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Abstract
INTRODUCTION Adolescents' engagement with online social networking platforms is advancing at an exponential rate and research is needed to investigate any impact on young users' mental health. This study examined appearance-related activity (e.g. looking at photos of friends) on social media and body dissatisfaction among adolescent girls. METHODS Self-report measures of online appearance-related activity, social comparisons to female target groups, internalization of the thin ideal, body dissatisfaction, and self-esteem were administered to 210 girls (mean age = 15.16 years). RESULTS Body dissatisfaction was significantly related to (i) time spent engaged in social comparisons and (ii) upward social comparisons with various female targets while online. Evaluating oneself less favorably than the target group of close friends was most strongly associated with poorer body image appraisals. Serial multiple mediation analysis revealed that even after controlling for age and self-esteem, time spent engaged in social comparisons significantly mediated the relationship between online appearance-related activity and body dissatisfaction. This association was then further partially mediated by internalization of the thin ideal, which significantly mediated the relationship between time engaged in social comparisons and body dissatisfaction. DISCUSSION Results are discussed in terms of online social media platforms representing an additional appearance culture environment for adolescent girls. The effects of this on the mental health of vulnerable users and how future research should investigate protective factors that may buffer young girls from the adverse effects of social media are considered.
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Affiliation(s)
- M Scully
- School of Psychology and Trinity Research in Childhood Centre, Trinity College Dublin
| | - L Swords
- School of Psychology and Trinity Research in Childhood Centre, Trinity College Dublin
| | - E Nixon
- School of Psychology and Trinity Research in Childhood Centre, Trinity College Dublin
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2
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Mitchell EJ, Sprange K, Treweek S, Nixon E. Value and engagement: what can clinical trials learn from techniques used in not-for-profit marketing? Trials 2022; 23:457. [PMID: 35655239 PMCID: PMC9164393 DOI: 10.1186/s13063-022-06417-3] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Marketing is a core business function in commercial companies but is also frequently used by not-for-profit organisations. Marketing focuses on understanding what people value to make choices about engaging with a product or service: a concept also key to understanding why people may choose to engage with a clinical trial. Understanding the needs and values of stakeholders, whether they are participants, staff at recruiting sites or policy-makers, is critical for a clinical trial to be a success. As many trials fail to recruit and retain participants, perhaps it is time for us to consider approaches from other disciplines. Though clinical trial teams may consider evidence- and non-evidence-based recruitment and retention strategies, this is rarely done in a systematic, streamlined way and is often in response to challenges once the trial has started. In this short commentary, we argue the need for a formal marketing approach to be applied to clinical trials, from the outset, as a potential prevention to recruitment and retention problems.
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Affiliation(s)
- E J Mitchell
- Nottingham Clinical Trials Unit, Applied Health Research Building, University Park, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - K Sprange
- Nottingham Clinical Trials Unit, Applied Health Research Building, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | - S Treweek
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - E Nixon
- Nottingham University Business School, Jubilee Campus, University of Nottingham, Nottingham, NG8 1BB, UK
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Cooper AR, Nixon E, Rose Vineer H, Abdullah S, Newbury H, Wall R. Fleas infesting cats and dogs in Great Britain: spatial distribution of infestation risk and its relation to treatment. Med Vet Entomol 2020; 34:452-458. [PMID: 32697393 DOI: 10.1111/mve.12462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Abstract
The spatial pattern of flea (Siphonaptera: Pulicidae) infestation risk in cats and dogs across Great Britain is quantified, using data collected from a national survey undertaken in 2018, with particular attention given to the association between insecticidal treatment and infestation risk. Flea infestation risk declined significantly from south to north. None of the factors: pet breed, sex, neutered status or whether the pet had been abroad, showed any relationship with the underlying geographic distribution, which is most likely to be associated with climatic factors. However, overall, only 23.6% of the cats and 35% of the dogs inspected had been treated with identifiable flea products that were still 'in date' at the point of inspection. The percentage of owners treating their pet broadly followed infestation risk. The insecticide fipronil is a common active in a wide range of flea treatments and was the most frequently applied insecticide class, particularly in cats. However, 62% of cats and 45% of dogs that had been treated with a fipronil-based product that was 'in date' at the point of inspection still had fleas. Persistent flea infestation is likely to be due to a range of factors, including compliance and application failure, but the data provide strong inferential evidence for a lack of efficacy of fipronil-based products. Given the ubiquity of flea infestation, this finding and the relatively low-level of treatment compliance, highlight a clear need for greater owner education about the importance of flea management and a better understanding of the efficacy of different products.
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Affiliation(s)
- A-R Cooper
- School of Biological Sciences, University of Bristol, Bristol, U.K
| | - E Nixon
- School of Biological Sciences, University of Bristol, Bristol, U.K
| | - H Rose Vineer
- Department of Infection and Microbiome, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, U.K
| | - S Abdullah
- School of Veterinary Science, University of Queensland, Brisbane, Queensland, Australia
| | - H Newbury
- Companion Animal Technical Team, MSD Animal Health, Walton Manor, Milton Keynes, U.K
| | - R Wall
- School of Biological Sciences, University of Bristol, Bristol, U.K
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Bristowe K, Murtagh FEM, Clift P, James R, Josh J, Platt M, Whetham J, Nixon E, Post FA, McQuillan K, Cheallaigh CN, Kall M, Anderson J, Sullivan AK, Harding R. The development and cognitive testing of the positive outcomes HIV PROM: a brief novel patient-reported outcome measure for adults living with HIV. Health Qual Life Outcomes 2020; 18:214. [PMID: 32631444 PMCID: PMC7336444 DOI: 10.1186/s12955-020-01462-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/23/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND People living with HIV experience burdensome multidimensional symptoms and concerns requiring person-centred care. Routine use of patient reported outcome measures can improve outcomes. There is no brief patient reported outcome measure (PROM) that currently reflects the breadth of concerns for people living with HIV. This study aimed to develop and cognitively test a brief novel patient reported outcome measure for use within routine adult HIV care- the "Positive Outcomes" HIV PROM. METHODS Development followed the COSMIN taxonomy and guidance for relevance and comprehensiveness, and Rothrock guidance on development of valid patient reported outcome measures. The Positive Outcomes HIV PROM was developed by a steering group (people living with HIV, HIV professionals and health services researchers) using findings from a previously reported qualitative study of priority outcomes for people living with HIV. The prototype measure was cognitively tested with a purposive sample of people living with HIV. RESULTS The Positive Outcomes HIV PROM consists of 23 questions (22 structured, and one open question) informed by the priorities of key stakeholders (n = 28 people living with HIV, n = 21 HIV professionals and n = 8 HIV commissioners) to ensure face and content validity, and refined through cognitive testing (n = 6 people living with HIV). Cognitive testing demonstrated high levels of acceptability and accessibility. CONCLUSIONS The Positive Outcomes HIV PROM is the first brief patient reported outcome measure reflecting the diverse needs of people living with HIV designed specifically for use in the clinical setting to support patient assessment and care, and drive service quality improvement. It is derived from primary data on the priority outcomes for people living with HIV and is comprehensive and acceptable. Further psychometric testing is required to ensure reliability and responsiveness.
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Affiliation(s)
- K Bristowe
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Bessemer Road, London, SE5 9PJ, UK.
| | - F E M Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - P Clift
- King's College Hospital NHS Foundation Trust, London, UK
| | - R James
- University of Sussex, Brighton, UK
| | | | | | - J Whetham
- Brighton and Sussex University Hospitals Trust, Brighton, UK
| | - E Nixon
- Brighton and Sussex University Hospitals Trust, Brighton, UK
| | - F A Post
- King's College Hospital NHS Foundation Trust, London, UK
| | - K McQuillan
- St James's Hospital Dublin and Trinity College Dublin, Dublin, Ireland
| | - C Ní Cheallaigh
- St James's Hospital Dublin and Trinity College Dublin, Dublin, Ireland
| | - M Kall
- Public Health England, London, UK
| | - J Anderson
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - A K Sullivan
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - R Harding
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Bessemer Road, London, SE5 9PJ, UK
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Sellers R, Smith AF, Leve LD, Nixon E, Cane T, Cassell JA, Harold GT. Utilising Genetically-Informed Research Designs to Better Understand Family Processes and Child Development: Implications for Adoption and Foster Care Focused Interventions. Adopt Foster 2019; 43:351-371. [PMID: 31576061 PMCID: PMC6771282 DOI: 10.1177/0308575919866526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Understanding the interplay between genetic factors and family environmental processes (e.g., inter-parental relationship quality, positive versus negative parenting practices) and children's mental health (e.g., anxiety, depression, conduct problems, ADHD) in the contexts of adoption and foster-care research and practice is critical for effective prevention and intervention programme development. Whilst evidence highlights the importance of family environmental processes for the mental health and well-being of children in adoption and foster care, there is relatively limited evidence of effective interventions specifically for these families. Additionally, family-based interventions not specific to the context of adoption and foster-care typically show small to medium effects, and even where interventions are efficacious, not all children benefit. One explanation for why interventions may not work well for some is that responses to intervention may be influenced by an individual's genetic make-up. This paper summarises how genetically-informed research designs can help disentangle genetic from environmental processes underlying psychopathology outcomes for children, and how this evidence can provide improved insights into the development of more effective preventative intervention targets for adoption and foster-care families. We discuss current difficulties in translating behavioural genetics research to prevention science, and provide recommendations to bridge the gap between behavioural genetics research and prevention science, with lessons for adoption and foster-care research and practice.
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Affiliation(s)
- R Sellers
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - A F Smith
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
| | - L D Leve
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - E Nixon
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
| | - T Cane
- School of Social Work and Social Care, University of Sussex, UK
| | - J A Cassell
- Brighton and Sussex Medical School, Falmer, Brighton BN1 9PH
| | - G T Harold
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
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Soop M, Khan H, Nixon E, Teubner A, Abraham A, Carlson G, Lal S. SUN-PO306: Causes and Outcomes of Intestinal Failure in Crohn’s Disease: An 18-Year Experience from a National Centre. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32936-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bristowe K, Clift P, James R, Josh J, Platt M, Whetham J, Nixon E, Post FA, McQuillan K, Ní Cheallaigh C, Murtagh F, Anderson J, Sullivan AK, Harding R. Towards person-centred care for people living with HIV: what core outcomes matter, and how might we assess them? A cross-national multi-centre qualitative study with key stakeholders. HIV Med 2019; 20:542-554. [PMID: 31162817 DOI: 10.1111/hiv.12758] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES People living with HIV (PLWH) have multidimensional concerns requiring person-centred care. Routine use of patient-reported outcome measures (PROMs) improves outcomes. No brief PROM currently reflects the breadth of concerns for PLWH. This study sought to identify priority outcomes for PLWH, model current practice, explore views on introducing PROMs into routine care, and devise a model for person-centred care incorporating the PROM. METHODS A cross-national multi-centre study (London, Brighton and Dublin) was carried out. Semi-structured qualitative interviews with adult PLWH, HIV health care professionals and HIV commissioners (responsible for planning and commissioning services) were performed. Interviews were analysed using thematic and framework analysis. RESULTS PLWH (n = 28), professionals (n = 21) and commissioners (n = 8) described concerns related to living with HIV across six domains: physical (e.g. pain and gastrointestinal symptoms), cognitive (e.g. memory and sleep), psychological (e.g. anxiety and depression), social (e.g. isolation and intimacy), welfare (e.g. finances and fears regarding change of immigration status), and information (e.g. long-term outcomes) needs. Themes were highly inter-related, impacting across domains of need (e.g. physical and cognitive problems impacting on psychological and social wellbeing). Perceived benefits of using PROMs in routine HIV care included improved person-centredness, patient empowerment, fewer missed concerns, increased engagement with services, and informed planning of services. Potential challenges included heterogeneity of PLWH, literacy, and utility for those who struggle to engage with care. CONCLUSIONS This study presents a novel model of person-centred care incorporating an HIV-specific PROM. The model reflects priorities of key stakeholders. Explicit use of PROMs in routine HIV care could afford benefits for PLWH, clinical teams and commissioners.
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Affiliation(s)
- K Bristowe
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | - P Clift
- King's College Hospital NHS Foundation Trust, London, UK
| | - R James
- University of Sussex, Brighton, UK
| | | | | | - J Whetham
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - E Nixon
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - F A Post
- King's College Hospital NHS Foundation Trust, London, UK
| | - K McQuillan
- St James's Hospital Dublin and Trinity College Dublin, Dublin, Ireland
| | - C Ní Cheallaigh
- St James's Hospital Dublin and Trinity College Dublin, Dublin, Ireland
| | - Fem Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - J Anderson
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - A K Sullivan
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - R Harding
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
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Youssef E, Cooper V, Nixon E, Vera JH, Fisher M, Wright J. The management of comorbidities in older people living with HIV in England: a cross sectional survey. HIV Med 2017; 18:534-535. [DOI: 10.1111/hiv.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E Youssef
- Brighton and Sussex Medical School; Brighton UK
| | - V Cooper
- Brighton and Sussex University Hospitals NHS Trust; Brighton UK
| | - E Nixon
- Brighton and Sussex University Hospitals NHS Trust; Brighton UK
| | - JH Vera
- Brighton and Sussex Medical School; Brighton UK
- Brighton and Sussex University Hospitals NHS Trust; Brighton UK
| | - M Fisher
- Brighton and Sussex University Hospitals NHS Trust; Brighton UK
| | - J Wright
- Brighton and Sussex Medical School; Brighton UK
- Brighton and Sussex University Hospitals NHS Trust; Brighton UK
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Cooper V, Clatworthy J, Youssef E, Llewellyn C, Miners A, Lagarde M, Sachikonye M, Perry N, Nixon E, Pollard A, Sabin C, Foreman C, Fisher M. Which aspects of health care are most valued by people living with HIV in high-income countries? A systematic review. BMC Health Serv Res 2016; 16:677. [PMID: 27899106 PMCID: PMC5129660 DOI: 10.1186/s12913-016-1914-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 09/07/2016] [Accepted: 11/09/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Increasing numbers of people with HIV are living into older age and experiencing comorbidities. The development of new models of care to meet the needs of this population is now a priority. It is important that the views and preferences of patients inform the development of services in order to maintain high levels of patient satisfaction and engagement. The aim of this systematic review was to determine which aspects of healthcare are particularly valued by people living with HIV. METHODS We searched electronic databases and reference lists of relevant articles. The search strategy was developed to identify articles reporting on HIV positive patients' perceptions, evaluations or experiences of healthcare services and factors associated with satisfaction with care. Peer-reviewed papers and conference abstracts were included if the study reported on aspects of health care that were valued by people living with HIV, data were collected during the era of combination therapy (from 1996 onwards), and the paper was published in English. A thematic approach to data synthesis was used. RESULTS Twenty-three studies met the inclusion criteria. Studies used both qualitative and quantitative methods. Six studies specifically reported on relative importance to patients of different aspects of care. The valued aspects of care identified were grouped into seven themes. These highlighted the importance to patients of: a good health care professional-patient relationship, HIV specialist knowledge, continuity of care, ease of access to services, access to high quality information and support, effective co-ordination between HIV specialists and other healthcare professionals, and involvement in decisions about treatment and care. We were unable to determine the relative importance to patients of different aspects of care because of methodological differences between the studies. CONCLUSIONS This review identified several attributes of healthcare that are valued by people living with HIV, many of which would be relevant to any future reconfiguration of services to meet the needs of an ageing population. Further research is required to determine the relative importance to patients of different aspects of care.
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Affiliation(s)
- V. Cooper
- Elton John Centre, Sussex House, Brighton and Sussex University Hospitals NHS Trust, 1 Abbey Road, Brighton, BN2 1ES UK
| | - J. Clatworthy
- Elton John Centre, Sussex House, Brighton and Sussex University Hospitals NHS Trust, 1 Abbey Road, Brighton, BN2 1ES UK
| | - E. Youssef
- Elton John Centre, Sussex House, Brighton and Sussex University Hospitals NHS Trust, 1 Abbey Road, Brighton, BN2 1ES UK
| | - C. Llewellyn
- Division of Public Health & Primary Care, Brighton & Sussex Medical School, Room 317 Mayfield House, Falmer, Brighton, BN1 9PH UK
| | - A. Miners
- Health Services Research Unit, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - M. Lagarde
- Health Services Research Unit, Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1E 9SY UK
| | - M. Sachikonye
- UK Community Advisory Board Country United Kingdom (England), c/o HIV i-Base, 4th Floor, 57 Great Suffolk Street, London, SE1 0BB UK
| | - N. Perry
- Elton John Centre, Sussex House, Brighton and Sussex University Hospitals NHS Trust, 1 Abbey Road, Brighton, BN2 1ES UK
| | - E. Nixon
- Elton John Centre, Sussex House, Brighton and Sussex University Hospitals NHS Trust, 1 Abbey Road, Brighton, BN2 1ES UK
| | - A. Pollard
- Division of Public Health & Primary Care, Brighton & Sussex Medical School, Room 317 Mayfield House, Falmer, Brighton, BN1 9PH UK
| | - C. Sabin
- UCL Medical School, Infection and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - C. Foreman
- NHS England, Southside - Mezzanine Floor, 105 Victoria Street, London, SW1E 6QT UK
| | - M. Fisher
- Elton John Centre, Sussex House, Brighton and Sussex University Hospitals NHS Trust, 1 Abbey Road, Brighton, BN2 1ES UK
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Mody N, Nixon E, Buckingham T, Churchill D. It's the quality that counts: audit of the quality of transfer information for patients moving their HIV care between units. HIV Med 2016; 17:708. [PMID: 27594051 DOI: 10.1111/hiv.12370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- N Mody
- King's College Hospital, London, UK
| | - E Nixon
- Royal Sussex County Hospital, Brighton, UK
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Hayes CB, Reulbach U, Kelly D, Taut C, Nixon E, Zgaga L, Williams J, O’Dowd T. P124 Bullying and Health Care Utilisation in 9-year-olds: Baseline Analysis of a Longitudinal Cohort. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Miners AH, Llewellyn CD, Cooper VL, Youssef E, Pollard AJ, Lagarde M, Sabin C, Nixon E, Sachikonye M, Perry N, Fisher M. A discrete choice experiment to assess people living with HIV's (PLWHIV's) preferences for GP or HIV clinic appointments. Sex Transm Infect 2016; 93:105-111. [PMID: 27535762 PMCID: PMC5339551 DOI: 10.1136/sextrans-2016-052643] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 03/23/2016] [Revised: 06/30/2016] [Accepted: 07/17/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To understand which aspects of general practitioner (GP) and HIV clinic appointments people living with HIV (PLWHIV) most value when seeking advice for new health problems. METHODS A discrete choice experiment using a convenience sample of people diagnosed with HIV. Participants were recruited from 14 general HIV clinics in the South East of England between December 2014 and April 2015. ORs were calculated using conditional logit (CLOGIT) and latent class models (LCMs). RESULTS A total of 1106 questionnaires were returned. Most participants were male (85%), white (74%) and were men who have sex with men (69%). The CLOGIT analysis showed people particularly valued shorter appointment waiting times (ORs between 1.52 and 3.62, p<0.001 in all instances). The LCM analysis showed there were two distinct classes, with 59% and 41% of respondents likely to be in each. The first class generally preferred GP to HIV clinic appointments and particularly valued 'being seen quickly'. For example, they had strong preferences for shorter appointment waiting times and longer GP opening hours. People in the second class also valued shorter waiting times, but they had a strong general preference for HIV clinic rather than GP appointments. CONCLUSIONS PLWHIV value many aspects of care for new health problems, particularly short appointment waiting times. However, they appear split in their general willingness to engage with GPs.
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Affiliation(s)
- A H Miners
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - C D Llewellyn
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, UK
| | - V L Cooper
- Department of Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - E Youssef
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, UK
| | - A J Pollard
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, UK
| | - M Lagarde
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - C Sabin
- HIV Epidemiology & Biostatistics Group, University College London, London, UK
| | - E Nixon
- Department of Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - M Sachikonye
- UK Community Advisory Board Country (UKCAB), London, UK
| | - N Perry
- Brighton and Sussex Clinical Trials Unit, Brighton and Sussex Medical Schools, Brighton, UK
| | - M Fisher
- Department of Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Hancock S, Clements C, Hyer D, Nixon E, Martin E, Wang B, Jani S, Gossman M. SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables. Med Phys 2016. [DOI: 10.1118/1.4957039] [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: 11/07/2022] Open
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Nixon NL, Liddle PF, Nixon E, Worwood G, Liotti M, Palaniyappan L. Biological vulnerability to depression: linked structural and functional brain network findings. Br J Psychiatry 2015; 204:283-9. [PMID: 24357570 DOI: 10.1192/bjp.bp.113.129965] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients in recovery following episodes of major depressive disorder (MDD) remain highly vulnerable to future recurrence. Although psychological determinants of this risk are well established, little is known about associated biological mechanisms. Recent work has implicated the default mode network (DMN) in this vulnerability but specific hypotheses remain untested within the high risk, recovered state of MDD. AIMS To test the hypothesis that there is excessive DMN functional connectivity during task performance within recovered-state MDD and to test for connected DMN cortical gyrification abnormalities. METHOD A multimodal structural and functional magnetic resonance imaging (fMRI) study, including task-based functional connectivity and cortical folding analysis, comparing 20 recovered-state patients with MDD with 20 matched healthy controls. RESULTS The MDD group showed significant task-based DMN hyperconnectivity, associated with hypogyrification of key DMN regions (bilateral precuneus). CONCLUSIONS This is the first evidence of connected structural and functional DMN abnormalities in recovered-state MDD, supporting recent hypotheses on biological-level vulnerability.
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Affiliation(s)
- N L Nixon
- N. L. Nixon, MBBS, MRCPsych, MMedSci, P. F. Liddle, BMBCh, MRCPsych, PhD, E. Nixon, PhD, G. Worwood, MBBCh, MRCPsych, MMedSci, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Nottingham, UK; M. Liotti, MD, PhD, Department of Psychology, Simon Fraser University, Burnaby, Canada; L. Palaniyappan, MBBS, MRCPsych, PhD, Centre for Translational Neuroimaging, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Nottingham, UK
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Allan P, Nixon E, Sidhu S, Teubner A, Abraham A, Carlson G, Lal S. PP152-SUN: Development and Outcome of Intestinal Failure in Crohn’s Disease: 3 Decades of Experience. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50194-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: 11/28/2022]
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Abstract
BACKGROUND Recent models of major depressive disorder (MDD) have proposed the rostral anterior cingulate (rACC) and dorsomedial prefrontal cortex (dmPFC) as nexus sites in the dysfunctional regulation of cognitive-affective state. Limited evidence from remitted-state MDD supports these theories by suggesting that aberrant neural activity proximal to the rACC and the dmPFC may play a role in vulnerability to recurrence/relapse within this disorder. Here we present a targeted analysis assessing functional activity within these two regions of interest (ROIs) for groups with identified vulnerability to MDD: first, remitted, high predicted recurrence-risk patients; and second, patients suffering observed 1-year recurrence. Method Baseline T2* images sensitive to blood oxygen level-dependent (BOLD) contrast were acquired from patients and controls during a Go/No-Go (GNG) task incorporating negative feedback, with 1-year patient follow-up to identify recurrence. BOLD contrast data for error commission (EC) and visual negative feedback (VNF) were used in an ROI analysis based on rACC and dmPFC coordinates from the literature, comparing patients versus controls and recurrence versus non-recurrence versus control groups. RESULTS Analysis of patients (n = 20) versus controls (n = 20) showed significant right dmPFC [Brodmann area (BA) 9] hypoactivity within the patient group, co-localized during EC and VNF, with additional significant rACC (BA 32) hypoactivity during EC. The results from the follow-up analysis were undermined by small groups and potential confounders but suggested persistent right dmPFC (BA 9) hypoactivity associated with 1-year recurrence. CONCLUSIONS Convergent hypoactive right dmPFC (BA 9) processing of VNF and EC, possibly impairing adaptive reappraisal of negative experience, was associated most clearly with clinically predicted vulnerability to MDD.
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Affiliation(s)
- N L Nixon
- Division of Psychiatry, The Institute of Mental Health, University of Nottingham, Nottingham, UK.
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Julius B, Lin S, Rahmani D, Rockey W, Tracy C, Nixon E, Modrick J, Sander E, Kim Y. SU-E-J-36: Development of a Low Cost, Easily-Made, Interchangeable, Prostate Brachytherapy Phantom for Multi-Imaging Guidance Using Ultrasound, CT and MRI. Med Phys 2013. [DOI: 10.1118/1.4814248] [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: 11/07/2022] Open
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19
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Leonards PEG, Besselink H, Klungsøyr J, McHugh B, Nixon E, Rimkus GG, Brouwer A, de Boer J. Toxicological risks to humans of toxaphene residues in fish. Integr Environ Assess Manag 2012; 8:523-529. [PMID: 22162326 DOI: 10.1002/ieam.1275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 06/08/2011] [Accepted: 12/05/2011] [Indexed: 05/31/2023]
Abstract
A revised risk assessment for toxaphene was developed, based on the assumption that fish consumers are only exposed to toxaphene residues that differ substantially from technical toxaphene due to environmental degradation and metabolism. In vitro studies confirmed that both technical toxaphene and degraded toxaphene inhibit gap junctional intercellular communication that correlates with the mechanistic potential to cause tumor promotion. In vivo rat studies established the NOAEL for degraded and technical toxaphene at the highest dose tested in the bioassay. Toxaphene residue intakes from European fishery products were estimated and compared to the provisional tolerable daily intakes (TDIs) from various regulatory agencies including Canada, the United States, and Germany. The estimated intake was also compared to a new calculated provisional MATT pTDI. The MATT pTDI is based on new toxicological information (in vivo rat studies) developed on a model for environmental toxaphene residues rather than technical toxaphene. A MATT pTDI (1.08 mg total toxaphene for a person of 60 kg) for tumor promotion potency was adopted for use in Europe and is referred to here as the MATT pTDI. These new data result in a better estimate of safety and a higher TDI than previously used. Based on realistic fish consumption data and recent baseline concentration data of toxaphene in European fishery products, the toxaphene intake for the consumers of Germany, Ireland, Norway, and the Netherlands was estimated. For an average adult fish consumer, the average daily intake of toxaphene was estimated to be 1.2, 0.4, 0.5, and 0.2 µg for the consumers of Norway, Germany, Ireland, and the Netherlands, respectively. The toxaphene intake of these average fish consumers was far below the MATT pTDI of 1.08 mg/60 kg bw. In conclusion, based on the most relevant toxicological studies and the most realistic estimates of fish consumption and recent concentrations of toxaphene in European fishery products, adverse health effects are unlikely for the average European consumer of fishery products. In no case is the MATT pTDI exceeded.
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Affiliation(s)
- Pim E G Leonards
- Institute for Environmental Studies, VU University, Amsterdam, The Netherlands.
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Pollet P, Liotta CL, Eckert CA, Verma M, Nixon E, Sivaswamy S, Jha R, Momin F, Gelbaum L, Chaudhary BI, Cogen JM. Radical-Mediated Graft Modification of Polyethylene Models with Vinyltrimethoxysilane: A Fundamental Study. Ind Eng Chem Res 2011. [DOI: 10.1021/ie201081g] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - B. I. Chaudhary
- The Dow Chemical Company, 171 River Road, Piscataway, New Jersey 08854, United States
| | - J. M. Cogen
- The Dow Chemical Company, 171 River Road, Piscataway, New Jersey 08854, United States
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Fitzgerald A, Heary C, Nixon E, Kelly C. Factors influencing the food choices of Irish children and adolescents: a qualitative investigation. Health Promot Int 2010; 25:289-98. [DOI: 10.1093/heapro/daq021] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Flynn R, Hartmann J, Bani-Hashemi A, Nixon E, Siochi R, Pennington E, Bayouth J. TH-D-BRC-02: Dosimetric Characterization of An Imaging Beam Line with a Carbon Electron Target for Megavoltage Cone Beam Computed Tomography. Med Phys 2009. [DOI: 10.1118/1.3182673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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23
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Worden M, Nixon E, Fanella L. Comparison of 8-Channel Versus 32-Channel Coils for BOLD Imaging at 3T. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)72222-0] [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: 11/27/2022] Open
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24
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Nelms D, Shukla H, Nixon E, Bayouth J, Flynn R. SU-FF-J-03: Quantitative Assessment of Three Dead Detector Interpolative Correction Methods for Cone Beam CT Images. Med Phys 2009. [DOI: 10.1118/1.3181295] [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: 11/07/2022] Open
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Sayer C, Fisher M, Nixon E, Nambiar K, Richardson D, Perry N, Llewellyn C. Will I? Won't I? Why do men who have sex with men present for post-exposure prophylaxis for sexual exposures? Sex Transm Infect 2008; 85:206-11. [DOI: 10.1136/sti.2008.033662] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Besselink H, Nixon E, McHugh B, Rimkus G, Klungsøyr J, Leonards P, De Boer J, Brouwer A. Evaluation of tumour promoting potency of fish borne toxaphene residues, as compared to technical toxaphene and UV-irradiated toxaphene. Food Chem Toxicol 2008; 46:2629-38. [PMID: 18558458 DOI: 10.1016/j.fct.2008.04.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 03/27/2008] [Accepted: 04/21/2008] [Indexed: 10/22/2022]
Abstract
In this study the potential impact of food chain-based biotransformation and physico-chemical weathering of toxaphene on its tumour promoting potential was investigated in vitro and in vivo. Human exposure to toxaphene is mainly through consumption of contaminated fish, therefore fish-borne residues of toxaphene (cod liver extract, CLE) were prepared by exposing cod to technical toxaphene (TT) for 63 days. UV-irradiated toxaphene (uvT) was included to represent a physico-chemical weathered toxaphene mixture. In vitro, TT, uvT and CLE all showed a dose- and time-dependent inhibition of gap junctional intercellular communication (GJIC) with a relative potency of CLE>TT=uvT. Tumour promoting potency was further studied in vivo in a medium term two-stage initiation/promotion bioassay in female Sprague-Dawley rats, using an increase in altered hepatic foci positive for glutathione-S-transferase-P (AHF-GST-P) as read out. No increase in AHF-GST-P occurred following exposure to either TT, uvT, or CLE, except for the positive control group (2,3,7,8-TCDD). Based on this study the no observed adverse effect level (NOAEL) for tumour promoting potency is at least 12.5mg/kg/week, or higher for CLE. Considering current human exposure levels in Europe it is doubtful that consumption of fish at current levels of toxaphene contamination give rise to human health risk.
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Affiliation(s)
- H Besselink
- BioDetection Systems BV, Kruislaan 406, 1098 SM, Amsterdam, The Netherlands.
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Flynn R, Shukla H, Nixon E, Bayouth J. SU-GG-I-24: A Quantitative Assessment of the Effects of a Simple Dead Detector Pixel Correction Method for Megavoltage Cone Beam CT Images. Med Phys 2008. [DOI: 10.1118/1.2961423] [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: 11/07/2022] Open
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28
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Nixon E, Shukla H, Siochi R, Bayouth J. SU-FF-T-210: Evaluation of CT Extended Field of View Imaging Impact On Radiation Therapy Treatment Planning. Med Phys 2007. [DOI: 10.1118/1.2760871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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29
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Bayouth J, Shukla H, Pavord D, Nixon E, Siochi R. SU-FF-T-429: Treatment Planning Modeling and Dose Delivery Advantages of Standard Linac Without Flattening Filter. Med Phys 2007. [DOI: 10.1118/1.2761154] [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: 11/07/2022] Open
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McHugh B, McGovern E, Nixon E, Klungsøyr J, Rimkus GG, Leonards PE, deBoer J. Baseline survey of concentrations of toxaphene congeners in fish from European waters. J Environ Monit 2004; 6:665-72. [PMID: 15292948 DOI: 10.1039/b403169e] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The European Union project "Investigation into the monitoring, analysis and toxicity of toxaphene"(MATT) began in 1997 involving participants from the Netherlands, Ireland, Norway and Germany. Concentration information, analytical methodology and statistical interpretation of 207 samples covering 23 different fish species from European waters are presented for three toxaphene indicator congeners: CHBs 26, 50 and 62 (CHB = chlorobornane). Concentrations for the Sigma3CHBs were more elevated in fish from more northern latitudes, such as the Barents and Norwegian Sea, compared to fish from Irish, Dutch and German waters. Concentrations were lowest in shellfish and in fish species having low lipid content and were highest in medium/high lipid species. Females from a number of fish species were shown to contain significantly higher concentrations than those observed in male fish. Overall no samples were shown to exceed existing German MRL legislation, with only one Greenland halibut sample shown to exceed Canadian TDI recommendations.
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Affiliation(s)
- Brendan McHugh
- Marine Institute, Abbotstown, Castleknock, Dublin 15, Ireland.
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31
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de Boer J, Leonards PEG, Klungsøyr J, McHugh B, Nixon E, McGovern E, Rimkus GG. Comparative tests to improve the gas chromatographic analysis of chlorobornanes in fish samples. J AOAC Int 2003; 86:432-8. [PMID: 12723927] [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: 03/02/2023]
Abstract
A comparison was made between electron capture negative ionization quadrupole mass spectrometry (ECNI-MS) and electron capture detection (ECD) with regard to repeatability and reproducibility for the gas chromatographic (GC) analysis of toxaphene congeners [chlorobornanes (CHBs)]. The tests, including standard solutions and several cleaned fish extracts, showed larger relative standard deviations (RSDs) for the repeatability of ECNI-MS but no differences in the reproducibility of the 2 techniques. The sensitivity of the GC-ECNI-MS was considerably better than that of GC/ECD. Four stepwise-designed comparative tests were also conducted on GC analysis, cleanup, and the complete method. The results showed that, according to the current state-of-the-art, coefficients of variation for the between-laboratory performance were not < 20% and were usually between 20 and 30%. In spite of separation problems, e.g., for CHB 26, which cannot be separated into a single-component peak, a 95% methyl 5% phenyl polysiloxane (CP Sil 8) column was preferred to more polar columns for the analysis of CHBs 26, 40, 41, 44, 50, and 62. CHB 62 was more difficult to determine than CHB 26 and 50. Addition of the CHBs 40, 41, and 44 to the standard set of 3 chlorobornanes (26, 50, and 62) resulted in more separation problems. A 3-step cleanup method was recommended.
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Affiliation(s)
- Jacob de Boer
- Netherlands Institute for Fisheries Research, PO Box 68, 1970 AB IJmuiden, The Netherlands.
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Boer JD, Leonards PEG, Klungsoyr J, McHugh B, Nixon E, McGovern E, Rimkus GG. Comparative Tests To Improve the Gas Chromatographic Analysis of Chlorobornanes in Fish Samples. J AOAC Int 2003. [DOI: 10.1093/jaoac/86.2.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
A comparison was made between electron capture negative ionization quadrupole mass spectrometry (ECNI-MS) and electron capture detection (ECD) with regard to repeatability and reproducibility for the gas chromatographic (GC) analysis of toxaphene congeners [chlorobornanes (CHBs)]. The tests, including standard solutions and several cleaned fish extracts, showed larger relative standard deviations (RSDs) for the repeatability of ECNI-MS but no differences in the reproducibility of the 2 techniques. The sensitivity of the GC-ECNI-MS was considerably better than that of GC/ECD. Four stepwise-designed comparative tests were also conducted on GC analysis, cleanup, and the complete method. The results showed that, according to the current state-of-the-art, coefficients of variation for the between-laboratory performance were not <20% and were usually between 20 and 30%. In spite of separation problems, e.g., for CHB 26, which cannot be separated into a single-component peak, a 95% methyl 5% phenyl polysiloxane (CP Sil 8) column was preferred to more polar columns for the analysis of CHBs 26, 40, 41, 44, 50, and 62. CHB 62 was more difficult to determine than CHB 26 and 50. Addition of the CHBs 40, 41, and 44 to the standard set of 3 chlorobornanes (26, 50, and 62) resulted in more separation problems. A 3-step cleanup method was recommended.
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Affiliation(s)
- Jacob de Boer
- Netherlands Institute for Fisheries Research, PO Box 68, 1970 AB IJmuiden, The Netherlands
| | - Pim E G Leonards
- Netherlands Institute for Fisheries Research, PO Box 68, 1970 AB IJmuiden, The Netherlands
| | - Jarle Klungsoyr
- Institute of Marine Research, PO Box 1870, 5024 Bergen-Nordnes, Norway
| | - Brendan McHugh
- Marine Institute, Abbotstown, Castleknock, Dublin 15, Ireland
| | - Eugene Nixon
- Marine Institute, Abbotstown, Castleknock, Dublin 15, Ireland
| | - Evin McGovern
- Marine Institute, Abbotstown, Castleknock, Dublin 15, Ireland
| | - Gerhard G Rimkus
- Food and Veterinary Institute Schleswig-Holstein, PO Box 2743, D 24517 Neumünster, Germany; Present address: European Commission, DG Health and Consumer Protection, Food and Veterinary Office, F5.3 Residues, Grange, Dublin, Ireland
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Benjamin I, Nixon E. PR 1 The sealing ability of retrograde filling materials on a serum contaminated and noncontaminated surface: Spectrophotometric study. J Endod 1999. [DOI: 10.1016/s0099-2399(99)80225-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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de Geus HJ, Besselink H, Brouwer A, Klungsøyr J, McHugh B, Nixon E, Rimkus GG, Wester PG, de Boer J. Environmental occurrence, analysis, and toxicology of toxaphene compounds. Environ Health Perspect 1999; 107 Suppl 1:115-44. [PMID: 10229713 PMCID: PMC1566367 DOI: 10.1289/ehp.99107s1115] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Toxaphene production, in quantities similar to those of polychlorinated biphenyls, has resulted in high toxaphene levels in fish from the Great Lakes and in Arctic marine mammals (up to 10 and 16 microg g-1 lipid). Because of the large variabiliity in total toxaphene data, few reliable conclusions can be drawn about trends or geographic differences in toxaphene concentrations. New developments in mass spectrometric detection using either negative chemical ionization or electron impact modes as well as in multidimensional gas chromatography recently have led researchers to suggest congener-specific approaches. Recently, several nomenclature systems have been developed for toxaphene compounds. Although all systems have specific advantages and limitations, it is suggested that an international body such as the International Union of Pure and Applied Chemistry make an attempt to obtain uniformity in the literature. Toxicologic information on individual chlorobornanes is scarce, but some reports have recently appeared. Neurotoxic effects of toxaphene exposure such as those on behavior and learning have been reported. Technical toxaphene and some individual congeners were found to be weakly estrogenic in in vitro test systems; no evidence for endocrine effects in vivo has been reported. In vitro studies show technical toxaphene and toxaphene congeners to be mutagenic. However, in vivo studies have not shown genotoxicity; therefore, a nongenotoxic mechanism is proposed. Nevertheless, toxaphene is believed to present a potential carcinogenic risk to humans. Until now, only Germany has established a legal tolerance level for toxaphene--0.1 mg kg-1 wet weight for fish.
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Affiliation(s)
- H J de Geus
- DLO-Netherlands Institute for Fisheries Research, IJmuiden, The Netherlands.
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Abstract
In view of changes over the past 2 years in the intravenous (i.v.) management of patients with AIDS and cytomegalovirus (CMV) disease, a small study was carried out at the Kobler Clinic, an HIV treatment centre in London, to examine optimal i.v. access for CMV induction treatment. Thirty lines were analysed over a period of 4 months: 18 were peripherally inserted central catheters (PICCs) and 12 were midline catheters. Each line was monitored and evaluated for reason for choice of line, insertion data, line survival, patient self-administration, patient comfort scores, infection rate, and other difficulties encountered during treatment induction. The study results indicated noticeable differences between PICC and midline catheter performances, although a change in treatment protocol during the study influenced the choice of line used. There were also marked differences from other studies, carried out predominantly in non-HIV patients, when infection rate, dwell time of lines and thrombus formation were compared. Significant changes in practice have been implemented and further clinical studies/research identified.
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Affiliation(s)
- J Sargent
- Community Liaison Team, St. Mary's Paddington
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Nixon E. Continence. Easing the social stress. Nurs Times 1995; 91:60. [PMID: 8559688] [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: 01/31/2023]
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Hu T, Doyle J, Jackson D, Marr J, Nixon E, Pleasance S, Quilliam MA, Walter JA, Wright JLC. Isolation of a new diarrhetic shellfish poison from Irish mussels. ACTA ACUST UNITED AC 1992. [DOI: 10.1039/c39920000039] [Citation(s) in RCA: 93] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mawer GE, Nixon E. The net absorption of the amino acid constituents of a protein meal in normal and cystinuric subjects. Clin Sci (Lond) 1969; 36:463-77. [PMID: 5795236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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