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Colhoun SR, Parker K, McCook S, Bartholomew K, Baty B, Maxwell A, Pipi K, Marama M, Crengle S. Perspectives of potentially eligible Indigenous Māori on a lung cancer screening programme: a qualitative study. N Z Med J 2024; 137:45-55. [PMID: 38603786 DOI: 10.26635/6965.6335] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
AIMS Lung cancer causes more deaths than any other cancer, globally and in Aotearoa New Zealand, where it disproportionately affects Māori. We aimed to understand Māori perspectives on lung cancer screening in Aotearoa New Zealand to guide its equity-focussed implementation, including identifying enablers and barriers. METHODS We took a Kaupapa Māori based co-design approach to inform future screening, recruiting Māori current/ex-smokers and members of their whānau (family) for three focus group phases held in Auckland, Aotearoa New Zealand in August 2019. Participants responded to a proposed lung cancer screening pathway and shared their attitudes and beliefs about lung cancer and screening. Results were thematically analysed. RESULTS The 21 Māori participants supported future lung cancer screening in Aotearoa New Zealand. Perceived benefits included being more informed about lung cancer and screening and enabling healthier future generations. Barriers to screening were previous negative health service experiences; fear; stigma; and access, including time, cost and transport. Enablers included providers' cultural competence; clear communication; a one-stop shop; and support with transport. A range of factors could potentially influence a decision to participate in screening. CONCLUSIONS Participants favoured future lung cancer screening and identified key barriers and facilitators of screening.
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Affiliation(s)
- Sarah R Colhoun
- Assistant Research Fellow, Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Aotearoa New Zealand
| | - Kate Parker
- Programme Manager, Te Whatu Ora Waitematā, Auckland, Aotearoa New Zealand
| | - Sharon McCook
- GM Strategic Investment and Planning, Te Aka Whai Ora, Auckland, Aotearoa New Zealand
| | - Karen Bartholomew
- Public Health Physician, Director Health Outcomes, Te Whatu Ora Waitematā, Auckland, Aotearoa New Zealand
| | - Billie Baty
- Research Assistant, Te Whatu Ora Waitematā, Auckland, Aotearoa New Zealand
| | - Anna Maxwell
- Project Manager, Te Whatu Ora Waitematā, Auckland, Aotearoa New Zealand
| | - Kataraina Pipi
- Independent Consultant, FEM, Auckland, Aotearoa New Zealand
| | - Maria Marama
- Independent Consultant, FEM, Auckland, Aotearoa New Zealand
| | - Sue Crengle
- Professor, Ngāi Tahu Māori Health Research Unit, Dunedin, Aotearoa New Zealand
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Persad-Paisley E, Laguna A, Paracha S, Maxwell A. Abstract No. 102 Using Representation Quotients to Examine Trends in Representation of Racial/Ethnic and Gender Groups Applying and Matriculating into Interventional Radiology Residency Programs Between 2017 and 2021. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.151] [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: 02/27/2023] Open
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Bartholomew K, Grant J, Maxwell A, Bromhead C, Gillett F, Saraf R, Moodabe K, Sherman SM, McPherson G, Flower D, Kathuria J, Crengle S, Massey R, Scott N, Coote P. Feasibility and acceptability of telehealth and contactless delivery of human papillomavirus (HPV) self-testing for cervical screening with Māori and Pacific women in a COVID-19 outbreak in Aotearoa New Zealand. N Z Med J 2022; 135:83-94. [PMID: 36356272] [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: 06/16/2023]
Abstract
AIM To determine the feasibility and acceptability of a telehealth offer and contactless delivery of human papillomavirus (HPV) cervical screening self-test during the 2021 COVID-19 Level 4 lockdown in Auckland, New Zealand. METHODS A small proof-of-concept study was undertaken to test telehealth approaches in never-screened, due or overdue Māori and Pacific women enrolled in a local Primary Health Organisation (PHO). Study invitation, active follow-up, nurse-led discussions, result notification and a post-test questionnaire were all delivered through telehealth. RESULTS A sample of 197 eligible Māori and Pacific women were invited to take part, of which 86 women were successfully contacted. Sixty-six agreed to take part. Overall uptake was 61 samples returned (31.8%) and uptake of all contactable women was 70.9%. Six of the 61 HPV self-tests (9.8%) were positive, all for non 16/18 types, and were referred for cytology. Three had negative cytology results, and three with positive cytology results were referred for colposcopy. CONCLUSION The offer of HPV self-testing during COVID-19 lockdown was both feasible and highly acceptable for Māori and Pacific women. Importantly, HPV self-testing via telehealth and mail-out, alongside other options, offers a potential pro-equity approach for addressing the impact of deferred screens due to COVID-19 and other longstanding coverage issues.
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Affiliation(s)
- Karen Bartholomew
- Director Health Outcomes, Planning Funding and Outcomes, Waitematā and Auckland District Health Boards, New Zealand
| | - Jane Grant
- Nurse Specialist Women's Health, Planning, Funding and Outcomes, Waitematā and Auckland District Health Boards, New Zealand
| | - Anna Maxwell
- Project Coordinator, Planning Funding and Outcomes, Waitematā and Auckland District Health Boards, New Zealand
| | - Collette Bromhead
- Senior Lecturer, School of Health Sciences, Massey University, Wellington, New Zealand
| | - Fiona Gillett
- Nurse Specialist Women's Health, Planning, Funding and Outcomes, Waitematā and Auckland District Health Boards, New Zealand
| | - Rajneeta Saraf
- Research Fellow, Planning Funding and Outcomes, Waitematā and Auckland District Health Boards, New Zealand
| | - Kate Moodabe
- Manager Total Healthcare PHO, Ōtara, Auckland, New Zealand
| | | | | | - Deralie Flower
- Clinical Lead Colposcopy, Auckland District Health Board, New Zealand
| | - Jyoti Kathuria
- Clinical Lead Colposcopy, Counties Manukau District Health Board, New Zealand
| | - Sue Crengle
- Public Health Physician, GP and Professor Hauora Māori, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Richard Massey
- Director, Pathology Associates New Zealand Hospital Campus, Tauranga, New Zealand
| | - Nina Scott
- Director of Māori Equity, Strategy and Research, Waikato District Health Board, New Zealand
| | - Pania Coote
- Director of AwhiMai Consultancy - Māori Health and Strategy, New Zealand
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Sherman SM, Brewer N, Bartholomew K, Bromhead C, Crengle S, Cunningham C, Douwes J, Foliaki S, Grant J, Maxwell A, McPherson G, Scott N, Wihongi H, Potter JD. Human papillomavirus self-testing among unscreened and under-screened Māori, Pasifika and Asian women in Aotearoa New Zealand: A preference survey among responders and interviews with clinical-trial nonresponders. Health Expect 2022; 25:2914-2923. [PMID: 36161964 DOI: 10.1111/hex.13599] [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] [Received: 05/04/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Māori, Pasifika and Asian women are less likely to attend cervical screening and Māori and Pasifika women are more likely to be diagnosed with later-stage cervical cancer than other women in Aotearoa New Zealand. This study-with under-screened women taking part in a randomized-controlled trial comparing self-testing and standard screening-explored the acceptability of a human papillomavirus (HPV) self-test kit and the preferred method for receiving it. METHODS Māori, Pasifika and Asian women (N= 376) completed a cross-sectional postal questionnaire. Twenty-six women who had not accepted the trial invitation were interviewed to understand their reasons for nonparticipation. RESULTS Most women found the self-test kit easy and convenient to use and reported that they did not find it painful, uncomfortable or embarrassing. This was reflected in the preference for a self-test over a future smear test on the same grounds. Most women preferred to receive the kit by mail and take the test themselves, rather than having it done by a doctor or nurse. There was a range of preferences relating to how to return the kit. Phone calls with nonresponders revealed that, although most had received the test kit, the reasons for not choosing to be involved included not wanting to, being too busy or forgetting. CONCLUSION HPV self-testing was acceptable for Māori, Pasifika and Asian women in Aotearoa New Zealand. HPV self-testing has considerable potential to reduce the inequities in the current screening programme and should be made available with appropriate delivery options as soon as possible. PATIENT OR PUBLIC CONTRIBUTION This study explored the acceptability of HPV self-testing and their preferences for engaging with it among Māori, Pasifika and Asian women. Thus, women from these underserved communities were the participants and focus of this study.
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Affiliation(s)
| | - Naomi Brewer
- Research Centre for Hauora and Health, Massey University, Wellington, Aotearoa, New Zealand
| | - Karen Bartholomew
- Waitematā District Health Board (DHB), Auckland, New Zealand.,Auckland DHB, Auckland, New Zealand
| | - Collette Bromhead
- School of Health Sciences, Massey University, Wellington, Aotearoa, New Zealand
| | - Sue Crengle
- Department of Preventive and Social Medicine, University of Otago, Dunedin, Aotearoa, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora and Health, Massey University, Wellington, Aotearoa, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, Aotearoa, New Zealand
| | - Sunia Foliaki
- Research Centre for Hauora and Health, Massey University, Wellington, Aotearoa, New Zealand
| | - Jane Grant
- Waitematā District Health Board (DHB), Auckland, New Zealand.,Auckland DHB, Auckland, New Zealand
| | - Anna Maxwell
- Waitematā District Health Board (DHB), Auckland, New Zealand.,Auckland DHB, Auckland, New Zealand
| | | | - Nina Scott
- Waitematā District Health Board (DHB), Auckland, New Zealand.,Hei Āhuru Mōwai
| | - Helen Wihongi
- Waitematā District Health Board (DHB), Auckland, New Zealand.,Auckland DHB, Auckland, New Zealand
| | - John D Potter
- Research Centre for Hauora and Health, Massey University, Wellington, Aotearoa, New Zealand
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Iheanacho F, Rex N, Collins S, Baird G, Maxwell A. Abstract No. 60 Treatment margins and local tumor progression following thermal ablation of small renal masses. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Maxwell A, Mendoza H, Sellitti M, Camacho J, Deipolyi A, Ziv E, Sofocleous C, Yarmohammadi H, Maybody M, Humm J, Schwartz J, Juluru K, Dunphy M, Boas F. Abstract No. 26 Optimizing Y-90 particle density improves outcomes after radioembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.107] [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] Open
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Brewer N, Bartholomew K, Grant J, Maxwell A, McPherson G, Wihongi H, Bromhead C, Scott N, Crengle S, Foliaki S, Cunningham C, Douwes J, Potter JD. Acceptability of human papillomavirus (HPV) self-sampling among never- and under-screened Indigenous and other minority women: a randomised three-arm community trial in Aotearoa New Zealand. Lancet Reg Health West Pac 2021; 16:100265. [PMID: 34590066 PMCID: PMC8427317 DOI: 10.1016/j.lanwpc.2021.100265] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/01/2021] [Accepted: 08/08/2021] [Indexed: 12/02/2022]
Abstract
Background Internationally, self-sampling for human papillomavirus (HPV) has been shown to increase participation in cervical-cancer screening. In Aotearoa New Zealand, there are long-standing ethnic inequalities in cervical-cancer screening, incidence, and mortality, particularly for indigenous Māori women, as well as Pacific and Asian women. Methods We invited never- and markedly under-screened (≥5 years overdue) 30-69-year-old Māori, Pacific, and Asian women to participate in an open-label, three-arm, community-based, randomised controlled trial, with a nested sub-study. We aimed to assess whether two specific invitation methods for self-sampling improved screening participation over usual care among the least medically served populations. Women were individually randomised 3:3:1 to: clinic-based self-sampling (CLINIC – invited to take a self-sample at their usual general practice); home-based self-sampling (HOME – mailed a kit and invited to take a self-sample at home); and usual care (USUAL – invited to attend a clinic for collection of a standard cytology sample). Neither participants nor research staff could be blinded to the intervention. In a subset of general practices, women who did not participate within three months of invitation were opportunistically invited to take a self-sample, either next time they attended a clinic or by mail. Findings We randomised 3,553 women: 1,574 to CLINIC, 1,467 to HOME, and 512 to USUAL. Participation was highest in HOME (14.6% among Māori, 8.8% among Pacific, and 18.5% among Asian) with CLINIC (7.0%, 5.3% and 6.9%, respectively) and USUAL (2.0%, 1.7% and 4.5%, respectively) being lower. In fully adjusted models, participation was statistically significantly more likely in HOME than USUAL: Māori OR=9.7, (95%CI 3.0-31.5); Pacific OR=6.0 (1.8-19.5); and Asian OR=5.1 (2.4-10.9). There were no adverse outcomes reported. After three months, 2,780 non-responding women were invited to participate in a non-randomised, opportunistic, follow-on substudy. After 6 months,192 (6.9%) additional women had taken a self-sample. Interpretation Using recruitment methods that mimic usual practice, we provide critical evidence that self-sampling increases screening among the groups of women (never and under-screened) who experience the most barriers in Aotearoa New Zealand, although the absolute level of participation through this population approach was modest. Follow-up for most women was routine but a small proportion required intensive support. Trial registration ANZCTR Identifier: ACTRN12618000367246 (date registered 12/3/2018) https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371741&isReview=true; UTN: U1111-1189-0531 Funding Health Research Council of New Zealand (HRC 16/405) Protocol http://publichealth.massey.ac.nz/assets/Uploads/Study-protocol-V2.1Self-sampling-for-HPV-screening-a-community-trial.pdf
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Affiliation(s)
- Naomi Brewer
- Research Centre for Hauora and Health, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - Karen Bartholomew
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
| | - Jane Grant
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
| | - Anna Maxwell
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
| | | | - Helen Wihongi
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
| | - Collette Bromhead
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Nina Scott
- University of Auckland, Waikato District Health Board, New Zealand
| | - Sue Crengle
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Sunia Foliaki
- Research Centre for Hauora and Health, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora and Health, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - John D Potter
- Research Centre for Hauora and Health, Massey University, PO Box 756, Wellington 6140, New Zealand.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Bromhead C, Wihongi H, Sherman SM, Crengle S, Grant J, Martin G, Maxwell A, McPherson G, Puloka ‘A, Reid S, Scott N, Bartholomew K. Human Papillomavirus (HPV) Self-Sampling among Never-and Under-Screened Indigenous Māori, Pacific and Asian Women in Aotearoa New Zealand: A Feasibility Study. Int J Environ Res Public Health 2021; 18:ijerph181910050. [PMID: 34639352 PMCID: PMC8507781 DOI: 10.3390/ijerph181910050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/25/2022]
Abstract
In Aotearoa, New Zealand, the majority of cervical cancer cases occur in women who have never been screened or are under-screened. Wāhine Māori, Pacific and Asian women have the lowest rate of cervical screening. Self-sampling for human papillomavirus (HPV-SS) has been shown to increase participation in cervical cancer screening. A whole-of-system approach, driven by evidence in the most effective delivery of HPV-SS, is required to mitigate further widening of the avoidable gap in cervical screening access and outcomes between groups of women in Aotearoa. This single-arm feasibility and acceptability study of HPV self-sampling invited never- and under-screened (≥5 years overdue) 30–69-year-old women from general practices in Auckland, Aotearoa. Eligible women were identified by data matching between the National Cervical Programme (NCSP) Register and practice data. Focus groups were additionally held with eligible wāhine Māori, Asian and Pacific women to co-design new patient information materials. Questionnaires on HPV knowledge and post-test experience were offered to women. Our follow-up protocols included shared decision-making principles, and we committed to follow-up ≥90% of women who tested positive for HPV. Data matching identified 366 eligible never- and under-screened wāhine Māori, Pacific and Asian women in participating practices. We were only able to contact 114 women, and 17, during the discussion, were found to be ineligible. Identifying and contacting women overdue for a cervical screen was resource-intensive, with a high rate of un-contactability despite multiple attempts. We found the best uptake of self-sampling was at focus groups. Of the total 84 HPV-SS tests, there were five positive results (6%), including one participant with HPV18 who was found to have a cervical Adenocarcinoma at colposcopy. In our feasibility study, self-sampling was acceptable and effective at detecting HPV and preventing cervical cancer in under-screened urban wāhine Māori, Pacific and Asian women in Aotearoa. This is the first report of cervical Adenocarcinoma (Grade 1B) as a result of an HPV-18 positive self-sample in Aotearoa. We co-designed new patient information materials taking a health literacy and ethnicity-specific approach. This work provides policy-relevant information to the NCSP on the resources required to implement an effective HPV self-sampling programme to improve equity in national cervical cancer screening.
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Affiliation(s)
- Collette Bromhead
- School of Health Sciences, Massey University, Wellington 6021, New Zealand;
| | - Helen Wihongi
- Ngāti Porou, Ngāpuhi, Te Whānau a Apanui, Ngāti Hine, Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand;
| | | | - Sue Crengle
- Waitaha, Kāti Mamoe and Kāi Tahu, Department of Preventive and Social Medicine, University of Otago, Dunedin 9016, New Zealand;
| | - Jane Grant
- Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand; (J.G.); (A.M.)
| | - Georgina Martin
- Te Rarawa, Te Aupōuri, Ngāpuhi, Wai Research, Te Whānau O Waipareira. Level 1, 6-8 Pioneer Street, Henderson, Waitakere City, Auckland 0605, New Zealand;
| | - Anna Maxwell
- Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand; (J.G.); (A.M.)
| | - Georgina McPherson
- Makea Ngāti Kao, Ngāti Tane, Waitematā District Health Board, Auckland 0740, New Zealand;
| | - ‘Aivi Puloka
- The Fono Health & Social Services, Henderson, Auckland 0612, New Zealand;
| | - Susan Reid
- Te Rarawa, Health Literacy New Zealand Limited, Auckland 1347, New Zealand;
| | - Nina Scott
- Ngāpuhi, Ngāti Whātua, Waikato, Waikato District Health Board, Hamilton 3240, New Zealand;
| | - Karen Bartholomew
- Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand; (J.G.); (A.M.)
- Correspondence:
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Bartholomew K, Lawton B, Sherman SM, Bromhead C, Grant J, McPherson G, Maxwell A, Saville M, Crengle S, Scott N. Recommendations for implementing HPV self-testing in Aotearoa. N Z Med J 2021; 134:11-16. [PMID: 34012136] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Karen Bartholomew
- Planning Funding and Outcomes, Waitematā District Health Board; Auckland District Health Board
| | - Beverley Lawton
- Centre for Women's Health Research Te Tātai Hauora o Hine, Victoria University
| | | | | | - Jane Grant
- Planning Funding and Outcomes, Waitematā District Health Board; Auckland District Health Board
| | - Georgina McPherson
- Clinical Lead Colposcopy, Women's Health, Waitematā District Health Board
| | - Anna Maxwell
- Planning Funding and Outcomes Waitematā District Health Board; Auckland District Health Board
| | | | - Sue Crengle
- Department of Preventive and Social Medicine, University of Otago
| | - Nina Scott
- Hei Āhuru Mowai; Funding, Strategy and Equity, Waikato District Health Board
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Maxwell A, Sofocleous C, Solomon S, Kemeny N, Camacho J, Deipolyi A, Yarmohammadi H, Ziv E, Petre E, Boas F. Abstract No. 19 Optimal timing of cytotoxic chemotherapy when combined with thermal ablation of liver metastases. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.433] [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] Open
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Yarmohammadi H, Elsakka A, Nurili F, Maxwell A, Ridouani F, Ziv E, O’Reilly E, Cheleuitte-Nieves C, Schook L, Solomon S, Boas F. Abstract No. 86 Treatment of pancreatic cancer by intra-arterial injection of an emulsion of lipiodol and bumetanide (an anti-glycolytic drug) in a transgenic mutated pig model (Oncopig). J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.510] [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: 11/17/2022] Open
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Seow TXF, Benoit E, Dempsey C, Jennings M, Maxwell A, McDonough M, Gillan CM. A dimensional investigation of error-related negativity (ERN) and self-reported psychiatric symptoms. Int J Psychophysiol 2020; 158:340-348. [PMID: 33080287 PMCID: PMC7612131 DOI: 10.1016/j.ijpsycho.2020.09.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/07/2019] [Revised: 08/05/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
Alterations in error processing are implicated in a range of DSM-defined psychiatric disorders. For instance, obsessive-compulsive disorder (OCD) and generalised anxiety disorder show enhanced electrophysiological responses to errors-i.e. error-related negativity (ERN)-while others like schizophrenia have an attenuated ERN. However, as diagnostic categories in psychiatry are heterogeneous and also highly intercorrelated, the precise mapping of ERN enhancements/impairments is unclear. To address this, we recorded electroencephalograms (EEG) from 196 participants who performed the Flanker task and collected scores on 9 questionnaires assessing psychiatric symptoms to test if a dimensional framework could reveal specific transdiagnostic clinical manifestations of error processing dysfunctions. Contrary to our hypothesis, we found non-significant associations between ERN amplitude and symptom severity of OCD, trait anxiety, depression, social anxiety, impulsivity, eating disorders, alcohol addiction, schizotypy and apathy. A transdiagnostic approach did nothing to improve signal; there were non-significant associations between all three transdiagnostic dimensions (anxious-depression, compulsive behaviour and intrusive thought, and social withdrawal) and ERN magnitude. In these same individuals, we replicated a previously published transdiagnostic association between goal-directed learning and compulsive behaviour and intrusive thought. Possible explanations discussed are (i) that associations between the ERN and psychopathology might be smaller than previously assumed, (ii) that these associations might depend on a greater level of symptom severity than other transdiagnostic cognitive biomarkers, or (iii) that task parameters, such as the ratio of compatible to incompatible trials, might be crucial for ensuring the sensitivity of the ERN to clinical phenomena.
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Affiliation(s)
- T X F Seow
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - E Benoit
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - C Dempsey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M Jennings
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - A Maxwell
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M McDonough
- St. Patrick's University Hospital, Dublin, Ireland
| | - C M Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Patel K, Maxwell A, Bailey C. 3:54 PM Abstract No. 361 Safety and efficacy of central venous line placement via internal jugular vein in patients with total artificial hearts. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.420] [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: 10/25/2022] Open
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Brewer N, Bartholomew K, Maxwell A, Grant J, McPherson G, Wihongi H, Bromhead C, Scott N, Crengle S, Cunningham C, Douwes J, Potter JD. Correction to: Comparison of two invitation-based methods for human papillomavirus (HPV) self-sampling with usual care among un- and under-screened Māori, Pacific and Asian women: study protocol for a randomised controlled community trial to examine the effect of self-sampling on participation in cervical-cancer screening. BMC Cancer 2020; 20:163. [PMID: 32106841 PMCID: PMC7047358 DOI: 10.1186/s12885-020-6671-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Naomi Brewer
- Centre for Public Health Research, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand.
| | - Karen Bartholomew
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | - Anna Maxwell
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | - Jane Grant
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | | | - Helen Wihongi
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | - Collette Bromhead
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Nina Scott
- University of Auckland, Waikato District Health Board, Hamilton, New Zealand
| | - Sue Crengle
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Chris Cunningham
- Research Centre for Māori Health and Development, Massey University, Wellington, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - John D Potter
- Centre for Public Health Research, Massey University, Wellington, New Zealand
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Maxwell A, Holman T, Novak T. Idiopathic Pulmonary Arterial Hypertension Unmasked by Pregnancy. Acute Med 2020; 19:240-243. [PMID: 33215178] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 31-year old woman presented to the acute medical unit 9 days post-partum with shortness of breath and peripheral oedema. Initially suspected to have either a pulmonary embolism or post-partum cardiomyopathy, she proceeded to have imaging including a CT Pulmonary angiogram and echocardiogram, which were suggestive of pulmonary hypertension and severe right heart failure. Her history and other investigations did not reveal any obvious cause for this. She was transferred to a specialist centre where she was diagnosed with Idiopathic Pulmonary Arterial Hypertension (IPAH), previously known as primary pulmonary hypertension. Shortness of breath during pregnancy and in the postpartum period is a relatively common acute medical presentation. Whilst IPAH is a rare diagnosis, it carries a high mortality rate, particularly in pregnancy, and requires prompt specialist investigation, diagnosis and management.
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Affiliation(s)
- A Maxwell
- MBBS, MRCP Core Medical Trainee, Great Western Hospital, Swindon
| | - T Holman
- MBBS, MSc. Clinical Fellow in Acute Medicine, Great Western Hospital, Swindon
| | - T Novak
- MD, MRCP Acute Medical Consultant, Great Western Hospital, Swindon
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Brewer N, Bartholomew K, Maxwell A, Grant J, McPherson G, Wihongi H, Bromhead C, Scott N, Crengle S, Cunningham C, Douwes J, Potter JD. Comparison of two invitation-based methods for human papillomavirus (HPV) self-sampling with usual care among un- and under-screened Māori, Pacific and Asian women: study protocol for a randomised controlled community trial to examine the effect of self-sampling on participation in cervical-cancer screening. BMC Cancer 2019; 19:1198. [PMID: 31815615 PMCID: PMC6902319 DOI: 10.1186/s12885-019-6401-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/10/2019] [Accepted: 11/22/2019] [Indexed: 01/25/2023] Open
Abstract
Background Māori, Pacific and Asian women in New Zealand have lower cervical-cancer screening rates than European women, and there are persistent inequities in cervical cancer outcomes for Māori and Pacific women. Innovative ways to address access barriers are required. New Zealand is transitioning to screening with human papillomavirus (HPV) DNA testing, which could allow women themselves, rather than a clinician, to take the sample. Internationally, self-sampling has been found to increase screening participation rates. The aim of this open-label community-based randomised controlled trial is to investigate whether self-sampling increases screening participation among un- and under-screened Māori, Pacific and Asian women in New Zealand. Methods/design We aim to invite at least 3550 un- or under-screened (≥5 years overdue) Māori, Pacific and Asian women (1050, 1250, 1250 respectively), aged 30–69 years, for screening. The three study arms are: usual care in which women are invited to attend a clinic for a standard clinician-collected cytology test; clinic-based self-sampling in which women are invited to take a self-sample at their usual general practice; and mail-out self-sampling in which women are mailed a kit and invited to take a self-sample at home. Women will be randomised 3:3:1 to the clinic and mail-out self-sampling groups, and usual care. There is also a nested sub-study in which non-responding women in all allocation groups, when they subsequently present to the clinic for other reasons, are offered clinic or home-kit self-sampling. The primary outcome will be the proportion of women who participate (by taking a self-sample or cytology test). Discussion This trial is the first to evaluate the effectiveness of mailed self-sampling in New Zealand and will be one of the first internationally to evaluate the effectiveness of opportunistic in-clinic invitations for self-sampling. The trial will provide robust evidence on the impact on participation proportions from different invitation approaches for HPV self-sampling in New Zealand un- and under-screened Māori, Pacific and Asian women. Trial registration ANZCTR Identifier: ACTRN12618000367246 (date registered 12/3/2018) https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371741&isReview=true; UTN: U1111–1189-0531.
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Affiliation(s)
- Naomi Brewer
- Centre for Public Health Research, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand.
| | - Karen Bartholomew
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | - Anna Maxwell
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | - Jane Grant
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | | | - Helen Wihongi
- Waitematā District Health Board (DHB) and Auckland DHB, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand
| | - Collette Bromhead
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Nina Scott
- University of Auckland, Waikato District Health Board, Hamilton, New Zealand
| | - Sue Crengle
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Chris Cunningham
- Research Centre for Māori Health and Development, Massey University, Wellington, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - John D Potter
- Centre for Public Health Research, Massey University, Wellington, New Zealand
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Grey C, Sandiford P, Hill A, Poppe K, Doughty R, Maxwell A, Bramley D. A Screening Programme for Abdominal Aortic Aneurysm and Atrial Fibrillation in Māori: An Equity-Focused Initiative in Auckland. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.05.123] [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: 11/26/2022]
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Maxwell A, Tsoutsoulis K, Menon Tarur Padinjareveettil A, Zivkovic F, Rogers JM. Longitudinal analysis of statistical and clinically significant psychosocial change following mental health rehabilitation. Disabil Rehabil 2018; 41:2927-2939. [PMID: 29978733 DOI: 10.1080/09638288.2018.1482505] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: With appropriate mental health rehabilitation, schizophrenia is increasingly associated with reports of recovery and stability. However, there is little empirical evidence evaluating the efficacy of services delivering this care. This study evaluated the effectiveness of rehabilitation for improving psychosocial function in consumers with schizophrenia.Methods: An electronic database of standardized assessment instruments mandated and maintained by the health service was retrospectively reviewed to extract ratings of psychosocial function, daily living skills, and mood state from consecutive admissions to an inpatient rehabilitation service. Outcomes were compared at admission, discharge, and one-year follow-up to identify statistically significant change. Individual reliable and clinically significant change was also assessed by comparison with a normative group of clients functioning independently in the community.Results: From admission to discharge the rehabilitation group made statistically significant gains in psychosocial function and daily living skills. Improvements were reliable and clinically significant in one-quarter to one-third of individual consumers. Approximately half sustained their improvements at follow-up, although this represented only a small fraction of the overall cohort. Consumers not demonstrating gains exhibited psychometric floor effects at admission.Conclusions: Rehabilitation can produce statistically and clinically significant immediate improvement in psychosocial function for a sub-set of consumers with elevated scores at admission. The durability of any gains is less clear, and strategies promoting longer-term maintenance are encouraged. Furthermore, currently mandated outcome measures are confounded by issues of sensitivity and reporting compliance, and exploration of alternative instruments for assessing recovery is recommended.Implications for RehabilitationRoutinely collected standardized outcome measures can be used to investigate the effectiveness of mental health rehabilitationIn addition to statistical significance, the clinical significance of outcomes should be evaluated to identify change that is individually meaningfulCurrently mandated outcomes instruments do not adequately evaluate many individuals' recovery journeyMental health service evaluation and quality improvement processes would likely benefit from adoption of recovery-oriented measures.
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Affiliation(s)
- Anna Maxwell
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Katrina Tsoutsoulis
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Aparna Menon Tarur Padinjareveettil
- South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia
| | - Frank Zivkovic
- South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Jeffrey M Rogers
- South Eastern Sydney Local Health District, Sydney, NSW, Australia
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Farrell LJ, Lo R, Wanford JJ, Jenkins A, Maxwell A, Piddock LJV. Revitalizing the drug pipeline: AntibioticDB, an open access database to aid antibacterial research and development. J Antimicrob Chemother 2018; 73:2284-2297. [DOI: 10.1093/jac/dky208] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L J Farrell
- Institute of Microbiology & Infection, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - R Lo
- School of Biological Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
- Department of Biological Chemistry, John Innes Centre, Norwich Research Park, Norwich NR4 7UH, UK
| | - J J Wanford
- Institute of Microbiology & Infection, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - A Jenkins
- British Society for Antimicrobial Chemotherapy, Griffin House, 53 Regent Place, Birmingham B1 3NJ, UK
| | - A Maxwell
- Department of Biological Chemistry, John Innes Centre, Norwich Research Park, Norwich NR4 7UH, UK
| | - L J V Piddock
- Institute of Microbiology & Infection, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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Tsoutsoulis K, Maxwell A, Menon Tarur Padinjareveettil A, Zivkovic F, Rogers JM. Impact of inpatient mental health rehabilitation on psychiatric readmissions: a propensity score matched case control study. J Ment Health 2018; 29:532-540. [DOI: 10.1080/09638237.2018.1466049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Katrina Tsoutsoulis
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia,
| | - Anna Maxwell
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia,
| | - Aparna Menon Tarur Padinjareveettil
- South Eastern Sydney Local Health District, Sydney, NSW, Australia, and
- School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia
| | - Frank Zivkovic
- South Eastern Sydney Local Health District, Sydney, NSW, Australia, and
| | - Jeffrey M. Rogers
- South Eastern Sydney Local Health District, Sydney, NSW, Australia, and
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Kanaan M, Mdege ND, Keding A, Parker RA, Mills N, Shah A, Strachan F, Keerie C, Weir CJ, Forbes A, Hemming K, Lawton SA, Healey E, Lewis M, Nicholls E, Jinks C, Tan V, Finney A, Mallen CD, Lenguerrand E, MacLennan G, Norrie J, Bhattacharya S, Draycott T, Hooper R, Teerenstra S, de Hoop E, Eldridge S, Girling A, Taljaard M, Di Tanna GL, Gasparrini A, Casula A, Caskey F, Lenguerrand E, Methven S, MacNeill S, May M, Selby N, Danon L, Christensen H, Finn A, May M, Takanashi F, Keding A, Crouch S, Kanaan M, Kristunas CA, Smith KL, Gray LJ, Matthews JN, Salman RAS, Parker RA, Maxwell A, Dennis M, Rudd A, Weir CJ, Thompson JA, Fielding KL, Davey C, Aiken AM, Hargreaves JR, Hayes RJ, Lyons VH, Li L, Hughes J, Rowhani-Rahbar A, Hemming K, Taljaard M, Forbes A. Proceedings of the First International Conference on Stepped Wedge Trial Design. Trials 2016; 17 Suppl 1:311. [PMID: 27454562 PMCID: PMC4959349 DOI: 10.1186/s13063-016-1436-8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
I1 Introduction Mona Kanaan, Noreen Dadirai Mdege, Ada Keding O1 The HiSTORIC trial: a hybrid before-and-after and stepped wedge design RA Parker, N Mills, A Shah, F Strachan, C Keerie, CJ Weir O2 Stepped wedge trials with non-uniform correlation structure Andrew Forbes, Karla Hemming O3 Challenges and solutions for the operationalisation of the ENHANCE study: a pilot stepped wedge trial within a general practice setting Sarah A Lawton, Emma Healey, Martyn Lewis, Elaine Nicholls, Clare Jinks, Valerie Tan, Andrew Finney, Christian D Mallen, on behalf of the ENHANCE Study Team O4 Early lessons from the implementation of a stepped wedge trial design investigating the effectiveness of a training intervention in busy health care settings: the Thistle study Erik Lenguerrand, Graeme MacLennan, John Norrie, Siladitya Bhattacharya, Tim Draycott, on behalf of the Thistle group O5 Sample size calculation for longitudinal cluster randomised trials: a unified framework for closed cohort and repeated cross-section designs Richard Hooper, Steven Teerenstra, Esther de Hoop, Sandra Eldridge O6 Restricted randomisation schemes for stepped-wedge studies with a cluster-level covariate Alan Girling, Monica Taljaard O7 A flexible modelling of the time trend for the analysis of stepped wedge trials: results of a simulation study Gian Luca Di Tanna, Antonio Gasparrini P1 Tackling acute kidney injury – a UK stepped wedge clinical trial of hospital-level quality improvement interventions Anna Casula, Fergus Caskey, Erik Lenguerrand, Shona Methven, Stephanie MacNeill, Margaret May, Nicholas Selby P2 Sample size considerations for quantifying secondary bacterial transmission in a stepped wedge trial of influenza vaccine Leon Danon, Hannah Christensen, Adam Finn, Margaret May P3 Sample size calculation for time-to-event data in stepped wedge cluster randomised trials Fumihito Takanashi, Ada Keding, Simon Crouch, Mona Kanaan P4 Sample size calculations for stepped-wedge cluster randomised trials with unequal cluster sizes Caroline A. Kristunas, Karen L. Smith, Laura J. Gray P5 The design of stepped wedge trials with unequal cluster sizes John N.S. Matthews P6 Promoting Recruitment using Information Management Efficiently (PRIME): a stepped wedge SWAT (study-within-a-trial) R Al-Shahi Salman, RA Parker, A Maxwell, M Dennis, A Rudd, CJ Weir P7 Implications of misspecified mixed effect models in stepped wedge trial analysis: how wrong can it be? Jennifer A Thompson, Katherine L Fielding, Calum Davey, Alexander M Aiken, James R Hargreaves, Richard J Hayes S1 Stepped Wedge Designs with Multiple Interventions Vivian H Lyons, Lingyu Li, James Hughes, Ali Rowhani-Rahbar S2 Analysis of the cross-sectional stepped wedge cluster randomised trial Karla Hemming, Monica Taljaard, Andrew Forbes
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Smith H, Szczepura K, Mercer C, Maxwell A, Hogg P. Does elevating image receptor increase breast receptor footprint and improve pressure balance? Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2015.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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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Schall KA, Holoyda KA, Grant CN, Levin DE, Torres ER, Maxwell A, Pollack HA, Moats RA, Frey MR, Darehzereshki A, Al Alam D, Lien C, Grikscheit TC. Adult zebrafish intestine resection: a novel model of short bowel syndrome, adaptation, and intestinal stem cell regeneration. Am J Physiol Gastrointest Liver Physiol 2015; 309:G135-45. [PMID: 26089336 PMCID: PMC4525108 DOI: 10.1152/ajpgi.00311.2014] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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] [Received: 08/15/2014] [Accepted: 05/28/2015] [Indexed: 01/31/2023]
Abstract
Loss of significant intestinal length from congenital anomaly or disease may lead to short bowel syndrome (SBS); intestinal failure may be partially offset by a gain in epithelial surface area, termed adaptation. Current in vivo models of SBS are costly and technically challenging. Operative times and survival rates have slowed extension to transgenic models. We created a new reproducible in vivo model of SBS in zebrafish, a tractable vertebrate model, to facilitate investigation of the mechanisms of intestinal adaptation. Proximal intestinal diversion at segment 1 (S1, equivalent to jejunum) was performed in adult male zebrafish. SBS fish emptied distal intestinal contents via stoma as in the human disease. After 2 wk, S1 was dilated compared with controls and villus ridges had increased complexity, contributing to greater villus epithelial perimeter. The number of intervillus pockets, the intestinal stem cell zone of the zebrafish increased and contained a higher number of bromodeoxyuridine (BrdU)-labeled cells after 2 wk of SBS. Egf receptor and a subset of its ligands, also drivers of adaptation, were upregulated in SBS fish. Igf has been reported as a driver of intestinal adaptation in other animal models, and SBS fish exposed to a pharmacological inhibitor of the Igf receptor failed to demonstrate signs of intestinal adaptation, such as increased inner epithelial perimeter and BrdU incorporation. We describe a technically feasible model of human SBS in the zebrafish, a faster and less expensive tool to investigate intestinal stem cell plasticity as well as the mechanisms that drive intestinal adaptation.
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Affiliation(s)
- K. A. Schall
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - K. A. Holoyda
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - C. N. Grant
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - D. E. Levin
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - E. R. Torres
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - A. Maxwell
- 2Developmental Biology and Regenerative Medicine Program, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - H. A. Pollack
- 3Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - R. A. Moats
- 3Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - M. R. Frey
- 2Developmental Biology and Regenerative Medicine Program, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California; ,4Department of Pediatrics and Department of Biochemistry and Molecular Biology, Keck School of Medicine at University of Southern California, Los Angeles, California; and
| | - A. Darehzereshki
- 2Developmental Biology and Regenerative Medicine Program, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - D. Al Alam
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
| | - C. Lien
- 2Developmental Biology and Regenerative Medicine Program, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California; ,5Department of Cardiothoracic Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California
| | - T. C. Grikscheit
- 1Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California; ,2Developmental Biology and Regenerative Medicine Program, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California;
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Stuart AV, Clement Y, Sealy P, Löbenberg R, Montane-Jaime L, Maharaj RG, Maxwell A. Comparing the Dissolution Profiles of Seven Metformin Formulations in Simulated Intestinal Fluid. DISSOLUT TECHNOL 2015. [DOI: 10.14227/dt220115p17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bundred S, Maxwell A, Morris J, Harake J, Whiteside S, Zhou J, Bundred N. PB.9. Randomised controlled trial of stereotactic 11G vacuum-assisted core biopsy for diagnosis and management of malignant microcalcification. Breast Cancer Res 2014. [PMCID: PMC4243960 DOI: 10.1186/bcr3741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Wilson M, Maxwell A, Gadde S, Hurley E, Bydder M, Harkness E, Ewins M, Astley S, Lim Y. PB.5. Accuracy of axillary nodal staging on MRI of the breasts: correlation with ultrasound of the axilla and histopathology findings. Breast Cancer Res 2014. [PMCID: PMC4243099 DOI: 10.1186/bcr3739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sivagnanam L, Hufton A, Berks M, Harkness E, Lim Y, Maxwell A, Wilson M, Bydder M, Gadde S, Evans DG, Howell A, Stavrinos P, Astley S. PB.23. Breast density in previous screening mammograms of women with and without breast cancer. Breast Cancer Res 2014. [PMCID: PMC4244072 DOI: 10.1186/bcr3717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Otsuka M, Harkness E, Chen X, Moschidis E, Bydder M, Gadde S, Lim Y, Maxwell A, Evans DG, Howell A, Stavrinos P, Wilson M, Astley S. Local breast density at lesion sites in diagnostic and previous screening mammograms. Breast Cancer Res 2014. [PMCID: PMC4243105 DOI: 10.1186/bcr3699] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Meyer J, Maxwell A, Harkness E, Astley S, Mercer C, Wilson M, Bydder M, Lim Y, Morris J. PB.22. Does mammographic compression force at breast screening influence the likelihood of subsequent screening attendance? Breast Cancer Res 2014. [PMCID: PMC4243119 DOI: 10.1186/bcr3710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Daniels J, Harkness E, Lim Y, Maxwell A, Morris J, Stavrinos P, Wilson M, Bydder M, Evans DG, Howell A. PB.24. How does volumetric breast density change with time? Breast Cancer Res 2014. [PMCID: PMC4243094 DOI: 10.1186/bcr3729] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Evans G, Stavrinos P, Dawe S, Harvie M, Wilson M, Maxwell A, Brentnall A, Cuzick J, Astley S, Howell A. 8LBA Assessing individual breast cancer risk within the UK National Health Service Breast Screening Programme: First prospective results from PROCAS. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70116-9] [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: 11/25/2022]
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Khan-Perez J, Mercer C, Bydder M, Sergeant J, Morris J, Maxwell A, Rylance C, Astley S. PB.10: Breast compression, compressed breast thickness and volumetric breast density. Breast Cancer Res 2013. [PMCID: PMC3980792 DOI: 10.1186/bcr3511] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Beattie L, Bydder M, Sergeant JC, Maxwell A, Barr N, Beetles U, Boggis CRM, Bundred S, Gadde S, Hurley E, Jain A, Lord E, Reece V, Wilson M, Stavrinos P, Evans DG, Howell A, Astley SM. PB.18: Factors affecting breast density assessment. Breast Cancer Res 2013. [PMCID: PMC3981048 DOI: 10.1186/bcr3518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Johnson PF, Sergeant JC, Bydder M, Maxwell A, Whiteside S, Stavrinos P, Wilson M, Evans DG, Howell A, Astley SM. PB.25: Relationship between volumetric breast density, age and hormonal factors. Breast Cancer Res 2013. [PMCID: PMC3980887 DOI: 10.1186/bcr3525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Samuels L, Astley SM, Maxwell A, Sergeant JC, Morris J, Wilson M, Stavrinos P, Evans DG, Howell A, Bydder M. PB.21: Relationship between volumetric breast density and socioeconomic status. Breast Cancer Res 2013; 15. [PMCID: PMC3981625 DOI: 10.1186/bcr3521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | - A Maxwell
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, UK
| | | | - J Morris
- University Hospital of South Manchester, UK
| | - M Wilson
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, UK
| | - P Stavrinos
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, UK
| | - DG Evans
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, UK
| | - A Howell
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, UK
| | - M Bydder
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, UK
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Kargel JS, Alho P, Buytaert W, Célleri R, Cogley JG, Dussaillant A, Guido Z, Haeberli W, Harrison S, Leonard G, Maxwell A, Meier C, Poveda G, Reid B, Reynolds J, Rodríguez CAP, Romero H, Schneider J. Glaciers in Patagonia: Controversy and prospects. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012eo220011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Robertson C, Arcot Ragupathy SK, Boachie C, Dixon JM, Fraser C, Hernández R, Heys S, Jack W, Kerr GR, Lawrence G, MacLennan G, Maxwell A, McGregor J, Mowatt G, Pinder S, Ternent L, Thomas RE, Vale L, Wilson R, Zhu S, Gilbert FJ. The clinical effectiveness and cost-effectiveness of different surveillance mammography regimens after the treatment for primary breast cancer: systematic reviews registry database analyses and economic evaluation. Health Technol Assess 2012; 15:v-vi, 1-322. [PMID: 21951942 DOI: 10.3310/hta15340] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Following primary breast cancer treatment, the early detection of ipsilateral breast tumour recurrence (IBTR) or ipsilateral secondary cancer in the treated breast and detection of new primary cancers in the contralateral breast is beneficial for survival. Surveillance mammography is used to detect these cancers, but the optimal frequency of surveillance and the length of follow-up are unclear. OBJECTIVES To identify feasible management strategies for surveillance and follow-up of women after treatment for primary breast cancer in a UK setting, and to determine the effectiveness and cost-effectiveness of differing regimens. METHODS A survey of UK breast surgeons and radiologists to identify current surveillance mammography regimens and inform feasible alternatives; two discrete systematic reviews of evidence published from 1990 to mid 2009 to determine (i) the clinical effectiveness and cost-effectiveness of differing surveillance mammography regimens for patient health outcomes and (ii) the test performance of surveillance mammography in the detection of IBTR and metachronous contralateral breast cancer (MCBC); statistical analysis of individual patient data (West Midlands Cancer Intelligence Unit Breast Cancer Registry and Edinburgh data sets); and economic modelling using the systematic reviews results, existing data sets, and focused searches for specific data analysis to determine the effectiveness and cost-utility of differing surveillance regimens. RESULTS The majority of survey respondents initiate surveillance mammography 12 months after breast-conserving surgery (BCS) (87%) or mastectomy (79%). Annual surveillance mammography was most commonly reported for women after BCS or after mastectomy (72% and 53%, respectively). Most (74%) discharge women from surveillance mammography, most frequently 10 years after surgery. The majority (82%) discharge from clinical follow-up, most frequently at 5 years. Combining initiation, frequency and duration of surveillance mammography resulted in 54 differing surveillance regimens for women after BCS and 56 for women following mastectomy. The eight studies included in the clinical effectiveness systematic review suggest surveillance mammography offers a survival benefit compared with a surveillance regimen that does not include surveillance mammography. Nine studies were included in the test performance systematic review. For routine IBTR detection, surveillance mammography sensitivity ranged from 64% to 67% and specificity ranged from 85% to 97%. For magnetic resonance imaging (MRI), sensitivity ranged from 86% to 100% and specificity was 93%. For non-routine IBTR detection, sensitivity and specificity for surveillance mammography ranged from 50% to 83% and from 57% to 75%, respectively, and for MRI from 93% to 100% and from 88% to 96%, respectively. For routine MCBC detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI, although this was a highly select population. Data set analysis showed that IBTR has an adverse effect on survival. Furthermore, women experiencing a second tumour measuring >20 mm in diameter were at a significantly greater risk of death than those with no recurrence or those whose tumour was <10 mm in diameter. In the base-case analysis, the strategy with the highest net benefit, and most likely to be considered cost-effective, was surveillance mammography alone, provided every 12 months at a societal willingness to pay for a quality-adjusted life-year of either £20,000 or £30,000. The incremental cost-effectiveness ratio for surveillance mammography alone every 12 months compared with no surveillance was £4727. LIMITATIONS Few studies met the review inclusion criteria and none of the studies was a randomised controlled trial. The limited and variable nature of the data available precluded any quantitative analysis. There was no useable evidence contained in the Breast Cancer Registry database to assess the effectiveness of surveillance mammography directly. The results of the economic model should be considered exploratory and interpreted with caution given the paucity of data available to inform the economic model. CONCLUSIONS Surveillance is likely to improve survival and patients should gain maximum benefit through optimal use of resources, with those women with a greater likelihood of developing IBTR or MCBC being offered more comprehensive and more frequent surveillance. Further evidence is required to make a robust and informed judgement on the effectiveness of surveillance mammography and follow-up. The utility of national data sets could be improved and there is a need for high-quality, direct head-to-head studies comparing the diagnostic accuracy of tests used in the surveillance population. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- C Robertson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Alt S, Mitchenall LA, Maxwell A, Heide L. Inhibition of DNA gyrase and DNA topoisomerase IV of Staphylococcus aureus and Escherichia coli by aminocoumarin antibiotics. J Antimicrob Chemother 2011; 66:2061-9. [DOI: 10.1093/jac/dkr247] [Citation(s) in RCA: 76] [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: 11/14/2022] Open
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Ku H, Maxwell A, Wong P, Huang J, Fung H. Relationship between electrical and mechanical loss tangents of hollow glass powder reinforced epoxy composites: A pilot study. J Appl Polym Sci 2010. [DOI: 10.1002/app.33009] [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: 11/09/2022]
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Ojugbana CC, Maxwell A, Christopher O, Olebunne K. Investigation on speed related road crashes on highways of developing countries. The Nigerian Case study. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.430] [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: 11/04/2022]
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Maxwell A, Anisha E, Ojugbana C, Unoka C. Addressing illegal road blockage by law enforcement agents and its attendant road deaths. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.594] [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: 11/04/2022]
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Olebunne K, David O, Maxwell A, Ojugbana C. Enhancing emergency response services in a developing country through community efforts. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.437] [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: 11/03/2022]
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Evans A, Clements K, Maxwell A, Bishop H, Hanby A, Lawrence G, Pinder SE. Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane project. Clin Radiol 2010; 65:181-4. [PMID: 20152272 DOI: 10.1016/j.crad.2009.05.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 04/28/2009] [Accepted: 05/08/2009] [Indexed: 11/19/2022]
Abstract
AIM To assess the radiological features of calcific ductal carcinoma in situ (DCIS) in a large, multicentre dataset according to grade and size, and to investigate the possibility that DCIS has different mammographic features when small. MATERIALS AND METHODS The dataset consisted of all Sloane Project DCIS cases where calcification was present mammographically and histological grade and size were available. The radiology data form classifies calcific DCIS as casting/linear, granular/irregular, or punctate. The pathology dataset includes cytonuclear grade and microscopic tumour size. Correlations were sought between the radiological findings and DCIS grade and size. The significance of differences was assessed using the chi-square test and chi-square test for trend. RESULTS One thousand, seven hundred and eighty-three cases were included in the study. Of these, 1128, 485, and 170 had high, intermediate, and low-grade DCIS, respectively. Casting calcification was more frequently seen the higher the grade of DCIS, occurring in 58% of high grade, 38% of intermediate grade, and 26% of low-grade cases, respectively (p<0.001). Casting calcification was also increasingly common with increasing lesion size, irrespective of the histological grade (p<0.001). Thus casting calcifications in small (<10mm) high-grade DCIS lesions were seen with a similar frequency (50%) to those in moderate-sized (21-30 mm) intermediate-grade lesions (48%), and to those in large (>30 mm) low-grade lesions (46%). CONCLUSION Lesion size has a strong influence on the radiological features of calcific DCIS; small, high-grade lesions often show no casting calcifications, whereas casting calcifications are seen in nearly half of large, low-grade lesions. As small clusters of punctate or granular calcifications may represent high-grade DCIS, an aggressive clinical approach to the diagnosis of such lesions is recommended as the adequate treatment of high-grade DCIS will prevent the occurrence of potentially life-threatening high-grade invasive disease.
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Affiliation(s)
- A Evans
- Ninewells Hospital and Medical School, Dundee, Scotland, UK.
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Manyalich M, Ricart A, Martínez I, Balleste C, Paredes D, Vilardell J, Avsec D, Dias L, Fehrman-Eckholm I, Hiesse C, Kyriakides G, Line PD, Maxwell A, Nanni Costa A, Paez G, Turcu R, Walaszewski J. EULID project: European living donation and public health. Transplant Proc 2010; 41:2021-4. [PMID: 19715823 DOI: 10.1016/j.transproceed.2009.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The choice of transplantation from a living donor offers advantages over a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety. Furthermore, there are several controversial ethical aspects to be taken into account. Several national and international institutions and the scientific community have stated standards that have great influence on professional codes and legislations. Living organ donation and transplantation are to some extent regulated by parliamentary acts in most European countries. It is necessary to take a step forward to develop a legal framework to regulate all of these processes to guarantee the quality and to prevent illegal and nonethical practices. It is also necessary to develop and implement living donor protection practices not only in terms of physical health, but also to minimize potential impacts on the psychological, social, and economic spheres. Finally, an additional effort should be made to create a database model with recommendations for registration practices as part of the standardized follow-up care for the living donor. The European Living Donation (EULID) project's (http://www.eulivingdonor.eu/) main objective was to contribute to a European consensus to set standards and recommendations about legal, ethical, and living donor protection practices to guarantee the health and safety of living donors.
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Affiliation(s)
- M Manyalich
- Hospital Clínic of Barcelona, Barcelona, Spain.
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Robertson C, Thomas R, Heys S, Maxwell A, Gilbert F. A survey of UK breast surgeons and radiologists to determine current and aspired mammography surveillance practice after treatment for primary breast cancer. Breast Cancer Res 2009. [PMCID: PMC4284845 DOI: 10.1186/bcr2384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Maxwell A, Ward HA, Nairn RC. Freezing in an Isopentane-Liquid Nitrogen Mixture and Storage in 2-Octanol: Technical Improvements for Immunofluorescence. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10520296609116329] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Borthwick E, Harris S, Welch C, Maxwell A, McAuley DF, Glover P, Harrison D, Rowan K. Early acute kidney injury in Northern Ireland ICUs. Crit Care 2009. [PMCID: PMC4084149 DOI: 10.1186/cc7427] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Evans A, Clements K, Maxwell A, Bishop H, Hanby A, Lawrence G, Kearins O, Pinder S. Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane Project. Breast Cancer Res 2008. [PMCID: PMC3332584 DOI: 10.1186/bcr2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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