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Leahy E, Mutua F, Grace D, Lambertini E, Thomas LF. Foodborne zoonoses control in low- and middle-income countries: Identifying aspects of interventions relevant to traditional markets which act as hurdles when mitigating disease transmission. Front Sustain Food Syst 2022. [DOI: 10.3389/fsufs.2022.913560] [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: 12/24/2022] Open
Abstract
Globally, foodborne zoonoses are responsible for approximately one third of all foodborne disease burden and this picture is likely to worsen if consumption of animal source foods continues to rise with insufficient attention to risk mitigation. Traditional markets represent highly important nodes that can be targeted for risk mitigation; in this series of case studies, we discuss food safety interventions relevant to this nexus. We illustrate that to improve food safety within traditional markets it is essential to consider some of the motivations and incentives of the stakeholders involved and the cultural, social, and economic context in which interventions are undertaken, highlighting barriers, enablers future interventions should aim to avoid, embrace. We also conclude that a holistic approach to foodborne zoonoses control will require the institutionalization of One Health across food systems of which traditional markets are part.
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Sharma G, Leahy E, Deka RP, Shome BR, Bandyopadhyay S, Dey TK, Goyal NK, Lundkvist Å, Grace D, Lindahl JF. Antibiotic use, knowledge, and practices of milk vendors in India's informal dairy value chain. Front Sustain Food Syst 2022. [DOI: 10.3389/fsufs.2022.1058384] [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: 12/05/2022] Open
Abstract
BackgroundMilk vendors play an important role in India's dairy value chain; however, their food safety practices are poorly understood. From a milk safety perspective, vendor behavior is significant because it has the potential to affect both consumer and producer behavior. This study describes the types of milk vendors in two Indian states, in an attempt to investigate vendors' hygienic knowledge and practices toward safety and antimicrobial resistance (AMR).MethodsA cross-sectional study was conducted in the states of Assam and Haryana, India. In selected villages, all the milk vendors identified at the time of visit were interviewed. A questionnaire was used to assess the knowledge and practices on antibiotics, milk safety and hygiene. The milk samples were tested for presence of antibiotic resistant bacteria using antibiotic susceptibility testing.ResultsIn total, 244 milk vendors were interviewed during the survey. Out of these, 146 (59.8%) of the vendors traded raw milk, while 40.2% traded pasteurized milk. Vendors were categorized depending on whom they supplied milk to. Five categories were identified: (a) those who sold at grocery shops; (b) those who sold on roadside (roadside vendors); (c) those who sold from door to door; (d) those who sold to sweet makers/tea stalls, and (e) those who sold from own home/other entity. The level of training among vendors on milk hygiene was non-existent and the knowledge related to antibiotics was low. Most of them [210/244 (86.07%)] agreed that boiled milk is always safer than raw milk but almost half [119 (48.77%)] of them admitted that sometimes they drink milk without boiling it. Most vendors believed that they could identify whether milk is safe or not for consumption just by its appearance and smell. Out of 124 milk samples collected from surveyed milk vendors and tested for the presence of antibiotic-resistant bacteria, 80 (64.52%) were tested positive.ConclusionThis study highlights the low levels of knowledge regarding food safety among milk vendors. It shows the predominance of informal milk vendors in the surveyed states and prevalence of AMR bacteria in milk traded by them. Training may be a beneficial strategy for addressing the issue.
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Leahy E, Shome R, Deka RP, Sahay S, Grace D, Mazeri S, Lindahl JF. Risk factors for Brucella spp. and Coxiella burnetii infection among small ruminants in Eastern India. Infect Ecol Epidemiol 2020; 10:1783091. [PMID: 32944161 PMCID: PMC7480416 DOI: 10.1080/20008686.2020.1783091] [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] [Indexed: 01/30/2023] Open
Abstract
Small ruminants are the main reservoirs for brucellosis and coxiellosis, two zoonotic diseases affecting livestock production, and posing a public health threat in India. Understanding disease prevalence and risk factors associated with small ruminant infection can help mitigate disease transmission. We report a cross-sectional survey in the states of Assam and Odisha in Eastern India. We interviewed 244 farmers to assess knowledge, attitude and practices relevant to brucellosis and coxiellosis infection. Serum samples from 411 goats and 21 sheep were analysed using enzyme-linked immunosorbent assay and Rose-Bengal Brucella agglutination plate test. Higher Brucella and Coxiella burnetii seroprevalence were found in Odisha (22% and 11.5%, respectively) than Assam (9.8% and 1.6%, respectively), and certain districts in Odisha were at higher risk. No association was found between seropositive animals and clinical signs, a challenge when attempting to identify seropositive animals in the herd. None of the farmers interviewed were aware of brucellosis, its aetiology, clinical form, or zoonotic risk. This study acts as a first indication of the extent of these diseases among small ruminants in these Indian states, highlighting how farming practices are associated with increased risk of infection. More research is urgently needed to mitigate zoonoses transmission in this region.
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Affiliation(s)
- Eithne Leahy
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Rajeswari Shome
- Department ofAgricultural Research, ICAR- National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Bengaluru, India
| | - Ram Pratim Deka
- Department of Agricultural Research, International Livestock Research Institute, Guwahati, Assam, India
| | - Swati Sahay
- Department ofAgricultural Research, ICAR- National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Bengaluru, India
| | - Delia Grace
- Department ofAgricultural Research, International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Stella Mazeri
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Johanna F Lindahl
- International Livestock Research Institute, Southeast Asia Regional Office, Hanoi, Vietnam.,Zoonosis Science Centre, Uppsala University, Uppsala, Sweden.,Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Naydenova K, McMullan G, Peet MJ, Lee Y, Edwards PC, Chen S, Leahy E, Scotcher S, Henderson R, Russo CJ. CryoEM at 100 keV: a demonstration and prospects. IUCrJ 2019; 6:1086-1098. [PMID: 31709064 PMCID: PMC6830209 DOI: 10.1107/s2052252519012612] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/10/2019] [Indexed: 05/23/2023]
Abstract
100 kV is investigated as the operating voltage for single-particle electron cryomicroscopy (cryoEM). Reducing the electron energy from the current standard of 300 or 200 keV offers both cost savings and potentially improved imaging. The latter follows from recent measurements of radiation damage to biological specimens by high-energy electrons, which show that at lower energies there is an increased amount of information available per unit damage. For frozen hydrated specimens around 300 Å in thickness, the predicted optimal electron energy for imaging is 100 keV. Currently available electron cryomicroscopes in the 100-120 keV range are not optimized for cryoEM as they lack both the spatially coherent illumination needed for the high defocus used in cryoEM and imaging detectors optimized for 100 keV electrons. To demonstrate the potential of imaging at 100 kV, the voltage of a standard, commercial 200 kV field-emission gun (FEG) microscope was reduced to 100 kV and a side-entry cryoholder was used. As high-efficiency, large-area cameras are not currently available for 100 keV electrons, a commercial hybrid pixel camera designed for X-ray detection was attached to the camera chamber and was used for low-dose data collection. Using this configuration, five single-particle specimens were imaged: hepatitis B virus capsid, bacterial 70S ribosome, catalase, DNA protection during starvation protein and haemoglobin, ranging in size from 4.5 MDa to 64 kDa with corresponding diameters from 320 to 72 Å. These five data sets were used to reconstruct 3D structures with resolutions between 8.4 and 3.4 Å. Based on this work, the practical advantages and current technological limitations to single-particle cryoEM at 100 keV are considered. These results are also discussed in the context of future microscope development towards the goal of rapid, simple and widely available structure determination of any purified biological specimen.
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Affiliation(s)
- K. Naydenova
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - G. McMullan
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - M. J. Peet
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - Y. Lee
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - P. C. Edwards
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - S. Chen
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - E. Leahy
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - S. Scotcher
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - R. Henderson
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
| | - C. J. Russo
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, England
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Andrus S, Hayat N, Kuemmerle A, Leahy E, Bernstein S, Zambell K, Chung S, Sumner A, Courville A. Comparison of Body Composition Methods in African Immigrants. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leahy E, Bronsvoort B, Gamble L, Gibson A, Kaponda H, Mayer D, Mazeri S, Shervell K, Sargison N. Proof of concept of faecal egg nematode counting as a practical means of veterinary engagement with planned livestock health management in a lower income country. Ir Vet J 2017; 70:16. [PMID: 28588763 PMCID: PMC5457739 DOI: 10.1186/s13620-017-0094-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/30/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The wellbeing and livelihood of farmers in impoverished regions of the world is intrinsically linked to the health and welfare of their livestock; hence improved animal health is a pragmatic component of poverty alleviation. Prerequisite knowledge and understanding of the animal health challenges facing cattle keepers in Malawi is constrained by the lack of veterinary infrastructure, which inevitably accompanies under-resourced rural development in a poor country. METHODS We collaborated with public and private paraveterinary services to locate 62 village Zebu calves and 60 dairy co-operative calves dispersed over a wide geographical area. All calves were visited twice about 2 to 3 weeks apart, when they were clinically examined and faecal samples were collected. The calves were treated with 7.5 mg/kg of a locally-available albendazole drench on the first visit, and pre- and post- treatment trichostrongyle and Toxocara faecal egg counts were performed using a modified McMaster method. RESULTS Our clinical findings point towards a generally poor level of animal health, implying a role of ticks and tick-transmitted diseases in village calves and need for improvement in neonatal calf husbandry in the dairy co-operative holdings. High faecal trichostrongyle egg counts were not intuitive, based on our interpretation of the animal management information that was provided. This shows the need for better understanding of nematode parasite epidemiology within the context of local husbandry and environmental conditions. The albendazole anthelmintic was effective against Toxocara, while efficacy against trichostrongyle nematodes was poor in both village and dairy co-operative calves, demonstrating the need for further research to inform sustainable drug use. CONCLUSIONS Here we describe the potential value of faecal nematode egg counting as a platform for communicating with and gaining access to cattle keepers and their animals, respectively, in southern Malawi, with the aim of providing informative background knowledge and understanding that may aid in the establishment of effective veterinary services in an under-resourced community.
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Affiliation(s)
- Eithne Leahy
- Worldwide Veterinary Service, 14 Wimborne Street, Cranborne, Dorset BH21 5PP UK
| | - Barend Bronsvoort
- Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, University of Edinburgh, Roslin, Midlothian EH25 9RG UK.,The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute, Easter Bush, Roslin, Midlothian EH26 9RG UK
| | - Luke Gamble
- Worldwide Veterinary Service, 14 Wimborne Street, Cranborne, Dorset BH21 5PP UK
| | | | - Henderson Kaponda
- Blantyre District Agricultural Development Office, Kunthembwe EPA, Malawi
| | - Dagmar Mayer
- Worldwide Veterinary Service, 14 Wimborne Street, Cranborne, Dorset BH21 5PP UK
| | - Stella Mazeri
- Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, University of Edinburgh, Roslin, Midlothian EH25 9RG UK.,The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute, Easter Bush, Roslin, Midlothian EH26 9RG UK
| | | | - Neil Sargison
- Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, University of Edinburgh, Roslin, Midlothian EH25 9RG UK
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Leahy E, O’Flaherty J, Hearne L. The ‘tyranny of time’: getting to the heart of the impact of educational cuts on the provision of guidance counselling in Ireland. British Journal of Guidance & Counselling 2016. [DOI: 10.1080/03069885.2016.1254722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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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Nieminen I, Ramon S, Dawson I, Flores P, Leahy E, Pedersen ML, Kaunonen M. Experiences of Social Inclusion and Employment of Mental Health Service Users in a European Union Project. International Journal of Mental Health 2014. [DOI: 10.2753/imh0020-7411410401] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Irja Nieminen
- a School of Health Sciences, University of Tampere, Tampere, Finland
| | - Shulamit Ramon
- b Faculty of Health and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ian Dawson
- c Salten District Psychiatric Centre, Nordland Hospital, Bodø, Norway
| | - Paz Flores
- d Day Psychiatric Hospital, Centre Forum-Hospital del Mar, Barcelona, Spain
| | - Eithne Leahy
- e Biomedical Research Institute, Barcelona, Spain
| | | | - Marja Kaunonen
- g School of Health Sciences/Pirkanmaa Hospital District, Science Center, University of Tampere, Tampere, Finland
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Greacen T, Jouet E, Ryan P, Cserhati Z, Grebenc V, Griffiths C, Hansen B, Leahy E, da Silva KM, Šabić A, De Marco A, Flores P. Developing European guidelines for training care professionals in mental health promotion. BMC Public Health 2012; 12:1114. [PMID: 23270332 PMCID: PMC3553026 DOI: 10.1186/1471-2458-12-1114] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 12/07/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although mental health promotion is a priority mental health action area for all European countries, high level training resources and high quality skills acquisition in mental health promotion are still relatively rare. The aim of the current paper is to present the results of the DG SANCO-funded PROMISE project concerning the development of European guidelines for training social and health care professionals in mental health promotion. METHODS The PROMISE project brought together a multidisciplinary scientific committee from eight European sites representing a variety of institutions including universities, mental health service providers and public health organisations. The committee used thematic content analysis to filter and analyse European and international policy documents, scientific literature reviews on mental health promotion and existing mental health promotion programmes with regard to identifying quality criteria for training care professionals on this subject. The resulting PROMISE Guidelines quality criteria were then subjected to an iterative feedback procedure with local steering groups and training professionals at all sites with the aim of developing resource kits and evaluation tools for using the PROMISE Guidelines. Scientific committees also collected information from European, national and local stakeholder groups and professional organisations on existing training programmes, policies and projects. RESULTS The process identified ten quality criteria for training care professionals in mental health promotion: embracing the principle of positive mental health; empowering community stakeholders; adopting an interdisciplinary and intersectoral approach; including people with mental health problems; advocating; consulting the knowledge base; adapting interventions to local contexts; identifying and evaluating risks; using the media; evaluating training, implementation processes and outcomes. The iterative feedback process produced resource kits and evaluation checklists linked with each of these quality criteria in all PROMISE languages. CONCLUSIONS The development of generic guidelines based on key quality criteria for training health and social care professionals in mental health promotion should contribute in a significant way to implementing policy in this important area.
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Affiliation(s)
- Tim Greacen
- Etablissement public de santé Maison Blanche, Paris, France
| | | | - Peter Ryan
- Middlesex University, London, United Kingdom
| | - Zoltan Cserhati
- Semmelweis University, Institute of Behavioural Sciences, Budapest, Hungary
| | - Vera Grebenc
- Faculty of Social Work, University of Ljubljana, Ljubljana, Slovenia
| | | | - Bettina Hansen
- Human Resources Department, Capacity Building Unit, Central Region, Denmark
| | - Eithne Leahy
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Amra Šabić
- Faculty of Social Work, University of Ljubljana, Ljubljana, Slovenia
| | | | - Paz Flores
- Centre Fòrum, Institut de Neuropsiquiatria i Adiccions, Hospital del Mar Medical Research Institute, Barcelona, Spain
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Flores P, Izquierdo R, Leahy E, Masferrer C, Ryan P. Promoting mental health minimising mental illness and integrating through education (PROMISE). Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72240-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
With the implementation of the European Green Paper on Mental Health, and the development of the Mental Health Pact, the strategic importance of Mental Health promotion and illness reduction as keystones of a European mental health policy and practice has never been greater.The PROMISE project is a EU project and is financed by the European Commission, Directorate General for Health and Consumers, DG Sanco. It aims to develop and disseminate guidelines for generic training and education with respect to Mental Health Promotion and Illness Reduction. The best practice guidelines will specifically focus on the prevention of suicide, depression, and alcohol and drug abuse, and the promotion of healthy living.A specific innovation is the involvement of mental health service users as non-traditional actors by developing multi-disciplinary training guidelines and training programs with a special emphasis on positive mental health, healthy living, diet and exercise project.Project partners are all ‘multiplier’ organizations from 8 different European countries and have extensive previous expertise in their designated roles.The role of Parc de Salut Mar, Barcelona PROMISE is: Identify best practice media guidelines for engaging press and media with the mental health promotion agenda through the use of positive role models. Monitor the implementation of the best practice guidelines through the design and development of local case studies in 7 sites across Europe.Outcomes are an integrated and comprehensive set of training guidelines and model training programs accessed through an interactive website, endorsed by European level professional body and university networks.
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Palomer E, Izquierdo R, Leahy E, Masferrer C, Flores P. El usuario como experto: concepto, modalidades y experiencia desde el Proyecto Emilia. Rev Asoc Esp Neuropsiq 2010. [DOI: 10.4321/s0211-57352010000100006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Flores P, Leahy E, Sorro M, Izquierdo R, Masferrer C. The empowerment and sharing of knowledge among mental health service users: bridging the gap between the users and the mental health institution. Int J Integr Care 2009. [PMCID: PMC2707539] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Introduction Aim Methodology Conclusion
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Affiliation(s)
- Paz Flores
- Hospital del Mar y Centre Fórum, IMAS-IMIM, Barcelona, Spain
| | - Eithne Leahy
- Hospital del Mar y Centre Fórum, IMAS-IMIM, Barcelona, Spain
| | - Montse Sorro
- Hospital del Mar y Centre Fórum, IMAS-IMIM, Barcelona, Spain
| | - Roser Izquierdo
- Hospital del Mar y Centre Fórum, IMAS-IMIM, Barcelona, Spain
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Rai R, Kolesnikov A, Li Y, Young WB, Leahy E, Sprengeler PA, Verner E, Shrader WD, Burgess-Henry J, Sangalang JC, Allen D, Chen X, Katz BA, Luong C, Elrod K, Cregar L. Development of potent and selective factor Xa inhibitors. Bioorg Med Chem Lett 2001; 11:1797-800. [PMID: 11459634 DOI: 10.1016/s0960-894x(01)00311-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The development of potent and selective small molecule inhibitors of factor Xa is described.
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Affiliation(s)
- R Rai
- Departments of Medicinal Chemistry, Structural Chemistry and Enzymology, Axys Pharmaceuticals, Inc., 385 Oyster Point Blvd., 94080, South San Francisco, CA, USA
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Ackers ML, Mahon BE, Leahy E, Goode B, Damrow T, Hayes PS, Bibb WF, Rice DH, Barrett TJ, Hutwagner L, Griffin PM, Slutsker L. An outbreak of Escherichia coli O157:H7 infections associated with leaf lettuce consumption. J Infect Dis 1998; 177:1588-93. [PMID: 9607837 DOI: 10.1086/515323] [Citation(s) in RCA: 332] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In July 1995, 40 Montana residents were identified with laboratory-confirmed Escherichia coli O157:H7 infection; 52 residents had bloody diarrhea without laboratory confirmation. The median age of those with laboratory-confirmed cases was 42 years (range, 4- 86); 58% were female. Thirteen patients were hospitalized, and 1 developed hemolytic-uremic syndrome. A case-control study showed that 19 (70%) of 27 patients but only 8 (17%) of 46 controls reported eating purchased (not home-grown) leaf lettuce before illness (matched odds ratio, 25.3; 95% confidence interval, 3.9-1065.6). Pulsed-field gel electrophoresis identified a common strain among 22 of 23 isolates tested. Implicated lettuce was traced to two sources: a local Montana farm and six farms in Washington State that shipped under the same label. This outbreak highlights the increasing importance of fresh produce as a vehicle in foodborne illness. Sanitary growing and handling procedures are necessary to prevent these infections.
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Affiliation(s)
- M L Ackers
- Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Burgio LD, McCormick KA, Scheve AS, Engel BT, Hawkins A, Leahy E. The effects of changing prompted voiding schedules in the treatment of incontinence in nursing home residents. J Am Geriatr Soc 1994; 42:315-20. [PMID: 8120318 DOI: 10.1111/j.1532-5415.1994.tb01758.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine the effects of different prompted voiding schedules on urinary incontinence on a continence unit (CU) and the maintenance of benefits on normal nursing units. DESIGN Multiphase study with both intra- and inter-subject comparisons. PARTICIPANTS Subjects were 41 consenting incontinent nursing home residents. Based on clinical criteria, subjects were assigned to one of four treatment groups that varied as to the schedule of prompted voiding received. MEASUREMENT The study used chart review, Katz ADL, and MMSE. Urologic status, self-initiated toileting, urine volumes voided, and incontinence assessed by pad/pants checks were measured by research nurses. Baseline pad check data were collected on residents' normal nursing units. Residents were transferred to the CU where baseline measurement was repeated, and the effects of different prompted voiding schedules were then assessed. Indigenous staff were trained to use prompted voiding, and nurse supervisors were instructed in special procedures for enhancing maintenance of the intervention. Residents were returned to their normal units and the maintenance of improvements in continence status was assessed at 2 weeks and 3 months post-CU discharge. RESULTS One of the four groups showed significant improvement on the CU in response to the 2-hour schedule; two groups improved on the less intensive 3-hour schedule (P < 0.05). Two groups maintained this improvement on their normal nursing units (P < 0.05); one group showed a non-significant trend toward improvement. Self-initiated toileting decreased (P < 0.05) and volume voids in an appropriate receptacle increased (P < 0.05) during training. CONCLUSIONS Prompted voiding is an effective treatment for urinary incontinence, and a less intensive 3-hour schedule may be superior to the standard 2-hour schedule for some residents. These improvements in dryness can be maintained by normal nursing home staff if formal staff management procedures are utilized by nurse supervisors.
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Affiliation(s)
- L D Burgio
- Center for the Aging, Birmingham School of Medicine, Alabama
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Abstract
Continence improves from 44.7% dryness at baseline to 54.7% at the end of treatment, an improvement of 22%, or about one incontinent episode per day. Urinary incontinence is improved in cognitively impaired residents by augmenting the prompted voiding procedure with a bellpad. Bladder behavior changes with behavioral treatment strategies, because the volume voided into an appropriate receptacle increased an average of 26 mL per 2 hours. Reimbursement policies should not exclude treatment of the severely cognitively impaired nor the immobile in nursing homes.
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Affiliation(s)
- B T Engel
- Laboratory of Behavioral Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224
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Seyfer AE, Prohazka D, Leahy E. The effectiveness of the superiorly based pharyngeal flap in relation to the type of palatal defect and timing of the operation. Plast Reconstr Surg 1988; 82:760-4. [PMID: 3174867 DOI: 10.1097/00006534-198811000-00005] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A 10-year review of 39 patients who underwent a superiorly based pharyngeal flap for severe velopharyngeal insufficiency was performed. The effectiveness of the operation, as scored by standardized preoperative and postoperative evaluations, was related to age at operation, type of defect, and duration of velopharyngeal inadequacy. There was no statistical difference between those who were under the age of 6 years (100 percent were improved) at the time of the operation versus those 6 years and older (74 percent improved). Likewise, there was no difference between those patients who received an early flap (92 percent were improved) versus those who received a flap 2 or more years after initial palatorrhaphy (90 percent were improved). The type of palatal defect also was not a significant factor, and none of the patients exhibited a postoperative decrease in function (p less than or equal to 0.001). The operation offered reliable salvage of velopharyngeal competency regardless of the above-mentioned factors.
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Affiliation(s)
- A E Seyfer
- Plastic Surgery Service, Walter Reed Army Medical Center, Washington, D.C. 20307-5001
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McCormick KA, Scheve AA, Leahy E. Nursing management of urinary incontinence in geriatric inpatients. Nurs Clin North Am 1988; 23:231-64. [PMID: 3347579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The management and treatment of incontinence represent two interrelated areas--providing enough providers of care and describing the types of management and treatment options available to the incontinent patient. This article has stressed that adequate staffing underlies any successful program of continence management and treatment. In addition, many options for the management and treatment of incontinence in the elderly have been presented. Of importance are the specific nursing implications that will make many continence protocols successful. These guidelines can provide the basis for planning patient care through the nursing process. This article has also addressed management and treatment strategies for incontinence that not only improve incontinence in patients but may cure it. These include behavioral management strategies which nurses should be encouraged to use in treating incontinent patients in the community. These same behavioral management strategies are being studied in inpatient settings, and the results indicate that nurses in inpatient settings and long-term care facilities should implement behavioral treatment programs for incontinent patients.
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Affiliation(s)
- K A McCormick
- Gerontology Research Center, National Institute on Aging, Baltimore, Maryland
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Bourke AM, Bresnihan PC, Clarke DM, Leahy E, Lucey C, Taaffe J, Lehane S, Solan J. An intensive care unit in a County Hospital. J Ir Med Assoc 1973; 66:205-7. [PMID: 4698648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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