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O'Mahony L, O'Shea E, O'Connor E, Tierney A, Dunne N, Harkin M, Harrington J, Tobin K, Kennelly S, Arendt E, O'Toole P, Timmons S. 36 WHAT DO OLDER ADULTS AND HEALTH CARE PROFESSIONALS LOOK FOR IN A FOOD PRODUCT? Age Ageing 2022. [DOI: 10.1093/ageing/afac218.028] [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: 11/14/2022] Open
Abstract
Abstract
Background
The Mediterranean diet (Medi-diet) has proven benefits for healthy ageing but isn’t the habitual diet of most middle-aged or older adults in Ireland; there can be accessibility and tolerability issues with high amounts of fresh fruit and vegetables. Providing key Medi-diet nutrients in a food product is a novel approach to this challenge. This research aims to explore what ‘younger-old’ adults and healthcare professionals (HCPs) would value in such a novel food product.
Methods
Semi-structured 1:1 interviews and Focus Groups (FGs) were conducted remotely from July 2021 to January 2022. Older adults, defined as over 55’s, were recruited through relevant social, retirement and disease-support groups. Purposive sampling recruited a gender balance and a range of ages and disease profiles. HCPs were recruited through researcher networks and professional associations. Interviews/FGs were recorded, transcribed, and subsequently examined using inductive thematic analysis.
Results
Older adults (n=47; 50% male) were mostly aged 60-69 years (48.9%). Recruited HCPs (n=26) included dieticians (n=8); geriatricians (n=5); therapists (n=4); and nurses, pharmacists, catering managers (community; residential), and meal delivery service coordinators (n=2 each). Participants supported a food product for older adults requiring a nutrient-dense “boost”, or supplementary fibre or protein, but generally preferred a “food-first” approach, as opposed to a “silver bullet” product. Older adults largely associated functional foods with probiotic products “to repair the gut”, something to have “every now and then”. Product texture and portion size should consider changing dentition and appetite, and consider packaging (dexterity) and preparation ease, but should not stigmatize older adults through targeted branding. Participants felt pre-made soups or cake-type bars would be appealing, but not drinks.
Conclusion
A novel food product could supplement a balanced diet for older adults, providing high-protein content, and high-fibre for gut health, complimenting an overall lifestyle approach to health improvement and disease prevention.
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Affiliation(s)
- L O'Mahony
- University College Cork Centre for Gerontology and Rehabilitation, School of Medicine, , Cork, Ireland
| | - E O'Shea
- University College Cork Centre for Gerontology and Rehabilitation, School of Medicine, , Cork, Ireland
| | - E O'Connor
- University of Limerick Department of Biological Sciences, , Limerick, Ireland
- University of Limerick Health Research Institute, , Limerick, Ireland
- University College Cork APC Microbiome Ireland, Alimentary Pharmabiotic Centre, , Cork, Ireland
| | - A Tierney
- University of Limerick School of Allied Health, Health Implementation Science and Technology Research Group, , Limerick, Ireland
| | - N Dunne
- Family Carers Ireland , Dublin, Ireland
| | - M Harkin
- Age & Opportunity , Dublin, Ireland
| | - J Harrington
- University College Cork School of Public Health, , Cork, Ireland
| | - K Tobin
- Munster Technological University Clean Technology Centre, , Cork, Ireland
| | - S Kennelly
- National Primary Care Strategy and Planner, Health Service Executive, Ireland , Dublin, Ireland
| | - E Arendt
- University College Cork School of Food and Nutritional Sciences, , Cork, Ireland
| | - P O'Toole
- University College Cork School of Microbiology, , Cork, Ireland
- University College Cork APC Microbiome Ireland, Alimentary Pharmabiotic Centre, , Cork, Ireland
| | - S Timmons
- University College Cork Centre for Gerontology and Rehabilitation, School of Medicine, , Cork, Ireland
- University College Cork APC Microbiome Ireland, Alimentary Pharmabiotic Centre, , Cork, Ireland
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Tierney A, Curran M, Collins L, Kennedy L, McDonnell C, Jurascheck A, Sheikhi A, Walsh C, Button B, Casserly B, Cahalan R. P231 Steps Ahead: optimising physical activity in adults with cystic fibrosis - a pilot randomised trial using wearable technology, goal setting and text message feedback. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00560-4] [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: 10/18/2022]
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Raad T, Griffin A, Larkin L, Kennedy N, Tierney A. POS0243 THE EFFECT OF A MEDITERRANEAN DIET ON PHYSICAL FUNCTION AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS – THE MEDRA STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4259] [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: 11/03/2022]
Abstract
BackgroundThe immunomodulatory and anti-inflammatory effects of the Mediterranean Diet (MedDiet) suggest a protective role in rheumatic conditions1. A small but increasing body of evidence from randomised controlled trials demonstrates that increased adherence to a MedDiet in patients with Rheumatoid Arthritis (RA) can have a beneficial effect on disease activity, pain levels and physical function2.ObjectivesThe primary aim of the MEDRA study was to determine the effects of a MedDiet compared to the current food based dietary guidelines in Ireland (Healthy Eating Guidelines/HEG) on the physical function and quality of life in patients with RA.MethodsIn this randomised controlled trial, 44 patients with RA were randomly allocated to either the MedDiet or the HEG arm of the study. The 12-week dietary intervention study was delivered online by a Registered Dietitian (RD) and included data collection at three time points: baseline, mid-intervention (6 weeks) and post-intervention (12 weeks). Participants in both dietary intervention groups attended three video consultations with the RD, at baseline, weeks 6 and 12, and two follow up reviews by telephone at weeks 3 and 9. All participants were provided resources designed to specifically explain the assigned diet and how it can be successfully adhered to. Primary outcomes were changes in physical function and quality of life measured using the validated Health Assessment Questionnaire - Disability Index (HAQ-DI) and Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL), respectively. Secondary outcomes included changes in physical activity and patient-reported pain levels.ResultsForty patients with RA completed the study (mean age:47.5 SD10.9 years, females: 87.5%). No significant differences were found in the distribution of age, anthropometric measures, disease duration, physical activity, and quality of life between the two diet groups at baseline. However, the group assigned to the MedDiet had better mean values for quality of life compared to the HEG group; 0.9 ± 0.5 vs. 1.4 ±0.7, p<0.001, respectfully. Compared to baseline, there was a significant improvement in HAQ-DI scores in participants following both the MedDiet (0.9 ±0.5 to 0.5 ± 0.4, p<0.001) and HEG (1.4 ± 0.7 to 1.0 ± 0.6, p<0.001). Significant improvements in RAQoL scores were also seen in both the MedDiet (10.1 ±7.5 to 4.0 ± 4.7, p<0.001) and HEG (11.25 ± 7.2 to 7.9 ± 6.4, p=0.02) groups. At 12 weeks, participants in the MedDiet group reported a significantly better physical function status (mean difference -0.5, 95% CI -0.8 to -0.1, p=0.007) and quality of life (mean difference -3.9, 95% CI -7.5 to -0.2, p=0.04) compared to the HEG group. Participants in the MedDiet group demonstrated a significant increase in physical activity levels (56.7 ± 28.6 to 70.6 ± 33.5, p=0.01). Conversely, a non-significant decrease in physical activity levels was observed in the HEG group from baseline to post-intervention.ConclusionThe study indicates positive effects of a Mediterranean and low-fat diet as per the Healthy Eating Guidelines on physical function and quality of life in patients with RA. The MedDiet may be superior in improving physical activity levels. Further studies and a larger cohort are needed to confirm these findings.References[1]Oliviero, F., Spinella, P., Fiocco, U., Ramonda, R., Sfriso, P. and Punzi, L., 2015. How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis. Swiss medical weekly, 145(4546).[2]Forsyth, C., Kouvari, M., D’Cunha, N.M., Georgousopoulou, E.N., Panagiotakos, D.B., Mellor, D.D., Kellett, J. and Naumovski, N., 2018. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatology international, 38(5), pp.737-747.AcknowledgementsThis work was funded by the School of Allied Health Postgraduate scholarship at the University of Limerick.Disclosure of InterestsNone declared
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Tierney A, Holmes N, Kinsella E, O’Sullivan D, Daly D. P197 Bone health status over time in people with cystic fibrosis and adherence to assessment of bone health guidelines at University Hospital Limerick. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00526-4] [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: 10/18/2022]
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Larkin L, Moses A, Raad T, Tierney A, Kennedy N, Costello W. OP0191-PARE DEVELOPMENT OF A PUBLIC AND PATIENT INVOLVEMENT (PPI) RESEARCH NETWORK FOR PEOPLE WHO HAVE RHEUMATIC CONDITIONS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.442] [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: 11/04/2022]
Abstract
Background:Public and patient involvement (PPI) improves quality and relevance of research (1). PPI is advocated by policy makers and funding bodies and is supported by EULAR (2). Arthritis Research Limerick (ARL) is a partnership between researchers at the University of Limerick and clinicians at University Hospitals Limerick. PPI representatives have been involved in ARL projects, however no formal PPI network had been established prior to 2020. The need for a formal PPI network to collaborate with ARL was identified by both ARL and patient representatives. This need arose from a joint ambition to promote meaningful involvement of the public and patients in ARL projects and to develop a platform through which researchers and PPI representatives could collaboratively set research priorities.Objectives:The aim of this project was to create a formal PPI network to engage with people living with rheumatic and musculoskeletal diseases (RMDs) and their families and to identify collaborative research opportunities between ARL and PPI representatives.Methods:A face-to-face PPI seminar was planned for October 2020. The seminar consisted of speakers from ARL providing an overview of research projects and a World Café research ideas session. Funding was obtained through a competitive, peer-review funding call from the PPI Ignite group at the University of Limerick to support the PPI seminar. The funding application was a joint application between ARL members and a PPI partner (iCAN - Irish Children’s Arthritis Network). The seminar was advertised through national patient organisations (iCAN and Arthritis Ireland), social media and ARL research networks.Results:Due to Covid-19 public health restrictions the PPI seminar was held virtually. The ARL PPI inaugural seminar was attended by N=19 researchers and people living with RMDs. The seminar speakers included ARL researchers and a PPI representative. The World Café event was modified to adapt to the virtual seminar delivery. Research ideas were noted by the seminar organiser and summarised for attendees at the end of the research ideas and priorities session. An ARL PPI mailing list was set-up post seminar as a means of communicating with seminar attendees and will serve as a formal PPI network for ARL. Research updates and opportunities will be communicated via this formal network to people living with RMDs and researchers alike.Conclusion:This was the first PPI seminar organised by ARL in collaboration with a PPI seminar, and has led to the creation of a formal PPI network. Delivery mode of the PPI seminar was changed due to Covid-19 public health restrictions. This change may also have impacted engagement and attendance at the PPI seminar, given that virtual events are not accessible to all of the RMD population. Future PPI seminars will consider a hybrid approach of face-to-face and virtual attendance, to enhance accessibility. A formal PPI communication network has been established. Future work will focus future collaborative opportunities between the PPI panel and the ARL group, including project development, co-led research funding applications and joint research dissemination.References:[1]INVOLVE. (2012). Briefing notes for researchers: Involving the public in NHS, public health and social care research. Retrieved from www.invo.org.uk 7th January 2020.[2]de Wit MPT, Berlo SE, Aanerud GJ, et al (2011). European League Against Rheumatism recommendations for the inclusion of patient representatives in scientific projects. Annals of the Rheumatic Diseases 70:722-726Disclosure of Interests:None declared
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Doyle A, Drummond N, Tierney A, Hollander F, King S. EPS2.06 What do people with cystic fibrosis eat? Diet quality, macronutrient and micronutrient intakes compared to recommended guidelines in adults with cystic fibrosis: a systematic literature review. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01013-4] [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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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Jurascheck A, Sheikhi A, Button B, Casserly B, Cahalan R. P198 Physical activity is associated with aerobic capacity and lung function in adults with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01223-6] [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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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Button B, Casserly B, Cahalan R. P201 The effectiveness of exercise interventions to increase physical activity in cystic fibrosis: a systematic review. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tierney A, O’Connell S, Daly D. P269 Exploring gastrointestinal symptoms in paediatric patients with cystic fibrosis and impact on quality of life. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Sheikhi A, Walsh C, Casserly B, Cahalan R. ePS3.10 Reliability and validity of the ActivPAL and Fitbit Charge 2 as a measure of step count in cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30268-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Murphy N, Collins L, Tierney A, Linnane B, Casserly B. WS12.2 Supporting cystic fibrosis care at University Hospital Limerick (UHL) through eHealth. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30185-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tierney A, King S, Edgeworth D, Williams E, Finlayson F, Keating D, Clark D, Button B, Kotsimbos T, Wilson J. P204 An increase in weight and fat mass observed following five months of ivacaftor treatment plateaus at 24 months in adults with G551D-related cystic fibrosis. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30499-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Keating D, Edgeworth D, Heretier S, Denise C, Tierney A, Kotsimbos T, Wilson J. 45 Sweat chloride response does not reliably correlate with clinical parameters: a placebo controlled crossover trial of ivacaftor in G551D CF patients. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30410-1] [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]
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Murnane L, Tierney A, Koukounaris J, Pilgrim C. SUN-P090: The Effects of Sarcopenia and Nutritional Status on Postoperative Outcomes after Resection of Gastric Carcinoma. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30433-2] [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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Tierney A. Research literacy: an essential prerequisite for knowledge-led practice. Nurse Res 2016; 1:79-83. [PMID: 27292362 DOI: 10.7748/nr.1.1.79.s10] [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: 11/09/2022]
Abstract
Fitting to the theme of this first issue of Nurse Researcher, this article examines what the recently published Strategy for Research in Nursing, Midwifery and Health Visiting ( 1 ) has to say about raising the level of research appreciation in nursing and improving nurses' skills in accessing and reading reports of research. If all of the Strategy's recommendations relevant to this and other areas were to be implemented, then there would be solid grounds for optimism that longstanding notions of nursing as a research-based profession might become, at last, something more concrete than mere rhetoric.
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Affiliation(s)
- A Tierney
- The Nursing Research Unit. University of Edinburgh, and Chair of the RCN Research Advisory Group
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Abstract
Barrett's esophagus is a well-recognized risk factor for esophageal adenocarcinoma. The natural history of Barrett's esophagus classified as ‘indefinite for dysplasia’ (IND) is poorly characterized. The aim of this study is to characterize the natural history of IND by determining the rate of neoplastic progression and identifying risk factors for progression. Patients from the University of Pennsylvania Health System pathology database and Barrett's esophagus registry with a diagnosis of IND between 2000 and 2014 were identified. Exclusion criteria included: (1) prior diagnosis of low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma (EAC); (2) presence of LGD, HGD, or EAC at the time of diagnosis of IND; and (3) lack of follow-up endoscopy after diagnosis. Patients with neoplastic progression were classified as having either prevalent disease (LGD, HGD, or EAC on surveillance biopsy within 12 months of IND diagnosis) or incident disease (LGD, HGD, or EAC on surveillance biopsy >12 months after IND diagnosis). One hundred six patients were eligible for analysis. Of 87 patients with follow-up endoscopy and biopsies within 1 year of IND diagnosis, 7 (8%) had prevalent disease (2 LGD, 4 HGD, 1 EAC). The prevalence of LGD was 2.3%, HGD was 4.6%, and EAC was 1.1%. Importantly, four of the seven prevalent (2 LGD, 2 HGD) cases were found to have dysplasia within 6 months of IND diagnosis. No demographic or endoscopic characteristics studied were associated with prevalent disease. Of the 106 IND patients, there were 66 patients without prevalent dysplasia with >1-year follow-up. Three (4.5%) progressed (1 to LGD after 12 months, 2 to HGD after 16.5 and 28 months), yielding an incidence rate for any dysplasia of 1.4 cases/100 person-years and HGD/EAC of 0.9/100 person-years. Risk factors for incident disease were smoking (p = 0.02) and Barrett's esophagus segment length (p = 0.03). IND is associated with considerable risk of prevalent dysplasia, especially within the first 6 months after diagnosis. However, the incidence of HGD/EAC is low and similar to previous studies of IND. These data suggest that IND patients should have repeat endoscopy within 6 months with careful surveillance protocols. Longer BE length and smoking history may help predict which patients are more likely to develop dysplasia, and therefore identify patients who may warrant even closer monitoring.
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Affiliation(s)
| | | | | | | | | | - A. Tierney
- Center for Clinical Epidemiology and Biostatistics, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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Kasherman L, Foy A, Tierney A, Reeves GEM, Tran HA. Primary hypothyroidism masquerading as hepatocellular necrosis. QJM 2015; 108:581-4. [PMID: 23345467 DOI: 10.1093/qjmed/hcs241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/13/2022] Open
Affiliation(s)
- L Kasherman
- From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia
| | - A Foy
- From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia
| | - A Tierney
- From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia
| | - G E M Reeves
- From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia
| | - H A Tran
- From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia From the School of Medicine and Population Health, University of Newcastle, Department of General Medicine, Calvary Mater Hospital, Department of Immunopathology, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre and Department of Clinical Chemistry, Hunter Area Pathology Service, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia
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Roche H, Finucane O, Lyons C, Murphy A, Reynolds C, Healy N, Tierney A, Morine M, Alcala‐Diaz J, Lopez‐Miranda J, O'Neill L, McGillicuddy F. Monounsaturated Fatty Acid High‐Fat Diets Impede Adipose IL‐1β Secretion and Insulin Resistance. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.602.7] [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)
- H Roche
- NutrigenomicsResearch Group UCDIreland
| | | | - C Lyons
- NutrigenomicsResearch Group UCDIreland
| | - A Murphy
- NutrigenomicsResearch Group UCDIreland
| | | | - N Healy
- NutrigenomicsResearch Group UCDIreland
| | - A Tierney
- Department of Dietetics and Human Nutrition La Trobe UniversityAustralia
| | - M Morine
- Microsoft Research and University of Trento Centre for Computational and Systems Biology University of TrentoItaly
| | - J Alcala‐Diaz
- Lipids and Atherosclerosis Research Unit University of CordobaSpain
| | - J Lopez‐Miranda
- Lipids and Atherosclerosis Research Unit University of CordobaSpain
| | - L O'Neill
- InflammatoryResearch Group TCDIreland
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Abstract
BACKGROUND Provision of internal medicine services in rural Australia is always problematic. AIM The aim was to undertake an audit of an outreach service operating in Northern New South Wales since 2006. METHODS The service is conducted eight times a year, involving a consultant and an advanced trainee who travel by car to the towns of Moree and Mungindi and conduct clinics in a general practice setting, an Aboriginal medical service and a local health district clinic. Since 2008, a cardiology service and a diabetes service have been added on a fly-in fly-out basis. Case records of all patients enrolled in the service between February 2006 and July 2013 were reviewed in determining the demographics, clinical presentations and level of service coverage. The experience of the authors in establishing the service provided insights into the challenges and the success factors involved. RESULTS Five hundred and eighty-three patients were seen on a total of 1070 occasions relating to a wide variety of clinical presentations. Of these, 31.3% were indigenous compared with 20% in the local statistical area, and both indigenous and non-indigenous patients were seen in all settings. Patients fell into 15 different diagnostic categories with indigenous patients more likely to present for diabetes (P < 0.001) and hepatitis B (P < 0.01), but less likely to present for treatment of hepatitis C (P < 0.01). CONCLUSIONS In providing an outreach service to a mixed community, flexibility in both setting and personnel are essential. Diabetes and liver disease are highly prevalent in indigenous patients, but the low numbers presenting for hepatitis C requires further study.
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Jones PH, Dawson S, Gaskell RM, Coyne KP, Tierney A, Setzkorn C, Radford AD, Noble PJM. Surveillance of diarrhoea in small animal practice through the Small Animal Veterinary Surveillance Network (SAVSNET). Vet J 2014; 201:412-8. [PMID: 25011707 DOI: 10.1016/j.tvjl.2014.05.044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 01/04/2013] [Revised: 04/23/2014] [Accepted: 05/31/2014] [Indexed: 10/25/2022]
Abstract
Using the Small Animal Veterinary Surveillance Network (SAVSNET), a national small animal disease-surveillance scheme, information on gastrointestinal disease was collected for a total of 76 days between 10 May 2010 and 8 August 2011 from 16,223 consultations (including data from 9115 individual dogs and 3462 individual cats) from 42 premises belonging to 19 UK veterinary practices. During that period, 7% of dogs and 3% of cats presented with diarrhoea. Adult dogs had a higher proportional morbidity of diarrhoea (PMD) than adult cats (P <0.001). This difference was not observed in animals <1 year old. Younger animals in both species had higher PMDs than adult animals (P < 0.001). Neutering was associated with reduced PMD in young male dogs. In adult dogs, miniature Schnauzers had the highest PMD. Most animals with diarrhoea (51%) presented having been ill for 2-4 days, but a history of vomiting or haemorrhagic diarrhoea was associated with a shorter time to presentation. The most common treatments employed were dietary modification (66% of dogs; 63% of cats) and antibacterials (63% of dogs; 49% of cats). There was variability in PMD between different practices. The SAVNET methodology facilitates rapid collection of cross-sectional data regarding diarrhoea, a recognised sentinel for infectious disease, and characterises data that could benchmark clinical practice and support the development of evidence-based medicine.
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Affiliation(s)
- P H Jones
- Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; National Consortium for Zoonosis Research, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - S Dawson
- University of Liverpool School of Veterinary Science, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - R M Gaskell
- Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - K P Coyne
- Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - A Tierney
- Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - C Setzkorn
- Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - A D Radford
- Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - P-J M Noble
- University of Liverpool School of Veterinary Science, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK.
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King S, Sekuloska Z, Gallo R, Swan I, Al-Helou Z, Wilson J, Tierney A. 210 Changes in the nutritional status and dietary intake of adults with cystic fibrosis since 1997. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60345-3] [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: 10/25/2022]
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Menezes A, Tierney A, Yang YX, Forde KA, Bewtra M, Metz D, Ginsberg GG, Falk GW. Adherence to the 2011 American Gastroenterological Association medical position statement for the diagnosis and management of Barrett's esophagus. Dis Esophagus 2014; 28:538-46. [PMID: 24849246 DOI: 10.1111/dote.12228] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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: 12/11/2022]
Abstract
Considerable variability exists in adherence to practice guidelines for Barrett's esophagus (BE). Rapid advances in management approaches to BE led to a new American Gastroenterological Association (AGA) medical position statement in 2011. Our aim was to assess how well members of the AGA Clinical Practice section adhered to these guidelines. A self-administered survey incorporating questions on diagnostic criteria, cancer risk estimates, screening, surveillance, and therapeutics for BE was distributed electronically to 5850 North American members of the AGA Clinical Practice section. The response rate was 470 of 2040 opened e-mails (23%). Intestinal metaplasia was required for diagnosis of BE by 90%, but the Prague classification was used by only 53% of those aware of it. The annual risk of progression to esophageal adenocarcinoma was reported as 0.1-0.5% by 76%. Screening practices were variable, with 35% screening all patients with chronic gastroesophageal reflux disease and 15% repeating endoscopy in patients with gastroesophageal reflux disease following a negative screening. Surveillance guidelines were followed by 79% for nondysplastic BE and 86% for low-grade dysplasia, with expert pathology confirmation of dysplasia reported by 86%. Proton pump inhibitor dosing was variable, with 18% administering twice-daily doses and 30% titrating dose to symptoms. Ablation therapy was recommended by 6% for nondysplastic BE, 38% for low-grade dysplasia, and 52% for high-grade dysplasia. There is satisfactory adherence to the new AGA guidelines with respect to diagnosis, cancer risk estimates, and surveillance intervals in a select group of respondents. However, adherence continues to be variable in the use of the Prague classification, screening, and dosing of antisecretory therapy. Use of ablation therapy increases with grade of dysplasia. The reason for continued variability in adherence to BE practice guidelines remains unclear, and more evidence-based guidance is required to enhance clinical practice.
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Affiliation(s)
- A Menezes
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - A Tierney
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Y-X Yang
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - K A Forde
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M Bewtra
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - D Metz
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - G G Ginsberg
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - G W Falk
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Mehta P, Holder S, Fisher B, Vincent T, Nadesalingam K, Maciver H, Shingler W, Bakshi J, Hassan S, D'Cruz D, Chan A, Litwic AE, McCrae F, Seth R, McCrae F, Nandagudi A, Jury E, Isenberg D, Karjigi U, Paul A, Rees F, O'Dowd E, Kinnear W, Johnson S, Lanyon P, Bakshi J, Stevens R, Narayan N, Marguerie C, Robinson H, Ffolkes L, Worsnop F, Ostlere L, Kiely P, Dharmapalaiah C, Hassan N, Nandagudi A, Bharadwaj A, Skibinska M, Gendi N, Davies EJ, Akil M, Kilding R, Ramachandran Nair J, Walsh M, Farrar W, Thompson RN, Borukhson L, McFadyen C, Singh D, Rajagopal V, Chan AML, Wearn Koh L, Christie JD, Croot L, Gayed M, Disney B, Singhal S, Grindulis K, Reynolds TD, Conway K, Williams D, Quin J, Dean G, Churchill D, Walker-Bone KE, Goff I, Reynolds G, Grove M, Patel P, Lazarus MN, Roncaroli F, Gabriel C, Kinderlerer AR, Nikiphorou E, Hall FC, Bruce E, Gray L, Krutikov M, Wig S, Bruce I, D'Agostino MA, Wakefield R, Berner Hammer H, Vittecoq O, Galeazzi M, Balint P, Filippucci E, Moller I, Iagnocco A, Naredo E, Ostergaard M, Gaillez C, Kerselaers W, Van Holder K, Le Bars M, Stone MA, Williams F, Wolber L, Karppinen J, Maatta J, Thompson B, Atchia I, Lorenzi A, Raftery G, Platt P, Platt PN, Pratt A, Turmezei TD, Treece GM, Gee AH, Poole KE, Chandratre PN, Roddy E, Clarson L, Richardson J, Hider S, Mallen C, Lieberman A, Prouse PJ, Mahendran P, Samarawickrama A, Churchill D, Walker-Bone KE, Ottery FD, Yood R, Wolfson M, Ang A, Riches P, Thomson J, Nuki G, Humphreys J, Verstappen SM, Chipping J, Hyrich K, Marshall T, Symmons DP, Roy M, Kirwan JR, Marshall RW, Matcham F, Scott IC, Rayner L, Hotopf M, Kingsley GH, Scott DL, Steer S, Ma MH, Dahanayake C, Scott IC, Kingsley G, Cope A, Scott DL, Dahanayake C, Ma MH, Scott IC, Kingsley GH, Cope A, Scott DL, Wernham A, Ward L, Carruthers D, Deeming A, Buckley C, Raza K, De Pablo P, Nikiphorou E, Carpenter L, Jayakumar K, Solymossy C, Dixey J, Young A, Singh A, Penn H, Ellerby N, Mattey DL, Packham J, Dawes P, Hider SL, Ng N, Humby F, Bombardieri M, Kelly S, Di Cicco M, Dadoun S, Hands R, Rocher V, Kidd B, Pyne D, Pitzalis C, Poore S, Hutchinson D, Low A, Lunt M, Mercer L, Galloway J, Davies R, Watson K, Dixon W, Symmons D, Hyrich K, Mercer L, Lunt M, Low A, Galloway J, Watson KD, Dixon WG, Symmons D, Hyrich KL, Low A, Lunt M, Mercer L, Bruce E, Dixon W, Hyrich K, Symmons D, Malik SP, Kelly C, Hamilton J, Heycock C, Saravanan V, Rynne M, Harris HE, Tweedie F, Skaparis Y, White M, Scott N, Samson K, Mercieca C, Clarke S, Warner AJ, Humphreys J, Lunt M, Marshall T, Symmons D, Verstappen S, Chan E, Kelly C, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Ahmad Y, Koduri G, Young A, Kelly C, Chan E, Ahmad Y, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Koduri G, Young A, Cumming J, Stannett P, Hull R, Metsios G, Stavropoulos Kalinoglou A, Veldhuijzen van Zanten JJ, Nightingale P, Koutedakis Y, Kitas GD, Nikiphorou E, Dixey J, Williams P, Kiely P, Walsh D, Carpenter L, Young A, Perry E, Kelly C, de-Soyza A, Moullaali T, Eggleton P, Hutchinson D, Veldhuijzen van Zanten JJ, Metsios G, Stavropoulos-Kalinoglou A, Sandoo A, Kitas GD, de Pablo P, Maggs F, Carruthers D, Faizal A, Pugh M, Jobanputra P, Kehoe O, Cartwright A, Askari A, El Haj A, Middleton J, Aynsley S, Hardy J, Veale D, Fearon U, Wilson G, Muthana M, Fossati G, Healy L, Nesbitt A, Becerra E, Leandro MJ, De La Torre I, Cambridge G, Nelson PN, Roden D, Shaw M, Davari Ejtehadi H, Nevill A, Freimanis G, Hooley P, Bowman S, Alavi A, Axford J, Veitch AM, Tugnet N, Rylance PB, Hawtree S, Muthana M, Aynsley S, Mark Wilkinson J, Wilson AG, Woon Kam N, Filter A, Buckley C, Pitzalis C, Bombardieri M, Croft AP, Naylor A, Zimmermann B, Hardie D, Desanti G, Jaurez M, Muller-Ladner U, Filer A, Neumann E, Buckley C, Movahedi M, Lunt M, Ray DW, Dixon WG, Burmester GR, Matucci-Cerinic M, Navarro-Blasco F, Kary S, Unnebrink K, Kupper H, Mukherjee S, Cornell P, Richards S, Rahmeh F, Thompson PW, Westlake SL, Javaid MK, Batra R, Chana J, Round G, Judge A, Taylor P, Patel S, Cooper C, Ravindran V, Bingham CO, Weinblatt ME, Mendelsohn A, Kim L, Mack M, Lu J, Baker D, Westhovens R, Hewitt J, Han C, Keystone EC, Fleischmann R, Smolen J, Emery P, Genovese M, Doyle M, Hsia EC, Hart JC, Lazarus MN, Kinderlerer AR, Harland D, Gibbons C, Pang H, Huertas C, Diamantopoulos A, Dejonckheere F, Clowse M, Wolf D, Stach C, Kosutic G, Williams S, Terpstra I, Mahadevan U, Smolen J, Emery P, Ferraccioli G, Samborski W, Berenbaum F, Davies O, Koetse W, Bennett B, Burkhardt H, Weinblatt ME, Fleischmann R, Davies O, Luijtens K, van der Heijde D, Mariette X, van Vollenhoven RF, Bykerk V, de Longueville M, Arendt C, Luijtens K, Cush J, Khan A, Maclaren Z, Dubash S, Chalam VC, Sheeran T, Price T, Baskar S, Mulherin D, Molloy C, Keay F, Heritage C, Douglas B, Fleischmann R, Weinblatt ME, Schiff MH, Khanna D, Furst DE, Maldonado MA, Li W, Sasso EH, Emerling D, Cavet G, Ford K, Mackenzie-Green B, Collins D, Price E, Williamson L, Golla J, Vagadia V, Morrison E, Tierney A, Wilson H, Hunter J, Ma MH, Scott DL, Reddy V, Moore S, Ehrenstein M, Benson C, Wray M, Cairns A, Wright G, Pendleton A, McHenry M, Taggart A, Bell A, Bosworth A, Cox M, Johnston G, Shah P, O'Brien A, Jones P, Sargeant I, Bukhari M, Nusslein H, Alten R, Galeazzi M, Lorenz HM, Boumpas D, Nurmohamed MT, Bensen W, Burmester GR, Peter HH, Rainer F, Pavelka K, Chartier M, Poncet C, Rauch C, Le Bars M, Lempp H, Hofmann D, Adu A, Congreve C, Dobson J, Rose D, Simpson C, Wykes T, Cope A, Scott DL, Ibrahim F, Schiff M, Alten R, Weinblatt ME, Nash P, Fleischmann R, Durez P, Kaine J, Delaet I, Kelly S, Maldonado M, Patel S, Genovese M, Jones G, Sebba A, Lepley D, Devenport J, Bernasconi C, Smart D, Mpofu C, Gomez-Reino JJ, Verma I, Kaur J, Syngle A, Krishan P, Vohra K, Kaur L, Garg N, Chhabara M, Gibson K, Woodburn J, Telfer S, Buckley F, Finckh A, Huizinga TW, Dejonckheere F, Jansen JP, Genovese M, Sebba A, Rubbert-Roth A, Scali JJ, Alten R, Kremer JM, Pitts L, Vernon E, van Vollenhoven RF, Sharif MI, Das S, Emery P, Maciver H, Shingler W, Helliwell P, Sokoll K, Vital EM. Case Reports * 1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGF Receptor Mutations in Benign Joint Hypermobility. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket197] [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: 11/12/2022] Open
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Parbery-Clark A, Tierney A, Strait DL, Kraus N. Musicians have fine-tuned neural distinction of speech syllables. Neuroscience 2012; 219:111-9. [PMID: 22634507 DOI: 10.1016/j.neuroscience.2012.05.042] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/09/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022]
Abstract
One of the benefits musicians derive from their training is an increased ability to detect small differences between sounds. Here, we asked whether musicians' experience discriminating sounds on the basis of small acoustic differences confers advantages in the subcortical differentiation of closely related speech sounds (e.g., /ba/ and /ga/), distinguishable only by their harmonic spectra (i.e., their second formant trajectories). Although the second formant is particularly important for distinguishing stop consonants, auditory brainstem neurons do not phase-lock to its frequency range (above 1000 Hz). Instead, brainstem neurons convert this high-frequency content into neural response timing differences. As such, speech tokens with higher formant frequencies elicit earlier brainstem responses than those with lower formant frequencies. By measuring the degree to which subcortical response timing differs to the speech syllables /ba/, /da/, and /ga/ in adult musicians and nonmusicians, we reveal that musicians demonstrate enhanced subcortical discrimination of closely related speech sounds. Furthermore, the extent of subcortical consonant discrimination correlates with speech-in-noise perception. Taken together, these findings show a musician enhancement for the neural processing of speech and reveal a biological mechanism contributing to musicians' enhanced speech perception in noise.
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Affiliation(s)
- A Parbery-Clark
- Auditory Neuroscience Laboratory, Northwestern University, Evanston, IL 60208, USA
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Tierney A, Parbery-Clark A, Skoe E, Kraus N. Frequency-dependent effects of background noise on subcortical response timing. Hear Res 2011; 282:145-50. [PMID: 21907782 DOI: 10.1016/j.heares.2011.08.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/23/2011] [Accepted: 08/29/2011] [Indexed: 11/25/2022]
Abstract
The addition of background noise to an auditory signal delays brainstem response timing. This effect has been extensively documented using manual peak selection. Peak picking, however, is impractical for large-scale studies of spectrotemporally complex stimuli, and leaves open the question of whether noise-induced delays are frequency-dependent or occur across the frequency spectrum. Here we use an automated, objective method to examine phase shifts between auditory brainstem responses to a speech sound (/da/) presented with and without background noise. We predicted that shifts in neural response timing would also be reflected in frequency-specific phase shifts. Our results indicate that the addition of background noise causes phase shifts across the subcortical response spectrum (70-1000 Hz). However, this noise-induced delay is not uniform such that some frequency bands show greater shifts than others: low-frequency phase shifts (300-500 Hz) are largest during the response to the consonant-vowel formant transition (/d/), while high-frequency shifts (720-1000 Hz) predominate during the response to the steady-state vowel (/a/). Most importantly, phase shifts occurring in specific frequency bands correlate strongly with shifts in the latencies of the predominant peaks in the auditory brainstem response, while phase shifts in other frequency bands do not. This finding confirms the validity of phase shift detection as an objective measure of timing differences and reveals that this method detects noise-induced shifts in timing that may not be captured by traditional peak latency measurements.
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Affiliation(s)
- A Tierney
- Auditory Neuroscience Laboratory, Northwestern University, Evanston, IL, USA
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Radford A, Tierney A, Coyne KP, Gaskell RM, Noble PJ, Dawson S, Setzkorn C, Jones PH, Buchan IE, Newton JR, Bryan JGE. Developing a network for small animal disease surveillance. Vet Rec 2010; 167:472-4. [PMID: 20871079 DOI: 10.1136/vr.c5180] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McKellar G, Morrison E, McEntegart A, Hampson R, Tierney A, Mackle G, Scoular J, Scott JA, Capell HA. A pilot study of a Mediterranean-type diet intervention in female patients with rheumatoid arthritis living in areas of social deprivation in Glasgow. Ann Rheum Dis 2007; 66:1239-43. [PMID: 17613557 PMCID: PMC1955146 DOI: 10.1136/ard.2006.065151] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats has been associated with health benefits, including improved cardiovascular profile and benefit in RA. OBJECTIVE To overcome obstacles to healthy eating by a community-based intervention promoting a Mediterranean-type diet in patients with RA living in socially deprived areas of Glasgow. METHODS 130 female patients with RA aged 30-70 years (median 55), disease duration 8 years were recruited from three hospital sites. The intervention group (n = 75) attended weekly 2-hour sessions for 6 weeks in the local community, including hands-on cooking classes backed up with written information. The control group (n = 55) were given dietary written information only. Both groups completed food frequency questionnaires (FFQs), and clinical and laboratory measures were assessed at baseline, 3 and 6 months. RESULTS Significant benefit was shown in the intervention group compared with controls for patient global assessment at 6 months (p = 0.002), pain score at 3 and 6 months (p = 0.011 and 0.049), early morning stiffness at 6 months (p = 0.041) and Health Assessment Questionnaire score at 3 months (p = 0.03). Analysis of the FFQs showed significant increases in weekly total fruit, vegetable and legume consumption and improvement in the ratio of monounsaturated:saturated fat intake and systolic BP in the intervention group only. The cooking classes were positively received by patients and tutors; cost/patient for the 6 week course was 84 pounds (124 euro). CONCLUSIONS Results demonstrate that a 6 week intervention can improve consumption of healthier foods. If implemented more widely it may prove a popular, inexpensive and useful adjunct to other RA treatment.
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Affiliation(s)
- G McKellar
- Glasgow Royal Infirmary Castle Street, G4 0SF Glasgow, UK.
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Ng K, Sutherland D, Tierney A. Lymphoproliferative disease causing angioedema--an uncommon association. Aust N Z J Med 2000; 30:732-3. [PMID: 11198588 DOI: 10.1111/j.1445-5994.2000.tb04375.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND/PURPOSE The purpose of this study was to evaluate the evolving outcome of newborns who have congenital diaphragmatic hernia (CDH) using a protocolized approach to management, which includes extracorporeal membrane oxygenation (ECMO) and to present the details of such a management protocol. METHODS A retrospective chart review was conducted of the neonatal outcome of near-term (>34 weeks' gestation) newborns with CDH all referred to the Royal Alexandra Hospital either before or after delivery. A protocol was developed that included antenatal assessment, the use of antenatal steroids, planned delivery, use of prophylactic surfactant, pressure limited gentle ventilation, permissive hypercarbia and hypoxia, and venovenous ECMO, if indicated. RESULTS Sixty-five infants with CDH were treated from February 1989 through August 1996. Twenty-three infants were inborn, 20 of whom were antenatal referrals. Overall, 51 of the 65 infants survived (78%). Thirteen of the 23 inborn infants survived with conservative management, and 10 required ECMO, of whom, eight were long-term survivors. Thirty-eight infants required ECMO, and 26 survived (68%), whereas there were only two deaths among the 27 conservatively treated infants. Eighteen of 20 inborn infants with an antenatal diagnosis survived, compared with 13 of 21 (62%) outborn infants. An antenatal diagnosis before 25 weeks' gestation was associated with a 60% survival rate. Sixty-three percent of infants whose best postductal PaO2 value before ECMO was less than 100 torr survived, and 7 of 11 infants with a best postductal PaO2 value of less than 50 torr before ECMO survived (64%). The average age at surgery progressively increased over time both for infants who did not require ECMO (1.3 days to 5.8 days; P = .01) and for infants who received ECMO (1.9 days to 8.2 days; P = .016). CONCLUSIONS The use of a protocolized management for infants with CDH has been associated with improving outcome in a population at high risk. The components (either separately or combined) of these protocolized approaches need to be tested in prospective trials to determine their true benefit. In addition, there is a need to evaluate prospectively the outcomes of infants with CDH born in ECMO centers compared with those infants born in other tertiary care neonatal units to determine the most appropriate management of the fetus with CDH.
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Affiliation(s)
- N N Finer
- Department of Newborn Medicine, Royal Alexandra Hospital, University of Alberta, Edmonton, Canada
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Kunkler I, Tierney A, Jodrell N. Nurse-practitioner-led breast clinics. J R Soc Med 1997; 90:586. [PMID: 9488023 PMCID: PMC1296617 DOI: 10.1177/014107689709001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Friedl A, Chang Z, Tierney A, Rapraeger AC. Differential binding of fibroblast growth factor-2 and -7 to basement membrane heparan sulfate: comparison of normal and abnormal human tissues. Am J Pathol 1997; 150:1443-55. [PMID: 9094999 PMCID: PMC1858159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fibroblast growth factors (FGFs) play multiple roles during development and in adult tissues as paracrine regulators of growth and differentiation. FGFs signal through transmembrane receptor tyrosine kinases, but heparan sulfate is also required for signaling by members of the FGF family. In addition, heparan sulfate may be involved in determining tissue distribution of FGFs. Using biotinylated FGF-2 and FGF-7 (KGF) as probes, we have identified specific interactions between FGFs and heparan sulfates in human tissues. Both FGF species bind to tissue mast cells and to epithelial cell membranes. Binding to basement membrane heparan sulfate is tissue source dependent and specific. Although FGF-2 strongly binds to basement membrane heparan sulfate in skin and most other tissue sites examined, FGF-7 fails to bind to basement membrane heparan sulfate in most locations. However, in subendothelial matrix in blood vessels and in the basement membrane of a papillary renal cell carcinoma, strong FGF-7 binding is seen. In summary, distinct and specific affinities of heparan sulfates for different FGFs were identified that may affect growth factor activation and local distribution. Heparan sulfate may have a gatekeeper function to either restrict or permit diffusion of heparin-binding growth factors across the basement membrane.
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Affiliation(s)
- A Friedl
- Department of Pathology, University of Wisconsin-Madison 53792, USA
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Kunkler I, Tierney A, Jodrell N, Forbes J. Routine follow up of breast cancer in primary care. More use should be made of specialist nurses. BMJ 1996; 313:1547-8. [PMID: 8978239 PMCID: PMC2353063 DOI: 10.1136/bmj.313.7071.1547b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Tierney A. Nursing research at the University of Edinburgh. Nurs Stand 1996; 10:32. [PMID: 8920303 DOI: 10.7748/ns.10.48.32.s53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Holzemer W, Tierney A. How nursing research makes a difference. Int Nurs Rev 1996; 43:49-52, 58. [PMID: 8778052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
"Better Health Through Nursing Research" is the theme of International Nurses' Day (IND) 1996. The following examples demonstrate that a large body of evidence exists that shows that nursing care has significant effects upon health outcomes and costs of care. While much more work remains to be done, particularly with the link of research to practice and research to policy, nurse scientists are very active in making significant contributions to the quality of peoples' lives.
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Sigalet DL, Tierney A, Adolph V, Perreault T, Finer N, Hallgren R, Laberge JM. Timing of repair of congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation support. J Pediatr Surg 1995; 30:1183-7. [PMID: 7472978 DOI: 10.1016/0022-3468(95)90017-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Treatment of congenital diaphragmatic hernia (CDH) has undergone a revolutionary change in philosophy, from previous urgent repair to the present practice of stabilization and delayed repair. However, when extracorporeal membrane oxygenation (ECMO) is required, many people believe that the risk of postoperative pulmonary hypertension (PPHN) mandates hernia repair while on ECMO. This report details the experience in two ECMO centers with stabilization, ECMO if required, and CDH repair post-ECMO. All CDH patients symptomatic in the first hour of life with a gestational age of at least 34 weeks during the period were reviewed retrospectively. Standard criteria were used to select patients for ECMO. High-frequency jet or oscillating ventilators and nitric oxide were not routinely available throughout the study period, but were used in some of the more recent patients. A total of 60 patients presented to the two centers; 24 cases were stabilized with conventional management, repair of the CDH was done elective, and survival was 100%. Eight patients were referred after having repair elsewhere; six survived (75%). The two deaths were attributable to associated lethal lesions--complex cyanotic heart disease and alveolar capillary dysplasia. Eight patients who required ECMO were managed with the intention of repairing the defect on ECMO. Four survived (50%). Two patients died before repair. Twenty patients were managed with ECMO, with the intention of repairing the defect after decannulation. Overall survival was 13 (65%), deaths were caused by pre-ECMO hypoxia, pulmonary insufficiency, and associated cardiac disease. No patient had recurrent pulmonary hypertension after late repair.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D L Sigalet
- Department of Surgery, Royal Alexandra Hospital, University of Alberta, Edmonton
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36
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Abstract
OBJECTIVE To determine the effects of maternal abdominal carbon dioxide (CO2) insufflation on placental blood flow and fetal blood gas measurements in the pregnant ewe. METHOD Five time-bred ewes at 110 days' gestation were surgically prepared with maternal and fetal catheters placed for subsequent measurement of vascular pressures, blood gas tensions, and placental blood flows. On surgical recovery day 3, the ewe was anesthetized, placed on her right side, intubated, and manually ventilated to maintain a constant maternal carbon dioxide pressure (PCO2) range (37.1 +/- 3.3 mmHg) for the duration of the experiment. The maternal abdomen was inflated with CO2 to maintain an intraabdominal pressure of 20.7 +/- 0.6 mmHg. Maternal and fetal blood flows and blood gases were determined at 30 minutes of ventilation, 60 minutes of insufflation, and 40 minutes of desufflation. Simultaneous maternal and fetal organ blood flows were determined using the radioactive microsphere technique. RESULTS Maternal perfusion pressure fell 22% (P = .01) in response to insufflation, whereas pressure in the inferior vena cava rose 53% (P = .003). Maternal placental blood flow fell to 61% (P = .002) of control. Seventy-seven percent of this blood-flow change was in response to the decreased perfusion pressure, with 23% resulting from an increased placental vascular resistance of 32% (P = .02). Maternal blood gas values did not change with insufflation or desufflation. Despite the marked decrease in maternal placental blood flow, the fetal placental perfusion pressure and blood flow, pH, and blood gas tensions were unaffected by insufflation or desufflation. CONCLUSION The sheep fetus has sufficient placental flow reserves or compensatory responses to maintain adequate gas exchange during a 1-hour, 20 mmHg maternal pneumoperitoneum. Laparoscopic surgical procedures may prove to be a safe alternative to laparotomy during pregnancy.
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Affiliation(s)
- J M Barnard
- Department of Obstetrics and Gynecology, University of Wisconsin Medical School, Madison, USA
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37
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Tierney A, Worth A, Closs SJ, King C, Macmillan M. Older patients' experiences of discharge from hospital. Nurs Times 1994; 90:36-9. [PMID: 8008597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The second paper in a series describes the work of the Nursing Research Unit at the University of Edinburgh studying discharge planning for older patients going home from acute hospital care is described. Data were collected on the views and experiences of 326 patients aged 75 years and over and 117 of their carers. Ward sisters also completed questionnaires about ward structures and processes relating to discharge planning. Problems typical of those reported in previous similar studies were found.
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Abstract
The role of community nurses in discharge planning for elderly patients leaving hospital is of increasing importance in the wake of the NHS and Community Care Act 1990. Community nurses can play a key role in contributing to pre-discharge assessments and in providing continuing post-discharge assessment and care. The Nursing Research Unit at the University of Edinburgh conducted a survey early in 1993, just prior to implementation of the Community Care Act in Scotland, to ascertain the views and experiences of a national 1 in 3 sample of community nurses relating to the discharge of elderly people from acute hospitals. This article presents the results of that survey and offers recommendations regarding the role of community nurses in discharge planning for elderly patients.
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Mueser KT, Bellack AS, Wade JH, Sayers SL, Tierney A, Haas G. Expressed emotion, social skill, and response to negative affect in schizophrenia. J Abnorm Psychol 1993. [PMID: 8408945 DOI: 10.1037//0021-843x.102.3.339] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The social skills and social perception of schizophrenia patients in response to negative affect was examined as a function of family expressed emotion (EE). Patients participated in a role-play test, a social perception test, and a problem-solving discussion with a family member and were assessed on several measures of symptomatology. EE of family members was evaluated with the Camberwell Family Interview. On the role-play test, patients with less critical relatives became more assertive in response to increased negative affect from a confederate portraying either a family member or friend, but patients with highly critical relatives did not. Patients with highly critical relatives were also less assertive when confronted with negative affect from a confederate portraying a family member rather than a friend. The behaviors of both relatives and patients during a family problem-solving interaction were related to the EE dimensions of criticism, emotional overinvolvement, and warmth. Patient gender was also related to family problem solving but was independent of EE. Patient ratings of affect on a videotaped social perception task were not related to family EE, and there were few differences in psychopathology between patients with high and low EE relatives. The results support the validity of the EE construct as an index of relatives' affective behavior and suggest that patients' social skills, such as assertiveness, may mediate negative affective exchanges in their families.
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Affiliation(s)
- K T Mueser
- Department of Psychiatry, Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute, Philadelphia 19129
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40
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King M, Lapsley I, Llewellyn S, Tierney A, Anderson J, Sladden S. Purchasing palliative care: availability and cost implications. Health Bull (Edinb) 1993; 51:370-84. [PMID: 7508427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This paper reports on a survey of the availability of palliative care in Scotland, in the context of the internal market introduced as part of the NHS reforms. It is based on a survey of both the cost and availability of such service, with a discussion of the implications of this information for purchasers of palliative care.
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Affiliation(s)
- M King
- Institute of Public Sector Accounting Research (IPSAR), University of Edinburgh
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41
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Abstract
Discharge planning for older patients is gaining recognition as a process requiring improvement. Demographic changes have produced an increasing population of elderly patients in the acute hospital sector, many of whom need co-ordinated discharge planning and appropriate post-discharge support. This article discusses the accumulated research findings of the past 20 years, which have highlighted the need for health services research, policy and practice to improve the effectiveness of discharge planning for elderly people.
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42
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Mueser KT, Bellack AS, Wade JH, Sayers SL, Tierney A, Haas G. Expressed emotion, social skill, and response to negative affect in schizophrenia. J Abnorm Psychol 1993; 102:339-51. [PMID: 8408945 DOI: 10.1037/0021-843x.102.3.339] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The social skills and social perception of schizophrenia patients in response to negative affect was examined as a function of family expressed emotion (EE). Patients participated in a role-play test, a social perception test, and a problem-solving discussion with a family member and were assessed on several measures of symptomatology. EE of family members was evaluated with the Camberwell Family Interview. On the role-play test, patients with less critical relatives became more assertive in response to increased negative affect from a confederate portraying either a family member or friend, but patients with highly critical relatives did not. Patients with highly critical relatives were also less assertive when confronted with negative affect from a confederate portraying a family member rather than a friend. The behaviors of both relatives and patients during a family problem-solving interaction were related to the EE dimensions of criticism, emotional overinvolvement, and warmth. Patient gender was also related to family problem solving but was independent of EE. Patient ratings of affect on a videotaped social perception task were not related to family EE, and there were few differences in psychopathology between patients with high and low EE relatives. The results support the validity of the EE construct as an index of relatives' affective behavior and suggest that patients' social skills, such as assertiveness, may mediate negative affective exchanges in their families.
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Affiliation(s)
- K T Mueser
- Department of Psychiatry, Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute, Philadelphia 19129
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43
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Woods ML, Currie BJ, Howard DM, Tierney A, Watson A, Anstey NM, Philpott J, Asche V, Withnall K. Neurological melioidosis: seven cases from the Northern Territory of Australia. Clin Infect Dis 1992; 15:163-9. [PMID: 1617057 DOI: 10.1093/clinids/15.1.163] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Pseudomonas pseudomallei, which causes melioidosis, is most commonly associated with pulmonary infection. We describe seven patients who developed a neurological syndrome as the predominant manifestation of melioidosis: this syndrome was characterized by peripheral motor weakness (mimicking Guillain-Barré syndrome), brain-stem encephalitis, aseptic meningitis, and respiratory failure. Neurological melioidosis occurred in the absence of demonstrable foci of infection in the central nervous system (CNS) in five of six patients whose cerebrospinal fluid was available for culture. Computed tomography and magnetic resonance imaging of the brain and spinal cord of these patients were not suggestive of pyogenic infection, although the latter procedure detected brain-stem encephalitis. Autopsy findings in one case confirmed brain-stem encephalitis without evidence of direct bacterial infection. The clinical presentation of neurological melioidosis includes features of an exotoxin-induced neurological syndrome, with profound neurological disease occurring in the absence of apparent direct infection of the CNS. This syndrome appears to be a newly recognized clinical presentation of melioidosis.
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Affiliation(s)
- M L Woods
- Department of Medicine, University of Utah School of Medicine, Salt Lake City
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44
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Tierney A. Nursing research. Challenges for nursing. Nurs Stand 1992; 6:54-5. [PMID: 1547103 DOI: 10.7748/ns.6.20.54.s70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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45
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Grunfeld C, Kotler DP, Shigenaga JK, Doerrler W, Tierney A, Wang J, Pierson RN, Feingold KR. Circulating interferon-alpha levels and hypertriglyceridemia in the acquired immunodeficiency syndrome. Am J Med 1991; 90:154-62. [PMID: 1996584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The metabolic disturbances seen during infection are thought to be due to cytokines, modulators of the immune response. The acquired immunodeficiency syndrome (AIDS) is characterized by a high prevalence of hypertriglyceridemia and at times depletion of body cell mass (wasting). Elevated circulating levels of cytokines have also been reported in AIDS. Therefore, we determined the relationship between circulating cytokine levels and lipid levels and between circulating cytokine levels and wasting in AIDS and human immunodeficiency virus (HIV) infection. PATIENTS AND METHODS Serum samples from 45 patients with AIDS, 13 subjects with evidence of HIV infection by presence of antibody but without AIDS (HIV positive), and 17 seronegative control subjects who had previously undergone body composition analysis were analyzed for triglyceride, cholesterol, interferon, tumor necrosis factor (TNF), and interleukin-1 levels. Eleven subjects with AIDS or HIV infection had sequential measurements. Interferon was analyzed by bioassay with identification using specific antibodies. TNF and interleukin-1 were assayed by enzyme-linked immunosorbent assay. Lean body mass was assessed by total body potassium. RESULTS Serum interferon-alpha levels were significantly elevated in patients with AIDS (p less than 0.001 compared to controls), with detectable levels in 84% of AIDS patients. Interferon-alpha was not detectable in serum from controls, while three of 13 HIV-positive subjects had detectable interferon-alpha levels. There was a significant correlation between interferon-alpha levels and serum triglyceride levels in AIDS and HIV-positive patients (R = 0.446, p less than 0.002). There was no relationship between interferon-alpha and serum cholesterol levels (R = -0.039, NS). In contrast only 11% of AIDS patients had detectable circulating TNF levels; the mean value for and the prevalence of detectable serum TNF levels were not significantly different from those of control subjects. Interleukin-1 was not detected in the circulation. There was no correlation between the presence of circulating TNF and serum triglycerides. There was no relationship between circulating interferon-alpha or TNF levels and the presence of wasting as measured by total body potassium. CONCLUSION These studies suggest that interferon-alpha, which has previously been shown to modulate lipid metabolism in vivo and in vitro, may be responsible for the hypertriglyceridemia found in AIDS.
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Affiliation(s)
- C Grunfeld
- Department of Medicine, University of California, San Francisco
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47
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Abstract
Studies have suggested that schizophrenia is characterized by an impairment in the dorsolateral prefrontal cortex that prevents learning of some elementary information processing tasks. To test this hypothesis, the authors administered the Wisconsin Card Sorting Test to 16 schizophrenic inpatients with standard instructions and either contingent or noncontingent reinforcement. Performance was markedly impaired under each condition. A second cohort (N = 12) was tested after receiving instructions plus rehearsal and feedback. These subjects' performance was comparable to nonpatient norms and was maintained on a subsequent day. The results indicate that deficits in performance on the Wisconsin Card Sorting Test are remediable, whether or not they are due to neurological impairment.
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Affiliation(s)
- A S Bellack
- Department of Psychiatry, Medical College of Pennsylvania, Philadelphia 19129
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48
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Bond S, Rhodes T, Philips P, Tierney A. HIV infection and community nursing staff in Scotland--2. Knowledge and attitudes. Nurs Times 1990; 86:49-51. [PMID: 2235624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Findings from a survey of community nursing staff in Scotland reveal that there is limited knowledge about many aspects of HIV infection. Respondents were concerned about their lack of experience and knowledge as well as the in-service education that they had received. A substantial minority of community nursing staff felt that they should have the right to refuse to care for HIV-infected patients and those whose lifestyle put them at risk of HIV infection. A majority of staff felt that health professionals who are most at risk of contact with HIV-infected materials should be informed of patients' HIV-antibody status without their consent. There were also some indications of a lack of confidence in service managers and recommendations are made regarding ways of increasing both the knowledge and confidence of front-line staff.
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49
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Fox CH, Kotler D, Tierney A, Wilson CS, Fauci AS. Detection of HIV-1 RNA in the lamina propria of patients with AIDS and gastrointestinal disease. J Infect Dis 1989; 159:467-71. [PMID: 2915167 DOI: 10.1093/infdis/159.3.467] [Citation(s) in RCA: 123] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Thirty formaldehyde-fixed, paraffin-embedded endoscopic biopsy specimens from the colon and rectum of 25 patients with acquired immunodeficiency syndrome were examined using a [35S]HIV-RNA in situ hybridization procedure. Nine of the specimens contained cells that bound significant amounts of probe. Cells were considered positive if more than 50 grains of silver (over background) per 200 micron 2 were seen over cells that did not stain with eosin. Most of the positive cells resembled macrophages, although cells with condensed nuclei resembling lymphocytes were found. No epithelial cells expressing viral RNA were detected. Formaldehyde-fixed eosinophils gave spurious signals that could be reduced with sulfhydryl modifying agents. HIV-1 may be disseminated in the lamina propria of the gut at low concentrations in some patients but may not be detectable in others. The lower gut lining may be both a portal of initial infection with HIV and a target of disseminated HIV infection.
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Affiliation(s)
- C H Fox
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892
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50
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Abstract
PURPOSE A relationship between the induction of hypertriglyceridemia by cytokines and the cachexia seen in chronic infection has been proposed by other investigators. Since patients with the acquired immunodeficiency syndrome (AIDS) often experience progressive tissue wasting, we decided to examine serum lipid levels and body cell mass in patients with AIDS. PATIENTS AND METHODS Serum lipid levels and body cell mass were measured in 32 patients with the acquired immunodeficiency syndrome (AIDS), eight asymptomatic subjects who were anti-human immunodeficiency virus (HIV) antibody positive, and 17 heterosexual and homosexual control subjects who did not have antibodies to HIV. RESULTS Mean triglyceride concentrations and the prevalence of hypertriglyceridemia (50 percent) were significantly increased in patients with AIDS compared with control subjects (p less than 0.002 and p less than 0.005, respectively), whereas the mean triglyceride levels of HIV-positive subjects were intermediate. There were no differences in cholesterol levels among the three groups. Using total body potassium adjusted for height and age (KHT) as a measure of body cell mass, 16 of 32 patients with AIDS but none of the HIV-positive or control subjects had significant depletion of body cell mass. There was no direct relationship between triglyceride levels and KHT among AIDS or HIV-positive subjects. In patients with AIDS, mean triglyceride levels and the prevalence of hypertriglyceridemia were similar in the presence and absence of wasting. CONCLUSION Hypertriglyceridemia is a common finding in AIDS and is independent of the degree of wasting.
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Affiliation(s)
- C Grunfeld
- Metabolism Section, Veterans Administration Medical Center, San Francisco, California 94121
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