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Foeller ME, Nosrat C, Krystosik A, Noel T, Gérardin P, Cudjoe N, Mapp-Alexander V, Mitchell G, Macpherson C, Waechter R, LaBeaud AD. Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study. BJOG 2020; 128:1077-1086. [PMID: 33040457 DOI: 10.1111/1471-0528.16562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN Retrospective observational study. SETTING Grenada. POPULATION Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
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Affiliation(s)
- M E Foeller
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - C Nosrat
- Program in Human Biology, Stanford University, Stanford, CA, USA
| | - A Krystosik
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
| | - T Noel
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - P Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion.,Unité Mixte 134 PIMIT (INSERM 1187, CNRS 9192, IRD 249, Université de La Réunion), Sainte Clotilde, Réunion
| | - N Cudjoe
- Windward Islands Research and Education Foundation, True Blue, Grenada
| | - V Mapp-Alexander
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - G Mitchell
- Ministry of Health, St. Georges, Grenada
| | - C Macpherson
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - R Waechter
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - A D LaBeaud
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
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Mitchell G, Porter S, Manias E. Enabling sustained communication with patients for safe and effective management of oral chemotherapy: A longitudinal ethnography. J Adv Nurs 2020; 77:899-909. [PMID: 33210337 DOI: 10.1111/jan.14634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 09/09/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023]
Abstract
AIMS To examine how patients received, understood, and acted on healthcare professional communication about their oral chemotherapeutic regimen throughout their treatment. DESIGN A longitudinal ethnographic study. METHODS Over 60 hr of observational data were recorded, in the form of field notes and audio-recordings from interactions among nine oncology doctors, six oncology nurses, eight patients, and 11 family members over a period of 6 months in outpatient departments in one hospital in Northern Ireland. Sixteen semi-structured interviews with patients and three focus groups with healthcare professionals were also carried out. This study took place from October 2013-June 2016. Data were thematically analysed. RESULTS Three themes where identified from the data. These were initiating concordance through first communication about oral chemotherapy; which focused on initial communication during oncology consultations about oral chemotherapy, sustained communication of managing chemotherapy side effects; which was about how communication processes supported timely and effective side effect management and un-sustained communication of oral chemotherapy medication-taking practice; when patients and healthcare professionals failed to communicate effectively about chemotherapy medication-taking. CONCLUSION The two most important factors in ensuring the optimal management of oral chemotherapeutic medicines are early recognition and appropriate response to side effects and the maintenance of safe and effective medication administration. This study found that oncology doctors and nurses engaged in sustained communication about the side effects of chemotherapy but did not focus their communication on safe administration after the first consultation. IMPACT Based on this evidence, we recommend that healthcare professionals who provide oral chemotherapy for home administration should review their processes and procedures. Healthcare professionals need to ensure that they embed frequent communication for the duration of treatment between themselves and patients, including open discussion and advice, about side effects and medication administration.
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Sam Porter
- Department of Social Sciences & Social Work, Bournemouth University, Poole, UK
| | - Elizabeth Manias
- School of Nursing & Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Burwood, Vic., Australia
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Hongmanorom P, Ashok J, Das S, Dewangan N, Bian Z, Mitchell G, Xi S, Borgna A, Kawi S. Zr–Ce-incorporated Ni/SBA-15 catalyst for high-temperature water gas shift reaction: Methane suppression by incorporated Zr and Ce. J Catal 2020. [DOI: 10.1016/j.jcat.2019.11.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Mitchell G, McVeigh C, Carlisle S, Brown-Wilson C. Evaluation of a co-produced delirium awareness programme for undergraduate nursing students in Northern Ireland: a pre-test/post-test study. BMC Nurs 2020; 19:34. [PMID: 32351326 PMCID: PMC7183703 DOI: 10.1186/s12912-020-00427-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 04/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Delirium is recognised internationally as a common disorder that causes acute deterioration in a person's cognitive abilities. Healthcare professionals play a key role in the early identification and management of delirium and effective education can support timely recognition and treatment. There is currently a lack of research exploring the delirium education provided to undergraduate nursing students. The aim of this study was to evaluate the effectiveness of a co-produced delirium awareness programme on undergraduate nursing students in Northern Ireland. METHODS The intervention was a 2-h delirium workshop, delivered in April 2019, to a convenience sample of year one undergraduate nursing students (n = 206) completing a BSc Honours Nursing degree programme in a Northern Ireland University. The workshop focused on four core elements: defining delirium, reflecting on practice, recognition of delirium and management of delirium. Participants completed a 35-item true-false Delirium Knowledge Questionnaire (DKQ) at baseline and post intervention using Socrative, a cloud-based student response system. In addition, students also completed a short questionnaire at baseline and post-workshop, designed by the authors, to ascertain perceived confidence about caring for people with delirium. Data were analysed using paired t-tests and descriptive statistics. RESULTS In the DKQ, Scores were normally distributed around the mean at baseline (71.89%) and post intervention (81.89%). Students improved across all three core areas in the post-test questionnaire, demonstrating improvements in knowledge about symptoms of delirium (7.32% increase), causes and risk factors of delirium (17.91% increase) and management of delirium (5.72% increase). In relation to perceived confidence, students reported a 60.20% increase in confidence related to recognition of delirium, a 49.51% increase in relation to delirium management and a 45.04% increase their ability to communicate about delirium. Both questionnaires were statistically significant (P < 0.01). CONCLUSIONS A 2-h workshop on delirium improved first year student nurse knowledge about delirium. Nursing students expressed that this approach to delirium education enabled collective thinking about how knowledge could be transferred into individual practises. Students also stated that learning incorporating the voice of the person who has experienced delirium, was an effective and powerful way to deliver education.
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Affiliation(s)
- Gary Mitchell
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, County Antrim, Belfast, Northern Ireland BT9 7BL
| | - Clare McVeigh
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, County Antrim, Belfast, Northern Ireland BT9 7BL
| | - Susan Carlisle
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, County Antrim, Belfast, Northern Ireland BT9 7BL
| | - Christine Brown-Wilson
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, County Antrim, Belfast, Northern Ireland BT9 7BL
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Mitchell G, Crooks S. Delirium occurrence in hospitalised older people is positively associated with development of dementia postdischarge. Evid Based Nurs 2020; 24:54. [PMID: 32213511 DOI: 10.1136/ebnurs-2019-103227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Gary Mitchell
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, UK
| | - Sophie Crooks
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, UK
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Oliver JB, Rigatti AL, Noll T, Spaulding J, Hettrick J, Gruschow V, Mitchell G, Sadowski D, Smith C, Charles B. Large-aperture coatings for fusion-class laser systems. Appl Opt 2020; 59:A7-A15. [PMID: 32225346 DOI: 10.1364/ao.59.0000a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/17/2019] [Indexed: 06/10/2023]
Abstract
Optical coatings for fusion-class laser systems pose unique challenges, given the large substrate sizes, the high intensities incident on the coatings, and the system-focusing requirements, necessitating a well-controlled optical wavefront. Significant advancements have taken place in the past 30 years to achieve the coating capabilities necessary to build laser systems such as the National Ignition Facility, Laser Mégajoule, OMEGA EP, and OMEGA. This work summarizes the coating efforts and advancements to support such system construction and maintenance.
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Haley N, Donner R, Henderson D, Tennant J, Hoover E, Manca M, Caughey B, Kondru N, Manne S, Kanthasamay A, Hannaoui S, Chang S, Gilch S, Smiley S, Mitchell G, Lehmkuhl A, Thomsen B. Cross-validation of the RT-QuIC assay for the antemortem detection of chronic wasting disease in elk. Prion 2020; 14:47-55. [PMID: 31973662 PMCID: PMC6984646 DOI: 10.1080/19336896.2020.1716657] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Chronic wasting disease is a progressively fatal, horizontally transmissible prion disease affecting several members of the cervid species. Conventional diagnosis relies on ELISA or IHC evaluation using tissues collected post-mortem; however, recent research has focused on newly developed amplification techniques using samples collected antemortem. The present study sought to cross-validate the real-time quaking-induced conversion assay (RT-QuIC) evaluation of rectal biopsies collected from an elk herd with endemic CWD, assessing both binary positive/negative test results as well as relative rates of amplification between laboratories. We found that results were correlative in both categories across all laboratories performing RT-QuIC, as well as to conventional IHC performed at a national reference laboratory. A significantly higher number of positive samples were identified using RT-QuIC, with results seemingly unhindered by low follicle counts. These findings support the continued development and implementation of amplification assays in the diagnosis of prion diseases of veterinary importance, targeting not just antemortem sampling strategies, but post-mortem testing approaches as well.
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Affiliation(s)
- N.J. Haley
- Department of Microbiology and Immunology, College of Graduate Studies, Midwestern University, Glendale, AZ, USA,CONTACT N.J. Haley Department of Microbiology and Immunology, College of Graduate Studies, Midwestern University, Glendale, AZ, USA
| | - R. Donner
- Department of Microbiology and Immunology, College of Graduate Studies, Midwestern University, Glendale, AZ, USA
| | - D.M. Henderson
- Prion Research Center, Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - J. Tennant
- Prion Research Center, Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - E.A. Hoover
- Prion Research Center, Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - M. Manca
- TSE/Prion Biochemistry Section, Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, Hamilton, MT, USA
| | - B. Caughey
- TSE/Prion Biochemistry Section, Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, Hamilton, MT, USA
| | - N. Kondru
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - S. Manne
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - A. Kanthasamay
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - S. Hannaoui
- Calgary Prion Research Unit, University of Calgary, Calgary, Alberta, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada,Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S.C. Chang
- Calgary Prion Research Unit, University of Calgary, Calgary, Alberta, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada,Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S. Gilch
- Calgary Prion Research Unit, University of Calgary, Calgary, Alberta, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada,Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S. Smiley
- National and OIE Reference Laboratory for Scrapie and CWD, Canadian Food Inspection, Agency, Ottawa Laboratory-Fallowfield, Ottawa, Ontario, Canada
| | - G. Mitchell
- National and OIE Reference Laboratory for Scrapie and CWD, Canadian Food Inspection, Agency, Ottawa Laboratory-Fallowfield, Ottawa, Ontario, Canada
| | - A.D. Lehmkuhl
- United States Department of Agriculture, APHIS, VS, National Veterinary Services Laboratories, Ames, IA, USA
| | - B.V. Thomsen
- United States Department of Agriculture, APHIS, VS, National Veterinary Services Laboratories, Ames, IA, USA,United States Department of Agriculture, APHIS, VS, Center for Veterinary Biologics, Ames, IA, USA
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DuBose L, Magnotta V, Moser D, Mitchell G, Nuckols V, Ward R, Pierce G, Boles Ponto L. P102 Large Artery Stiffness is Associated with Lower Brain pH and Memory Performance in Middle-aged and Older Adults. Artery Res 2020. [DOI: 10.2991/artres.k.191224.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Mitchell G, McTurk V. Combining physical and cognitive interventions positively affects gait in older adults with cognitive impairment. Evid Based Nurs 2019; 24:14. [PMID: 31831566 DOI: 10.1136/ebnurs-2019-103065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Victoria McTurk
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Nikles J, Tate R, Mitchell G, Perdices M, McGree J, Freeman C, Jacob S, Taing M, Sterling M. Personalised treatments for acute whiplash injuries: A pilot study of nested N-of-1 trials in a multiple baseline single-case experimental design. Contemp Clin Trials Commun 2019; 16:100480. [PMID: 31763492 PMCID: PMC6859231 DOI: 10.1016/j.conctc.2019.100480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Whiplash associated disorder (WAD), a common and disabling condition, incurs huge burden and costs to Australia. Yet, current treatments for whiplash are not very effective; improved outcomes are urgently needed. Clinical guidelines recommend simple analgesia (paracetamol and non-steroidal anti-inflammatory drugs) but there have been no trials of guideline-recommended drugs. This study will investigate the effectiveness of evidence-based advice (EBA), paracetamol, naproxen, and both paracetamol and naproxen, in reducing daily neck pain and preventing chronic neck pain after whiplash injury. METHODS This study is a pilot series of multi-cycle, double-blinded, randomised N-of-1 trials, nested in a multiple baseline design. The design will comprise three baselines of 5, 8 or 11 days duration. Post enrolment, participants will be randomly assigned to one of the baselines. Fifteen participants with acute (<2 weeks) Grade II WAD, experiencing at least moderate pain (NRS: ≥ 5/10), and at risk of poor recovery will be recruited from hospitals in Queensland, Australia, and through local physiotherapists. Patients will receive EBA plus a randomised sequence of three cycles of ten day treatment triplets (paracetamol designated as a C phase, naproxen, designated as a D phase, and both paracetamol and naproxen, designated as an E phase). DISCUSSION We will test the effects of different treatments on the primary outcome of average neck pain intensity collected daily and at 4 and 7 months post-injury. Secondary outcomes, including disability, depression, post-traumatic stress symptoms, pain catastrophizing, and feasibility of study procedures, will also be evaluated. The results of this study will inform a larger trial aiming to strengthen the evidence on EBA and simple analgesics for WAD. TRIAL REGISTRATION Clinical Trials Primary Registry: Australian and New Zealand Clinical Trials Registry. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12618001291279. DATE OF REGISTRATION 31/07/2018. PRIMARY TRIAL SPONSOR The University of Queensland, Brisbane QLD 4072 Australia. FUNDING The University of Queensland.
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Affiliation(s)
- J. Nikles
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
- NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Australia
| | - R.L. Tate
- John Walsh Centre for Rehabilitation Studies, Northern Clinical School, The University of Sydney, Sydney, Australia
| | - G. Mitchell
- Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Limestone Medical Centre, Ipswich, QLD, Australia
| | - M. Perdices
- Royal North Shore Hospital, Sydney, Australia
| | - J.M. McGree
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - C. Freeman
- School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, QLD, Australia
| | - S. Jacob
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
| | - M.W. Taing
- School of Pharmacy, The University of Queensland, QLD, Australia
| | - M. Sterling
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
- NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Australia
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Mitchell G, Tsao H, Randell T, Marks J, Mackay P. Impact of electric scooters to a tertiary emergency department: 8-week review after implementation of a scooter share scheme. Emerg Med Australas 2019; 31:930-934. [PMID: 31423709 DOI: 10.1111/1742-6723.13356] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/19/2019] [Accepted: 06/26/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A retrospective audit of presentations to a tertiary trauma centre reviewing the demographics of electric scooter injuries in the first 2 months of the scooter-share scheme, which was commenced in Brisbane in November 2018. METHODS Electric scooter-associated presentations to the Royal Brisbane and Women's Hospital Emergency and Trauma Centre from November 2018 to January 2019 were identified. Data collected included patient demographics, type and location of injuries, helmet use, alcohol consumption, length of stay and disposition. Estimates of costs associated with electric scooter presentation were also obtained. RESULTS Fifty-four electric scooter encounters were included during the 2-month period. Helmets were worn in 46% and was associated with reduced risk of head injury (odds ratio (OR) 0.18, P = 0.029). Alcohol was involved in 27% although this did not impact on admission rates (OR 1.25, P = 0.83) or operative management (OR 2.14, P = 0.42). Contusions/abrasions and fractures/dislocations were the most common types of injury, whereas upper limb and minor head injuries were the most common sites of injury. Most patients were discharged home (87%), with 74% completing their emergency visit in under 4 h. Six patients required operative management and 15 patients needed outpatient follow-up. There were no deaths. Average patient cost per presentation was $542 and ranged from $285 to $1345. CONCLUSIONS The findings characterised injury patterns and costs associated with electric scooters in our ED. Given the increasing popularity of electric scooters as an alternate form of transportation, our study may help to inform public policy for future injury prevention.
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Affiliation(s)
- Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Emergency Department, Redland Hospital, Brisbane, Queensland, Australia
| | - Henry Tsao
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Thomas Randell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jacqueline Marks
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Prudence Mackay
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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63
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Valisno JA, Elavalakanar P, Minetti E, Nicholson C, Singh K, Avram D, Cohen R, Mitchell G, Morgan K, Seta F. Bcl11b Regulates Vascular Smooth Muscle Phenotype and Arterial Stiffness. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.120.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Erika Minetti
- Vascular BiologyBoston University School of MedicineBostonMA
| | | | | | - Dorina Avram
- College of MedicineUniversity of FloridaGainsevilleFL
| | - Richard Cohen
- Vascular BiologyBoston University School of MedicineBostonMA
| | | | | | - Francesca Seta
- Vascular BiologyBoston University School of MedicineBostonMA
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Abstract
Dementia care has evolved over the years, with a rise in person-centred non-pharmacological interventions such as reminiscence therapy, reality orientation and validation therapy. While these non-pharmacological interventions are an important facet of dementia care, nurses also require up-to-date knowledge of the medicines used to manage the symptoms of dementia, including antidepressants, cognitive enhancers and analgesics. Nurses should also understand the effects of behaviour-modifying medicines such as antipsychotics, anxiolytics and hypnotics, which are often overused or inappropriately prescribed in people with dementia. This article discusses the use of all these medicines in dementia care. It also examines the effect of polypharmacy on people with dementia, as well as some of the challenges involved in medicines administration in this patient group, such as covert administration of medicines, polypharmacy and non-adherence.
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, Northern Ireland
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Mitchell G, Porter S, Manias E. From telling to sharing to silence: A longitudinal ethnography of professional‐patient communication about oral chemotherapy for colorectal cancer. Psychooncology 2018; 28:336-342. [DOI: 10.1002/pon.4945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/02/2018] [Accepted: 11/13/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Gary Mitchell
- School of Nursing and MidwiferyQueen's University Belfast Belfast Northern Ireland, UK
| | - Sam Porter
- Department of Social Sciences & Social WorkBournemouth University Dorset England, UK
| | - Elizabeth Manias
- School of Nursing & Midwifery, Centre for Quality and Patient Safety ResearchDeakin University Melbourne Australia
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Mitchell G, Rooney S, Sheeran C, Strain J. Medicines management for people with dementia. Nurs Stand 2018:e11079. [PMID: 30507097 DOI: 10.7748/ns.2018.e11079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 06/09/2023]
Abstract
Dementia care has evolved over the years, with a rise in person-centred non-pharmacological interventions such as reminiscence therapy, reality orientation and validation therapy. While these non-pharmacological interventions are an important facet of dementia care, nurses also require up-to-date knowledge of the medicines used to manage the symptoms of dementia, including antidepressants, cognitive enhancers and analgesics. Nurses should also understand the effects of behaviour-modifying medicines such as antipsychotics, anxiolytics and hypnotics, which are often overused or inappropriately prescribed in people with dementia. This article discusses the use of all these medicines in dementia care. It also examines the effect of polypharmacy on people with dementia, as well as some of the challenges involved in medicines administration in this patient group, such as covert administration of medicines, polypharmacy and non-adherence.
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, Northern Ireland
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67
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Mitchell G. Problems hidden in plain sight. Br J Dermatol 2018; 179:817-818. [PMID: 30318807 DOI: 10.1111/bjd.17017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Mitchell
- Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Australia
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Oshi DC, Ricketts-Roomes T, Oshi SN, Mitchell C, Agu CF, Belinfante A, Mitchell G, Whitehorne-Smith P, Harrison J, Atkinson U, Abel WD. Gender differences in the factors associated with early age of initiation of cannabis use in Jamaica. Journal of Substance Use 2018. [DOI: 10.1080/14659891.2018.1531946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D. C. Oshi
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - T. Ricketts-Roomes
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - S. N. Oshi
- Department of General Studies and Behavioural Sciences, University of the Commonwealth Caribbean, Kingston, Jamaica
| | - C. Mitchell
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - C. F. Agu
- School of Nursing, The University of the West Indies, Kingston, Jamaica
| | - A. Belinfante
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - G. Mitchell
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - P. Whitehorne-Smith
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - Joy Harrison
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
| | - U. Atkinson
- National Council on Drug Abuse, Kingston, Jamaica
| | - W. D. Abel
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston, Jamaica
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Daulbayev C, Mansurov Z, Mitchell G, Zakhidov A. Obtaining of Biologically Soluble Membranes Based on Polymeric Nanofibres and Hydroxyapatite of Calcium. Eurasian Chem Tech J 2018. [DOI: 10.18321/ectj690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In this paper, the possibility of obtaining a synthetic hydroxyapatite of calcium from a biological waste material is shown. The characteristics influencing the synthesis process are studied. Based on the results of the X-ray analysis and the obtained electron microscope images, it can be concluded that the synthesized HAP has a Ca/P ratio of 1.5 and with crystals with an average size of 2 microns. In work, experiments on obtaining biologically soluble films based on nanoscale polymer fibers and calcium hydroxyapatite were carried out. As a result, the main parameters of the process for the electroforming of nano-sized fibers with HAP are determined. The proposed method allows the laying of strictly directed nanofibers from a polymer with a diameter of 50 to 500 nm. The use of different types of electrodes makes it possible to vary the size of nanofibers. The characteristics such as solution viscosity, high voltage and optimum parameters were selected, which allowed obtaining films from biologically soluble polymer nanofibers and HAP. Also, experiments were conducted to introduce medicines into the film structure.
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Nikles J, Keijzers G, Mitchell G, Schug S, Ware R, McLean SA, Connelly L, Gibson S, Farrell SF, Sterling M. Pregabalin versus placebo in targeting pro-nociceptive mechanisms to prevent chronic pain after whiplash injury in at-risk individuals - a feasibility study for a randomised controlled trial. Trials 2018; 19:44. [PMID: 29343280 PMCID: PMC5773126 DOI: 10.1186/s13063-018-2450-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Whiplash-associated disorders (WAD) are an enormous and costly burden to Australian society. Up to 50% of people who experience a whiplash injury will never fully recover. Whiplash is resistant to treatment and no early management approach has yet been shown to prevent chronic pain. The early presence of central sensitization is associated with poor recovery. Pregabalin's effects on central sensitization indicate the potential to prevent or modulate these processes after whiplash injury and to improve health outcomes, but this has not been investigated. This paper describes the protocol for a feasibility study for a randomised controlled trial of pregabalin plus evidence-based advice compared to placebo plus evidence-based advice for individuals with acute whiplash injury who are at risk of poor recovery. METHODS This double blind, placebo-controlled randomised feasibility study will examine the feasibility and potential effectiveness of pregabalin and evidence-based advice (intervention) compared to placebo and evidence-based advice (control) for individuals with acute whiplash injury at risk of poor recovery. Thirty participants (15 per group) aged 18-65 years with Grade II WAD, within 48 hours of injury and currently experiencing at least moderate pain (NRS: ≥ 5/10) will be recruited from Emergency Departments of public hospitals in Queensland, Australia. Pregabalin will be commenced at 75 mg bd and titrated up to 300 mg bd as tolerated for 4 weeks followed by 1 week of weaning. RESULTS The feasibility of trial procedures will be tested, as well as the potential effect of the intervention on the outcomes. The primary outcome of neck pain intensity at 3 months from randomisation will be compared between the treatment groups using standard analysis of variance techniques. DISCUSSION Feasibility and potential effectiveness data will inform an appropriately powered full trial, which if successful, will provide an effective and cost-effective intervention for a costly and treatment resistant condition. It will also have implications for the early management of other traumatic conditions beyond whiplash. TRIAL REGISTRATION Clinical Trials Primary Registry: Australian and New Zealand Clinical Trials Registry. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12617000059369 . Date of Registration: 11/01/2017. Primary Trial Sponsor: The University of Queensland, Brisbane QLD 4072 Australia.
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Affiliation(s)
- J. Nikles
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
| | - G. Keijzers
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland Australia
- School of Medicine, Bond University, Gold Coast, QLD Australia
- School of Medicine, Griffith University, Gold Coast, QLD Australia
| | - G. Mitchell
- Faculty of Medicine, The University of Queensland, Herston, Australia
| | - S. Schug
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia
| | - R. Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - S. A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA
| | - L. Connelly
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
- Dipartimento di Sociologia e Diritto dell’Economia, University of Bologna, Bologna, Italy
| | - S. Gibson
- Caulfield Pain Management and Research Centre, Melbourne, Australia
| | - S. F. Farrell
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - M. Sterling
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Royston C, Mitchell G, Sheeran C, Strain J, Goldsmith S. Optimisation of dementia care in care homes: Dementia care framework (innovative practice). Dementia (London) 2017; 19:1316-1324. [PMID: 29164907 DOI: 10.1177/1471301217740009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are an increasing number of people living with dementia in care home settings. Recent reports suggest that people who deliver care to residents living with dementia in care homes require specialist support to provide optimum care. To address this need Four Seasons Health Care, the largest provider of care homes within the UK today, sought to design a dementia care framework that enhanced the quality of life for people living with dementia in their care homes. The framework was designed using a robust evidence base, engagement with people living with dementia, their care partners, policy-writers, multidisciplinary professionals and people within the organisation. This paper describes the methodology behind the dementia care framework and outcomes data from the first phase (of 20 care homes that included the care of 451 people living with dementia). The main outcome was a significant improvement in the quality of the lives of residents across biological, psychological, social and spiritual needs.
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Mitchell G. In defence of care homes: a call to arms. ACTA ACUST UNITED AC 2017; 26:S17. [PMID: 29125352 DOI: 10.12968/bjon.2017.26.20.s17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gary Mitchell
- Research Coordinator, Four Seasons Health Care, 2016 BJN Nurse of the Year
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Meiser B, Wong WKT, Peate M, Julian-Reynier C, Kirk J, Mitchell G. Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: a systematic literature review. Hered Cancer Clin Pract 2017; 15:14. [PMID: 28943990 PMCID: PMC5607482 DOI: 10.1186/s13053-017-0075-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 09/14/2017] [Indexed: 12/02/2022] Open
Abstract
Background Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen’s well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use ‘s amongst high-risk women. Methods Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women’s decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies. Results A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism. Conclusions Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological.
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Affiliation(s)
- B Meiser
- Prince of Wales Clinical School, UNSW, Level 4, Lowy Cancer Research Centre C25, Sydney, NSW 2052 Australia
| | - W K T Wong
- Prince of Wales Clinical School, UNSW, Level 4, Lowy Cancer Research Centre C25, Sydney, NSW 2052 Australia.,School of Social Sciences and Prince of Wales Clinical School, UNSW Sydney, Kensington, NSW 2052 Australia
| | - M Peate
- Prince of Wales Clinical School, UNSW, Level 4, Lowy Cancer Research Centre C25, Sydney, NSW 2052 Australia.,Department of Obstetrics and Oncology, Royal Women's Hospital, University of Melbourne, Melbourne, VIC 3052 Australia
| | | | - J Kirk
- Familial Cancer Service, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145 Australia.,Westmead Millennium Institute for Medical Research at the University of Sydney, PO Box 412, Westmead, NSW 2145 Australia
| | - G Mitchell
- Sir Peter MacCallum Dept of Oncology, University of Melbourne, Parkville, VIC 3010 Australia.,Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC 8006 Australia
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Mitchell G, Anderson D, Meadows A, Morris Z, Ludy M. Bacterial Presence on Common Objects at Bar-and-Grille Restaurants. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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75
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de Roos A, van der Grond J, Mitchell G, Westenberg J. Magnetic Resonance Imaging of Cardiovascular Function and the Brain: Is Dementia a Cardiovascular-Driven Disease? Circulation 2017; 135:2178-2195. [PMID: 28559496 DOI: 10.1161/circulationaha.116.021978] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The proximal aorta acts as a coupling device between heart and brain perfusion, modulating the amount of pressure and flow pulsatility transmitted into the cerebral microcirculation. Stiffening of the proximal aorta is strongly associated with age and hypertension. The detrimental effects of aortic stiffening may result in brain damage as well as heart failure. The resulting cerebral small vessel disease and heart failure may contribute to early cognitive decline and (vascular) dementia. This pathophysiological sequence of events underscores the role of cardiovascular disease as a contributory mechanism in causing cognitive decline and dementia and potentially may provide a starting point for prevention and treatment. Magnetic resonance imaging is well suited to assess the function of the proximal aorta and the left ventricle (eg, aortic arch pulse wave velocity and distensibility) as well as the various early and late manifestations of cerebral small vessel disease (eg, microbleeds and white matter hyperintensities in strategically important regions of the brain). Specialized magnetic resonance imaging techniques are explored for diagnosing preclinical changes in white matter integrity or brain microvascular pulsatility.
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Affiliation(s)
- Albert de Roos
- From Leiden University Medical Center, Department of Radiology, The Netherlands (A.d.R., J.v.d.G., J.W.); and Cardiovascular Engineering, Inc, Norwood, MA (G.M.).
| | - Jeroen van der Grond
- From Leiden University Medical Center, Department of Radiology, The Netherlands (A.d.R., J.v.d.G., J.W.); and Cardiovascular Engineering, Inc, Norwood, MA (G.M.)
| | - Gary Mitchell
- From Leiden University Medical Center, Department of Radiology, The Netherlands (A.d.R., J.v.d.G., J.W.); and Cardiovascular Engineering, Inc, Norwood, MA (G.M.)
| | - Jos Westenberg
- From Leiden University Medical Center, Department of Radiology, The Netherlands (A.d.R., J.v.d.G., J.W.); and Cardiovascular Engineering, Inc, Norwood, MA (G.M.)
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Scott T, Mitchell G, Liddle J, Beattie E, Pachana N. STRATEGIES USED BY PRIMARY CARE PRACTITIONERS TO SUPPORT PEOPLE WITH DEMENTIA WTH DRIVING CESSATION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T.L. Scott
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia,
| | - G. Mitchell
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia,
| | - J. Liddle
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia,
| | - E.R. Beattie
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - N.A. Pachana
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia,
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Affiliation(s)
- S.L. Dupuis
- Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada,
| | - P. Kontos
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada,
| | | | | | - J. Gray
- University of Toronto, Toronto, Ontario, Canada
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Ploeger HW, Ankum L, Moll L, van Doorn DCK, Mitchell G, Skuce PJ, Zadoks RN, Holzhauer M. Presence and species identity of rumen flukes in cattle and sheep in the Netherlands. Vet Parasitol 2017; 243:42-46. [PMID: 28807308 DOI: 10.1016/j.vetpar.2017.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 05/12/2017] [Accepted: 06/07/2017] [Indexed: 11/17/2022]
Abstract
The purpose of the study was to gain knowledge about the prevalence and identity of rumen flukes (RF) in cattle and sheep in the Netherlands. Routine faecal examinations of diagnostic submissions between May 2009 and September 2014 showed a mean annual herd or flock RF prevalence of 15.8% for cattle and 8.0% for sheep. Prevalence in cattle was higher after 2012 than before, which may reflect a change in detection method as well as an increase in true prevalence. During November and December 2014, an abattoir survey was conducted to allow for scoring of rumen fluke burden and to obtain specimens for molecular species characterization. Over 8 visits to 5 abattoirs in areas deemed to pose a high risk for trematode infection, 116 cows and 41 sheep from 27 herds and 10 flocks were examined. Prevalence of RF was higher in beef cattle than in dairy cattle and higher in cattle than in sheep. Median fluke burden was >100 specimens per animal for most positive animals. Using a semi-quantitative RF density score as a gold standard, sensitivity and specificity of a modified quantitative Dorsman egg counting method were estimated at 82.6% and 83.3%, respectively. Of 14 collected adult rumen flukes, twelve (8 bovine and 4 ovine specimens) were identified as Calicophoron daubneyi. The other two, of bovine origin, were identified as Paramphistomum leydeni, which was unexpected as in other European countries all recently collected rumen flukes in both cattle and sheep were identified as C. daubneyi. The findings implicate that multiple rumen fluke species, intermediate host species and transmission cycles may play a role in rumen fluke infections in the Netherlands.
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Affiliation(s)
- H W Ploeger
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands
| | - L Ankum
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands
| | - L Moll
- GD Animal Health, P.O. Box 9, 7400 AA, Deventer, The Netherlands
| | - D C K van Doorn
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands; GD Animal Health, P.O. Box 9, 7400 AA, Deventer, The Netherlands
| | - G Mitchell
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik EH26 0PZ, United Kingdom
| | - P J Skuce
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik EH26 0PZ, United Kingdom
| | - R N Zadoks
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik EH26 0PZ, United Kingdom; Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - M Holzhauer
- GD Animal Health, P.O. Box 9, 7400 AA, Deventer, The Netherlands.
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Murray SA, Kendall M, Mitchell G, Moine S, Amblàs-Novellas J, Boyd K. Authors' reply to Wise's letter on including palliative care doctors in treatment discussions. BMJ 2017; 357:j2432. [PMID: 28526700 DOI: 10.1136/bmj.j2432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Scott A Murray
- Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - M Kendall
- Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - G Mitchell
- Faculty of Medicine and Biomedical Science, University of Queensland, Brisbane, Australia
| | - S Moine
- Health Education and Practices Laboratory, Amiens University Hospital, Amiens, France
| | - J Amblàs-Novellas
- Geriatric and Palliative Care Department, University of Vic, Barcelona, Spain
| | - K Boyd
- Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Abstract
Cancer care is complex, and made more so by multimorbidity and ageing. Multimorbidity affects all stages of cancer care from prevention and early detection through to end of life care. The effectiveness of cancer treatments in multimorbid patients may not be understood, as many conditions common in older people may be exclusion criteria in oncology clinical trials. The interaction between pre-existing physical capacity, multiple medical conditions and ageing can delay diagnosis, impact on treatments, complicate survivor care, and impact on decisions about starting and ceasing treatments. General Practitioners (GPs) manages multimorbidity routinely, yet the GP role in comprehensive cancer care is limited. Integration of GP management of multimorbidity in conjunction with oncology services should improve patient outcomes. Integration of care for these patients can educate patients on the minimisation of multimorbidity, develop personalised screening plans and contribute to the wholistic management of people in the surveillance period. GPs should have a major role in end of life care. Integration of general practice and oncology should benefit patient care.
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Affiliation(s)
- D Mazza
- School of Primary Care and Allied Health, Monash University, Notting Hill, Vic., Australia
| | - G Mitchell
- Primary Care Clinical Unit, The University of Queensland Faculty of Medicine, Royal Brisbane & Women's Hospital, Herston, Qld, Australia
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Mitchell G. Dementia Care at a Glance Jenkins Catharine Ginesi Laura and Keenan Bernie Dementia Care at a Glance 176pp £26.99 Wiley-Blackwell 9781118859988 1118859987 [Formula: see text]. Nurs Older People 2017; 29:15. [PMID: 28361628 DOI: 10.7748/nop.29.3.15.s18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This book adds to Wiley's critically acclaimed 'at a glance' series with an overview of dementia care for all grades of healthcare providers, including healthcare assistants.
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Sardana M, Lessard D, Parikh N, Ogunsua A, Vaze A, Nah G, Cheng S, Thomas R, Aurigemma G, Benjamin E, Mitchell G, Ramachandran V, Tsao C, Schiller N, McManus D. LEFT ATRIAL FUNCTION INDEX AS A PREDICTOR OF CARDIOVASCULAR DISEASE AND ATRIAL FIBRILLATION: DATA FROM THE FRAMINGHAM OFFSPRING STUDY. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34916-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- Scott A Murray
- Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - M Kendall
- Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - G Mitchell
- Faculty of Medicine and Biomedical Science, University of Queensland, Brisbane, Australia
| | - S Moine
- Health Education and Practices Laboratory, Amiens University Hospital, Amiens, France
| | - J Amblàs-Novellas
- Geriatric and Palliative Care Department, University of Vic, Barcelona, Spain
| | - K Boyd
- Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Abstract
Aim To present a narrative review of the empirical literature on the use of horticultural therapy in dementia care. Method A comprehensive literature search, conducted in December 2014, resulted in the selection of 15 primary research articles for review. Of these, three used qualitative methods, five used quantitative methods and seven used mixed methodology. The articles were critically appraised, and the narrative synthesis used a thematic approach whereby prominent themes from the articles were grouped to form representative themes. Findings Three main themes emerged from the narrative synthesis: the emotional health of people living with dementia, their perceived self-identity and their levels of engagement. Conclusion Horticultural therapy can be beneficial. At a macro-level, it is an inexpensive therapy that does not require specialist training to deliver. At a micro-level, it enhances the wellbeing of people living with dementia. Recommendations are made to promote access to appropriate horticultural therapy for people living with dementia, and for further research in this area.
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Affiliation(s)
- Marianne Blake
- School of Nursing and Midwifery, University of Dundee, Scotland
| | - Gary Mitchell
- Four Seasons Health Care, Irish Regional Office, Belfast, Northern Ireland
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85
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Abstract
Care homes are an increasingly important part of the UK's healthcare system. Despite their importance, particularly in providing care for older people with complex needs, the sector is often disadvantaged and overlooked by commissioners, policymakers and researchers. The authors provide an overview of some important challenges for the sector. These challenges relate to funding, education and research, overseas staff, career pathways and staff recruitment and retention. They conclude that recruitment and retention of registered nurses is arguably the greatest challenge, as high staff turnover is the catalyst for other challenges identified. The care home sector should be considered as equal to hospitals, community settings and hospices. Care homes offer registered nurses many opportunities for development of clinical and organisational skills.
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86
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Abstract
There is a plethora of literature on person-centred care and its importance in health care. The principles of person-centred care are especially important for people living with dementia because of the clinical manifestations of the disease. This article intends to provide nurses with an overview of the work of Tom Kitwood and how it pertains to providing best practice in dementia care. Various person-centred theories have been developed. However, Kitwood's work is by far the most widely referred to in dementia care. An understanding of Kitwood's ideas, in particular those of malignant social psychology and positive person work, enables nurses to develop competence in delivering optimum person-centred care to people with dementia in clinical practice.
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Affiliation(s)
- Gary Mitchell
- Four Seasons Health Care, Irish Regional Office, Belfast, Northern Ireland
| | - Joanne Agnelli
- Four Seasons Health Care, Irish Regional Office, Belfast, Northern Ireland
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Marwick T, Watts G, Stanton T, Mitchell G, Tonkin A, Nicholls S. Absence of Coronary Calcification is a Common and Reassuring Finding in Half of Intermediate Risk Patients with a Family History of CAD: Baseline Results from the CAUGHT-CAD Study. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mitchell G, Cousins C, Burrows R, Cousins G. A review of safe-staffing models and their applicability to care homes. J Nurs Manag 2016; 25:157-162. [DOI: 10.1111/jonm.12450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 12/01/2022]
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Blower E, Sridharan U, Kiernan T, Tansley A, Mitchell G, Holcombe C. Does the oncotype DX assay recurrence score correlate with other predictive tools when planning adjuvant chemotherapy in early breast cancer? Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
AIM The aim of this study was to determine care home managers' knowledge of palliative care using the palliative care quiz for nursing (PCQN). BACKGROUND Palliative care is strongly advocated for all people living with advancing incurable illness. Within a care home setting there should be a particular emphasis on the importance of palliative care, particularly for those residents who, because of their advancing age, are likely to live with non-malignant diseases such as dementia, chronic obstructive pulmonary disease or heart failure to name a few. METHODS Before the beginning of a workshop on optimising palliative care for people living in care homes, 56 care home managers (all nurses) completed the PCQN, a validated questionnaire that is used to assess a nurse's knowledge of palliative care, as part of a learning exercise. RESULTS The quiz consisted of 20 questions for which participants could answer true, false or don't know. The average score was 12.89 correct answers out of a possible 20 (64.45%). CONCLUSION This study highlights the need to develop the knowledge and competence of care home managers in relation to palliative care. This is particularly important given the increasing number of people who are living with non-malignant disease within a care home setting.
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Affiliation(s)
- Gary Mitchell
- Resident Experience Care Specialist, Four Seasons Health Care, Northern Ireland
| | | | | | - Joanne Agnelli
- Resident Experience Support Manager at Four Seasons Health Care
| | - Monica Diamond
- Resident Experience Care Specialist at Four Seasons Health Care
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91
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Mitchell G, Agnelli J, McGreevy J, Diamond M, Roble H, McShane E, Strain J. Palliative and end-of-life care for people living with dementia in care homes: part 2. Nurs Stand 2016; 30:54-63. [PMID: 27353937 DOI: 10.7748/ns.2016.e10582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article, the second of two, provides healthcare practitioners with an overview of best practice in palliative and end-of-life care, including nutrition, hydration, oral hygiene and pain management. Communication and spiritual care are discussed, as well as care after death. Providing support and education for families is an important aspect of palliative and end-of-life care. Care home nurses should ensure that the person living with dementia is at the centre of decision making, and provide care that is inclusive of their needs and wishes. The article is framed in a care home context; there is little research about how to optimise palliative care for people living with dementia in care homes.
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Affiliation(s)
- Gary Mitchell
- Four Seasons Health Care, Irish Regional Office, Belfast, Northern Ireland
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92
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Mitchell G, Agnelli J, McGreevy J, Diamond M, Roble H, McShane E, Strain J. Palliative and end of life care for people living with dementia in care homes: part 1. Nurs Stand 2016; 30:54-63. [PMID: 27332611 DOI: 10.7748/ns.2016.e10099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The terms palliative and end of life care are often used interchangeably and healthcare practitioners may perceive that palliative care is only appropriate during the terminal stages of an illness. This article, the first of two parts, provides healthcare practitioners with an overview of the concept of palliative care. It explains how this can be differentiated from end of life care and how it should be commenced in a timely manner, so that people who are living with dementia can contribute to the planning of their future care and death. The policies and tools used in the provision of palliative and end of life care are discussed, including advance care planning and The Gold Standards Framework. The article is framed in a care home context; there is little research about how to optimise palliative care for people living with dementia in care homes. The second part of this article will discuss end of life care and the best practices for providing end of life care, including nutrition and hydration, oral hygiene, pain management and spiritual care.
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Affiliation(s)
- Gary Mitchell
- Four Seasons Health Care, Irish Regional Office, Belfast, Northern Ireland
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93
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Yafi F, Peak T, Mitchell G, Sangkum P, Hellstrom W. 151 Synchronous Dual AUS/IPP Insertion through a Single Penoscrotal Incision. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hall J, Mitchell G, Webber C, Johnson K. Effect of horticultural therapy on wellbeing among dementia day care programme participants: A mixed-methods study (Innovative Practice). Dementia 2016; 17:611-620. [DOI: 10.1177/1471301216643847] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fourteen people attending an adult day programme were recruited to a structured horticultural therapy programme which took place over 10 weeks. The effects were assessed using Dementia Care Mapping and questionnaires completed by family carers. High levels of wellbeing were observed while the participants were engaged in horticultural therapy, and these were sustained once the programme was completed. This study adds to the growing evidence on the benefits of horticultural therapy for people with dementia who have enjoyed gardening in the past.
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Affiliation(s)
- Jodi Hall
- Faculty of Health Science, Human Services and Nursing, School of Nursing, Fanshawe College, London, ON, Canada
| | - Gary Mitchell
- Four Seasons Health Care United Kingdom, Belfast, Ireland
| | | | - Karen Johnson
- Alzheimer Outreach Services of McCormick Home, London, ON, Canada
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95
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Affiliation(s)
- Helen Noble
- School of Nursing and Midwifery, Queens's University Belfast, Belfast, UK
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96
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Mitchell G, McGreevy J, Carlisle S, Frazer P, Traynor M, Lundy H, Diamond M, Agnelli J. Evaluation of 'Dementia Friends' programme for undergraduate nursing students: Innovative practice. Dementia (London) 2016; 16:1075-1080. [PMID: 26979582 DOI: 10.1177/1471301216638589] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 'dementia friends' programme was launched by the Alzheimer's Society in the UK two years ago with the purpose of educating members of the public about the things they can do which can enhance the lives of people living with dementia. The aim of this project was to deliver a two-hour 'Dementia Friendly Community Workshop' written by the Alzheimer's Society, to an entire cohort of first-year undergraduate nursing students in one Higher Education Institutions in Northern Ireland. Following delivery of the programme, students were asked to complete a short questionnaire on their knowledge and confidence in relation to dementia care before and after the Dementia Friendly Community programme. A total of 322 undergraduate first-year nursing students took part in the Dementia Friendly Community programme. Of these, 304 returned questionnaires; 31.25% of students stated their perceived improvement in dementia knowledge was 'good' while 49.01% stated their perceived improvement in dementia knowledge was 'very good' and 13.49% stated their perceived improvement in dementia knowledge was 'excellent'. In relation to confidence in engaging with people with dementia, 31.91% stated 'good' improvement, 40.79% stated 'very good' improvement and 11.84% stated 'excellent' improvement. The Dementia Friendly Community programme was positively reviewed by the undergraduate students as it enhanced knowledge and confidence in relation to care of someone living with dementia.
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Affiliation(s)
- Gary Mitchell
- Four Seasons Health Care, Dementia Services, Belfast, Northern Ireland
| | - Jessie McGreevy
- Four Seasons Health Care, Dementia Services, Belfast, Northern Ireland
| | - Susan Carlisle
- Queen's University Belfast, School of Nursing and Midwifery, Northern Ireland
| | | | - Marian Traynor
- Queen's University Belfast, School of Nursing and Midwifery, Northern Ireland
| | | | - Monica Diamond
- Four Seasons Health Care, Dementia Services, Belfast, Northern Ireland
| | - Joanne Agnelli
- Four Seasons Health Care, Dementia Services, Belfast, Northern Ireland
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97
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Affiliation(s)
| | | | - Alison Twycross
- School of Health and Social Care, London South Bank University, London, UK
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98
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Campbell IG, Thompson ER, Rowely SM, Li N, McInerny S, Devereux L, Wong-Brown MW, Trainer AH, Mitchell G, Scott RJ, James PA. Abstract P2-09-02: Panel testing for familial breast cancer: Tension at the boundary of research and clinical care. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-09-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Gene panel sequencing is revolutionizing germline risk assessment for hereditary breast cancer. Despite scant evidence supporting the role of many of these genes in breast cancer predisposition, results are often reported to families as the definitive explanation for their family history. We assessed the frequency of mutations in 18 genes commonly included in hereditary breast cancer panels among 2,000 index cases from breast cancer families and 1,997 population controls. Cases were predominantly breast cancer-affected women referred to specialized familial cancer centers (BRCA1 and BRCA2 wild-type). Controls were cancer-free women from the LifePool study (www.lifepool.org). Sequencing data were filtered for known pathogenic or novel loss of function mutations.
The frequency of pathogenic mutations in BRCA1 and BRCA2 in the control group was 0.2% (4 mutations) and 0.4% (8 mutations), respectively, which is consistent with previous indirect estimates for Caucasian populations but to our knowledge this the largest direct assessment of their prevalence.
Excluding 18 mutations identified in BRCA1 and BRCA2 among the cases and controls, a total of 69 cases (3.5%) and 26 controls (1.3%) were found to carry an "actionable mutation". PALB2 was most frequently mutated (22 cases, 3 controls), while no mutations were identified in PTEN or STK11. Among the remaining genes, loss of function mutations were rare with similar frequency between cases and controls.
The frequency of mutations in most breast cancer panel genes among individuals selected for possible hereditary breast cancer is low and in many cases similar or even lower than that observed among cancer-free population controls. While multi-gene panels can significantly aid in cancer risk management, they equally have the potential to provide clinical misinformation and harm at the individual level if the data is not interpreted cautiously.
Citation Format: Campbell IG, Thompson ER, Rowely SM, Li N, McInerny S, Devereux L, Wong-Brown MW, Trainer AH, Mitchell G, Scott RJ, James PA. Panel testing for familial breast cancer: Tension at the boundary of research and clinical care. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-02.
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Affiliation(s)
- IG Campbell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - ER Thompson
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - SM Rowely
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - N Li
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - S McInerny
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - L Devereux
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - MW Wong-Brown
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - AH Trainer
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - G Mitchell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - RJ Scott
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - PA James
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; The University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
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Abstract
This is a case study of an ethical dilemma concerning the appropriateness of encouraging care-staff, working within a dementia care home, to either wear a clinical uniform or not to wear a clinical uniform in practice. It is proposed that people living with dementia may sustain higher levels of wellbeing if care-staff wear clothes that are more akin to their care home environment, for example, wearing similar clothes to the residents or even wearing pyjamas and nightwear during a night shift. The counter argument is that the practice may lead to greater levels of distress due to disorientation, increased potential for infection and inability to identify nurses when needed.
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McEniery C, Ben-Shlomo Y, May M, Spears M, Brumback L, Cameron J, Chen CH, Chirinos J, Czarnecka D, Dart A, Devereux R, Dhaun N, Duprez D, Hwang SJ, Jacobs D, Jankowski P, Janner J, Lacy P, Mitchell G, Pini R. 2.1 THE RELATIVE IMPORTANCE OF CENTRAL AND BRACHIAL BLOOD PRESSURE IN PREDICTING CARDIOVASCULAR EVENTS: AN INDIVIDUAL PARTICIPANT META-ANALYSIS OF PROSPECTIVE OBSERVATIONAL DATA FROM 22,433 SUBJECTS. Artery Res 2016. [DOI: 10.1016/j.artres.2016.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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