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McCormick KL, Xu W, Cozzarelli NF, Crawford D, Wilson EJ, Berend KR, Fricka KB, Lonner JH, Geller JA. Debridement, Antibiotics, and Implant Retention in Unicompartmental Knee Arthroplasty Infection. J Arthroplasty 2024:S0883-5403(24)00273-0. [PMID: 38548232 DOI: 10.1016/j.arth.2024.03.057] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND This multicenter study sought to further investigate the method and outcome of debridement, antibiotics, and implant retention (DAIR) for the management of unicompartmental knee periprosthetic joint infection (PJI). METHODS This retrospective study was performed on 52 patients who underwent DAIR for PJI of a unicompartmental knee arthroplasty (UKA) across 4 academic medical centers, all performed by fellowship-trained arthroplasty surgeons. Patient demographics, American Society of Anesthesiologists score, infecting organism, operative data, antibiotic data, and success in infection control at 1 year were collected. RESULTS The average time from index surgery to diagnosis of PJI was 11.1 weeks (range, 1.4 to 48). There was no correlation between time of diagnosis and success at 1 year (R = 0.09, P = .46). There was an association between surgical synovectomy and the eradication of infection (R = 0.28, P = .04). Overall, there was an 80.8% (42 of 52) infection-controlled success rate at 1 year from the DAIR procedure. All DAIR failures went on to require another procedure, either 1-stage (2 of 10) or 2-stage (8 of 10) revision to total knee arthroplasty (TKA). Of the DAIR successes, 6 (14.3%) went on to require conversion to TKA for progression of arthritis within 5 years. CONCLUSIONS This study demonstrates that DAIR is a safe and moderately effective procedure in the setting of acute PJI of UKA across institutions, with a success rate consistent with DAIR for TKA. The data suggest that a wide exposure and thorough synovectomy be incorporated during the DAIR UKA to improve the likelihood of successful eradication of PJI at the 1-year mark. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Kyle L McCormick
- Department of Orthopedic Surgery, New York Presbyterian - Columbia University, New York, New York
| | - Winnie Xu
- Department of Orthopedic Surgery, New York Presbyterian - Columbia University, New York, New York
| | - Nicholas F Cozzarelli
- Department of Orthopedic Surgery, Rothman Orthopaedic Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - David Crawford
- Department of Orthopedic Surgery, Joint Implant Surgeons (JIS) Orthopedics, New Albany, Ohio
| | - Eric J Wilson
- Department of Orthopedic Surgery, Anderson Orthopaedic Clinic, Alexandria, Virginia
| | - Keith R Berend
- Department of Orthopedic Surgery, Joint Implant Surgeons (JIS) Orthopedics, New Albany, Ohio
| | - Kevin B Fricka
- Department of Orthopedic Surgery, Anderson Orthopaedic Clinic, Alexandria, Virginia
| | - Jess H Lonner
- Department of Orthopedic Surgery, Rothman Orthopaedic Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jeffrey A Geller
- Department of Orthopedic Surgery, New York Presbyterian - Columbia University, New York, New York
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Shore ND, Hussain M, Saad F, Fizazi K, Sternberg CN, Crawford D, Tombal B, Nordquist L, Cookson M, Verholen F, Jhaveri J, Srinivasan S, Smith MR. Efficacy and Safety of Darolutamide in Combination With Androgen-Deprivation Therapy and Docetaxel in Black Patients From the Randomized ARASENS Trial. Oncologist 2024; 29:235-243. [PMID: 37812679 PMCID: PMC10911916 DOI: 10.1093/oncolo/oyad254] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/09/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND In the ARASENS trial (NCT02799602), darolutamide in combination with androgen-deprivation therapy (ADT) and docetaxel significantly reduced the risk of death by 32.5% (HR, 0.68; 95% CI, 0.57-0.80; P < .0001) compared with placebo plus ADT with docetaxel in patients with metastatic hormone-sensitive prostate cancer (mHSPC). We present efficacy and safety of darolutamide versus placebo in Black patients from ARASENS. PATIENTS AND METHODS Patients with mHSPC were randomized 1:1 to darolutamide 600 mg or placebo twice daily in combination with ADT and docetaxel. The primary endpoint was overall survival. Key secondary endpoints included time to castration-resistant prostate cancer (CRPC) and safety. RESULTS In ARASENS, 54 Black patients received darolutamide (n = 26) or placebo (n = 28) plus ADT and docetaxel. In Black patients, overall survival favored darolutamide versus placebo (median, not reached vs. 38.7 months; stratified HR, 0.41; 95% CI, 0.17-1.02), with 4-year survival rates of 62% versus 41%. The darolutamide group also had longer time to CRPC compared with the placebo group (median, not reached vs .12.6 months; HR, 0.09; 95% CI, 0.02-0.30). The safety profile of darolutamide in Black patients was consistent with that observed for the overall ARASENS population (grade 3/4 treatment-emergent adverse events, TEAEs: 61.5% vs. 66.1%; serious TEAEs: 42.3% vs. 44.8%). CONCLUSION In this small population of Black patients with mHSPC from the ARASENS trial, darolutamide was associated with an improvement in survival and time to CRPC and was well tolerated. Efficacy and safety findings in Black patients were consistent with the overall ARASENS population.
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Affiliation(s)
- Neal D Shore
- Carolina Urologic Research Center/Genesis Care, Myrtle Beach, SC, USA
| | - Maha Hussain
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Fred Saad
- Centre Hospitalier de l’Université de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Department of Medicine, Meyer Cancer Center, New York-Presbyterian Hospital, New York, NY, USA
| | - David Crawford
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Bertrand Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCLouvain, Brussels, Belgium
| | | | - Michael Cookson
- University of Oklahoma Stephenson Cancer Center, Oklahoma City, OK, USA
| | | | - Jay Jhaveri
- Bayer Healthcare Pharmaceuticals, Inc., Whippany, NJ, USA
| | | | - Matthew R Smith
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
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Karimi N, Opie R, Crawford D, O'Connell S, Ball K. Digitally Delivered Interventions to Improve Nutrition Behaviors Among Resource-Poor and Ethnic Minority Groups With Type 2 Diabetes: Systematic Review. J Med Internet Res 2024; 26:e42595. [PMID: 38300694 PMCID: PMC10870209 DOI: 10.2196/42595] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 06/22/2023] [Accepted: 07/30/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Resource-poor individuals, such as those with a low income, are disproportionately affected by diabetes and unhealthy eating patterns that contribute to poor disease self-management and prognosis. Digitally delivered interventions have the potential to address some of the barriers to healthy eating experienced by this group. However, little is known about their effectiveness in disadvantaged populations. OBJECTIVE This systematic review is conducted to assess the effectiveness of digitally delivered interventions in improving nutritional behaviors and nutrition-related health outcomes among disadvantaged people with type 2 diabetes (T2D). METHODS MEDLINE complete, Global Health, Embase, CINAHL complete, Informit Health, IEEE Xplore, and Applied Science and Technology Source databases were searched for studies published between 1990 and 2022 on digitally delivered nutrition interventions for disadvantaged people with T2D. Two reviewers independently assessed the studies for eligibility and determined the study quality using the Cochrane Risk-of-Bias Assessment Tool. The Behavioral Change Technique Taxonomy V1 was used to identify behavior change techniques used in the design of interventions. RESULTS Of the 2434 identified records, 10 (0.4%), comprising 947 participants, met the eligibility criteria and were included in the review. A total of 2 digital platforms, web and messaging services (eg, SMS text messaging interventions or multimedia messaging service), were used to deliver interventions. Substantial improvements in dietary behaviors were reported in 5 (50%) of the 10 studies, representing improvements in healthier food choices or increases in dietary knowledge and skills or self-efficacy. Of the 10 studies, 7 (70%) examined changes in blood glucose levels, of which 4 (57%) out of 7 achieved significant decreases in hemoglobin A1C levels ranging from 0.3% to 1.8%. The most frequently identified behavior change techniques across all studies were instruction on how to perform the behavior, information about health consequences, and social support. CONCLUSIONS This review provided some support for the efficacy of digitally delivered interventions in improving healthy eating behaviors in disadvantaged people with T2D, an essential dietary prerequisite for changes in clinical metabolic parameters. Further research is needed into how disadvantaged people with T2D may benefit more from digital approaches and to identify the specific features of effective digital interventions for supporting healthy behaviors among disadvantaged populations. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020149844; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=149844.
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Affiliation(s)
- Nazgol Karimi
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Rachelle Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Stella O'Connell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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Rizk N, Crawford D, Karanas Y, Barnes C, Pham TN, Sheckter CC. Amphetamine Positivity Prior to Burn Surgery Does not Adversely Affect Intraoperative Outcomes. J Burn Care Res 2024; 45:17-24. [PMID: 37875155 PMCID: PMC11023316 DOI: 10.1093/jbcr/irad165] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Indexed: 10/26/2023]
Abstract
The treatment of burn patients using amphetamines is challenging due hemodynamic liabilty and altered physiology. Wide variation exists in the operative timing for this patient population. We hypothesize that burn excision in patients admitted with amphetamine positivity is safe regardless of timing. Data from two verified burn centers between 2017 and 2022 with differing practice patterns in operative timing for amphetamine-positive patients. Center A obtains toxicology only on admission and proceeds with surgery based on hemodynamic status and operative urgency, whereas Center B sends daily toxicology until a negative test results. The primary outcome was the use of vasoactive agents during the index operation, modeled using logistic regression adjusting for burn severity and hospital days to index operation. Secondary outcomes included death and inpatient complications. A total of 270 patients were included, and there were no significant differences in demographics or burn characteristics between centers. Center A screened once and Center B obtained a median of four screens prior to the surgery. The adjusted OR of requiring vasoactive support intraoperatively was not associated with negative toxicology result (P = .821). Having a body surface area burned >20% conferred a significantly higher risk of vasoactive support (adj. OR 13.42 [3.90-46.23], P < .001). Mortality, number of operations, stroke, and hospital length of stay were similar between cohorts. Comparison between two verified burn centers indicates that waiting until a negative amphetamine toxicology result does not impact intraoperative management or subsequent burn outcomes. Serial toxicology tests are unnecessary to guide operative timing of burn patients with amphetamine use.
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Affiliation(s)
- Nada Rizk
- Department of Surgery, Stanford University School of Medicine, 770 Welch Road suite 400, Palo Alto, CA 94304, USA
| | - David Crawford
- UW Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave Seattle, WA 98104, USA
- Department of Surgery, University of Washington, 325 9th Ave Seattle WA 98104, USA
| | - Yvonne Karanas
- Regional Burn Center, Santa Clara Valley Medical Center, 751 S Bascom Ave San Jose, CA 95128, USA
| | - Christopher Barnes
- UW Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave Seattle, WA 98104, USA
- Department of Anesthesia, University of Washington, 325 9th Ave Seattle WA 98104, USA
| | - Tam N Pham
- UW Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave Seattle, WA 98104, USA
- Department of Surgery, University of Washington, 325 9th Ave Seattle WA 98104, USA
| | - Clifford C Sheckter
- Department of Surgery, Stanford University School of Medicine, 770 Welch Road suite 400, Palo Alto, CA 94304, USA
- Regional Burn Center, Santa Clara Valley Medical Center, 751 S Bascom Ave San Jose, CA 95128, USA
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Oostenbach LH, Lamb KE, Crawford D, Timperio A, Thornton LE. Do 20-minute neighbourhoods moderate associations between work and commute hours with food consumption? Public Health Nutr 2023; 26:2026-2035. [PMID: 36987863 PMCID: PMC10564605 DOI: 10.1017/s1368980023000587] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE To examine associations between work and commute hours with food consumption and test whether neighbourhood type (20-minute neighbourhood (20MN)/non-20MN) moderate associations. DESIGN Cross-sectional analysis of the Places and Locations for Activity and Nutrition study (ProjectPLAN). Exposures were work hours (not working (0 h), working up to full-time (1-38 h/week), working overtime (> 38 h/week)), and among those employed, combined weekly work and commute hours (continuous). Outcomes were usual consumption of fruit, vegetables, takeaway food, snacks and soft drinks, and number of discretionary food types (takeaway, snacks and soft drinks) consumed weekly. Generalised linear models were fitted to examine associations between each exposure and outcome. The moderating role of neighbourhood type was examined through interaction terms between each exposure and neighbourhood type (20MN/non-20MN). SETTING Melbourne and Adelaide, Australia, 2018-2019. PARTICIPANTS Adults ≥ 18 years old (n 769). RESULTS Although all confidence intervals contained the null, overall, patterns suggested non-workers and overtime workers have less healthy food behaviours than up-to-full-time workers. Among those employed, analysis of continuous work and commute hours data suggested longer work and commute hours were positively associated with takeaway consumption (OR = 1·014, 95 % CI 0·999, 1·030, P-value = 0·066). Patterns of better behaviours were observed across most outcomes for those in 20MN than non-20MN. However, differences in associations between work and commute hours with food consumption across neighbourhood type were negligible. CONCLUSIONS Longer work and commute hours may induce poorer food behaviours. There was weak evidence to suggest 20MN moderate associations between work and commute hours with food consumption, although behaviours appeared healthier for those in 20MN.
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Affiliation(s)
- Laura Helena Oostenbach
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
| | - Karen Elaine Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
| | - Lukar Ezra Thornton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
- Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
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Chong C, de Leon J, Tan H, Crawford D, Jameson M, Hogan L, Pagulayan C, Jelen U, Biggerstaff K, Chhabra A, Twentyman T, Rahim K, Leong E, Lim M, Batumalai V. MRI Guided Adaptive Radiotherapy (MRgART) in Primary and Metastatic Liver Lesions. Int J Radiat Oncol Biol Phys 2023; 117:e288-e289. [PMID: 37785067 DOI: 10.1016/j.ijrobp.2023.06.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The role of stereotactic body radiotherapy (SBRT) in the management of primary hepatic and metastatic tumors has increased significantly over the past few years. MR-Linac is rapidly gaining evidence in the delivery of ablative doses using MR guided adaptive radiotherapy (MRgART) with improved accuracy and dose coverage to the lesions. We report local control and toxicity of patients with primary and metastatic liver lesions treated with MR guided adaptive SBRT. MATERIALS/METHODS All patients were treated with MRgART on the Unity 1.5T MR Linacs at two institutions and consented to the ADAPT-MRL study (1). A 4DCT and MRI with abdominal compression were obtained at simulation and the primary MRI sequence used for online treatment included a T2 3D navigated scan. A balanced turbo field echo (btFFE) 2D cine motion scan was also acquired at every fraction to determine movement of the tumor to aid in internal target volume margin. All plans were treated with SBRT prescribed to 3-5 alternate daily fractions. Acute toxicity was reported according to Common Terminology Criteria for Adverse Events version 5 (CTCAE) v.5. Patient demographics, prescribed dose fractionation, acute toxicity and clinical response at 6 months were analyzed. Clinical response to treatment was measured according to RECIST criteria 1.1. RESULTS Between February 2021 to January 2023 a total of 30 patients were treated with 149 fractions to the liver. Patients were majority male (70%) with a median age of 66 (range 36-83). 16 patients were treated for primary hepatocellular carcinoma (HCC) of the liver and 14 patients for metastatic liver lesions. The median prescribed dose was 48 Gy (range 30-50Gy) in median 5 fractions (range (3-5 fractions). All patients completed treatment with no interruptions. The mean time from 'patient setup' to 'beam-off' was 52.6 minutes (range 37-73 minutes). Data on acute toxicity at 3 month follow up was available for 28 patients. Of these patients 7/28 (25%) had grade 1 or 2 toxicity and no >/ = grade 3 toxicity was reported. Clinical response at 6 months was available for 18 patients and showed complete response in 44% (8/18), partial response in 22% (4/18), stable disease in 22% (4/18) and progressive disease in 11.1% (2/18). CONCLUSION Our experience on MRgART to the liver has shown good local control and minimal acute toxicity in the treatment of primary and metastatic liver lesions. We continue to collect data on patient reported outcomes, clinical response and toxicity to determine the feasibility and safety of this system.
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Affiliation(s)
- C Chong
- GenesisCare Murdoch, Perth, Western Australia, Australia
| | - J de Leon
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
| | - H Tan
- GenesisCare Murdoch, Perth, Western Australia, Australia; Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - D Crawford
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
| | - M Jameson
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
| | - L Hogan
- GenesisCare Murdoch, Perth, Western Australia, Australia
| | - C Pagulayan
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
| | - U Jelen
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
| | - K Biggerstaff
- GenesisCare Murdoch, Perth, Western Australia, Australia
| | - A Chhabra
- GenesisCare Murdoch, Perth, Western Australia, Australia
| | - T Twentyman
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
| | - K Rahim
- GenesisCare Murdoch, Perth, Western Australia, Australia; Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - E Leong
- GenesisCare Murdoch, Perth, Western Australia, Australia; Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - M Lim
- GenesisCare Murdoch, Perth, Western Australia, Australia
| | - V Batumalai
- GenesisCare St. Vincent's Clinic, Sydney, NSW, Australia
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Carr ME, Jelen U, Picton M, Batumalai V, Crawford D, Peng V, Twentyman T, de Leon J, Jameson MG. Towards simulation-free MR-linac treatment: utilizing male pelvis PSMA-PET/CT and population-based electron density assignments. Phys Med Biol 2023; 68:195012. [PMID: 37652043 DOI: 10.1088/1361-6560/acf5c6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/31/2023] [Indexed: 09/02/2023]
Abstract
Objective. This study aimed to investigate the dosimetric impact of using population-based relative electron density (RED) overrides in lieu of simulation computerized tomography (CT) in a magnetic resonance linear accelerator (MRL) workflow for male pelvis patients. Additionally, the feasibility of using prostate specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scans to assess patients' eligibility for this proposed workflow was examined.Approach. In this study, 74 male pelvis patients treated on an Elekta Unity 1.5 T MRL were retrospectively selected. The patients' individual RED values for 8 organs of interest were extracted from their simulation-CT images to establish population-based RED values. These values were used to generate individual (IndD) and population-based (PopD) RED dose plans, representing current and proposed MRL workflows, respectively. Lastly, this study compared RED values obtained from CT and PET-CT scanners in a phantom and a subset of patients.Results. Population-based RED values were mostly within two standard deviations of ICRU Report 46 values. PopD plans were comparable to IndD plans, with the average %difference magnitudes of 0.5%, 0.6%, and 0.6% for mean dose (all organs), D0.1cm3(non-target organs) and D95%/D98% (target organs), respectively. Both phantom and patient PET-CT derived RED values had high agreement with corresponding CT-derived values, with correlation coefficients ≥ 0.9.Significance. Population-based RED values were considered suitable in a simulation-free MRL treatment workflow. Utilizing these RED values resulted in similar dosimetric uncertainties as per the current workflow. Initial findings also suggested that PET-CT scans may be used to assess prospective patients' eligibility for the proposed workflow. Future investigations will evaluate the clinical feasibility of implementing this workflow for prospective patients in the clinical setting. This is aimed to reduce patient burden during radiotherapy and increase department efficiencies.
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Affiliation(s)
- Madeline E Carr
- GenesisCare, New South Wales, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | | | | | - Vikneswary Batumalai
- GenesisCare, New South Wales, Australia
- School of Clinical Medicine, Medicine and Health, University of New South Wales, Australia
| | | | | | | | | | - Michael G Jameson
- GenesisCare, New South Wales, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
- School of Clinical Medicine, Medicine and Health, University of New South Wales, Australia
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Livingstone KM, Olstad DL, McNaughton SA, Nejatinamini S, Dollman J, Crawford D, Timperio A. Do food-related capabilities, opportunities and motivations of adolescents mediate the association between socioeconomic position in adolescence and diet quality in early adulthood? Int J Behav Nutr Phys Act 2023; 20:70. [PMID: 37308957 DOI: 10.1186/s12966-023-01477-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Socio-economic position (SEP) in adolescence may influence diet quality over the life course. However, knowledge of whether individual and environmental determinants of diet quality mediate the longitudinal association between SEP and diet quality is limited. This study examined whether and to what extent food-related capabilities, opportunities and motivations of adolescents mediated the longitudinal association between SEP in adolescence and diet quality in early adulthood overall and by sex. METHODS Longitudinal data (annual surveys) from 774 adolescents (16.9 years at baseline; 76% female) from ProjectADAPT (T1 (baseline), T2, T3) were used. SEP in adolescence (T1) was operationalized as highest level of parental education and area-level disadvantage (based on postcode). The Capabilities, Opportunities and Motivations for Behaviour (COM-B) model was used as a framework to inform the analysis. Determinants in adolescence (T2) included food-related activities and skills (Capability), home availability of fruit and vegetables (Opportunity) and self-efficacy (Motivation). Diet quality in early adulthood (T3) was calculated using a modified version of the Australian Dietary Guidelines Index based on brief dietary questions on intake of foods from eight food groups. Structural equation modelling was used to estimate the mediating effects of adolescents' COM-B in associations between adolescent SEP and diet quality in early adulthood overall and by sex. Standardized beta coefficients (β) and robust 95% confidence intervals (CI) were generated, adjusted for confounders (T1 age, sex, diet quality, whether still at school, and living at home) and clustering by school. RESULTS There was evidence of an indirect effect of area-level disadvantage on diet quality via Opportunity (β: 0.021; 95% CI: 0.003 to 0.038), but limited evidence for parental education (β: 0.018; 95% CI: -0.003 to 0.039). Opportunity mediated 60.9% of the association between area-level disadvantage and diet quality. There was no evidence of an indirect effect via Capability or Motivation for either area-level disadvantage or parental education, or in males and females separately. CONCLUSIONS Using the COM-B model, the home availability of fruit and vegetables (Opportunity) of adolescents explained a large proportion of the association between area-level disadvantage in adolescence and diet quality in early adulthood. Interventions to address poor diet quality among adolescents with a lower SEP should prioritize environmental determinants of diet quality.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James Dollman
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, 5000, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
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Batumalai V, Carr M, Jameson M, Crawford D, Jelen U, Pagulayan C, Twentyman T, Hong A, de Leon J. MR-Linac guided adaptive stereotactic ablative body radiotherapy for recurrent cardiac sarcoma with mitral valve bioprosthesis - a case report. J Med Radiat Sci 2023. [PMID: 36890690 DOI: 10.1002/jmrs.669] [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: 09/14/2022] [Accepted: 02/21/2023] [Indexed: 03/10/2023] Open
Abstract
We present the first case in the literature of a 78-year-old woman with recurrent cardiac sarcoma adjacent to a bioprosthetic mitral valve treated with magnetic resonance linear accelerator (MR-Linac) guided adaptive stereotactic ablative body radiotherapy (SABR). The patient was treated using a 1.5 T Unity MR-Linac system (Elekta AB, Stockholm, Sweden). The mean gross tumour volume (GTV) size was 17.9 cm3 (range 16.6-18.9 cm3 ) based on daily contours and the mean dose received by the GTV was 41.4 Gy (range 40.9-41.6 Gy) in five fractions. All fractions were completed as planned and the patient tolerated the treatment well with no acute toxicity reported. Follow-up appointments at 2 and 5 months after the last treatment showed stable disease and good symptomatic relief. Results of transthoracic echocardiogram after radiotherapy showed that the mitral valve prosthesis was normally seated with regular functionality. This study provides evidence that MR-Linac guided adaptive SABR is a safe and viable option for the treatment of recurrent cardiac sarcoma with mitral valve bioprosthesis.
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Affiliation(s)
- Vikneswary Batumalai
- GenesisCare, Sydney, New South Wales, Australia.,School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Madeline Carr
- GenesisCare, Sydney, New South Wales, Australia.,Centre for Medical and Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michael Jameson
- GenesisCare, Sydney, New South Wales, Australia.,School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.,Centre for Medical and Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
| | | | | | | | | | - Angela Hong
- GenesisCare, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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10
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Salmon J, Arundell L, Cerin E, Ridgers ND, Hesketh KD, Daly RM, Dunstan D, Brown H, Della Gatta J, Della Gatta P, Chinapaw MJM, Shepphard L, Moodie M, Hume C, Brown V, Ball K, Crawford D. Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers. Br J Sports Med 2023; 57:311-319. [PMID: 36428089 PMCID: PMC9985722 DOI: 10.1136/bjsports-2022-105825] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the efficacy of the Transform-Us! school- and home-based intervention on children's physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles. METHODS A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010-2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed. RESULTS At 18 months, there were intervention effects on children's weekday SB (-27 min, 95% CI: -47.3 to -5.3) for the PA intervention, and on children's average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children's average day SB (-33.3 min, 95% CI: -50.6 and -16.0) for the SB intervention. Children's BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters. CONCLUSIONS The Transform-Us! PA and SB interventions show promise as a pragmatic approach for reducing children's SB and adiposity indicators; but achieving substantial increases in PA remains challenging. TRIAL REGISTRATION ISRCTN83725066; ACTRN12609000715279.
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Affiliation(s)
- Jo Salmon
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Lauren Arundell
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University Faculty of Health Sciences, Melbourne, Victoria, Australia
| | - Nicola Dawn Ridgers
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kylie D Hesketh
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Robin M Daly
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - David Dunstan
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Helen Brown
- School of Exercise and Nutrition Sciences, Deakin University Centre for Sport Research, Geelong, Victoria, Australia
| | - Jacqui Della Gatta
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Paul Della Gatta
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lauren Shepphard
- Institute for Health Transformation, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Marj Moodie
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Clare Hume
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vicki Brown
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Kylie Ball
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - David Crawford
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
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11
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Crawford D, DeAngulo G, Gelman BF, Pillai A. Anaphylaxis to Cyclophosphamide Metabolites during Lymphodepletion for CAR-T Therapy. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00275-0] [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: 02/07/2023]
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12
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Crawford D, Silva JG, Chellapandian D, Joyce M, Kashif R, Milner J, Dalal M, McNerney KO, Cline J, Fort J, Castillo P, Ligon JA, Alperstein W, Ziga E, Wang S, Horn B. Risk Factors for Graft Failure in Children Undergoing Hematopoietic Cell Transplant (HCT) for Hemoglobinopathies, Bone Marrow Failure Syndromes, Severe Aplastic Anemia, Inborn Errors of Metabolism and Primary Immune Deficiencies. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00464-5] [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: 02/07/2023]
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13
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Mavragani A, Opie R, Crawford D, O'Connell S, Hamblin PS, Steele C, Ball K. Participants' and Health Care Providers' Insights Regarding a Web-Based and Mobile-Delivered Healthy Eating Program for Disadvantaged People With Type 2 Diabetes: Descriptive Qualitative Study. JMIR Form Res 2023; 7:e37429. [PMID: 36598815 PMCID: PMC9893734 DOI: 10.2196/37429] [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: 02/20/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Healthy eating is a key element of type 2 diabetes (T2D) self-management. Digital interventions offer new avenues to reach broad audiences to promote healthy eating behaviors. However, acceptance of these interventions by socioeconomically disadvantaged people (eg, those with lower levels of education and income or from ethnic minority groups) has not yet been fully evaluated. OBJECTIVE This study aimed to investigate the acceptability and usability of EatSmart, a 12-week web-based and mobile-delivered healthy eating behavior change support program, from the perspective of intervention participants living with T2D and health care providers (HCPs) involved in diabetes care. METHODS This study used a qualitative descriptive design. Overall, 60 disadvantaged adults with T2D, as determined by receipt of either a HealthCare Card or a pension or benefit as the main source of income, were recruited. Data from participants regarding their experiences with and perceptions of the program and longer-term maintenance of any behavior or attitudinal changes were collected through a web-based self-report survey with open-ended questions administered 12 weeks after baseline (54/60, 90%) and semistructured telephone interviews administered 36 weeks after baseline (16/60, 27%). Supplementary semistructured interviews with 6 HCPs involved in diabetes care (endocrinologists, accredited practicing dietitians, and diabetes nurse educators) were also conducted 36 weeks after baseline. These interviews aimed to understand HCPs' views on successful and unsuccessful elements of EatSmart as a technology-delivered intervention; any concerns or barriers regarding the use of these types of interventions; and feedback from their interactions with patients on the intervention's content, impact, or observed benefits. All data from the surveys and interviews were pooled and thematically analyzed. RESULTS In total, 5 key themes emerged from the data: program impact on food-related behaviors and routines, satisfaction with the program, reasons for low engagement and suggestions for future programs, benefits and challenges of digital interventions, and cultural considerations. Results showed that EatSmart was acceptable to participants and contributed positively to improving food-related behaviors. Most participants (27/43, 63%) mentioned that they enjoyed their experience with EatSmart and expressed high satisfaction with its content and delivery. The educational and motivational content was considered the most useful part of the program. Benefits discussed by intervention participants included gaining health knowledge and skills, positive changes in their food purchasing and cooking, and eating greater quantities and varieties of fruits and vegetables. HCPs also described the intervention as beneficial and persuasive for the target audience and had specific suggestions for future tailoring of such programs. CONCLUSIONS The findings suggested that this digitally delivered intervention with supportive educational modules and SMS text messages was generally appealing for both participants and HCPs. This intervention medium shows promise and could feasibly be rolled out on a broader scale to augment usual diabetes care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19488.
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Affiliation(s)
| | - Rachelle Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.,Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, Deakin University, Geelong, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Stella O'Connell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Peter Shane Hamblin
- Diabetes & Endocrinology Centre, Sunshine Hospital, Melbourne, Australia.,Department of Medicine-Western Precinct, University of Melbourne, Melbourne, Australia
| | - Cheryl Steele
- Diabetes Education Services, Sunshine Hospital, Melbourne, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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14
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Picton M, Crawford D, Jameson M, Alvares S, Hogan L, Loo C, Moutrie Z, Jelen U, Pagulayan C, Dunkerley N, Twentyman T, de Leon J, Batumalai V. Introduction of radiation therapist‐led adaptive treatments on a 1.5 T
MR
‐Linac. J Med Radiat Sci 2022; 70 Suppl 2:94-98. [PMID: 36572532 PMCID: PMC10122921 DOI: 10.1002/jmrs.643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022] Open
Abstract
The introduction of magnetic resonance (MR) linear accelerators (MR-Linac) marks the beginning of a new era in radiotherapy. MR-Linac systems are currently being operated by teams of radiation therapists (RTs), radiation oncology medical physicists (ROMPs) and radiation oncologists (ROs) due to the diverse and complex tasks required to deliver treatment. This is resource-intensive and logistically challenging. RT-led service delivery at the treatment console is paramount to simplify the process and make the best use of this technology for suitable patients with commonly treated anatomical sites. This article will discuss the experiences of our department in developing and implementing an RT-led workflow on the 1.5 T MR-Linac.
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Affiliation(s)
| | | | - Michael Jameson
- GenesisCare Alexandria New South Wales Australia
- School of Clinical Medicine, Faculty of Medicine and Health UNSW Sydney Kensington New South Wales Australia
| | | | - Louise Hogan
- GenesisCare Alexandria New South Wales Australia
| | - Conrad Loo
- GenesisCare Alexandria New South Wales Australia
| | - Zoe Moutrie
- GenesisCare Alexandria New South Wales Australia
- Department of Radiation Oncology South West Sydney Local Health District Sydney New South Wales Australia
| | | | | | | | | | | | - Vikneswary Batumalai
- GenesisCare Alexandria New South Wales Australia
- School of Clinical Medicine, Faculty of Medicine and Health UNSW Sydney Kensington New South Wales Australia
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15
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Hogan L, Jameson M, Crawford D, Alvares S, Loo C, Picton M, Moutrie Z, Pagulayan C, Jelen U, Dunkerley N, Twentyman T, de Leon J, Batumalai V. Old dogs, new tricks:
MR‐Linac
training and credentialing of radiation oncologists, radiation therapists and medical physicists. J Med Radiat Sci 2022; 70 Suppl 2:99-106. [PMID: 36502538 PMCID: PMC10122927 DOI: 10.1002/jmrs.640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The introduction of magnetic resonance (MR) linear accelerators (MR-Linacs) into radiotherapy departments has increased in recent years owing to its unique advantages including the ability to deliver online adaptive radiotherapy. However, most radiation oncology professionals are not accustomed to working with MR technology. The integration of an MR-Linac into routine practice requires many considerations including MR safety, MR image acquisition and optimisation, image interpretation and adaptive radiotherapy strategies. This article provides an overview of training and credentialing requirements for radiation oncology professionals to develop competency and efficiency in delivering treatment safely on an MR-Linac.
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Affiliation(s)
- Louise Hogan
- GenesisCare Alexandria New South Wales Australia
| | - Michael Jameson
- GenesisCare Alexandria New South Wales Australia
- School of Clinical Medicine, Faculty of Medicine and Health UNSW Sydney Australia
| | | | | | - Conrad Loo
- GenesisCare Alexandria New South Wales Australia
| | | | - Zoe Moutrie
- GenesisCare Alexandria New South Wales Australia
- Department of Radiation Oncology South West Sydney Local Health District Warwick Farm New South Wales Australia
| | | | - Ursula Jelen
- GenesisCare Alexandria New South Wales Australia
| | | | | | | | - Vikneswary Batumalai
- GenesisCare Alexandria New South Wales Australia
- School of Clinical Medicine, Faculty of Medicine and Health UNSW Sydney Australia
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16
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Delisle Nyström C, Campbell KJ, Crawford D, Hesketh KD. Mothers as advocates for healthier lifestyle behaviour environments for their children: results from INFANT 3.5-year follow-up. BMC Public Health 2022; 22:2211. [PMID: 36447165 PMCID: PMC9706958 DOI: 10.1186/s12889-022-14659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The amount of time children spend outside of their home environment has increased over the past decades. Therefore, the quality of the health behaviour environments where young children spend time is likely to impact their health behaviour opportunities. The aim of this study was to describe the proportion of mothers who consider it possible to make changes in their local communities to increase opportunities for children to eat healthily, be physically active, and limit screen time exposure, as well as the proportion who have attempted to do so. The characteristics of mothers with differing advocacy beliefs and intentions were explored. METHODS Cross-sectional data collected using questionnaires from 307 mothers who participated in the 3.5-year follow-up of the INFANT cluster-randomized controlled trial were used. Frequencies were used to assess the number of mothers who thought it possible to bring about change in their local communities and for the those who had attempted to do so. Binary logistic regression analyses were used to compare sociodemographic characteristics of mothers with differing responses. RESULTS Most mothers thought it was possible to bring about change in their local community with regards to providing more opportunities for their child to eat healthily (83.7%), be physically active (90.9%) as well as limit exposure to screen time (63.5%). However, less than 19% and 11% of mothers have thought about or tried to bring about change in their child's childcare centre or local community, respectively. No sociodemographic differences were found between the mothers who thought it was possible to bring about actioning change (p-values > 0.1) or for those that have thought about change (p-values > 0.1). CONCLUSION As children are continuously being exposed to obesogenic environments future quantitative and qualitative studies are needed to describe how to promote parental advocacy and engagement, in order to provide children with environments that support healthy lifestyle behaviours.
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Affiliation(s)
- Christine Delisle Nyström
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, Neo, 141 83 Huddinge, Sweden ,grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), Deakin University, 3125 Geelong, Australia
| | - Karen J Campbell
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), Deakin University, 3125 Geelong, Australia
| | - David Crawford
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), Deakin University, 3125 Geelong, Australia
| | - Kylie D Hesketh
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), Deakin University, 3125 Geelong, Australia
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17
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Verma S, Crawford D, Khateb A, Feng Y, Sergienko E, Pathria G, Ma CT, Olson SH, Scott D, Murad R, Ruppin E, Jackson M, Ronai ZA. NRF2 mediates melanoma addiction to GCDH by modulating apoptotic signalling. Nat Cell Biol 2022; 24:1422-1432. [PMID: 36050469 PMCID: PMC9977532 DOI: 10.1038/s41556-022-00985-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 07/26/2022] [Indexed: 11/09/2022]
Abstract
Tumour dependency on specific metabolic signals has been demonstrated and often guided numerous therapeutic approaches. We identify melanoma addiction to the mitochondrial protein glutaryl-CoA dehydrogenase (GCDH), which functions in lysine metabolism and controls protein glutarylation. GCDH knockdown induced cell death programmes in melanoma cells, an activity blocked by inhibition of the upstream lysine catabolism enzyme DHTKD1. The transcription factor NRF2 mediates GCDH-dependent melanoma cell death programmes. Mechanistically, GCDH knockdown induces NRF2 glutarylation, increasing its stability and DNA binding activity, with a concomitant transcriptional upregulation of ATF4, ATF3, DDIT3 and CHAC1, resulting in cell death. In vivo, inducible inactivation of GCDH effectively inhibited melanoma tumour growth. Correspondingly, reduced GCDH expression correlated with improved survival of patients with melanoma. These findings identify melanoma cell addiction to GCDH, limiting apoptotic signalling by controlling NRF2 glutarylation. Inhibiting the GCDH pathway could thus represent a therapeutic approach to treat melanoma.
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Affiliation(s)
- Sachin Verma
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - David Crawford
- Cancer Data Science Lab (CDSL), National Cancer Institute, National Institute of Health, Bethesda, MD 20892
| | - Ali Khateb
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Yongmei Feng
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Eduard Sergienko
- Conrad Prebys Center for Chemical Genomics, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Gaurav Pathria
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Chen-Ting Ma
- Conrad Prebys Center for Chemical Genomics, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Steven H Olson
- Conrad Prebys Center for Chemical Genomics, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - David Scott
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Rabi Murad
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Eytan Ruppin
- Cancer Data Science Lab (CDSL), National Cancer Institute, National Institute of Health, Bethesda, MD 20892
| | - Michael Jackson
- Conrad Prebys Center for Chemical Genomics, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037
| | - Ze’ev A Ronai
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037,Correspondence: Ze’ev Ronai, Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, 10901 N. Torrey Pines Rd, La Jolla, CA, 92037, USA.
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18
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Smith MR, Hussain M, Saad F, Fizazi K, Sternberg CN, Crawford D, Manarite J, Muslin D, Farrington T, Tombal B. Darolutamide and survival in metastatic, hormone-sensitive prostate cancer: a patient and caregiver perspective and plain language summary of the ARASENS study. Future Oncol 2022; 18:2585-2597. [PMID: 35656777 DOI: 10.2217/fon-2022-0433] [Citation(s) in RCA: 1] [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: 11/21/2022] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This is a summary of a publication about the ARASENS trial, which was published in the New England Journal of Medicine in February 2022. The trial includes 1,306 men with a type of prostate cancer called metastatic, hormone-sensitive prostate cancer (also called mHSPC). In the trial, researchers wanted to learn if combining a treatment called darolutamide (also known by the brand name Nubeqa®) with two other medicines called androgen deprivation therapy (also called ADT) and docetaxel (brand name Taxotere®) could help treat patients with mHSPC better than placebo plus ADT and docetaxel. ADT with docetaxel is a treatment used for patients with mHSPC. Darolutamide is an approved treatment for a different type of prostate cancer called non-metastatic, castration-resistant prostate cancer (also called nmCRPC). WHAT WERE THE RESULTS? The trial results showed that combining darolutamide with ADT and docetaxel increased the chance of survival and lowered the risk of death by 32.5% compared to combining ADT and docetaxel with placebo instead. Compared to patients who received the placebo, patients who received darolutamide had a delay in: their cancer becoming castration-resistant worsening pain having cancer-related bone fractures or related symptoms needing additional therapies for cancer The percentage of trial patients who had medical problems during the trial, also called adverse events, was similar between trial patients who received darolutamide and those who received the placebo. WHAT DO THE RESULTS OF THE STUDY MEAN? Combining darolutamide with ADT and docetaxel helped treat trial patients with mHSPC better than placebo with ADT and docetaxel. Darolutamide in combination with ADT and docetaxel could be a treatment option for patients with mHSPC. Patients should always talk to their doctors and nurses before making any decisions about their treatment. This summary also includes perspectives on the ARASENS trial and prostate cancer from 3 members of the patient community. ClinicalTrials.gov NCT number: NCT02799602.
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Affiliation(s)
| | - Maha Hussain
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Fred Saad
- University of Montreal Hospital Center, Montreal, Quebec, Canada
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Department of Medicine, Meyer Cancer Center, New York-Presbyterian Hospital, New York, NY
| | | | | | | | | | - Bertrand Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCLouvain, Brussels, Belgium
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19
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Oostenbach LH, Lamb KE, Crawford D, Thornton L. Influence of work hours and commute time on food practices: a longitudinal analysis of the Household, Income and Labour Dynamics in Australia Survey. BMJ Open 2022; 12:e056212. [PMID: 35523493 PMCID: PMC9083384 DOI: 10.1136/bmjopen-2021-056212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Work hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food practices and (2) within-individual associations between changes in work and commute hours with changes in food practices. DESIGN Longitudinal study SETTING: Australia PARTICIPANTS: Data were from 14 807 respondents in waves 7 (2007), 9 (2009), 13 (2013) and 17 (2017) of the Household, Income and Labour Dynamics in Australia Survey. The sample for this analysis included individuals who were in paid employment in at least one of the four waves. PRIMARY AND SECONDARY OUTCOME MEASURES Outcomes included frequency of out-of-home food purchasing for breakfast, lunch, dinner and all three summed eating occasions, and fruit and vegetables consumption. RESULTS Results indicated the longer individuals spent working and commuting, the more likely they were to purchase out-of-home foods (frequency of total out-of-home food purchasing: incidence rate ratio (IRR)=1.007 (95% CI 1.007 to 1.008)), and the less they consumed fruit and vegetables, although reductions in fruit and vegetables servings were minimal (fruit: β=-0.002 (95% CI -0.003 to -0.001), vegetables: β=-0.002 (95% CI -0.003 to -0.001)). Similar results regarding associations with out-of-home food purchasing were observed when examining within-individual changes (IRR=1.006 (95% CI 1.005 to 1.007)). CONCLUSIONS Results suggest employment-related time demands push towards more frequent out-of-home food purchasing. In the long term, this may have negative health consequences as out-of-home foods tend to be less healthy than home-prepared foods.
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Affiliation(s)
- Laura Helena Oostenbach
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Karen Elaine Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Lukar Thornton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
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Batumalai V, Crawford D, Pagulayan C, Hogan L, Jelen U, Loo C, Dunkerley N, Picton M, Geddes L, Alvares S, Sampaio S, Heinke M, Twentyman T, Jameson M, de Leon J. MO-0649 Feasibility of MR-guided stereotactic ablative body radiotherapy of lymph node oligometastases. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Hassan S, Jameson M, Batumalai V, Crawford D, Moutrie Z, Hogan L, Loo C, Picton M, Pagulayan C, Jelen U, Alvares S, Heinke M, Sampaio S, Simon K, Twentyman T, Dwivedi N, de Leon J. PO-1374 Feasibility of magnetic resonance-guided adaptive post-prostatectomy radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Geddes L, Crawford D, Batumalai V, Pagulayan C, Hogan L, Jelen U, Loo C, Dunkerley N, Picton M, Alvares S, Sampaio S, Heinke M, Twentyman T, Jameson M, De Leon J. PD-0325 Feasibility and safety of MR-guided stereotactic ablative body radiotherapy for Prostate Cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02818-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Picton M, Batumalai V, Crawford D, Pagulayan C, Hogan L, Jelen U, Loo C, Dunkerley N, Geddes L, Sampaio S, Heinke M, Twentyman T, Jameson M, de Leon J. PD-0334 Feasibility of magnetic resonance-guided stereotactic ablative body radiotherapy of liver cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zheng M, Hesketh KD, McNaughton SA, Salmon J, Crawford D, Cameron AJ, Lioret S, Campbell KJ. Quantifying the overall impact of an early childhood multi-behavioural lifestyle intervention. Pediatr Obes 2022; 17:e12861. [PMID: 34658152 DOI: 10.1111/ijpo.12861] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 05/18/2021] [Revised: 08/10/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The overall impact of interventions targeting multiple behaviours remains largely unexplored. OBJECTIVES This study adopted an integrative lifestyle pattern analysis approach to assess the overall effectiveness of an early childhood intervention on change across multiple behaviours. METHODS The Melbourne INFANT program was a 15-month cluster-randomized controlled trial involving 4-month-old infants and their parents at baseline in 2008 (n = 542). The intervention included six education sessions helping parents to promote a healthy diet, physical activity and limit sedentary behaviour in their infants. Participants were followed-up twice post-intervention, at ages 3.6 (2011) and 5 years (2013), to assess sustained effects of the intervention. Previous principal component analyses identified two lifestyle patterns from dietary intake, outdoor time and television viewing time. Random effect linear regression models were conducted to assess the impact of the intervention on lifestyle patterns. RESULTS The intervention group had a lower 'Discretionary consumption and TV' lifestyle pattern score than the control group at all time points with adjusted mean difference: -0.29, 95% CI -0.49, -0.09, p = 0.004 post-intervention at age 1.5 years; -0.29, 95% CI -0.54, -0.04, p = 0.02 at the first follow-up (age 3.6 years); and -0.21, 95% CI -0.43, 0.01, p = 0.06 at the second follow-up (age 5.0 years). No evidence of between-group differences was found for the 'Fruit, vegetables and outdoor' lifestyle pattern score. CONCLUSION This early childhood intervention designed to promote change in more than one obesity-related behaviour was effective in improving correlated unhealthy lifestyle behaviours. Lifestyle pattern analysis is a useful and interpretable approach for evaluating multi-behavioural interventions.
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Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Sarah A McNaughton
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - David Crawford
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), Deakin University, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Sandrine Lioret
- INSERM, INRAE, Université de Paris, Research Center in Epidemiology and Biostatistics (CRESS), Paris, France
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
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Tan SY, Curtis AR, Leech RM, Ridgers ND, Crawford D, McNaughton SA. A systematic review of temporal body weight and dietary intake patterns in adults: implications on future public health nutrition interventions to promote healthy weight. Eur J Nutr 2022; 61:2255-2278. [DOI: 10.1007/s00394-021-02791-x] [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] [Received: 08/02/2021] [Accepted: 12/20/2021] [Indexed: 11/04/2022]
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Lamb KE, Crawford D, Thornton LE, Shariful Islam SM, Maddison R, Ball K. Educational differences in diabetes and diabetes self-management behaviours in WHO SAGE countries. BMC Public Health 2021; 21:2108. [PMID: 34789208 PMCID: PMC8597224 DOI: 10.1186/s12889-021-12131-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes mellitus represents a substantial global health challenge, with prevalence rising in low- and middle-income countries (LMICs). Although diabetes is known to follow a socioeconomic gradient, patterns in LMICs are unclear. This study examined associations between education and diabetes, and diabetes self-management behaviours, in six LMICs. Methods Cross-sectional data for 31,780 participants from China, Ghana, India, Mexico, Russia, and South Africa from the World Health Organization Study on Global AGEing and adult health (SAGE) study were used. Participants aged ≥50 years completed face-to-face interviews between 2007 and 2010. Participants self-reported diabetes diagnosis, physical activity, sedentary time, fruit and vegetable consumption, any special diet/program for diabetes, whether they were taking insulin for diabetes and number of years of education. Height, weight, waist, and hip circumference were measured. Country-specific survey-weighted log-binomial regression models were fitted to examine associations between the number of years of education and self-reported diabetes diagnosis (primary analysis). In secondary analyses, among those with a self-reported diabetes diagnosis, generalised linear regression models were fitted to examine associations between education and i) physical activity, ii) sedentary time, iii) fruit and vegetable consumption, iv) special diet for diabetes, v) taking insulin, vi) BMI, vii) waist circumference and viii) hip circumference. Results There was strong evidence of an association between years of education and diabetes diagnosis in Ghana (RR = 1.09, 95% CI: 1.06–1.13) and India (RR = 1.09, 95% CI: 1.07–1.12) only. In India, greater years of education was associated with higher leisure physical activity, fruit and vegetable intake, rates following a special diet or taking insulin, but also higher mean BMI, waist and hip circumference. Relationships between education and self-management behaviours were rarely seen in the other countries. Conclusions Associations between education and diabetes, and behavioural self-management (India only) was more evident in the two least developed (Ghana and India) of the WHO SAGE countries, indicating increasing diabetes diagnosis with greater numbers of years of education. The lack of gradients elsewhere may reflect shifting risk from higher to lower educated populations. While there was some suggestion that self-management behaviours were greater with increased education in India, this was not observed in the other countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12131-7.
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Affiliation(s)
- Karen E Lamb
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia. .,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia. .,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
| | - David Crawford
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Lukar E Thornton
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Sheikh M Shariful Islam
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Ralph Maddison
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Kylie Ball
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia.
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Ramalho A, Silva I, Suen S, Bierlaagh M, Vonk A, Pott J, Boj S, Crawford D, Goddeeris M, Vermeulen F, Amaral M, de Boeck K, Beekman J, van der Ent C. 660: Screening of ELX-02 readthrough effect by forskolin-induced swelling assay in CFTR nonsense mutation–bearing organoids as predictive test for clinical trial patient stratification. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02083-x] [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: 11/29/2022]
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de Leon J, Crawford D, Moutrie Z, Alvares S, Hogan L, Pagulayan C, Jelen U, Loo C, Aylward JD, Condon K, Dunkerley N, Heinke MY, Sampaio S, Simon K, Twentyman T, Jameson MG. Early experience with MR-guided adaptive radiotherapy using a 1.5 T MR-Linac: First 6 months of operation using adapt to shape workflow. J Med Imaging Radiat Oncol 2021; 66:138-145. [PMID: 34643065 DOI: 10.1111/1754-9485.13336] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 03/16/2021] [Accepted: 09/17/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The magnetic resonance linear accelerator (MRL) offers improved soft tissue visualization to guide daily adaptive radiotherapy treatment. This manuscript aims to report initial experience using a 1.5 T MRL in the first 6 months of operation, including training, workflows, timings and dosimetric accuracy. METHODS All staff received training in MRI safety and MRL workflows. Initial sites chosen for treatment were stereotactic and hypofractionated prostate, thoraco-abdomino-pelvic metastasis, prostate bed and bladder. The Adapt To Shape (ATS) workflow was chosen to be the focus of treatment as it is the most robust solution for daily adaptive radiotherapy. A workflow was created addressing patient suitability, simulation, planning, treatment and peer review. Treatment times were recorded breaking down into the various stages of treatment. RESULTS A total of 37 patients were treated and 317 fractions delivered (of which 313 were delivered using an ATS workflow) in our initial 6 months. Average treatment times over the entire period were 50 and 38 min for stereotactic and non-stereotactic treatments respectively. Average treatment times reduced each month. The average difference between reference planned and ionization chamber measured dose was 0.0 ± 1.4%. CONCLUSION The MRL was successfully established in an Australian setting. A focus on training and creating a detailed workflow from patient selection, review and treatment are paramount to establishing new treatment programmes.
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Affiliation(s)
| | | | - Zoë Moutrie
- GenesisCare, Sydney, New South Wales, Australia
| | | | | | | | | | - Conrad Loo
- GenesisCare, Sydney, New South Wales, Australia
| | - Jack D Aylward
- GenesisCare, Sydney, New South Wales, Australia.,Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK.,Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | | | | | | | | | - Kathy Simon
- GenesisCare, Sydney, New South Wales, Australia
| | | | - Michael G Jameson
- GenesisCare, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Haining H, Hollyer J, Crawford D, Bell F, Gamino V, Millins C. What is your diagnosis? Fine-needle aspirate biopsy from a skin mass on the distal metatarsus of a dog. Vet Clin Pathol 2021; 50:462-464. [PMID: 34346092 DOI: 10.1111/vcp.12939] [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: 07/30/2020] [Revised: 10/03/2020] [Accepted: 10/28/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Hayley Haining
- Veterinary Diagnostic Services, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | - Jennifer Hollyer
- Veterinary Diagnostic Services, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | | | - Frazer Bell
- Veterinary Diagnostic Services, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | - Virginia Gamino
- Veterinary Diagnostic Services, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | - Caroline Millins
- Veterinary Diagnostic Services, University of Glasgow School of Veterinary Medicine, Glasgow, UK
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Jameson M, Crawford D, Hogan L, Loo C, Twentyman T, baker A, de Leon J. PH-0163 1.5 T MR Linac RO-Lite Workflow. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07255-8] [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: 10/20/2022]
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de Leon J, Crawford D, Hogan L, Moutrie Z, Pagulayan C, Loo C, Heinke M, Sampaio S, Alvares S, Johnson A, Simon K, Twentyman T, Jameson M. PO-1558 MR Linac Stereotactic Prostate:Accumulated dose comparison of adaptive versus non adaptive treatment. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08009-9] [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: 11/30/2022]
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Crawford D, Allan B, Cogle A, Brown G. Client-led care in HIV: perspectives from community and practice. HIV Med 2021; 22 Suppl 1:3-14. [PMID: 34296511 DOI: 10.1111/hiv.13133] [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: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES While current antiretroviral and care strategies can effectively suppress HIV, achieving optimal quality of life (QoL) requires a wider consideration of clients' well-being, the complexity of individuals' lives and social determinants of health. The objective of this commentary was to develop a definition of client-led care in the Australian context and its key supporting principles for people living with HIV (PLHIV). METHODS The authors used two sources of evidence to support their HIV community experience with client-led care: (1) a scoping review of the literature, and (2) consultations with colleagues who were PLHIV advocates or HIV specialist physicians. The findings from the scoping review and consultations were summarised and the key principles of client-led care compared with those identified by the authors. RESULTS Seven articles met the inclusion criteria for qualitative analysis in the scoping review. Five PLHIV advocates and three HIV specialist physicians were consulted. Key principles supporting client-led care identified by the authors based on their experience centred around the themes of: (1) clients and healthcare providers working in partnership, (2) information and communication, (3) coordinating access to care, (4) building trust, and (5) respect for client's needs and preferences. The principles identified by the authors were supported by those of the scoping review and colleague consultations. CONCLUSIONS A client-led approach can complement conventional HIV care strategies and enable empowerment and greater engagement with care, potentially improving the care continuum and overall QoL for individuals living with HIV who can, and want to, lead their own care.
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Affiliation(s)
- David Crawford
- Positive Life New South Wales, Surry Hills, NSW, Australia
| | - Brent Allan
- International AIDS Society and the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Melbourne, VIC, Australia
| | - Aaron Cogle
- National Association of People Living with HIV, Newtown, NSW, Australia
| | - Graham Brown
- Centre for Social Impact, University of New South Wales, Kensington, NSW, Australia.,Australian Research Centre in Sex Health and Society, La Trobe University, Bundoora, VIC, Australia
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33
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Affiliation(s)
- David Crawford
- Departments of Sociology and Anthropology and International Studies Fairfield University Fairfield CT 06824 USA
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Crawford D, Kim S, Guevara C. Abstract No. 148 Does transcervical retrograde thoracic duct access improve clinical outcomes of thoracic duct embolization for patients with chyle leak? J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.154] [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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MacGibbon J, Lea T, Ellard J, Murphy D, Kolstee J, Power C, Crawford D, Bear B, De Wit J, Holt M. Access to Subsidized Health Care Affects HIV Pre-Exposure Prophylaxis (PrEP) Uptake Among Gay and Bisexual Men in Australia: Results of National Surveys 2013-2019. J Acquir Immune Defic Syndr 2021; 86:430-435. [PMID: 33230031 DOI: 10.1097/qai.0000000000002572] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/04/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND We assessed willingness to use HIV pre-exposure prophylaxis (PrEP) and current PrEP use among gay and bisexual men (GBM) in Australia. METHODS National, online cross-sectional surveys of GBM were conducted in 2013, 2015, 2017, and 2019. Willingness to use PrEP was measured on a previously validated scale. Trends and associations with key measures were analyzed using multivariate logistic regression. RESULTS During 2013-2019, 4908 surveys were completed. Among HIV-negative and untested men not currently using PrEP, willingness to use PrEP increased from 23.0% in 2013 to 36.5% in 2017 (P < 0.001) but then plateaued at 32% in 2019 (P = 0.13). The proportion of current PrEP users increased significantly from 2.5% in 2015 to 38.5% in 2019 (P < 0.001). In 2019, factors independently associated with being a current PrEP user (compared with non-PrEP users who were willing to use PrEP) included having subsidized health care (Medicare), knowing HIV-positive people, being recently diagnosed with an STI other than HIV, having higher numbers of recent male sexual partners, recent condomless sex with casual and regular partners, and frequent PrEP sorting. CONCLUSION Willingness to use PrEP has plateaued as its use has rapidly increased among GBM in Australia. PrEP use is concentrated among more sexually active men with access to subsidized health care. Free or low cost access schemes may facilitate broader access among GBM who want or need PrEP but lack access to subsidized health care.
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Affiliation(s)
- James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Jeanne Ellard
- Australian Federation of AIDS Organisations, Sydney, Australia
| | - Dean Murphy
- Kirby Institute, UNSW Sydney, Sydney, Australia
| | | | - Cherie Power
- New South Wales Ministry of Health, Sydney, Australia
| | | | | | - John De Wit
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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Holt M, MacGibbon J, Bear B, Lea T, Kolstee J, Crawford D, Murphy D, Power C, Ellard J, de Wit J. Trends in Belief That HIV Treatment Prevents Transmission Among Gay and Bisexual Men in Australia: Results of National Online Surveys 2013-2019. AIDS Educ Prev 2021; 33:62-72. [PMID: 33617321 DOI: 10.1521/aeap.2021.33.1.62] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We have tracked belief in the effectiveness of HIV treatment as prevention (TasP) among Australian gay and bisexual men (GBM) since 2013. National, online cross-sectional surveys of GBM were conducted every 2 years during 2013-2019. Trends and associations were analyzed using multivariate logistic regression. Data from 4,903 survey responses were included. Belief that HIV treatment prevents transmission increased from 2.6% in 2013 to 34.6% in 2019. Belief in the effectiveness of TasP was consistently higher among HIV-positive participants than other participants. In 2019, higher levels of belief in TasP were independently associated with university education, being HIV-positive, using pre-exposure prophylaxis, knowing more HIV-positive people, being recently diagnosed with a sexually transmitted infection (STI) and use of post-exposure prophylaxis. Belief that HIV treatment prevents transmission has increased substantially among Australian GBM, but remains concentrated among HIV-positive GBM, those who know HIV-positive people, and GBM who use antiretroviral-based prevention.
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Affiliation(s)
- Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | | | - Dean Murphy
- The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Cherie Power
- New South Wales Ministry of Health, Sydney, Australia
| | - Jeanne Ellard
- Australian Federation of AIDS Organisations, Sydney, Australia
| | - John de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
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Karimi N, Crawford D, Opie R, Maddison R, O'Connell S, Hamblin PS, Ng AH, Steele C, Rasmussen B, Ball K. EatSmart, a Web-Based and Mobile Healthy Eating Intervention for Disadvantaged People With Type 2 Diabetes: Protocol for a Pilot Mixed Methods Intervention Study. JMIR Res Protoc 2020; 9:e19488. [PMID: 33155571 PMCID: PMC7679211 DOI: 10.2196/19488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/10/2020] [Accepted: 09/16/2020] [Indexed: 12/30/2022] Open
Abstract
Background People of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group. Objective This study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management. Methods EatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 18 to 75 years will be recruited. Participants will complete self-reported baseline assessments of their basic demographic and clinical data, dietary intake, dietary self-efficacy, and barriers to healthy eating. They will be provided with login access to the EatSmart web program, which includes six progressive skill-based modules covering healthy eating planning; smart food budgeting and shopping; time-saving meal strategies, healthy cooking methods, modifying recipes; and a final reinforcement and summary module. Over the 3-month intervention, participants will also receive 3 text messages weekly, encouraging them to review goals, continue to engage with different components of the EatSmart web program, and eat healthily. Participants will undertake follow-up assessments directly following the intervention 3 months post baseline and again after a 6-month postintervention follow-up period (9 months post baseline). Feasibility will be evaluated using the number of participants recruited and retained and objective indicators of engagement with the website. Program appeal and potential effects on primary and secondary outcomes will be assessed via the same surveys used at baseline, with additional questions asking about experience with and perceptions of the program. In-depth qualitative interviews will also be conducted 6 months post intervention to provide deeper insight into experiences with EatSmart and a more comprehensive description of the program’s appeal. Results The EatSmart website has been developed, and all participants have viewed the modules as of May 2020. Results are expected to be submitted for publication in December 2020. Conclusions This study will provide data to address the currently limited evidence regarding whether disadvantaged populations with T2D may benefit from digitally delivered behavior change programs that facilitate eating healthily on a budget. Trial Registration Australian New Zealand Clinical Trials Registry, ACTRN12619001111167; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001111167 International Registered Report Identifier (IRRID) DERR1-10.2196/19488
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Affiliation(s)
- Nazgol Karimi
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Rachelle Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Stella O'Connell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Peter Shane Hamblin
- Diabetes & Endocrinology Centre, Sunshine Hospital, St Albans, Australia.,Department of Medicine-Western Precinct, University of Melbourne, St Albans, Australia
| | - Ashley Huixian Ng
- Department of Dietetics, Human Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Cheryl Steele
- Diabetes Education Services, Sunshine Hospital, St Albans, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research, Western Health Partnership, Sunshine Hospital, St Albans, Australia.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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Lyons C, Crawford D. The Osler Library of the History of Medicine: Mcgill’s Medical Memory. Mcgill J Med 2020. [DOI: 10.26443/mjm.v13i1.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sir william Osler bequeathed his library to Mcgill University in 1919; a decade later, the 8000 volumes arrived in Montreal. Then, as now, the collection consisted of primary works (“rare books”), secondary commentaries, and current works on the history of the health sciences. In the last 80 years the collection has grown considerably and the library now adds about 1,000 books to its collection yearly (mainly current publications) and receives 200 current serial titles. The Osler Library is one of the largest “history of medicine” libraries in the world and the largest of its kind in Canada. The library tries to collect current material on the history of the health sciences from all over the world and attempts to collect all medical history published in Canada. The Osler offers its resources to researchers and students through its website, publications and Research Travel grant programme.
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McNaughton S, Ball K, Crawford D. Research skills. Public Health Nutr 2020. [DOI: 10.4324/9781003116929-18] [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: 11/11/2022]
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Hesketh KD, Salmon J, McNaughton SA, Crawford D, Abbott G, Cameron AJ, Lioret S, Gold L, Downing KL, Campbell KJ. Long-term outcomes (2 and 3.5 years post-intervention) of the INFANT early childhood intervention to improve health behaviors and reduce obesity: cluster randomised controlled trial follow-up. Int J Behav Nutr Phys Act 2020; 17:95. [PMID: 32711523 PMCID: PMC7382091 DOI: 10.1186/s12966-020-00994-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 02/25/2020] [Accepted: 07/07/2020] [Indexed: 11/21/2022] Open
Abstract
Background The few health behavior interventions commencing in infancy have shown promising effects. Greater insight into their longer-term benefits is required. This study aimed to assess post-intervention effects of the Melbourne INFANT Program to child age 5y on diet, movement and adiposity. Methods Two and 3.5y post-intervention follow-up (2011–13; analyses completed 2019) of participants retained in the Melbourne INFANT Program at its conclusion (child age ~ 19 m; 2008–10) was conducted. The Melbourne INFANT Program is a 15-month, six session program delivered within first-time parent groups in Melbourne, Australia, between child age 4-19 m. It involves strategies to help parents promote healthy diet, physical activity and reduced sedentary behavior in their infants. No intervention was delivered during the follow-up period reported in this paper. At all time points height, weight and waist circumference were measured by researchers, children wore Actigraph and activPAL accelerometers for 8-days, mothers reported children’s television viewing and use of health services. Children’s dietary intake was reported by mothers in three unscheduled telephone-administered 24-h recalls. Results Of those retained at program conclusion (child age 18 m, n = 480; 89%), 361 families (75% retention) participated in the first follow-up (2y post-intervention; age 3.6y) and 337 (70% retention) in the second follow-up (3.5y post-intervention; age 5y). At 3.6y children in the intervention group had higher fruit (adjusted mean difference [MD] = 25.34 g; CI95:1.68,48.99), vegetable (MD = 19.41; CI95:3.15,35.67) and water intake (MD = 113.33; CI95:40.42,186.25), than controls. At 5y they consumed less non-core drinks (MD = -27.60; CI95:-54.58,-0.62). Sweet snack intake was lower for intervention children at both 3.6y (MD = -5.70; CI95:-9.75,-1.65) and 5y (MD = -6.84; CI95:-12.47,-1.21). Intervention group children viewed approximately 10 min/day less television than controls at both follow-ups, although the confidence intervals spanned zero (MD = -9.63; CI95:-30.79,11.53; MD = -11.34; CI95:-25.02,2.34, respectively). There was no evidence for effect on zBMI, waist circumference z-score or physical activity. Conclusions The impact of this low-dose intervention delivered during infancy was still evident up to school commencement age for several targeted health behaviors but not adiposity. Some of these effects were only observed after the conclusion of the intervention, demonstrating the importance of long-term follow-up of interventions delivered during early childhood. Trial registration ISRCTN Register ISRCTN81847050, registered 7th November 2007.
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Affiliation(s)
- Kylie D Hesketh
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Sarah A McNaughton
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - David Crawford
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Gavin Abbott
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Sandrine Lioret
- Université de Paris, Research Center in Epidemiology and Biostatistics (CRESS), INSERM, INRA, Paris, France
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Geelong, Australia
| | - Katherine L Downing
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Srinivasan A, Crawford D, Bajana S, Yuen C, Sun XH, Shah R. Recovery of innate lymphoid cells after allogeneic stem cell transplant: A single institution pilot study. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.87.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
The response of Innate Lymphoid Cells (ILCs) to conditioning regimens and subsequent recovery in the setting of allogeneic hematopoietic stem cell transplant (aHSCT) in pediatric patients is not known. The impact of this recovery pattern on graft versus host disease (GVHD) has not been prospectively studied. We aim to study the recovery of ILCs after aHSCT in children and discover its role in GVHD. Pediatric patients undergoing aHSCT were enrolled in a prospective translational study since May 2019. Patients blood were analysed by flow cytometry at following time points: prior to the conditioning regimen, weekly starting on day 0 until +30 (+/− 3 days), then +60, +90 and +180 days. Ten patients have been enrolled to date - demographics: median age 9.5 years; 4 malignant, 6 non-malignant; haploidentical donor (n=1), matched sibling (n=3), unrelated (n= 6). Graft source was bone marrow for all patients. Most common conditioning regimen was fludarabine, busulfan and rabbit antithymocyte globulin (40%). GVHD prophylaxis for most patients was tacrolimus with mini-methotrexate (90%). We saw substantial drop in number of ILCs in response to conditioning regimen in all patients, with nadir on +14 that plateaued through +30, followed by a spike on +60 and return to normal levels by +90. Similar trend was seen in type 1 ILCs (Lin− CD127+ CRTH2− CD117−) but showed a slower drop, reaching nadir on +21 with slow recovery by +60. Type 2 ILCs (Lin− CD127+ CRTH2+) and Type 3 ILCs (Lin− CD127+ CRTH2-ve CD117+) however showed a small increase on +7 compared to day 0 with both cell types recovering by +60. We showed that it is feasible to prospectively study the recovery of ILCs after aHSCT. Continued enrollment will allow us to evaluate the correlation between ILCs and GVHD.
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Affiliation(s)
| | | | | | - Carrie Yuen
- 1The University of Oklahoma Health Sciences Center
| | | | - Rikin Shah
- 1The University of Oklahoma Health Sciences Center
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Opie RS, Ball K, Abbott G, Crawford D, Teychenne M, McNaughton SA. Adherence to the Australian dietary guidelines and development of depressive symptoms at 5 years follow-up amongst women in the READI cohort study. Nutr J 2020; 19:30. [PMID: 32276594 PMCID: PMC7149932 DOI: 10.1186/s12937-020-00540-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Depression is the single largest contributor to global disability. There is growing evidence that a healthy diet is associated with reduced depression risk. However, beyond the Mediterranean diet, few longitudinal studies have explored the relationship between adherence to national dietary guidelines and depression. Hence, this study investigates the relationship between adherence to Australian Dietary Guidelines and depressive symptoms. METHODS Data was drawn from the READI longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 837 women. A generalized linear model was used to explore whether baseline diet (assessed using the Dietary Guideline Index (DGI-2013; score range 0 to 85)) was associated with risk of developing depressive symptoms (measured by the Centre for Epidemiologic Studies Depression (CES-D)) at 5 years follow-up, whilst adjusting for potential confounders. A fixed-effects model was used to assess associations between concurrent changes in diet quality and depressive symptoms from baseline to 5 years follow-up. RESULTS An association between baseline diet quality and risk of developing depressive symptoms at follow-up was observed, where a 10 unit increase in DGI-2013 score was associated with an estimated 12% lower risk of developing heightened depressive symptoms (RR = 0.875, 95%CI 0.784 to 0.978, p = 0.018). The fixed-effects model indicated that an increase in DGI score over 5 years follow-up was associated with a lower (improved) CES-D score (B = -0.044, 95% CI - 0.08 to - 0.01, p = 0.024). CONCLUSIONS Our results provide evidence that better adherence to the Australian Dietary Guidelines may result in improved depressive symptoms. The growing high-quality evidence regarding the diet-depression relationship provides us with a rationale for developing strategies for supporting dietary behaviour change programs to lower depression rates.
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Affiliation(s)
- Rachelle S. Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Megan Teychenne
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Sarah A. McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
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Abstract
Background and Objectives: The general surgery residency at the University of Illinois College of Medicine at Peoria has a long tradition of integrating robotic surgery into training since 2002. The purpose of this paper is to investigate our curriculum and evaluation system, which was designed to achieve a standardized format for education in general robotic surgery. Methods: The curriculum consists of two phases: phase 1 (PGY 1–2): Complete 4 robotic surgery training modules; read two assigned robotic surgery articles; and practice simulation modules on the robot. phase 2 (PGY 3–5): Refresh training modules, score >90% on the simulator modules every 6 months; bedside assist minimum of 4 robotic procedures; and act as console surgeon for a minimum of 10 procedures with 2 separate attending surgeons. The required simulator modules were specially selected to incorporate all of the skills categories documented in the simulator. The faculty evaluate the resident's operative performance using the Global Evaluative Assessment of Robotic Skills validated rubric. Results: Since the curriculum was instituted in June 2017, 73 evaluations from 8 surgeons have been collected. We examined data from 6 residents who had at least 5 Global Evaluative Assessment of Robotic Skills assessments completed. Correlation coefficient scores showed a positive correlation ranging from 0.476 to 0.862 for average skills and 0.334 to 0.866 for overall performance scores. Discussion: The preliminary results suggest an improvement of resident robotic surgical skills through tailored education. This curriculum is designed to enhance robotic general surgery education that could potentially produce general surgeons able to operate robotically without needing a robotic/MIS (Minimally Invasive Surgery) fellowship.
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Affiliation(s)
- Harley Moit
- Department of Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
| | - Anthony Dwyer
- Department of Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
| | - Michelle De Sutter
- Graduate Medical Education, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
| | - Sally Heinzel
- Graduate Medical Education, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
| | - David Crawford
- Department of Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
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Cleland V, Cocker F, Canary J, Teychenne M, Crawford D, Timperio A, Ball K. Social-ecological predictors of physical activity patterns: A longitudinal study of women from socioeconomically disadvantaged areas. Prev Med 2020; 132:105995. [PMID: 31954139 DOI: 10.1016/j.ypmed.2020.105995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/10/2019] [Accepted: 01/13/2020] [Indexed: 11/26/2022]
Abstract
Limited longitudinal evidence of the predictors of physical activity (PA) patterns over time exists, particularly among high-risk groups such as women living in socioeconomically disadvantaged areas. This study aimed to: 1) describe leisure-time PA (LTPA) and transport-related PA (TRPA) patterns over time; and 2) identify individual, social and physical environmental predictors of LTPA and TRPA patterns over five years. Baseline (2007-08) data were collected and analysed (2016-18) from n = 4349 women (18-46 years) from disadvantaged areas of Victoria, Australia. Three- and five-year follow-up data were collected in 2010-11 (n = 1912) and 2012 (n = 1560). LTPA and TRPA were self-reported using the International Physical Activity Questionnaire, and patterns categorised as consistently low, persistently increasing, persistently decreasing, or inconsistent. Compared to a consistently low LTPA pattern, greater family support predicted both persistent decreases (odds ratio [OR] 1.20, 95% CI 1.05-1.36) and persistent increases (OR 1.17, 95% CI 1.04-1.32) in LTPA, while access to childcare predicted inconsistent LTPA patterns (OR 1.66, 95% CI 1.03-2.65). For both LTPA and TRPA, PA enjoyment predicted persistent increases (LTPA: OR 1.05, 95% CI 1.02-1.10; TRPA: OR 1.03, 95% CI 1.00-1.07), persistent decreases (LTPA: OR 1.04, 95% CI 1.00-1.08; TRPA OR 1.04, 95% CI 0.99-1.08), and inconsistent patterns (LTPA: OR 1.04, 95% CI 1.02-1.07; TRPA: OR 1.03, 95% CI 1.01-1.06). Although directionality was inconsistent, and the magnitude of effects were small, PA enjoyment, family social support for PA and access to childcare warrant further investigation and consideration as potentially key factors impacting PA patterns among women living in socioeconomically disadvantaged areas.
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Affiliation(s)
- Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Fiona Cocker
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jana Canary
- Department of Developmental Studies, University of Alaska Fairbanks, Fairbanks, AK, United States of America
| | - Megan Teychenne
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
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Abstract
Changing academic landscapes, including the increasing focus on performance rankings and metrics, are impacting universities globally, contributing to high-pressure environments and anxious academic staff. However, evidence and experience shows that fostering a high performing academic team need not be incompatible with staff happiness and wellbeing.
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Affiliation(s)
- Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
| | - David Crawford
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Srinivasan A, Ilonze CC, Travis SR, Crawford D. Hemophagocytic lymphohistiocytosis in systemic mastocytosis treated with allogeneic bone marrow transplant: A case report. Pediatr Blood Cancer 2020; 67:e28017. [PMID: 31556239 DOI: 10.1002/pbc.28017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 01/08/2023]
Abstract
Systemic mastocytosis is a rare entity in pediatrics, usually associated with mutations in the c-KIT gene. We describe a Caucasian female who presented with severe systemic mastocytosis with food allergies requiring prolonged total parenteral nutrition. Her course was further complicated by the onset of hemophagocytic lymphohistiocytosis, which responded poorly to conventional chemotherapy. She underwent an allogeneic hematopoietic stem cell transplant that resulted in resolution of all symptoms related to systemic mastocytosis and hemophagocytic lymphohistiocytosis. She is now disease-free and without any complications two years after the transplant.
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Affiliation(s)
- Anand Srinivasan
- Department of Pediatrics, Jimmy Everest Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Chibuzo C Ilonze
- Department of Pediatrics, Jimmy Everest Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Stephen R Travis
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - David Crawford
- Department of Pediatrics, Jimmy Everest Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Milte CM, Ball K, Crawford D, McNaughton SA. Diet quality and cognitive function in mid-aged and older men and women. BMC Geriatr 2019; 19:361. [PMID: 31864295 PMCID: PMC6925482 DOI: 10.1186/s12877-019-1326-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/23/2019] [Indexed: 01/24/2023] Open
Abstract
Background To date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over. Methods Adults aged 55–65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its individual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates. Results After adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported “sometimes” adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total sample (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported “usually” adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, − 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models. Conclusion An association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.
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Affiliation(s)
- Catherine M Milte
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia.
| | - Kylie Ball
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - David Crawford
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - Sarah A McNaughton
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia
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Thorpe MG, Milte CM, Crawford D, McNaughton SA. Education and lifestyle predict change in dietary patterns and diet quality of adults 55 years and over. Nutr J 2019; 18:67. [PMID: 31699092 PMCID: PMC6839215 DOI: 10.1186/s12937-019-0495-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022] Open
Abstract
Background Diet is a key risk factor for chronic disease, and an increasing concern among older adults. We aim to examine the changes in dietary patterns using principal component analysis and a diet quality index among older adults and examine the predictors of dietary change over a 4 year period. Methods Data was obtained via a postal survey in a prospective cohort, the Wellbeing Eating and Exercise for a Long Life (WELL) study. Australian adults aged 55 years and over (n = 1005 men and n = 1106 women) completed a food frequency at three time points and provided self-reported personal characteristics. Principal component analysis was used to assess dietary patterns and diet quality was assessed using the 2013 Revised Dietary Guideline Index. The relationships between predictors and change in dietary patterns were assessed by multiple linear regression. Results Two dietary patterns were consistently identified in men and women at three time points over 4 years. One was characterised by vegetables, fruit and white meat, and the other was characterised by red and processed meat and processed foods. Reduced consumption of key food groups within the principal component analysis-determined dietary patterns was observed. An increase in diet quality over 4 years was observed in men only. Reported higher education levels and favourable lifestyle characteristics, including not smoking and physical activity, at baseline predicted an increase in healthier dietary patterns over 4 years. Conclusions There was stability in the main dietary patterns identified over time, however participants reported an overall decrease in the frequency of consumption of key food groups. Compliance with the Australian Dietary Guidelines remained poor and therefore targeting this population in nutritional initiatives is important. Design of nutrition promotion for older adults need to consider those with lower socioeconomic status, as having a lower level of education was a predictor of poorer dietary patterns. It is important to consider how nutrition behaviours can be targeted alongside other lifestyle behaviours, such as smoking and inadequate physical activity to improve health.
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Affiliation(s)
- Maree G Thorpe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Abstract
Vedolizumab, a humanized monoclonal antibody approved for the treatment of adults with moderately to severely active ulcerative colitis or Crohn disease, targets α4β7 integrin and selectively blocks gut-specific lymphocyte trafficking. The potential effects of vedolizumab on development were assessed by standard preclinical toxicity studies in rabbits and cynomolgus monkeys. A single infusion of vedolizumab (0, 10, 30, or 100 mg/kg) was administered intravenously to pregnant rabbits on gestational day 7; rabbits were monitored to gestational day 29. Vedolizumab (0, 10, or 100 mg/kg) was administered intravenously every 2 weeks to pregnant cynomolgus monkeys beginning on gestational day 20 with the last dose on gestational day 132 (9 doses total). In rabbits, vedolizumab did not affect maternal net body weight or net gains, gravid uterine weights, or mean maternal food consumption, nor did it affect intrauterine growth or fetal survival. There were also no vedolizumab effects on embryo–fetal development compared to controls. In cynomolgus monkeys, there was no increase in prenatal loss/death or stillbirth and no maternal toxicity associated with vedolizumab. On day 28 postpartum, low levels of vedolizumab were detected in the breast milk of 3 of 11 monkeys in the 100 mg/kg group. No vedolizumab-related effects on the number of infants born, infant development, or animal hematology or clinical chemistry were noted. Administration of vedolizumab to pregnant rabbits and cynomolgus monkeys did not show any potential for maternal or developmental effects.
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Affiliation(s)
- David Crawford
- Takeda Pharmaceuticals Company Limited, Cambridge, MA, USA
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Crawford D. Carey, Matthew. Mistrust: an ethnographic theory. xiv, 128 pp., bibliogr. Chicago: Hau Books, 2017. £19.00 (paper). J R Anthropol Inst 2019. [DOI: 10.1111/1467-9655.13069] [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: 11/30/2022]
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