensitive to the low-energy electron recoils that would be induced by solar or dark matter axions. Using a total exposure of up to 448 kg.d, we searched for axion-induced electron recoils down to 2.5 keV within four scenarios involving different hypotheses on the origin and couplings of axions. We set a 95% CL limit on the coupling to photons $g_{A\gamma}

Published
2016

13. Quantum cascade laser absorption spectroscopy of the 1 ← 0 band of deuterium bromide at 5 μm

Author

Walker, RJ, Van Helden, JH, and Ritchie, GAD

Abstract

The invention, and subsequent development of external cavity quantum cascade lasers (EC-QCLs) has allowed relatively simple access to a wide spectral region for high resolution laser spectroscopy. In this Letter, we demonstrate the application of a broadly tunable 5.3 μm EC-QCL to absorption spectroscopy on the fundamental band of deuterium bromide. The large tuning range is utilised to record spectra allowing the hyperfine coupling constants to be determined for the v = 0 and v = 1 levels of both D79Br and D 81Br. We present the first measurement to our knowledge of e2Qq(v=1) for D81Br, given a value of 460.5 ± 12 MHz. © 2010 Elsevier B.V. All rights reserved.

Published
2016

14. The Vibration Bruising of Apples

Author

Conference on Agricultural Engineering (1978 : Toowoomba, Qld.), Walker, RJ, Schoorl, D, and Holt, JE

Published
1978

15. Introduction

Author

Walker Rj

Subjects
Pharmacology, Scientific career, Psychology, Classics
Published
1997

16. Background studies for the EDELWEISS dark matter experiment

Author

Armengaud, E, Augier, C, Benoit, A, Berge, L, Bergmann, T, Bluemer, J, Broniatowski, A, Brudanin, V, Censier, B, Chapellier, M, Charlieux, F, Couedo, F, Coulter, P, Cox, GA, De Jesus, M, Domange, J, Drilien, A-A, Dumoulin, L, Eitel, K, Filosofov, D, Fourches, N, Gascon, J, Gerbier, G, Gros, M, Henry, S, Herve, S, Heuermann, G, Holtzer, N, Juillard, A, Kleifges, M, Kluck, H, Kozlov, V, Kraus, H, Kudryavtsev, VA, Le Sueur, H, Loaiza, P, Marnieros, S, Menshikov, A, Navick, X-F, Nones, C, Olivieri, E, Pari, P, Paul, B, Rigaut, O, Robinson, M, Rozov, S, Sanglard, V, Schmidt, B, Scorza, S, Siebenborn, B, Semikh, S, Tcherniakhovski, D, Torrento-Coello, AS, Vagneron, L, Walker, RJ, Weber, M, Yakushev, E, Zhang, X, Collaboration, EDELWEISS, Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Institut de Physique Nucléaire de Lyon (IPNL), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Hélium : du fondamental aux applications (HELFA), Institut Néel (NEEL), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS), CSNSM INSTR, Centre de Spectrométrie Nucléaire et de Spectrométrie de Masse (CSNSM), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11), CSNSM PS1, Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11)-Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11), Laboratoire Souterrain de Modane (LSM - UMR 6417), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), EDELWEISS, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Hélium : du fondamental aux applications (NEEL - HELFA), Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])

Subjects
Physics, Particle physics, Physics - Instrumentation and Detectors, 010308 nuclear & particles physics, Dark matter, FOS: Physical sciences, Astronomy and Astrophysics, Instrumentation and Detectors (physics.ins-det), EDELWEISS, Neutron radiation, 7. Clean energy, 01 natural sciences, High Energy Physics - Experiment, Nuclear physics, High Energy Physics - Experiment (hep-ex), Recoil, WIMP, 0103 physical sciences, Electromagnetic shielding, Neutron, [PHYS.PHYS.PHYS-INS-DET]Physics [physics]/Physics [physics]/Instrumentation and Detectors [physics.ins-det], 010306 general physics, Background radiation
Abstract

The EDELWEISS-II collaboration has completed a direct search for WIMP dark matter using cryogenic Ge detectors (400 g each) and 384 kg$\times$days of effective exposure. A cross-section of $4.4 \times 10^{-8}$ pb is excluded at 90% C.L. for a WIMP mass of 85 GeV. The next phase, EDELWEISS-III, aims to probe spin-independent WIMP-nucleon cross-sections down to a few $\times10^{-9}$ pb. We present here the study of gamma and neutron background coming from radioactive decays in the set-up and shielding materials. We have carried out Monte Carlo simulations for the completed EDELWEISS-II setup with GEANT4 and normalised the expected background rates to the measured radioactivity levels (or their upper limits) of all materials and components. The expected gamma-ray event rate in EDELWEISS-II at 20-200 keV agrees with the observed rate of 82 events/kg/day within the uncertainties in the measured concentrations. The calculated neutron rate from radioactivity of 1.0-3.1 events (90% C.L.) at 20-200 keV in the EDELWEISS-II data together with the expected upper limit on the misidentified gamma-ray events ($\le0.9$), surface betas ($\le0.3$), and muon-induced neutrons ($\le0.7$), do not contradict 5 observed events in nuclear recoil band. We have then extended the simulation framework to the EDELWEISS-III configuration with 800 g crystals, better material purity and additional neutron shielding inside the cryostat. The gamma-ray and neutron backgrounds in 24 kg fiducial mass of EDELWEISS-III have been calculated as 14-44 events/kg/day and 0.7-1.4 events per year, respectively. The results of the background studies performed in the present work have helped to select better purity components and improve shielding in EDELWEISS-III to further reduce the expected rate of background events in the next phase of the experiment., Comment: 15 pages, 9 figures, to be published in Astroparticle Physics

Published
2013

17. Final results of the EDELWEISS-II WIMP search using a 4-kg array of cryogenic germanium detectors with interleaved electrodes

Author

Armengaud, E, Augier, C, Benoit, A, Berge, L, Bluemer, J, Broniatowski, A, Brudanin, V, Censier, B, Chardin, G, Chapellier, M, Charlieux, F, Coulter, P, Cox, GA, Defay, X, De Jesus, M, Dolgorouki, Y, Domange, J, Dumoulin, L, Eitel, K, Filosofov, D, Fourches, N, Gascon, J, Gerbier, G, Gironnet, J, Gros, M, Henry, S, Herve, S, Juillard, A, Kluck, H, Kozlov, V, Kraus, H, Kudryavtsev, VA, Loaiza, P, Marnieros, S, Navick, X-F, Nones, C, Olivieri, E, Pari, P, Pattavina, L, Paul, B, Robinson, M, Rozov, S, Sanglard, V, Schmidt, B, Scorza, S, Semikh, S, Torrento-Coello, AS, Vagneron, L, Verdier, M-A, Walker, RJ, Yakushev, E, Collaboration, EDELWEISS, Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Institut de Physique Nucléaire de Lyon (IPNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Hélium : du fondamental aux applications (NEEL - HELFA), Institut Néel (NEEL), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS), Centre de Spectrométrie Nucléaire et de Spectrométrie de Masse (CSNSM), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Souterrain de Modane (LSM - UMR 6417), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut Rayonnement Matière de Saclay (IRAMIS), EDELWEISS, HELFA - Hélium : du fondamental aux applications, Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Hélium : du fondamental aux applications (HELFA), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11), and Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)

Subjects
Cryogenic Ge detectors, Nuclear and High Energy Physics, Particle physics, Cosmology and Nongalactic Astrophysics (astro-ph.CO), [SDU.ASTR.CO]Sciences of the Universe [physics]/Astrophysics [astro-ph]/Cosmology and Extra-Galactic Astrophysics [astro-ph.CO], Physics::Instrumentation and Detectors, Dark matter, FOS: Physical sciences, WIMP searches, chemistry.chemical_element, Germanium, EDELWEISS, 7. Clean energy, 01 natural sciences, Particle detector, High Energy Physics - Experiment, Nuclear physics, [PHYS.ASTR.CO]Physics [physics]/Astrophysics [astro-ph]/Cosmology and Extra-Galactic Astrophysics [astro-ph.CO], High Energy Physics - Experiment (hep-ex), Recoil, WIMP, 0103 physical sciences, [PHYS.HEXP]Physics [physics]/High Energy Physics - Experiment [hep-ex], Nuclear Experiment, 010306 general physics, Physics, 010308 nuclear & particles physics, Astrophysics::Instrumentation and Methods for Astrophysics, 3. Good health, Semiconductor detector, chemistry, High Energy Physics::Experiment, Nucleon, Astrophysics - Cosmology and Nongalactic Astrophysics
Abstract

The EDELWEISS-II collaboration has completed a direct search for WIMP dark matter with an array of ten 400-g cryogenic germanium detectors in operation at the Laboratoire Souterrain de Modane. The combined use of thermal phonon sensors and charge collection electrodes with an interleaved geometry enables the efficient rejection of gamma-induced radioactivity as well as near-surface interactions. A total effective exposure of 384 kg.d has been achieved, mostly coming from fourteen months of continuous operation. Five nuclear recoil candidates are observed above 20 keV, while the estimated background is 3.0 events. The result is interpreted in terms of limits on the cross-section of spin-independent interactions of WIMPs and nucleons. A cross-section of 4.4x10^-8 pb is excluded at 90%CL for a WIMP mass of 85 GeV. New constraints are also set on models where the WIMP-nucleon scattering is inelastic., 23 pages, 5 figures; matches published version

Published
2011

19. The ZEPLIN-III dark matter detector: instrument design, manufacture and commissioning

Author

Akimov, DY, Alner, GJ, Araujo, HM, Bewick, A, Bungau, C, Burenkov, AA, Carson, MJ, Chagani, H, Chepel, V, Cline, D, Davidge, D, Daw, E, Dawson, J, Durkin, T, Edwards, B, Gamble, T, Chag, C, Hollingworth, RJ, Howard, AS, Jones, WG, Joshi, M, Mavrokoridis, K, Korolkova, E, Kovalenko, A, Kudryavtsev, VA, Kuznetsov, IS, Lawson, T, Lebedenko, VN, Lewin, JD, Lightfoot, P, Lindote, A, Liubarsky, I, Lopes, MI, Luscher, R, McMillan, JE, Majewski, P, Morgan, B, Muna, D, Murphy, AS, Neves, F, Nicklin, GG, Paling, SM, da Cunha, JP, Plank, SJS, Preece, R, Quenby, JJ, Robinson, M, Silva, C, Solovov, VN, Smith, NJT, Smith, PF, Spooner, NJC, Stekhanov, V, Sumner, TJ, Thorne, C, Tovey, DR, Tziaferi, E, Walker, RJ, Wang, H, White, J, Wolfs, F, APC - Neutrinos, AstroParticule et Cosmologie (APC (UMR_7164)), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Observatoire de Paris, PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Observatoire de Paris, PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-AstroParticule et Cosmologie (APC (UMR_7164)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Pierre et Marie Curie - Paris 6 (UPMC)-AstroParticule et Cosmologie (APC (UMR_7164)), Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)

Subjects
ZEPLIN-III, Physics::Instrumentation and Detectors, ARGON, Dark matter, chemistry.chemical_element, FOS: Physical sciences, dark matters, Astronomy & Astrophysics, SCINTILLATION EFFICIENCY, Astrophysics, Q1, RECOILS, 01 natural sciences, 7. Clean energy, Particle detector, Nuclear physics, ENERGY, Xenon, radiation detectors, 0103 physical sciences, [PHYS.HEXP]Physics [physics]/High Energy Physics - Experiment [hep-ex], 010306 general physics, Process engineering, QC, Physics, Scintillation, Contamination control, Science & Technology, 010308 nuclear & particles physics, business.industry, Detector, Astrophysics (astro-ph), PHYSICS, PARTICLES & FIELDS, LIQUID XENON, Astronomy and Astrophysics, Radiation detectors, WIMPs, ELECTRONS, chemistry, Scintillation counter, Physical Sciences, Liquid xenon, business
Abstract

We present details of the technical design and manufacture of the ZEPLIN-III dark matter experiment. ZEPLIN-III is a two-phase xenon detector which measures both the scintillation light and the ionisation charge generated in the liquid by interacting particles and radiation. The instrument design is driven by both the physics requirements and by the technology requirements surrounding the use of liquid xenon. These include considerations of key performance parameters, such as the efficiency of scintillation light collection, restrictions placed on the use of materials to control the inherent radioactivity levels, attainment of high vacuum levels and chemical contamination control. The successful solution has involved a number of novel design and manufacturing features which will be of specific use to future generations of direct dark matter search experiments as they struggle with similar and progressively more demanding requirements., Comment: 25 pages, 19 figures. Submitted to Astropart. Phys. Some figures down sampled to reduce size

Published
2007

24. Drug nephrotoxicity — The significance of cellular mechanisms

Author

Walker Rj and Fawcett Jp

Subjects
Drug, medicine.medical_specialty, business.industry, media_common.quotation_subject, Outer medulla, Bioinformatics, Nephrotoxicity, Cellular mechanism, medicine.anatomical_structure, Endocrinology, Internal medicine, medicine, Proximal tubule, business, media_common
Abstract

Drug-induced nephrotoxicity is a common clinical problem and is responsible for a substantial amount of nephrological consultations. The list of drugs that may produce nephrotoxicity is vast. However the aim of this review is not to provide a comprehensive coverage of all these agents but rather to highlight recent developments in our understanding of the mechanisms involved in the development of toxicity. The main focus will be at the intracellular level and to develop the concept that it is the critical interaction with intracellular pathways and metabolism that leads to the development of toxicity. Specific drugs will be reviewed for which there is good experimental evidence to support this concept.

Published
1993

32. The impact of standard high-flux polysulfone versus novel high-flux polysulfone dialysis membranes on inflammatory markers: a randomized, single-blinded, controlled clinical trial.

Author

Kerr PG, Sutherland WH, de Jong S, Vaithalingham I, Williams SM, and Walker RJ

Abstract

BACKGROUND: This study is a prospective, randomized, single-blind, clinical trial over 12 months involving 60 stable hemodialysis patients comparing standard high-flux polysulfone dialyzer membranes with a novel high-flux polysulfone dialyzer membrane (Helixone; Fresenius Medical Care, St Wendel, Germany) modified in the fiber-spinning process to enhance middle-molecule clearance through changing the distribution of pore size and increased filtration. METHODS: Markers of protein and lipid oxidation and inflammatory markers, including proinflammatory cytokines and cell adhesion molecules, were compared. The hypothesis tested was that improved clearances of middle molecules with the FX80 membrane would lead to less oxidative stress and inflammation compared with the high-flux polysulfone (HF80) membrane. RESULTS: Type of dialysis membrane used did not significantly affect lipid and protein peroxidation, C-reactive protein level, interleukin 6 level, or sgp130 level during 12 months. beta(2)-Microglobulin concentrations decreased significantly in the Helixone membrane group compared with those dialyzed using conventional polysulfone membranes during the study (-15%; 95% confidence interval, -20 to -10). CONCLUSION: Long-term dialysis with a Helixone membrane did not modify any parameters of oxidative stress or inflammation in this stable hemodialysis population compared with a high-flux polysulfone dialysis membrane.Copyright © 2007 by National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

Published
2007
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33. Using visual interventions as a component of positive behavioral support for a student with aggressive behaviors and mental retardation: a review and single case report.

Author

Ramsey SA, Walker RJ, and Walker A

Abstract

Aggressive behaviors are among the most ostracizing types of comportment observed across the educational spectrum. Aggressive behaviors may isolate the aggressor socially, academically, and educationally. The following study utilizes functional behavior assessment and single subject research methodology to assess and address aggressive behaviors in a student with a severe intellectual disability. Visual interventions were utilized as a component of a positive behavioral support system to reduce aggressive behaviors. Behavioral improvement was measured. [ABSTRACT FROM AUTHOR]

Published
2005
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35. Depression or grief? The experience of caregivers of people with dementia.

Author

Walker RJ and Pomeroy EC

Abstract

The exploratory study discussed in this article attempted to shed some light on the nature of the depression and grief experienced by caregivers of people with dementia. The findings suggest that the depression so frequently described in the literature may not be as severe or clinically significant as previously thought and that it may be more precisely described as anticipatory grief. Viewing caregivers' apparent depression as being the result of grief over the losses they are experiencing may assist practitioners in planning and evaluating the effectiveness of clinical interventions specifically designed for this growing group of clients. [ABSTRACT FROM AUTHOR]

Published
1996
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36. Anticipatory grief and Alzheimer's disease: strategies for intervention.

Author

Walker RJ, Pomeroy EC, McNeil JS, and Franklin C

Abstract

This article will identify a number of variables that can be expected to influence the anticipatory grief process, including the stigmatization of the disease process, multiple losses and psychosocial death. The impact of each of the variables on the anticipatory grief process of caregivers of patients with Alzheimer's disease (AD) will be delineated. Finally, the anticipatory mourning tasks for caregivers at each stage of chronic illness will be presented. Emphasis will be placed on the special tasks of the caregivers of persons with AD and the role of the practitioner in assisting the caregiver to simultaneously remain actively involved with the patient, while they grieve their losses and prepare for death, which is the very complicated work of anticipatory grief. [ABSTRACT FROM AUTHOR]

Published
1994

37. A psychoeducational model for caregivers of patients with Alzheimer's disease.

Author

Walker RJ, Pomeroy EC, McNeil JS, and Franklin C

Abstract

Psychoeducational groups for families of patients with Alzheimer's disease have been utilized as a means to reduce the burden experienced by caregivers and prolong the time a patient can remain in the community. Research studies utilizing clinical impressions typically report successful outcomes. However, studies utilizing more objective measures are inconclusive. The authors propose a conceptual model that takes into account the determinants of burden, the stage of illness of the patient, and the stage of mourning of the caregiver. These factors are utilized to assess the differential need of the caregiver for support and education, as well as the actual content of the education and focus of the support. It is felt by the authors that this model will assist researchers in overcoming some of the limitations of previous research and thus, in finding significant differences in objective outcome measures. More importantly, it will assist practitioners in designing more effective interventions. [ABSTRACT FROM AUTHOR]

Published
1994
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39. Intravenous enoxacin for the treatment of acute pyelonephritis: pharmacokinetic and clinical study.

Author

Bailey, RR, Walker, RJ, Lynn, KL, Donaldson, IM, Peddie, BA, and Dobbs, BR

Abstract

1. Eight women with acute pyelonephritis were treated with i.v. enoxacin for 5 days. All were clinically cured and five had a bacteriological cure. Five women reported side effects. 2. During treatment there was no significant accumulation of enoxacin and the total clearance of the drug did not alter with repeated dosing. Drug elimination half-life (mean 4.3 h, s.d. 2.1) was similar to that reported in healthy volunteers. 3. Enoxacin should be compared with the aminoglycosides and beta-lactam antibiotics for the treatment of severe or complicated urinary tract infections. [ABSTRACT FROM AUTHOR]

Published
1988
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40. Psychoeducational model for caregivers of persons with AIDS.

Author

Pomeroy EC, Walker RJ, and McNeil JS

Abstract

For every individual infected with the HIV virus, there is a group of friends, family and loved ones who are affected by the disease. Although support groups for these caregivers have begun to develop throughout the country, there is a paucity of research examining the effectiveness of these groups in relieving the stresses experienced by this hidden population. A review of the literature on caregiver groups of other chronically ill family members indicate that both education and support are necessary ingredients in effecting change. The authors propose a practice framework which integrates the determinants of burden, the stage of illness and the stage of mourning in assessing the differential needs of the caregiver for support and education. Implications for further research in this area are discussed. Finally, the authors delineate the usefulness of the model not only in assessing the stresses experienced by the individual caregiver but in developing and implementing a psychoeducational group. [ABSTRACT FROM AUTHOR]

Published
1996
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41. The impact of anticipatory grief on caregivers of persons with Alzheimer's disease.

Author

Walker RJ and Pomeroy EC

Abstract

Caregivers of persons with Alzheimer's disease (AD) and other dementias are known to experience many physical and emotional problems. However, research has consistently shown that the relationship between the demands of caregiving and the effects on the caregiver is not strong. Despite considerable research, a full understanding of how the demands of caregiving uniquely impact the individual has not been established. The present study examines anticipatory grief, an emotion that has not been studied to date for its possible impact on the current functioning of caregivers. Structured interviews, consisting primarily of standardized measures, were conducted with 100 caregivers. Results of the study show that physical and emotional problems and the expectation to place the patient out of the home were more likely to occur among those caregivers who expressed the most intense grief and those feelings of remorse and anger characteristic of the anger and guilt stages of grief. [ABSTRACT FROM AUTHOR]

Published
1997
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43. The management of alcohol-related seizures: an overview

Author

Ahmed, S, Chadwick, D, and Walker, RJ

Abstract

Alcohol-withdrawal seizures are one of the common medical emergencies. The seizures are generalized and usually occur abruptly between 6–8 hours after cessation of alcohol use (peak 12–24 hours). These patients are often uncooperative and therefore need careful assessment. Lorazepam is the first-line drug for termination and prophylaxis of alcohol-withdrawal seizures.

Published
2000
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49. Research methodologies for eliciting patients' preferences in invasive procedures: a scoping review.

Author

Muaddi H, Lovrics O, Walker RJ, de Mestral C, Nathens A, Stukel TA, and Karanicolas PJ

Subjects
Humans, Surgical Procedures, Operative psychology, Research Design, Patient Preference
Abstract

Background: Endpoints that patients and clinicians consider important may differ based on patients' preferences and values. Several methods are available to elicit patient preferences in a succinct and methodologically valid manner., Purpose: We conducted a scoping review of methods used to elicit patient preferences in invasive procedures to provide a framework for researchers and clinicians to incorporate these measures into future efforts., Methods: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and health and psychological instruments database were searched from inception until September 2020. Articles that examined patient preferences for any invasive procedure were eligible for inclusion. Selection and extraction were completed in duplicate. Preference elicitation methods were identified and summarized., Results: Three hundred ninety-four articles (n = 76,921 patients) were included representing several surgical specialties. Of included studies, 11.7% (n = 46) used both quantitative and qualitative methods, 81.2% (n = 320) used quantitative methods only, and 7.1% (n = 28) used qualitative methods only to elicit preferences. The most frequently employed quantitative method to elicit preferences was simple choice selection, while one-on-one interviews with participants was the most frequently used qualitative method. Preference elicitation was the primary outcome in 74.6% (n = 294) of included studies., Conclusion: There are several methods to elicit patient preferences in surgical research. Qualitative methods are valuable for exploring views and generating consensus statements. Quantitative methods are better suited for assessing relative preferences, establishing preference thresholds, or ascertaining the presence of preferences. The choice of method should align with the specific research objectives., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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50. Association Between Recent Criminal Legal Involvement and Functional Status Among US Adults with Diabetes: 2015-2019.

Author

Hawks LC, Walker RJ, and Egede LE

Abstract

Diabetes is a significant public health concern with significant implications for health equity. Functional disability undermines disease control and may be associated with the relationship between criminal legal involvement and poor chronic disease outcomes, but this relationship has not been studied. This study examined the association between recent criminal legal involvement and functional disability among a nationally representative sample of US adults with diabetes. Adult respondents to the National Survey of Drug Use and Health (2015-2019) who reported a diagnosis of diabetes were included in this analysis examining the association between three forms of recent criminal legal involvement (past year arrest, or supervision on probation or parole) and functional disability, as measured by the World Health Organization Disability Assessment Score 2.0. In multivariate linear regression analyses adjusted for relevant socio-demographic and clinical confounders, the functional disability score increased by 2.7 (95% CI, 1.6-3.9) for those with past year arrest compared to no past year arrest; 1.2 (95% CI, -0.1, 2.6) for those with past year probation compared to no past year probation; and 0.4 (95% CI, -1.1, 1.8) for those with past year parole compared to no past year parole. Recent criminal legal involvement, specifically past year arrest, is associated with greater functional disability, which may serve as an important mediator for poor health outcomes in patients with diabetes. Future research should examine this pathway and prioritize interventions to improve both functional disability and glycemic control among individuals with diabetes and recent criminal legal involvement., (© 2024. The New York Academy of Medicine.)

Published
2024
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