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Pozniak K, Swain A, Currie G, Doherty-Kirby A, Grahovac D, Lebsack J, Campbell W, Humphreys C, Patterson S, Raha S, Whitley J, Kraus de Camargo O. What supports and services post COVID-19 do children with disabilities and their parents need and want, now and into the future? Front Public Health 2024; 12:1294340. [PMID: 38655511 PMCID: PMC11036871 DOI: 10.3389/fpubh.2024.1294340] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Children and youth with disabilities and special healthcare needs, and their families, have been uniquely affected by the COVID-19 pandemic. However, the voices of children themselves are still not well represented in the existing literature. Methods This qualitative descriptive study used a combination of visual methods and interviews to learn about the experiences of Canadian children with disabilities (n=18) and their parents (n=14) during the COVID pandemic and into the post-pandemic period. Data collection was carried out between January and July 2023. The aim was to identify the supports and services children and families need at present and moving forward. Results Families' pandemic experiences were complex and nuanced. For many, the pandemic complicated and disrupted everyday activities and supports. These disruptions were largely buffered by parents. However, some families also identified unexpected benefits. Key themes pertaining to present and future needs included the need for services that are flexible; consistent; conducive to relationship-building; comprehensive; coordinated across sectors; and designed to support the needs of the whole family. Discussion Implications for policy and practice are outlined.
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Affiliation(s)
- K. Pozniak
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - A. Swain
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - G. Currie
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- School of Nursing and Midwifery, Mount Royal University, Calgary, AB, Canada
| | - A. Doherty-Kirby
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - D. Grahovac
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - J. Lebsack
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - W. Campbell
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - C. Humphreys
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - S. Patterson
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - S. Raha
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - J. Whitley
- Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - O. Kraus de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Olaitan S, Wagstaff M, Sevim O, Akieme R, Toska V, Humphreys C, Shah-Goodwin L, Bell J, Chevassut T, Morgan RG. Assessment of mononuclear cell populations derived from human umbilical cord blood. Eur J Haematol 2022; 109:787-788. [PMID: 35993113 DOI: 10.1111/ejh.13846] [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] [Received: 06/27/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- S Olaitan
- School of Life Sciences, University of Sussex, Brighton, UK
| | - M Wagstaff
- School of Life Sciences, University of Sussex, Brighton, UK
| | - O Sevim
- School of Life Sciences, University of Sussex, Brighton, UK
| | - R Akieme
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - V Toska
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - C Humphreys
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - L Shah-Goodwin
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - J Bell
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - T Chevassut
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.,Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - R G Morgan
- School of Life Sciences, University of Sussex, Brighton, UK
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Currie J, Boyce T, Evans L, Luker M, Senior S, Hartt M, Cottrell S, Lester N, Huws D, Humphreys C, Little K, Adekanmbi V, Paranjothy S. Life expectancy inequalities in Wales before COVID-19: an exploration of current contributions by age and cause of death and changes between 2002 and 2018. Public Health 2021; 193:48-56. [PMID: 33735693 DOI: 10.1016/j.puhe.2021.01.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/26/2020] [Accepted: 01/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The COVID-19 pandemic in Wales and the UK has highlighted significant and historic inequalities in health between social groups. To better understand the composition of these inequalities and inform planning after the pandemic, we undertook a decomposition of life expectancy inequalities between the most and least deprived quintiles for men and women by age and cause of death and explored trends between 2002 and 2018. STUDY DESIGN Statistical decomposition of life expectancy inequalities by age and cause of death using routine population mortality datasets. METHODS We used routine statistics from the Office for National Statistics for the period 2002-2018 on population and deaths in Wales stratified by age, gender, Welsh Index of Multiple Deprivation (WIMD) 2019 quintile and cause of death, categorised by International Classification of Disease, version 10, code into 15 categories of public health relevance. We aggregated data to 3-year rolling figures to account for low numbers of events in some groups annually. Next, we estimated life expectancy at birth by quintile, gender and period using life table methods. Lastly, we performed a decomposition analysis using the Arriaga method to identify the specific disease categories and ages at which excess deaths occur in more disadvantaged areas to highlight potential areas for action. RESULTS Life expectancy inequalities between the most and least WIMD quintiles rose for both genders between 2002 and 2018: from 4.69 to 6.02 years for women (an increase of 1.33 years) and from 6.34 to 7.42 years for men (an increase of 1.08 years). Exploratory analysis of these trends suggested that the following were most influential for women: respiratory disease (1.50 years), cancers (1.36 years), circulatory disease (1.35 years) and digestive disease (0.51 years). For men, the gap was driven by circulatory disease (2.01 years), cancers (1.39 years), respiratory disease (1.25 years), digestive disease (0.79 years), drug- and alcohol-related conditions (0.54 years) and external causes (0.54 years). Contributions for women from respiratory disease, cancers, dementia and drug- and alcohol-related conditions appeared to be increasing, while among men, there were rising contributions from respiratory, digestive and circulatory disease. CONCLUSIONS Life expectancy inequalities in Wales remain wide and have been increasing, particularly among women, with indications of worsening trends since 2010 following the introduction of fiscal austerity. As agencies recover from the pandemic, these findings should be considered alongside any resumption of services in Wales or future health and public policy.
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Affiliation(s)
- J Currie
- Division of Population Medicine, School of Medicine, Cardiff University, Division of Population Medicine, School of Medicine, Cardiff University, UHW Main Building, Heath Park, Cardiff, CF14 4XN, UK.
| | - T Boyce
- Institute of Health Equity, Department for Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - L Evans
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - M Luker
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - S Senior
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - M Hartt
- Department of Geography and Planning, Queen's University, Mackintosh-Corry Hall, Room E208, Kingston, Ontario, Canada
| | - S Cottrell
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - N Lester
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - D Huws
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - C Humphreys
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - K Little
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - V Adekanmbi
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, Great Maze Pond, Addison House, Guy's Campus, London SE1 9RT, UK
| | - S Paranjothy
- Division of Population Medicine, School of Medicine, Cardiff University, Division of Population Medicine, School of Medicine, Cardiff University, UHW Main Building, Heath Park, Cardiff, CF14 4XN, UK
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Agulnik M, Mohindra NA, Milhem MM, Attia S, Robinson SI, Rademaker A, Abbinanti SE, Cehic R, Humphreys C, Prudner B, Okuno SH, Van Tine BA. A phase II study of pazopanib with oral topotecan in patients with metastatic and non-resectable soft tissue and bone sarcomas. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.11550] [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: 11/20/2022] Open
Affiliation(s)
- Mark Agulnik
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Mohammed M. Milhem
- University of Iowa Hospitals and Clinics, Holden Comprehensive Cancer Center, Iowa City, IA
| | | | | | - Alfred Rademaker
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Rasima Cehic
- Northwestern University, Feinberg School of Medicine, Chicago, IL
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Rodrigues MA, Samarasekera N, Lerpiniere C, Humphreys C, McCarron MO, White PM, Nicoll JAR, Sudlow CLM, Cordonnier C, Wardlaw JM, Smith C, Al-Shahi Salman R. The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic test accuracy study. Lancet Neurol 2018; 17:232-240. [PMID: 29331631 PMCID: PMC5818029 DOI: 10.1016/s1474-4422(18)30006-1] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/10/2017] [Accepted: 11/20/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Identification of lobar spontaneous intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) is important because it is associated with a higher risk of recurrent intracerebral haemorrhage than arteriolosclerosis-associated intracerebral haemorrhage. We aimed to develop a prediction model for the identification of CAA-associated lobar intracerebral haemorrhage using CT features and genotype. METHODS We identified adults with first-ever intracerebral haemorrhage diagnosed by CT, who died and underwent research autopsy as part of the Lothian IntraCerebral Haemorrhage, Pathology, Imaging and Neurological Outcome (LINCHPIN) study, a prospective, population-based, inception cohort. We determined APOE genotype and radiologists rated CT imaging appearances. Radiologists were not aware of clinical, genetic, and histopathological features. A neuropathologist rated brain tissue for small vessel diseases, including CAA, and was masked to clinical, radiographic, and genetic features. We used CT and APOE genotype data in a logistic regression model, which we internally validated using bootstrapping, to predict the risk of CAA-associated lobar intracerebral haemorrhage, derive diagnostic criteria, and estimate diagnostic accuracy. FINDINGS Among 110 adults (median age 83 years [IQR 76-87], 49 [45%] men) included in the LINCHPIN study between June 1, 2010 and Feb 10, 2016, intracerebral haemorrhage was lobar in 62 (56%) participants, deep in 41 (37%), and infratentorial in seven (6%). Of the 62 participants with lobar intracerebral haemorrhage, 36 (58%) were associated with moderate or severe CAA compared with 26 (42%) that were associated with absent or mild CAA, and were independently associated with subarachnoid haemorrhage (32 [89%] of 36 vs 11 [42%] of 26; p=0·014), intracerebral haemorrhage with finger-like projections (14 [39%] of 36 vs 0; p=0·043), and APOE ɛ4 possession (18 [50%] of 36 vs 2 [8%] of 26; p=0·0020). A prediction model for CAA-associated lobar intracerebral haemorrhage using these three variables had excellent discrimination (c statistic 0·92, 95% CI 0·86-0·98), confirmed by internal validation. For the rule-out criteria, neither subarachnoid haemorrhage nor APOE ɛ4 possession had 100% sensitivity (95% CI 88-100). For the rule-in criteria, subarachnoid haemorrhage and either APOE ɛ4 possession or finger-like projections had 96% specificity (95% CI 78-100). INTERPRETATION The CT and APOE genotype prediction model for CAA-associated lobar intracerebral haemorrhage shows excellent discrimination in this cohort, but requires external validation. The Edinburgh rule-in and rule-out diagnostic criteria might inform prognostic and therapeutic decisions that depend on identification of CAA-associated lobar intracerebral haemorrhage. FUNDING UK Medical Research Council, The Stroke Association, and The Wellcome Trust.
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Affiliation(s)
- Mark A Rodrigues
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | | | | | - Catherine Humphreys
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Mark O McCarron
- Department of Neurology, Altnagelvin Hospital, Londonderry, UK
| | - Philip M White
- Institute of Neuroscience and Institute for Ageing, Newcastle University, Newcastle-upon-Tyne, UK; Newcastle upon Tyne Hospitals National Health Services Foundation Trust, Newcastle-upon-Tyne, UK
| | - James A R Nicoll
- Clinical Neurosciences, Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Cathie L M Sudlow
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK; Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Charlotte Cordonnier
- Université Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, Department of Neurology, Lille, France
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at The University of Edinburgh, The University of Edinburgh, Edinburgh, UK; Row Fogo Centre for Research into Ageing and the Brain, The University of Edinburgh, Edinburgh, UK
| | - Colin Smith
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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Humphreys C, Miners S, Wardlaw JM, Smith C, Love S. [P3–061]: POSTMORTEM BIOCHEMICAL ASSESSMENT OF SEVERITY AND MECHANISMS OF NEURORADIOLOGICALLY DOCUMENTED WHITE MATTER INJURY IN SMALL‐VESSEL DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1271] [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: 11/28/2022]
Affiliation(s)
- Catherine Humphreys
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUnited Kingdom
| | | | | | - Colin Smith
- Univeristy of EdinburghEdinburghUnited Kingdom
| | - Seth Love
- University of BristolBristolUnited Kingdom
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Agulnik M, Costa RLB, Milhem M, Rademaker AW, Prunder BC, Daniels D, Rhodes BT, Humphreys C, Abbinanti S, Nye L, Cehic R, Polish A, Vintilescu C, McFarland T, Skubitz K, Robinson S, Okuno S, Van Tine BA. A phase II study of tivozanib in patients with metastatic and nonresectable soft-tissue sarcomas. Ann Oncol 2017; 28:121-127. [PMID: 27771610 DOI: 10.1093/annonc/mdw444] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 01/09/2023] Open
Abstract
Background Soft tissue sarcomas (STSs) overexpress vascular endothelial growth factors (VEGF) and VEGF-receptors (VEGFR) activation have been associated with tumor aggressiveness. Tivozanib is a potent small molecule tyrosine kinase inhibitor against VEGFR1-3, with activity against PDGFRα/β and cKIT. The primary endpoint of this study was progression free survival (PFS) rate at 16 weeks. Secondary end points were overall survival (OS), response rate, safety and correlative studies. Patients and methods A Simon two-stage phase II trial was performed using tivozanib given orally at 1.5 mg daily, 3 week on 1 week off on a 28 day cycle until disease progression or intolerable toxicity. Results Fifty-eight patients were enrolled and treated with tivozanib. Leiomyosarcoma was the most common STS histological type in our cohort (47%) and 27 patients (46%) had received at least 3 lines of therapy prior to study entry. Up to 24 patients (41%) had prior VEGF targeted therapies. Partial response and stable disease were observed in 2 (3.6%) and 30 (54.5%) patients. The 16 week PFS rate was 36.4% [95% confidence interval (CI) 23.7-49.1] and a median PFS of 3.5 months (95% CI 1.8-3). Median OS observed was 12.2 months (95% CI 8.1-16.8). The most frequent all grade toxicities were fatigue (48.3%), hypertension (43.1%), nausea (31%) and diarrhea (27.6%). The most common grade three toxicity was hypertension (22.4%). Correlative studies demonstrate no correlation between the expression of VEGFR 1, 2 or 3, PDGFRα/β or FGF, and activity of tivozanib. Conclusion Tivozanib was well tolerated and showed antitumor activity with a promising median PFS and PFS rate at 4 months in a heavily pretreated population of metastatic STSs. Our results support further studies to assess the clinical efficacy of tivozanib in STS. Clinical Trial Number NCT01782313.
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Affiliation(s)
- M Agulnik
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - R L B Costa
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - M Milhem
- Division of Hematology/Oncology, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - A W Rademaker
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - B C Prunder
- Division of Hematology/Oncology, Washington University in St. Louis, St Louis, USA
| | - D Daniels
- Division of Hematology/Oncology, Washington University in St. Louis, St Louis, USA
| | - B T Rhodes
- Division of Hematology/Oncology, Washington University in St. Louis, St Louis, USA
| | - C Humphreys
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - S Abbinanti
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - L Nye
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - R Cehic
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - A Polish
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - C Vintilescu
- Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago, USA
| | - T McFarland
- Division of Hematology/Oncology, University of Wisconsin, Madison, USA
| | - K Skubitz
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, USA
| | - S Robinson
- Division of Hematology/Oncology, Mayo Clinic, Rochester, USA
| | - S Okuno
- Division of Hematology/Oncology, Mayo Clinic, Rochester, USA
| | - B A Van Tine
- Division of Hematology/Oncology, Washington University in St. Louis, St Louis, USA
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Agulnik M, Milhem MM, Rademaker A, Humphreys C, Abbinanti SE, Nye LE, Cehic R, Polish A, Vintilescu CR, McFarland T, Skubitz KM, Robinson SI, Okuno SH, Van Tine BA. A phase II study of tivozanib in patients with metastatic and non-resectable soft tissue sarcomas. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10515] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mark Agulnik
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | - Alfred Rademaker
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | | | | | - Rasima Cehic
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Ariel Polish
- Northwestern University, Feinberg School of Medicine, Chicago, IL
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Nye LE, Polish A, Abbinanti SE, Roxana Vintilescu C, Rademaker A, Humphreys C, Cehic R, McFarland T, Milhem MM, Skubitz KM, Van Tine BA, Okuno SH, Agulnik M. A phase II study of tivozanib in patients with metastatic and nonresectable soft-tissue sarcomas. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.tps10604] [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: 11/20/2022] Open
Affiliation(s)
| | - Ariel Polish
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | | | - Alfred Rademaker
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | - Rasima Cehic
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Thomas McFarland
- University of Wisconsin, School of Medicine and Public Health, Madison, WI
| | | | | | | | | | - Mark Agulnik
- Northwestern University, Feinberg School of Medicine, Chicago, IL
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Humphreys C, Railton C, O'Moore E, Lombard M, Newton A. An audit of hepatitis C service provision in a representative sample of prisons in England. J Public Health (Oxf) 2014; 37:151-6. [DOI: 10.1093/pubmed/fdu022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kliner M, Knight A, Elston J, Humphreys C, Mamvura C, Wright J, Walley J. Development and testing of models of tuberculosis contact tracing in rural southern Africa. Public Health Action 2013; 3:299-303. [PMID: 26393050 PMCID: PMC4463148 DOI: 10.5588/pha.13.0070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 11/26/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING A regional hospital in rural Swaziland. OBJECTIVES To evaluate a hospital-based contact screening programme and test approaches to improve its effectiveness. DESIGN An evaluation and quality improvement study of tuberculosis (TB) contact tracing services. RESULTS Hospital-based TB contact tracing led to screening of 157 (24%) of 658 contacts; of these, 4 (2.5%) were diagnosed with TB. Of 68 contacts eligible for human immunodeficiency virus (HIV) testing and counselling, 45 (66%) were tested and 7/45 (16%) were identified as HIV-positive. Twelve (50%) of 24 screened contacts aged <5 years were provided isoniazid prophylaxis. Three enhanced models of TB contact tracing were piloted to screen contacts in the community. Although some enhanced models screened large numbers of contacts, no contacts were diagnosed with TB. CONCLUSION Contact tracing of household members conducted in TB clinics within hospital settings is effective in high-burden, low-income settings, and can be provided using current resources. Enhanced household contact tracing models that followed up contacts in the community were not found to be effective. Additional resources would be required to provide household TB contact tracing in the community.
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Affiliation(s)
- M Kliner
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - J Elston
- Yorkshire and the Humber Deanery, University of Leeds, Leeds, UK
| | | | - C Mamvura
- Matsapha Health Care, Matsapha, Swaziland
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - J Walley
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Sharma V, Davey JGN, Humphreys C, Johnston PW. A new approach for measuring the work and quality of histopathology reporting. Histopathology 2013; 63:130-6. [PMID: 23701471 DOI: 10.1111/his.12144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/20/2013] [Indexed: 11/30/2022]
Abstract
AIMS Cancer datasets drive report quality, but require more work to inform compliant reports. The aim of this study was to correlate the number of words with measures of quality, to examine the impact of the drive for improved quality on the workload of histopathology reporting over time. METHODS AND RESULTS We examined the first 10 reports of colon, breast, renal, lung and ovarian carcinoma, melanoma resection, nodal lymphoma appendicitis and seborrhoeic keratosis (SK) issued in 1991, 2001 and 2011. Correlations were analysed using Pearson's partial correlation coefficients. Word count increased significantly over time for most specimen types examined. Word count almost always correlated with units of information, indicating that the word count was a good measure of the amount of information contained within the reports; this correlation was preserved following correction for the effect of time. A good correlation with compliance with cancer datasets was also observed, but was weakened or lost following correction for the increase in word count and units of information that occurred between time points. CONCLUSIONS These data indicate that word count could potentially be used as a measure of information content if its integrity and usefulness are continuously validated. Further prospective studies are required to assess and validate this approach.
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Affiliation(s)
- Vijay Sharma
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK; Division of Applied Medicine, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
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Macey S, Jones SJ, Pinder L, Humphreys C, Price T, Evans L, Hughes R, Lyons RA. WALES BURDEN OF INJURY STUDY. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580d.8] [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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Toumbourou JW, Hemphill SA, Tresidder J, Humphreys C, Edwards J, Murray D. Mental health promotion and socio-economic disadvantage: lessons from substance abuse, violence and crime prevention and child health. Health Promot J Austr 2008; 18:184-90. [PMID: 18201160 DOI: 10.1071/he07184] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ISSUE ADDRESSED Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems. METHODS Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES. RESULTS Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use. CONCLUSION Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.
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Affiliation(s)
- J W Toumbourou
- School of Psychology, Deakin University, Geelong, Victoria.
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Oliver D, Murtagh F, McMurray A, Humphreys C. International collaboration in palliative care. Croat Med J 2001; 42:689. [PMID: 11881585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
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Ashworth A, Lloyd S, Brown J, Gydesen S, Sorensen SA, Brun A, Englund E, Humphreys C, Housman D, Badura M, Stanton V, Taylor K, Cameron J, Munroe D, Johansson J, Rossor M, Fisher EM, Collinge J. Molecular genetic characterisation of frontotemporal dementia on chromosome 3. Dement Geriatr Cogn Disord 2001; 10 Suppl 1:93-101. [PMID: 10436350 DOI: 10.1159/000051222] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [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: 11/19/2022] Open
Abstract
We have previously localized a locus causing familial nonspecific dementia to the centromeric region of chromosome 3 in a pedigree from the Jutland area of Denmark. This pedigree shows anticipation. Here we present further analysis of these anticipation data which are suggestive of trinucleotide repeat expansion involvement. We also outline our strategies to clone the mutant gene via its putative associated trinucleotide repeat sequence.
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Affiliation(s)
- A Ashworth
- Department of Neurogenetics, Imperial College School of Medicine at St Mary's, London, UK
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Abstract
Police response to the escalating numbers of child sexual abuse cases has led to the development of a wide range of organizational models within both police departments and the interagency context. This paper compares the results of different models of police intervention in New South Wales, Australia. The data suggest that specialist police units in which police manage the full investigation provide a more comprehensive service than those where the police response is fragmented between units within the police force.
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Affiliation(s)
- C Humphreys
- School of Applied Social Studies, University of Warwick, Coventry, UK
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Abstract
A study of confirmed cases of child sexual abuse showed that only 56% of children received an appointment at a counselling agency in spite of explicit policy guidelines that children have an opportunity for counselling in the aftermath of the abuse. The study revealed that problems created at all levels within the interagency environment led to children becoming "lost" in the system and not receiving the services from which they could have benefited. Particular attention is given to changes in the broader policy and resource context which have ramifications at the local interagency level and in the services provided for sexually abused children.
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Affiliation(s)
- C Humphreys
- School of Applied Social Studies, University of Warwick, Coventry, UK
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Humphreys C, Kingston RD, Robinson CA. Stomach cancer--is it a lost cause? Eur J Surg Oncol 1995; 21:159-61. [PMID: 7720890 DOI: 10.1016/s0748-7983(95)90303-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A retrospective study of 7 years of endoscopy at Trafford General Hospital from 1986-1993 identified 143 patients diagnosed as having gastric cancer, of whom 13 cases were identified as early gastric cancer. Epigastric pain was the main symptom (66%) of those presenting with resectable disease. Weight loss (70%) was the most common symptom of patients presenting with advanced disease. Forty-seven patients had no surgery and 25 had palliative non-resective surgery. These two groups account for 50% of cases. With such a small detection rate of early gastric cancer and consequent curative surgery rate one must debate whether treatment of stomach cancer in the Trust hospital of the future is a lost cause.
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Affiliation(s)
- C Humphreys
- Department of Clinical Studies, Trafford General Hospital, Manchester, UK
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Abstract
How to theorize about power has been a controversial issue in systemic family therapy, which, in its understanding of power, has shown the legacy of Gregory Bateson's ideas in terms of its earlier censorship of the concept of power as well as in the way in which the more recent challenges continue to be framed in relation to Bateson's position. This essay examines the work of the French philosopher, Michel Foucault, and his ideas on power in relation to family therapy themes. The main aim in intersecting Foucault's ideas with the "problem" of power in family therapy is to shed a different light on the way in which family therapy has theorized about power. A strong point of connection is made between Foucault's commitment to a relational analysis of power and family therapy's commitment to recursive analysis. However, a number of major contrasts are also identified. These contrasts are used to underline the need for family therapy to abandon the restrictions of Bateson's ideas on power, and to tackle the task of developing and using a recursive understanding of power.
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Affiliation(s)
- C Flaskas
- School of Social Work, University of New South Wales, Kensington, Australia
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Johnson JE, Sparks DG, Humphreys C. Writing a winning business plan. J Nurs Adm 1988; 18:15-9. [PMID: 3171710] [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: 01/04/2023]
Abstract
Nurse executives are key contributors to business decisions in today's cost-conscious health care arena. To make sound decisions about initiating new services or expanding existing programs, nurse executives must know how to plan and produce sophisticated business plans that win support and speak successfully for nursing.
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Abstract
General practitioners' medical records of a geographically defined population of about 1600-1800 have been retained since 1964. Details of care by general practitioners and hospital correspondence were available for 500 deaths (277 men, 223 women) from 1964 to 1985, including deaths at home, at work, in the street, in short term and long term institutional care, and within six months of release from institutional care. The periods 1964-73 and 1974-85 were compared. The proportion of men aged greater than or equal to 80 who died increased from 20 (14%) in 1964-73 to 22 (16%) in 1974-85, but the proportion of women aged greater than or equal to 80 who died increased from 21 (23%) to 50 (39%). Of all deaths, 223 (45%) were thought to have had avoidable causal factors, of which 132 (59%) were attributed to patients, 45 (20%) to the general practitioner, 9 (4%) to hospitals, and 37 (17%) to others. The number of deaths related to smoking decreased from 31 (43%) in men aged less than 70 to 19 (30%) but in women aged less than 70 increased from 4 (10%) to 11 (26%). The proportion of deaths in women who were already dependent six months before death increased from 55 (58%) to 81 (63%) but in men remained constant at 64 (46%) in the first period and 62 (46%) in the second. Nearly two thirds of all deaths occurred at home in both periods--about twice the proportion for England and Wales--but the proportion of men dying at home decreased from 87 (62%) to 76 (56%). A critical analysis of deaths in whole populations by primary care teams can identify changes that are needed both in the work and organisation of the team and in the behaviour of the population itself.
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Lin TS, Zhou RX, Scanlon KJ, Brubaker WF, Lee JJ, Woods K, Humphreys C, Prusoff WH. Synthesis and biological activity of several amino nucleoside-platinum(II) complexes. J Med Chem 1986; 29:681-6. [PMID: 3701784 DOI: 10.1021/jm00155a017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Several platinum(II) complexes of 3',5'-diamino-3',5'-dideoxythymidine (compound 1), 5'-amino-5'-deoxythymidine (compound 2), and 3'-amino-3'-deoxythymidine (compound 3) and the respective 2'-deoxyuridine amino nucleoside complexes, 4-6, have been synthesized. Whereas compounds 1, 2, and 4-6 had no inhibitory effect on the replication of murine L1210 cells in cell culture, compound 3 [(3'-AdThd)2PtCl2] inhibited these cells with an ED50 of 0.8 microM. Incubation of L1210 cells with 10-20 microM compound 3 for 2 h produced less than 18% inhibition of RNA, DNA, or protein synthesis, which is of questionable significance. However a 16-h incubation resulted in an increased uptake of labeled thymidine into DNA (77%), labeled uridine into RNA (17%), and labeled amino acids into protein (100%). These unexpected results indicate that inhibition of macromolecules may not be involved in the inhibition of the replication of L1210 cells. The increased incorporation of labeled metabolites into macromolecules may be related to the increase in cell volume after a 2-h incubation of L1210 cells with compound 3 plus a marked increase after 2 h in the proportion of cells in their S phase. Compound 3 appears to delay the progression of cells through their cell cycle. A marked inhibitory effect on the transport of methionine or aminoisobutyric acid into L1210 cells was found with compound 3, which was slightly greater than that produced with cisplatin. Compound 3 had a dose-dependent effect on the survival of mice bearing the L1210 ascites neoplasm, with a T/C X 100 of 175 at a dose of 320 mg/kg. Investigation of the kinetics of decomposition in aqueous systems demonstrated that the primary UV-absorbing decomposition product is 3'-amino-3'-deoxythymidine and that only a limited amount of the compound is formed (less than 8%). Although 3'-amino-3'-deoxythymidine could account for a part of the inhibition of the replication of L1210 cells in culture, it cannot account for the inhibition of amino acid transport by compound 3, the platinum complex of 3'-amino-3'-deoxythymidine. Compound 3 has been shown to limit part of the amino acid uptake into L1210 cells in a similar manner to cisplatin.
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