1
|
Shah R, Finlay AY, Ali FM, Allen H, Nixon SJ, Nixon M, Otwombe K, Ingram JR, Salek MS. Measurement of the major ignored burden of multiple myeloma, pernicious anaemia and of other haematological conditions on partners and family members: A cross-sectional study. Eur J Haematol 2024. [PMID: 38577720 DOI: 10.1111/ejh.14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Having a haematological condition can adversely affect the quality of life (QoL) of family members/partners of patients. It is important to measure this often ignored burden in order to implement appropriate supportive interventions. OBJECTIVE To measure current impact of haematological conditions on the QoL of family members/partners of patients, using the Family Reported Outcome Measure-16 (FROM-16). METHODS A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with haematological conditions completing the FROM-16. RESULTS 183 family members/partners (mean age = 60.5 years, SD = 13.2; females = 62.8%) of patients (mean age = 64.1, SD = 12.8; females = 46.4%) with 12 haematological conditions completed the FROM-16. The FROM-16 mean total score was 14.0 (SD = 7.2), meaning 'a moderate effect on QoL'. The mean FROM-16 scores of family members of people with multiple myeloma (mean = 15.8, SD = 6.3, n = 99) and other haematological malignancies (mean = 13.9, SD = 7.8, n = 29) were higher than of people with pernicious anaemia (mean = 10.7, SD = 7.5, n = 47) and other non-malignant conditions (mean = 11, SD = 7.4, n = 56, p < .01). Over one third (36.1%, n = 183) of family members experienced a 'very large effect' (FROM-16 score>16) on their quality of life. CONCLUSIONS Haematological conditions, in particular those of malignant type, impact the QoL of family members/partners of patients. Healthcare professionals can now, using FROM-16, identify those most affected and should consider how to provide appropriate holistic support within routine practice.
Collapse
Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
| |
Collapse
|
2
|
Shah R, Finlay AY, Salek MS, Allen H, Nixon SJ, Nixon M, Otwombe K, Ali FM, Ingram JR. Responsiveness and minimal important change of the Family Reported Outcome Measure (FROM-16). J Patient Rep Outcomes 2024; 8:38. [PMID: 38530614 DOI: 10.1186/s41687-024-00703-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/15/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). METHODS Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). RESULTS Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = -0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. CONCLUSIONS The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice.
Collapse
Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
3
|
Stolbrink M, Chinouya MJ, Jayasooriya S, Nightingale R, Evans-Hill L, Allan K, Allen H, Balen J, Beacon T, Bissell K, Chakaya J, Chiang CY, Cohen M, Devereux G, El Sony A, Halpin DMG, Hurst JR, Kiprop C, Lawson A, Macé C, Makhanu A, Makokha P, Masekela R, Meme H, Khoo EM, Nantanda R, Pasternak S, Perrin C, Reddel H, Rylance S, Schweikert P, Were C, Williams S, Winders T, Yorgancioglu A, Marks GB, Mortimer K. Improving access to affordable quality-assured inhaled medicines in low- and middle-income countries. Int J Tuberc Lung Dis 2022; 26:1023-1032. [PMID: 36281039 PMCID: PMC9621306 DOI: 10.5588/ijtld.22.0270] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs), causing avoidable morbidity and mortality. The International Union Against Tuberculosis and Lung Disease convened a stakeholder meeting on this topic in February 2022.METHODS: Focused group discussions were informed by literature and presentations summarising experiences of obtaining inhaled medicines in LMICs. The virtual meeting was moderated using a topic guide around barriers and solutions to improve access. The thematic framework approach was used for analysis.RESULTS: A total of 58 key stakeholders, including patients, healthcare practitioners, members of national and international organisations, industry and WHO representatives attended the meeting. There were 20 pre-meeting material submissions. The main barriers identified were 1) low awareness of CRDs; 2) limited data on CRD burden and treatments in LMICs; 3) ineffective procurement and distribution networks; and 4) poor communication of the needs of people with CRDs. Solutions discussed were 1) generation of data to inform policy and practice; 2) capacity building; 3) improved procurement mechanisms; 4) strengthened advocacy practices; and 5) a World Health Assembly Resolution.CONCLUSION: There are opportunities to achieve improved access to affordable, quality-assured inhaled medicines in LMICs through coordinated, multi-stakeholder, collaborative efforts.
Collapse
Affiliation(s)
- M Stolbrink
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Stellenbosch University, Tygerberg, South Africa
| | - M J Chinouya
- Education Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - S Jayasooriya
- Academic Unit of Primary Care, University of Sheffield, Sheffield, UK
| | - R Nightingale
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | | | - K Allan
- Healthcare Consultant, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, The Gambia
| | - H Allen
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, The Gambia
| | - J Balen
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - T Beacon
- Medical Aid International, Bedford, UK
| | - K Bissell
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - J Chakaya
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya
| | - C-Y Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France, Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - M Cohen
- Asociación Latinoamericana del Tórax, Forum of International Respiratory Societies, Guatemala
| | - G Devereux
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A El Sony
- The Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum Sudan
| | - D M G Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - J R Hurst
- UCL Respiratory, University College London, London, UK
| | - C Kiprop
- IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | | | - C Macé
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - A Makhanu
- IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | - P Makokha
- IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | - R Masekela
- Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa
| | - H Meme
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - E M Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, International Primary Care Respiratory Group, Larbert, Scotland, UK
| | - R Nantanda
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - C Perrin
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H Reddel
- The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia, Global Initiative for Asthma (GINA), Fontana, WI, USA
| | - S Rylance
- Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | | | - C Were
- GlaxoSmithKline, Brentford, UK
| | - S Williams
- International Primary Care Respiratory Group, Larbert, Scotland, UK
| | - T Winders
- Global Allergy & Airways Patient Platform, Vienna, Austria
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey, Global Alliance Against Chronic Respiratory Diseases, Geneva, Switzerland
| | - G B Marks
- International Union Against Tuberculosis and Lung Disease, Paris, France, University of New South Wales, Sydney, NSW, Australia
| | - K Mortimer
- International Union Against Tuberculosis and Lung Disease, Paris, France, University of Cambridge, Cambridge, UK
| |
Collapse
|
4
|
McCue PM, Matthews PM, Prell MJ, Bellone RR, Allen H. Delayed embryonic development or long sperm survival in embryo donor mares. J Equine Vet Sci 2022. [DOI: 10.1016/j.jevs.2022.103987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Allen H, Mitchell H, Simms I, Baker K, Foster K, Hughes G, Dallman T, Jenkins C. Evidence for re-infection and persistent carriage of Shigella species in adult males reporting domestically acquired infection in England. Clin Microbiol Infect 2021; 27:126.e7-126.e13. [DOI: 10.1016/j.cmi.2020.03.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/20/2022]
|
6
|
Saddi V, Teng A, Pithers S, Allen H, Thambipillay G, Sullivan C. Nasal mask average volume-assured pressure support versus conventional bilevel respiratory support in a 10-month-old infant with congenital central hypoventilation syndrome: a case report. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1059] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
7
|
Pinto A, Adams S, Ahring K, Allen H, Almeida MF, Garcia-Arenas D, Arslan N, Assoun M, Atik Altınok Y, Barrio-Carreras D, Belanger Quintana A, Bernabei SM, Bontemps C, Boyle F, Bruni G, Bueno-Delgado M, Caine G, Carvalho R, Chrobot A, Chyż K, Cochrane B, Correia C, Corthouts K, Daly A, De Leo S, Desloovere A, De Meyer A, De Theux A, Didycz B, Dijsselhof ME, Dokoupil K, Drabik J, Dunlop C, Eberle-Pelloth W, Eftring K, Ekengren J, Errekalde I, Evans S, Foucart A, Fokkema L, François L, French M, Forssell E, Gingell C, Gonçalves C, Gökmen Özel H, Grimsley A, Gugelmo G, Gyüre E, Heller C, Hensler R, Jardim I, Joost C, Jörg-Streller M, Jouault C, Jung A, Kanthe M, Koç N, Kok IL, Kozanoğlu T, Kumru B, Lang F, Lang K, Liegeois I, Liguori A, Lilje R, Ļubina O, Manta-Vogli P, Mayr D, Meneses C, Newby C, Meyer U, Mexia S, Nicol C, Och U, Olivas SM, Pedrón-Giner C, Pereira R, Plutowska-Hoffmann K, Purves J, Re Dionigi A, Reinson K, Robert M, Robertson L, Rocha JC, Rohde C, Rosenbaum-Fabian S, Rossi A, Ruiz M, Saligova J, Gutiérrez-Sánchez A, Schlune A, Schulpis K, Serrano-Nieto J, Skarpalezou A, Skeath R, Slabbert A, Straczek K, Giżewska M, Terry A, Thom R, Tooke A, Tuokkola J, van Dam E, van den Hurk TAM, van der Ploeg EMC, Vande Kerckhove K, Van Driessche M, van Wegberg AMJ, van Wyk K, Vasconcelos C, Velez García V, Wildgoose J, Winkler T, Żółkowska J, Zuvadelli J, MacDonald A. Weaning practices in phenylketonuria vary between health professionals in Europe. Mol Genet Metab Rep 2018; 18:39-44. [PMID: 30705824 PMCID: PMC6349955 DOI: 10.1016/j.ymgmr.2018.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/22/2022] Open
Abstract
Background In phenylketonuria (PKU), weaning is considered more challenging when compared to feeding healthy infants. The primary aim of weaning is to gradually replace natural protein from breast milk or standard infant formula with solids containing equivalent phenylalanine (Phe). In addition, a Phe-free second stage L-amino acid supplement is usually recommended from around 6 months to replace Phe-free infant formula. Our aim was to assess different weaning approaches used by health professionals across Europe. Methods A cross sectional questionnaire (survey monkey®) composed of 31 multiple and single choice questions was sent to European colleagues caring for inherited metabolic disorders (IMD). Centres were grouped into geographical regions for analysis. Results Weaning started at 17–26 weeks in 85% (n = 81/95) of centres, >26 weeks in 12% (n = 11/95) and < 17 weeks in 3% (n = 3/95). Infant's showing an interest in solid foods, and their age, were important determinant factors influencing weaning commencement. 51% (n = 48/95) of centres introduced Phe containing foods at 17–26 weeks and 48% (n = 46/95) at >26 weeks. First solids were mainly low Phe vegetables (59%, n = 56/95) and fruit (34%, n = 32/95). A Phe exchange system to allocate dietary Phe was used by 52% (n = 49/95) of centres predominantly from Northern and Southern Europe and 48% (n = 46/95) calculated most Phe containing food sources (all centres in Eastern Europe and the majority from Germany and Austria). Some centres used a combination of both methods. A second stage Phe-free L-amino acid supplement containing a higher protein equivalent was introduced by 41% (n = 39/95) of centres at infant age 26–36 weeks (mainly from Germany, Austria, Northern and Eastern Europe) and 37% (n = 35/95) at infant age > 1y mainly from Southern Europe. 53% (n = 50/95) of centres recommended a second stage Phe-free L-amino acid supplement in a spoonable or semi-solid form. Conclusions Weaning strategies vary throughout European PKU centres. There is evidence to suggest that different infant weaning strategies may influence longer term adherence to the PKU diet or acceptance of Phe-free L-amino acid supplements; rendering prospective long-term studies important. It is essential to identify an effective weaning strategy that reduces caregiver burden but is associated with acceptable dietary adherence and optimal infant feeding development.
Collapse
Affiliation(s)
- A Pinto
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - S Adams
- Royal Victoria Infirmary, Newcastle, UK
| | - K Ahring
- Department of PKU, Kennedy Centre, Department of Paediatrics and Adolescents Medicine, Copenhagen University Hospital, Glostrup, Denmark
| | - H Allen
- Sheffield Children's NHS Foundation Trust, UK
| | - M F Almeida
- Centro de Genética Médica, Centro Hospitalar Universitário do Porto (CHP), Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto-UMIB/ICBAS/UP, Porto, Portugal.,Centro de Referência na área de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto - CHP, Porto, Portugal
| | - D Garcia-Arenas
- Congenital and Metabolic Disease Unit, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - N Arslan
- Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmır, Turkey
| | - M Assoun
- Hôpital Necker enfants Malades, Centre de référence des maladies héréditaires du métabolisme, Paris, France
| | - Y Atik Altınok
- Pediatric Metabolism Department, Ege University Medical Faculty, Izmir, Turkey
| | - D Barrio-Carreras
- Servicio de Pediatria, Unidad de Enfermedades Mitocondriales-Metabolicas Hereditarias, Hospital 12 de Octubre, Madrid, Spain
| | - A Belanger Quintana
- Servicio de Pediatria, Hospital Ramon y Cajal Madrid, Unidad de Enfermedades Metabolicas, Spain
| | - S M Bernabei
- Division of Artificial Nutrition, Children's Hospital Bambino Gesù, Rome, Italy
| | | | - F Boyle
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Italy
| | - G Bruni
- Meyer Children's hospital, Florence, Italy
| | | | | | - R Carvalho
- Hospital Divino Espírito Santo, Ponta Delgada, Portugal
| | - A Chrobot
- Children Voievodship Hospital, Bydgoszcz, Poland
| | - K Chyż
- Institute of Mother and Child, Warsaw, Poland
| | - B Cochrane
- Royal Hospital for Children, Glasgow, UK
| | - C Correia
- CHLC- Hospital Dona Estefânia, Lisboa, Portugal
| | | | - A Daly
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - S De Leo
- Department of Human Neuroscience, Sapienza University of Rome - Policlinico Umberto I of Rome, Italy
| | | | - A De Meyer
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - A De Theux
- IPG (Institut de Pathologie et de Genetique), Charleroi, Belgium
| | - B Didycz
- University Children's Hospital, Cracow, Poland
| | | | - K Dokoupil
- Dr. von Hauner Children's Hospital of the University of Munich, Germany
| | - J Drabik
- University Clinical Center in Gdansk, Poland
| | - C Dunlop
- Royal Hospital for Children Edinburgh, UK
| | | | - K Eftring
- Queen Silivia's Children's Hospital Gothenburg, Sweden
| | - J Ekengren
- Queen Silivia's Children's Hospital Gothenburg, Sweden
| | - I Errekalde
- Hospital Universitario de Cruces, Vizcaya, Spain
| | - S Evans
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - A Foucart
- Cliniques universitaires Saint-Luc, Belgium
| | - L Fokkema
- UMC Utrecht Wilhelmina Children's Hospital, Netherlands
| | - L François
- centre de référence des maladies héréditaires du métabolisme, Hôpital Universitaire Robert-Debré, Paris, France
| | - M French
- University Hospitals of Leicester NHS Trust, UK
| | - E Forssell
- Karolinska University Hospital, Stockholm, Sweden
| | | | | | - H Gökmen Özel
- İhsan Doğramacı Children's Hospital, Hacettepe University, Turkey
| | - A Grimsley
- Royal Belfast Hospital for Sick Children, Northern Ireland, UK
| | - G Gugelmo
- Department of Pediatrics, Inherited Metabolic Diseases Unit, University Hospital of Verona, Italy
| | - E Gyüre
- Albert Szent-Györgyi Clinical Centre, Hungary
| | - C Heller
- Kinder- und Jugendklinik Erlangen, Germany
| | - R Hensler
- Klinikum Stuttgart Olgahospital, Germany
| | - I Jardim
- Centro Hospitalar Lisboa Norte - H. Sta Maria - Unidade de Doenças Metabólicas, Portugal
| | - C Joost
- University Children's Hospital, University Medical Center Hamburg Eppendorf, Germany
| | - M Jörg-Streller
- Universitätsklinik Innsbruck department für Kinder- und Jugendheilkunde, Austria
| | | | - A Jung
- Charite, Virchow Klinikum Berlin, Germany
| | - M Kanthe
- Skane University Hospital, Sweden
| | - N Koç
- Child's Health and Diseases Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - I L Kok
- UMC Utrecht Wilhelmina Children's Hospital, Netherlands
| | - T Kozanoğlu
- İstanbul University İstanbul Faculty of Medicine, Turkey
| | - B Kumru
- Cengiz Gökçek Maternity and Children's Hospital, Gaziantep, Turkey
| | - F Lang
- University Hospital Mainz, Villa metabolica, Germany
| | - K Lang
- Ninewells Hospital, Dundee, Scotland, UK
| | | | - A Liguori
- Division of Artificial Nutrition, Children's Hospital Bambino Gesù, Rome, Italy
| | - R Lilje
- Oslo University Hospital, Norway
| | - O Ļubina
- Children's Clinical University Hospital, Riga, Latvia
| | | | - D Mayr
- Universitätsklinik für Jugend und Kinderheilkunde, Müllner Hauptstr, Salzburg, Austria
| | - C Meneses
- Hospital de Santo Espírito da Ilha Terceira, EPER, Portugal
| | - C Newby
- Bristol Royal Hospital for Children, UK
| | - U Meyer
- Clinic for Paediatric Kidney-, Liver and Metabolic Diseases, Medical School Hannover, Germany
| | - S Mexia
- Centro Hospitalar Lisboa Norte - H. Sta Maria - Unidade de Doenças Metabólicas, Portugal
| | - C Nicol
- Royal Victoria Infirmary, Newcastle, UK
| | - U Och
- Metabolic Department, University Hospital Muenster, Center for Pediatrics, Germany
| | - S M Olivas
- Congenital and Metabolic Disease Unit, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - C Pedrón-Giner
- Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - K Plutowska-Hoffmann
- The Independent Public Clinical Hospital, Medical University of Silesia in Katowice John Paul II Upper Silesian Child Health Centre, Poland
| | - J Purves
- Royal Hospital for Children Edinburgh, UK
| | - A Re Dionigi
- Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - K Reinson
- Tartu University Hospital, United Laboratories, Department of Genetics, Italy
| | - M Robert
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | | | - J C Rocha
- Centro de Genética Médica, Centro Hospitalar Universitário do Porto (CHP), Porto, Portugal.,Centro de Referência na área de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto - CHP, Porto, Portugal.,Centre for Health Technology and Services Research (CINTESIS), Portugal
| | - C Rohde
- Hospital for Children and Adolescents, Department of Women and Child Health, University Hospitals, University of Leipzig, Germany
| | - S Rosenbaum-Fabian
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - A Rossi
- Division of Inherited Metabolic Diseases, Reference Centre Expanded Newborn Screening, Department of Woman's and Child's Health, University Hospital of Padua, Italy
| | - M Ruiz
- Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
| | - J Saligova
- Children's Faculty Hospital, Kosice, Slovakia
| | - A Gutiérrez-Sánchez
- Congenital and Metabolic Disease Unit, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - A Schlune
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Duesseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - K Schulpis
- Agia Sophia Childrens' Hospital, Athens, Greece
| | | | - A Skarpalezou
- Institute of Child Health, "A. Sophia" Children's Hospital, Athens
| | - R Skeath
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - A Slabbert
- Evelina Children's Hospital, Guy's & St. Thomas' NHS Foundation Trust, London, UK
| | - K Straczek
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age Pomeranian Medica University, Poland
| | - M Giżewska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age Pomeranian Medica University, Poland
| | - A Terry
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - R Thom
- Royal Belfast Hospital for Sick Children, Northern Ireland, UK
| | - A Tooke
- Nottingham Children's Hospital, UK
| | - J Tuokkola
- Clinical Nutrition Unit, Internal Medicine and Rehabilitation and Pediatric Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - E van Dam
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Dietetics, Groningen, the Netherlands
| | | | | | | | | | - A M J van Wegberg
- Department of Gastroenterology and Hepatology - Dietetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - K van Wyk
- Manchester University NHS Foundation Trust, UK
| | | | - V Velez García
- Unit of Nutrition and Metabolopathies, Hospital La Fe, Valencia, Spain
| | | | - T Winkler
- Klinik für Kinder- und Jugendmedizin, Carl-Thiem-Klinikum gGmbH Cottbus, Germany
| | - J Żółkowska
- Institute of Mother and Child, Warsaw, Poland
| | - J Zuvadelli
- Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - A MacDonald
- Birmingham Women's and Children's Hospital, Birmingham, UK
| |
Collapse
|
8
|
Carmichael C, Miketinas D, Allen H, Champagne C. Behind the Serving Line: What Do We Know About the Health of Those Who Feed Our School Children? J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.08.085] [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: 12/01/2022]
|
9
|
Pinto A, Adams S, Ahring K, Allen H, Almeida MF, Garcia-Arenas D, Arslan N, Assoun M, Atik Altınok Y, Barrio-Carreras D, Belanger Quintana A, Bernabei SM, Bontemps C, Boyle F, Bruni G, Bueno-Delgado M, Caine G, Carvalho R, Chrobot A, Chyż K, Cochrane B, Correia C, Corthouts K, Daly A, De Leo S, Desloovere A, De Meyer A, De Theux A, Didycz B, Dijsselhof ME, Dokoupil K, Drabik J, Dunlop C, Eberle-Pelloth W, Eftring K, Ekengren J, Errekalde I, Evans S, Foucart A, Fokkema L, François L, French M, Forssell E, Gingell C, Gonçalves C, Gökmen Özel H, Grimsley A, Gugelmo G, Gyüre E, Heller C, Hensler R, Jardim I, Joost C, Jörg-Streller M, Jouault C, Jung A, Kanthe M, Koç N, Kok IL, Kozanoğlu T, Kumru B, Lang F, Lang K, Liegeois I, Liguori A, Lilje R, Ļubina O, Manta-Vogli P, Mayr D, Meneses C, Newby C, Meyer U, Mexia S, Nicol C, Och U, Olivas SM, Pedrón-Giner C, Pereira R, Plutowska-Hoffmann K, Purves J, Re Dionigi A, Reinson K, Robert M, Robertson L, Rocha JC, Rohde C, Rosenbaum-Fabian S, Rossi A, Ruiz M, Saligova J, Gutiérrez-Sánchez A, Schlune A, Schulpis K, Serrano-Nieto J, Skarpalezou A, Skeath R, Slabbert A, Straczek K, Giżewska M, Terry A, Thom R, Tooke A, Tuokkola J, van Dam E, van den Hurk TAM, van der Ploeg EMC, Vande Kerckhove K, Van Driessche M, van Wegberg AMJ, van Wyk K, Vasconcelos C, Velez García V, Wildgoose J, Winkler T, Żółkowska J, Zuvadelli J, MacDonald A. Early feeding practices in infants with phenylketonuria across Europe. Mol Genet Metab Rep 2018; 16:82-89. [PMID: 30101073 PMCID: PMC6082991 DOI: 10.1016/j.ymgmr.2018.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 07/27/2018] [Indexed: 01/15/2023] Open
Abstract
Background In infants with phenylketonuria (PKU), dietary management is based on lowering and titrating phenylalanine (Phe) intake from breast milk or standard infant formula in combination with a Phe-free infant formula in order to maintain blood Phe levels within target range. Professionals use different methods to feed infants with PKU and our survey aimed to document practices across Europe. Methods We sent a cross sectional, survey monkey® questionnaire to European health professionals working in IMD. It contained 31 open and multiple-choice questions. The results were analysed according to different geographical regions. Results Ninety-five centres from 21 countries responded. Over 60% of centres commenced diet in infants by age 10 days, with 58% of centres implementing newborn screening by day 3 post birth. At diagnosis, infant hospital admission occurred in 61% of metabolic centres, mainly in Eastern, Western and Southern Europe. Breastfeeding fell sharply following diagnosis with only 30% of women still breast feeding at 6 months. 53% of centres gave pre-measured Phe-free infant formula before each breast feed and 23% alternated breast feeds with Phe-free infant formula. With standard infant formula feeds, measured amounts were followed by Phe-free infant formula to satiety in 37% of centres (n = 35/95), whereas 44% (n = 42/95) advised mixing both formulas together. Weaning commenced between 17 and 26 weeks in 85% centres, ≥26 weeks in 12% and < 17 weeks in 3%. Discussion This is the largest European survey completed on PKU infant feeding practices. It is evident that practices varied widely across Europe, and the practicalities of infant feeding in PKU received little focus in the PKU European Guidelines (2017). There are few reports comparing different feeding techniques with blood Phe control, Phe fluctuations and growth. Controlled prospective studies are necessary to assess how different infant feeding practices may influence longer term feeding development.
Collapse
Affiliation(s)
- A Pinto
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - S Adams
- Royal Victoria Infirmary, Newcastle, UK
| | - K Ahring
- Department of PKU, Kennedy Centre, Copenhagen University Hospital, Glostrup, Denmark
| | - H Allen
- Sheffield Children's NHS Foundation Trust, UK
| | - M F Almeida
- Centro de Genética Médica, Centro Hospitalar do Porto (CHP), Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto-UMIB/ICBAS/UP, Porto, Portugal.,Centro de Referência na área de Doenças Hereditárias do Metabolismo, Centro Hospitalar do Porto - CHP, Porto, Portugal
| | - D Garcia-Arenas
- Congenital and Metabolic Disease Unit, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - N Arslan
- Dokuz Eylul University Faculty of Medicine, Division of Pediatric Metabolism and Nutrition, Izmır, Turkey
| | - M Assoun
- Centre de référence des maladies héréditaires du métabolisme, Hôpital Necker enfants Malades, Paris, France
| | - Y Atik Altınok
- Pediatric Metabolism Department, Ege University Medical Faculty, Izmir, Turkey
| | - D Barrio-Carreras
- Unidad de Enfermedades Mitocondriales-Metabolicas Hereditarias. Servicio de Pediatría, Hospital 12 de Octubre, Madrid, Spain
| | - A Belanger Quintana
- Unidad de Enfermedades Metabolicas, Servicio de Pediatria, Hospital Ramon y Cajal Madrid, Spain
| | - S M Bernabei
- Children's Hospital Bambino Gesù, Division of Artificial Nutrition, Rome, Italy
| | | | - F Boyle
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Ireland
| | - G Bruni
- Meyer Children's Hospital, Florence, Italy
| | | | | | - R Carvalho
- Hospital Divino Espírito Santo, Ponta Delgada, Portugal
| | - A Chrobot
- Children Voievodship Hospital, Bydgoszcz, Poland
| | - K Chyż
- Institute of Mother and Child, Warsaw, Poland
| | - B Cochrane
- Royal Hospital for Children, Glasgow, UK
| | - C Correia
- CHLC- Hospital Dona Estefânia, Lisboa, Portugal
| | | | - A Daly
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - S De Leo
- Department of Human Neuroscience, Sapienza University of Rome - Policlinico Umberto I of Rome, Italy
| | | | - A De Meyer
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - A De Theux
- IPG (Institut de Pathologie et de Genetique), Charleroi, Belgium
| | - B Didycz
- University Children's Hospital, Cracow, Poland
| | | | - K Dokoupil
- Dr. von Hauner Children's Hospital of the University of Munich, Germany
| | - J Drabik
- University Clinical Center in Gdansk, Poland
| | - C Dunlop
- Royal Hospital for Children Edinburgh, UK
| | | | - K Eftring
- Queen Silivia's Children's Hospital Gothenburg, Sweden
| | - J Ekengren
- Queen Silivia's Children's Hospital Gothenburg, Sweden
| | - I Errekalde
- Hospital Universitario de Cruces, Vizcaya, Spain
| | - S Evans
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - A Foucart
- Cliniques universitaires Saint-Luc, Belgium
| | - L Fokkema
- UMC Utrecht, Wilhelmina Children's Hospital, Netherlands
| | - L François
- Hôpital Universitaire Robert-Debré, Centre de référence des maladies héréditaires du métabolisme, Paris, France
| | - M French
- University Hospitals of Leicester NHS Trust, UK
| | - E Forssell
- Karolinska University Hospital, Stockholm, Sweden
| | | | | | - H Gökmen Özel
- Hacettepe University, İhsan Doğramacı Children's Hospital, Turkey
| | - A Grimsley
- Royal Belfast Hospital for Sick Children, Northern Ireland, UK
| | - G Gugelmo
- Department of Pediatrics, Inherited Metabolic Diseases Unit, University Hospital of Verona, Italy
| | - E Gyüre
- Albert Szent-Györgyi Clinical Centre, Hungary
| | - C Heller
- Kinder- und Jugendklinik Erlangen, Germany
| | - R Hensler
- Klinikum Stuttgart Olgahospital, Germany
| | - I Jardim
- Centro Hospitalar Lisboa Norte - H. Sta Maria - Unidade de Doenças Metabólicas, Portugal
| | - C Joost
- University Children's Hospital, University Medical Center Hamburg Eppendorf, Germany
| | - M Jörg-Streller
- Universitätsklinik Innsbruck department für Kinder- und Jugendheilkunde, Austria
| | | | - A Jung
- Charite, Virchow Klinikum Berlin, Germany
| | - M Kanthe
- Skane University Hospital, Sweden
| | - N Koç
- University of Health Sciences, Ankara Child's Health and Diseases Hematology Oncology Training and Research Hospital, Turkey
| | - I L Kok
- UMC Utrecht, Wilhelmina Children's Hospital, Netherlands
| | - T Kozanoğlu
- İstanbul University İstanbul Faculty of Medicine, Turkey
| | - B Kumru
- Gaziantep Cengiz Gökçek Maternity and Children's Hospital, Turkey
| | - F Lang
- University Hospital Mainz, Villa metabolica, Germany
| | - K Lang
- Ninewells Hospital, Dundee, UK
| | | | - A Liguori
- Children's Hospital Bambino Gesù, Division of Artificial Nutrition, Rome, Italy
| | - R Lilje
- Oslo University Hospital, Norway
| | - O Ļubina
- Children's Clinical University Hospital, Riga, Latvia
| | - P Manta-Vogli
- Inborn Errors of Metabolism Department, Institute of Child Health, Athens, Greece
| | - D Mayr
- Universitätsklinik für Jugend und Kinderheilkunde, Müllner Hauptstr, Salzburg, Austria
| | - C Meneses
- Hospital de Santo Espírito da Ilha Terceira, EPER, Portugal
| | - C Newby
- Bristol Royal Hospital for Children, UK
| | - U Meyer
- Medical School Hannover, Clinic for Paediatric Kidney- Liver and Metabolic Diseases, Germany
| | - S Mexia
- Centro Hospitalar Lisboa Norte - H. Sta Maria - Unidade de Doenças Metabólicas, Portugal
| | - C Nicol
- Royal Victoria Infirmary, Newcastle, UK
| | - U Och
- University Hospital Muenster, Center for Pediatrics, Metabolic Department, Germany
| | - S M Olivas
- Congenital and Metabolic Disease Unit, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - C Pedrón-Giner
- Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - K Plutowska-Hoffmann
- The Independent Public Clinical Hospital, No. 6 of the Medical University of Silesia in Katowice John Paul II Upper Silesian Child Health Centre, Poland
| | - J Purves
- Royal Hospital for Children Edinburgh, UK
| | - A Re Dionigi
- Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Italy
| | | | - M Robert
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | | | - J C Rocha
- Centro de Genética Médica, Centro Hospitalar do Porto (CHP), Porto, Portugal.,Centro de Referência na área de Doenças Hereditárias do Metabolismo, Centro Hospitalar do Porto - CHP, Porto, Portugal.,Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Portugal.,Centre for Health Technology and Services Research (CINTESIS), Portugal
| | - C Rohde
- Hospital for Children and Adolescents, Department of Women and Child Health, University Hospitals, University of Leipzig, Germany
| | - S Rosenbaum-Fabian
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - A Rossi
- Division of Inherited Metabolic Diseases, Reference Centre Expanded Newborn Screening, Department of Woman's and Child's Health, University Hospital of Padua, Italy
| | - M Ruiz
- Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
| | - J Saligova
- Children's Faculty Hospital, Kosice, Slovakia
| | - A Gutiérrez-Sánchez
- Congenital and Metabolic Disease Unit, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - A Schlune
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Duesseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - K Schulpis
- Inborn Errors of Metabolism Department, Institute of Child Health, Athens, Greece
| | | | - A Skarpalezou
- Institute of Child Health, "A. Sophia" Children's Hospital, Athens, Greece
| | - R Skeath
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - A Slabbert
- Evelina Children's Hospital, Guy's & St. Thomas' NHS Foundation Trust, London, UK
| | - K Straczek
- Clinic of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age Pomeranian Medica University, Poland
| | - M Giżewska
- Clinic of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age Pomeranian Medica University, Poland
| | - A Terry
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - R Thom
- Royal Belfast Hospital for Sick Children, Northern Ireland, UK
| | - A Tooke
- Nottingham Children's Hospital, UK
| | - J Tuokkola
- Clinical Nutrition Unit, Internal Medicine and Rehabilitation and Pediatric Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - E van Dam
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Dietetics, Groningen, Netherlands
| | | | | | | | | | - A M J van Wegberg
- Department of Gastroenterology and Hepatology - Dietetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - K van Wyk
- Manchester University NHS Foundation Trust, UK
| | | | - V Velez García
- Unit of Nutrition and Metabolopathies, Hospital La Fe, Valencia, Spain
| | | | - T Winkler
- Klinik für Kinder- und Jugendmedizin, Carl-Thiem-Klinikum gGmbH Cottbus, Germany
| | - J Żółkowska
- Institute of Mother and Child, Warsaw, Poland
| | - J Zuvadelli
- Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - A MacDonald
- Birmingham Women's and Children's Hospital, Birmingham, UK
| |
Collapse
|
10
|
Allen H, Shraga-Heled N, Blumenfeld M, Dego-Ashto T, Fuchs-Telem D, Gilert A, Aberman Z, Ofir R. Human placental-derived adherent stromal cells co-induced with TNF-α and IFN-γ inhibit triple-negative breast cancer in nude mouse xenograft models. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
11
|
Loukine L, O'Donnell S, Goldner EM, McRae L, Allen H. Health status, activity limitations, work-related restrictions and level of disability among Canadians with mood and/or anxiety disorders. Health Promot Chronic Dis Prev Can 2017; 36:289-301. [PMID: 27977084 DOI: 10.24095/hpcdp.36.12.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study provides the first overview of the perceived general and mental health, activity limitations, work-related restrictions and level of disability, as well as factors associated with disability severity, among Canadian adults with mood and/or anxiety disorders, using a population-based household sample. METHODS We used data from the 2014 Survey on Living with Chronic Diseases in Canada- Mood and Anxiety Disorders Component. The sample consists of Canadians aged 18 years and older with self-reported mood and/or anxiety disorders from the 10 provinces (n = 3361; response rate 68.9%). We conducted descriptive and multinomial multivariate logistic regression analyses. RESULTS Among Canadian adults with mood and/or anxiety disorders, over one-quarter reported "fair/poor" general (25.3%) and mental (26.1%) health; more than one-third (36.4%) reported one or more activity limitations; half (50.3%) stated a job modification was required to continue working; and more than one-third (36.5%) had severe disability. Those with concurrent mood and anxiety disorders reported poorer outcomes: 56.4% had one or more activity limitations; 65.8% required a job modification and 49.6% were severely disabled. Upon adjusting for individual characteristics, those with mood and/or anxiety disorders who were older, who had a household income in the lowest or lower-middle adequacy quintile or who had concurrent disorders were more likely to have severe disability. CONCLUSION Findings from this study affirm that mood and/or anxiety disorders, especially concurrent disorders, are associated with negative physical and mental health outcomes. Results support the role of public health policy and programs aimed at improving the lives of people living with these disorders, in particular those with concurrent disorders.
Collapse
Affiliation(s)
- L Loukine
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - S O'Donnell
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - E M Goldner
- Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - L McRae
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - H Allen
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| |
Collapse
|
12
|
Champagne C, Shapiro M, McCabe‐Sellers B, Allen H, Bogle M, Johnson W. Summer camp participants in rural Arkansas ő dietary and lifestyle findings (811.9). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.811.9] [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: 11/11/2022]
Affiliation(s)
- Catherine Champagne
- Nutritional Epidemiology Pennington Biomedical Research CenterBaton RougeLAUnited States
| | - Meredith Shapiro
- Biostatistics Pennington Biomedical Research CenterBaton RougeLAUnited States
| | | | - H. Allen
- Computing Services Pennington Biomedical Research CenterBaton RougeLAUnited States
| | | | - William Johnson
- Biostatistics Pennington Biomedical Research CenterBaton RougeLAUnited States
| |
Collapse
|
13
|
Thrush P, Viollet L, Flanigan K, Mendell J, Allen H. Natural History of Cardiomyopathy in Duchenne Muscular Dystrophy and the Effects of Angiotensin-Converting Enzyme Inhibitor with or without -Blocker (S15.003). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s15.003] [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: 11/15/2022] Open
|
14
|
|
15
|
Affiliation(s)
- H Allen
- Trachtenberg School of Public Policy and Public Administration, The George Washington University, Washington, DC 20052, USA.
| |
Collapse
|
16
|
Mevorach C, Allen H, Hodsoll J, Shalev L, Humphreys G. Up and down-regulation of visual cortex by posterior parietal cortex modulates selection-by-saliency: Evidence from combined TMS-fMRI. J Vis 2010. [DOI: 10.1167/9.8.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
17
|
Allen H, Dent K, Humphreys G. Common processes for segmentation by time and motion. J Vis 2010. [DOI: 10.1167/9.8.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
18
|
Payne H, Allen H. Active ignoring in early visual cortex. J Vis 2010. [DOI: 10.1167/9.8.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
19
|
Abstract
Hepatitis C (HCV) is a significant health issue for people with serious mental health problems (SMHP). Factors associated with this include high rates of substance use, injecting drug use, and lack of knowledge regarding the transmission and prevention of HCV. This population are at higher risk of experiencing conditions where transmission rates are high, e.g. night shelters and homelessness. People with SMHP also often have factors associated with acceleration of the disease, including excessive alcohol use and poor physical health. Nurses across services collaborated to develop and implement a protocol to address the needs of clients of an Assertive Outreach Team with or at risk of HCV. It has been successful in developing an effective approach to addressing the needs of people with or at risk of HCV and serious mental health problems. It guides staff in providing a flexible, accessible service for clients delivered across organizational boundaries. It has demonstrated improved health outcomes for clients. It is believed that this project can be used as a template to address other health needs of this client group for example diet, obesity and smoking.
Collapse
Affiliation(s)
- M Lewis
- Dorset HealthCare NHS Foundation Trust, Hahnemann House, UK.
| | | | | |
Collapse
|
20
|
Payne H, Allen H. Neural mechanisms underlying active ignoring in the ageing brain. J Vis 2010. [DOI: 10.1167/10.7.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
21
|
Dent K, Braithwaite J, Allen H, Humphreys G. Selective conjunctive suppression in visual search for motion - form conjunctions. J Vis 2010. [DOI: 10.1167/10.7.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
22
|
Havanur S, Humphreys G, Allen H. The effect of background grouping on central task in patients with parietal lobe lesions. J Vis 2010. [DOI: 10.1167/10.7.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
23
|
Allen H, Harris MG. Older adults misjudge deceleration. J Vis 2010. [DOI: 10.1167/10.7.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
24
|
Mevorach C, Allen H, Hodsoll J, Shalev L, Humphreys G. Interactivity between the left intraparietal sulcus and occipital cortex in ignoring salient distractors: Evidence from neuropsychological fMRI. J Vis 2010. [DOI: 10.1167/10.7.89] [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: 11/24/2022] Open
|
25
|
Snow J, Allen H, Rafal R, Humphreys G. Impaired attentional selectivity following lesions to human pulvinar. J Vis 2010. [DOI: 10.1167/7.9.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
26
|
Allen H, Humphreys G, Colin J. Ventral extra-striate visual regions, feedback and texture perception. J Vis 2010. [DOI: 10.1167/8.6.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
27
|
Shalev L, Mevorach C, Allen H, Humphreys G. Dissociating the cognitive mechanisms of sustained attention and response inhibition: An fMRI study using a conjunctive go/no-go task. J Vis 2010. [DOI: 10.1167/7.9.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
28
|
Mevorach C, Shalev L, Allen H, Humphreys G. The Left inferior parietal lobe modulates the selection of low salient stimuli. J Vis 2010. [DOI: 10.1167/7.9.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
29
|
Raman R, Allen H, Diffey S, Raman H, Martin P, McKelvie K. Localisation of quantitative trait loci for quality attributes in a doubled haploid population of wheat (Triticum aestivum L.). Genome 2009; 52:701-15. [PMID: 19767900 DOI: 10.1139/g09-045] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Selection of wheat germplasm for a range of quality traits has been a challenging exercise because of the cost of testing, the variation within testing data, and a poor understanding of the underlying genetics. The objective of this study was to identify quantitative trait loci (QTLs) underlying quality traits in wheat. A doubled haploid population comprising 190 lines from Chara/WW2449 was grown in two different environments and evaluated for various quality traits. A molecular map comprising 362 markers based upon simple sequence repeat, sequence tagged microsatellite, glutenin, and DArT loci was constructed and subsequently exploited to identify QTLs using a whole-genome approach. Fifteen QTLs that were consistent in the two different environments were identified for thousand kernel mass, grain protein content, milling yield, flour protein content, flour colour, flour water absorption, dough development time, dough strength (extensograph height and resistance at 5 cm), and dough extensibility (extensograph length) using the whole genome average interval mapping approach. The amount of genetic variation explained by individual QTLs ranged from 3% to 49%. A number of QTLs associated with dough strength, dough extensibility, dough development time, and flour water absorption were located close to the glutenin Glu-B1 locus on chromosome 1B. Identification of the chromosomal location and effect of the QTLs influencing wheat quality may hasten the development of superior wheats for target markets via marker-assisted selection.
Collapse
Affiliation(s)
- R Raman
- NSW Department of Plant Industries and NSW Agricultural Genomics Centre, Wagga Wagga Agricultural Institute, Wagga Wagga, NSW 2650, Australia
| | | | | | | | | | | |
Collapse
|
30
|
Mevorach C, Allen H, Hodsoll J, Humphreys G, Shalev L. Up and down-regulation of visual cortex by posterior parietal cortex modulates selection-by-saliency: evidence from combined TMS-fMRI. Brain Stimul 2008. [DOI: 10.1016/j.brs.2008.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
31
|
Chan D, Allen H, Hu E, Reese D, Patel G, Gottlieb C, Wax A, Sosa J, Slamon D, Kabbinavar F. Phase II study of docetaxel (D) plus bevacizumab (B) in Her/2 negative metastatic breast carcinoma (MBC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13047] [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] [Indexed: 11/20/2022] Open
Abstract
13047 Background: Taxol+Bevacizumab (B) has clinical activity in Her/2 negative chemotherapy naive MBC with a PFS (11.4 mo), RR (29.9%), and OS (28.4 mo). We are conducting a single arm Phase 2 trial to assess the efficacy of Docetaxel (D)+B. Primary endpoint: time to progression. Secondary endpoints: response rate (CR + PR), response duration, overall survival and safety. Methods: Eligibility criteria: MBC with no prior therapy; Her/2 negative by FISH, ECOG PS 0 or 1; measurable disease by RECIST, Hgb ≥ 9 g/dL, ANC ≥ 1.5 × 109/L, Platelet count ≥ 100 × 109/L, Creatinine ≤ 2.0 mg/dL, Total bilirubin ≤ 1.0 × upper limit of normal, no CNS metastasis, no MI or stroke within 6 mo, no GI perforation, no major surgery within 28 d, and no bleeding diathesis or coagulopathy. Pts receive B 15 mg/kg IV and D 75 mg/m2 IV Q 3 wk. Response assessed radiographically Q 3 cycles. Treatment is until disease progression or unacceptable toxicity. Results: Since Apr 2005, 43 of the planned 75 pts have been enrolled. 21 pts have had at least one assessment resulting in approximately 40% response rate. Common Gr3/4 AE’s have been neutropenia, febrile neutropenia, hypertension. Gr3 LVEF decline seen in one pt. No treatment related deaths occurred. Conclusions: D+ B is well tolerated, with no new safety concerns and manageable toxicities. D+B appears active in MBC. Updated efficacy and safety data will be presented. Study supported by Genentech, Inc. San Francisco, CA. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- D. Chan
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - H. Allen
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - E. Hu
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - D. Reese
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - G. Patel
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - C. Gottlieb
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - A. Wax
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - J. Sosa
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - D. Slamon
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| | - F. Kabbinavar
- Cancer Care Associates, Redondo Beach, CA; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Central Hematology-Oncology Medical Group, Alhambra, CA; Amgen, Inc., Thousand Oaks, CA; St. Jude Heritage Medical Group, Fullerton, CA; University of California at Los Angeles, Los Angeles, CA
| |
Collapse
|
32
|
Montresor A, Odermatt P, Muth S, Iwata F, Raja'a YA, Assis AM, Zulkifli A, Kabatereine NB, Fenwick A, Al-Awaidy S, Allen H, Engels D, Savioli L. The WHO dose pole for the administration of praziquantel is also accurate in non-African populations. Trans R Soc Trop Med Hyg 2005; 99:78-81. [PMID: 15550266 PMCID: PMC5628732 DOI: 10.1016/j.trstmh.2004.06.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2004] [Revised: 06/17/2004] [Accepted: 06/17/2004] [Indexed: 10/26/2022] Open
Abstract
In 2001, WHO developed a pole for the administration of praziquantel without the use of weighing scales, with encouraging results in African populations. In the present study, the pole was tested on height/weight data from 9354 individuals from 11 non-African countries. In more than 98% of the individuals (95% CI 97.8-98.4) the pole estimated an acceptable dosage (30-60 mg/kg), a performance statistically similar to that observed in African populations. Reproducing the present pole in the form of a strip of paper and including it in each container of praziquantel would greatly facilitate the administration of the drug in large-scale interventions.
Collapse
Affiliation(s)
- A Montresor
- Vectorborne and other Parasitic Diseases, World Health Organization, 63 Tran Hung Dao Street, Mail P.O. Box 52, Hanoi, Viet Nam.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Begossi G, Disiena M, Wrobleski D, Vezeridis M, Allen H, Wanebo HJ. Potential for surgical salvage of recurrent rectal cancer is governed by patterns of recurrence and ability to achieve an R0 resection. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Begossi
- Roger Williams Medical Center, Providence, RI
| | - M. Disiena
- Roger Williams Medical Center, Providence, RI
| | | | | | - H. Allen
- Roger Williams Medical Center, Providence, RI
| | | |
Collapse
|
34
|
Affiliation(s)
- A C Gill
- Department of Paediatrics, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | | | | |
Collapse
|
35
|
Abstract
OBJECTIVE To survey the frequency of use of complementary medicines (CM) and complementary therapies (CT) in asthmatic children. METHODOLOGY A 3-month survey of asthmatic inpatients and outpatients of a teaching hospital respiratory paediatrician was undertaken. Parents answered a structured questionnaire about their past and present usage and opinions of CM and CT. Parents and the physician independently assessed overall asthma control. 'Users' and 'non-users' of CM and CT were compared for characteristics of asthma, usage of conventional medications and parental demographics. RESULTS One hundred and seventy-four children with 331 parents were enrolled in the study. All of the children were on bronchodilators and 150 (86.2%) were on disodium cromoglycate or inhaled steroids. Control was assessed by a physician as good in 95 children (54.6%), fair in 65 (37.4%) and poor or very poor in 13 (7.5%). Ninety (51.7%) of the children had used at least one CM in their lifetime. Out of the 145 preparations used, 90 (62.1%) were in current use. Vitamins and minerals (53.2%) and herbal preparations (29%) were used most commonly. Only 47.8% of parents had told their doctors about the use of CM. Costs ranged from $A2-$A200 (median $A10) per month. Forty-three (24.7%) of the children had been taken to an alternative practitioner at a cost of $A25-$A400 (median $A40) per month. Users of CM and CT were significantly more likely than non-users to have persistent asthma (P < 0.02), be on high-dose inhaled or oral steroids (P < 0.05), to have poor or very poor control of symptoms (P < 0.04), and more frequent doctor visits (P < 0.05). They also had more adverse reactions to relieving bronchodilators (P < 0.02) and were significantly older than non-users (P < 0.02). The most common reasons for using CM and CT were dissatisfaction with conventional therapies and concerns about steroid side-effects. CONCLUSIONS Health professionals should be aware of the high rates of usage of CM and CT in asthmatic children and of parental attitudes to conventional and alternative therapies.
Collapse
Affiliation(s)
- G Shenfield
- Department of Clinical Pharmacology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
| | | | | |
Collapse
|
36
|
Armstrong FA, Allen H, Hill O, Oliver BN, Whitford D. Direct electrochemistry of the photosynthetic blue copper protein plastocyanin. Electrostatic promotion of rapid charge transfer at an edge-oriented pyrolytic graphite electrode. J Am Chem Soc 2002. [DOI: 10.1021/ja00292a004] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
37
|
Abstract
A child with psychotic symptoms and attention-deficit hyperactivity disorder who developed extrapyramidal symptoms while on a combination of risperidone, methylphenidate, sertraline, tropisetron and ketorolac is described herein. The extrapyramidal symptoms resolved with the administration of benztropine, an anticholinergic drug. Successful treatment of his psychosis was achieved by decreasing the dose of risperidone, followed by slow upward titration.
Collapse
Affiliation(s)
- L Teoh
- Department of Paediatrics, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
| | | | | |
Collapse
|
38
|
|
39
|
Abstract
A 96-capillary array gel electrophoresis Applied Biosystems 3700 instrument has been used to analyse AMPF/STR SGM Plus short tandem repeat (STR) loci for forensic applications. This multiplex consists of ten STR loci plus the Amelogenin locus and currently forms the basis of the UK National DNA database that currently holds more than 1 million profiles. Of particular interest is the accuracy of allele designation that is determined by comparison with standard control allelic ladder markers. Some loci have higher standard deviations than others. In particular the high-molecular-weight HUMFIBRA alleles have high standard deviations of the order of 0.15 and it is these alleles that are most likely to be misdesignated. However, this risk is minimised by the analysis of at least five different allelic ladders across the array to estimate the mean size of each allele. In conjunction with this, a series of guidelines that can be programmed into expert systems are used to minimise risks of misdesignation. The efficacy of the procedures utilised are tested by computer simulation and demonstrated to be robust.
Collapse
Affiliation(s)
- P Gill
- Forensic Science Service, Trident Court, Birmingham, UK.
| | | | | |
Collapse
|
40
|
Abstract
"Porcine bronchus" is a right upper lobe bronchus arising directly from the trachea. This is an infrequent congenital abnormality and it usually represents the displaced origin of a normal bronchus. We herewith report a case of a child who was diagnosed to have tracheal bronchus in neonatal period and followed subsequently until 13 months of age.
Collapse
Affiliation(s)
- N S Kabra
- Dept. of Neonatology and Pediatrics, Royal North Shore Hospital, University of Sydney, St Leonards, NSW 2065, Australia.
| | | | | |
Collapse
|
41
|
Salmerón A, Janzen J, Soneji Y, Bump N, Kamens J, Allen H, Ley SC. Direct phosphorylation of NF-kappaB1 p105 by the IkappaB kinase complex on serine 927 is essential for signal-induced p105 proteolysis. J Biol Chem 2001; 276:22215-22. [PMID: 11297557 DOI: 10.1074/jbc.m101754200] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The p105 precursor protein of NF-kappaB1 acts as an NF-kappaB inhibitory protein, retaining associated Rel subunits in the cytoplasm of unstimulated cells. Tumor necrosis factor alpha (TNFalpha) and interleukin-1alpha (IL-1alpha) stimulate p105 degradation, releasing associated Rel subunits to translocate into the nucleus. By using knockout embryonic fibroblasts, it was first established that the IkappaB kinase (IKK) complex is essential for these pro-inflammatory cytokines to trigger efficiently p105 degradation. The p105 PEST domain contains a motif (Asp-Ser(927)-Gly-Val-Glu-Thr), related to the IKK target sequence in IkappaBalpha, which is conserved between human, mouse, rat, and chicken p105. Analysis of a panel of human p105 mutants in which serine/threonine residues within and adjacent to this motif were individually changed to alanine established that only serine 927 is essential for p105 proteolysis triggered by IKK2 overexpression. This residue is also required for TNFalpha and IL-1alpha to stimulate p105 degradation. By using a specific anti-phosphopeptide antibody, it was confirmed that IKK2 overexpression induces serine 927 phosphorylation of co-transfected p105 and that endogenous p105 is also rapidly phosphorylated on this residue after TNFalpha or IL-1alpha stimulation. In vitro kinase assays with purified proteins demonstrated that both IKK1 and IKK2 can directly phosphorylate p105 on serine 927. Together these experiments indicate that the IKK complex regulates the signal-induced proteolysis of NF-kappaB1 p105 by direct phosphorylation of serine 927 in its PEST domain.
Collapse
Affiliation(s)
- A Salmerón
- Division of Cellular Immunology, the National Institute for Medical Research, Mill Hill, London NW7 1AA, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
42
|
Lyons RA, Delahunty AM, Heaven M, McCabe M, Allen H, Nash P. Incidence of childhood fractures in affluent and deprived areas: population based study. BMJ 2000; 320:149. [PMID: 10634734 PMCID: PMC27261 DOI: 10.1136/bmj.320.7228.149] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R A Lyons
- Welsh Combined Centres for Public Health, University of Wales College of Medicine, Swansea SA1 1LT.
| | | | | | | | | | | |
Collapse
|
43
|
Abstract
This DataWatch uses data from the 1993 Employee Health Care Value Survey (EHCVS) to compare the experiences of respondents with and without chronic illnesses under managed care. After controlling for potential confounders, we found that chronic illness was associated with increased odds of dissatisfaction in both independent practice association plans and prepaid group practices, but not under fee-for-service coverage. Chronic illness appeared to exacerbate difficulties and to attenuate the benefits experienced by healthy persons under managed care. We conclude that persons with chronic illnesses may be at particular risk under managed care; their experiences may warrant particular attention when health plan performance is being monitored.
Collapse
Affiliation(s)
- B G Druss
- Department of Psychiatry and Public Health, Yale University, USA
| | | | | | | |
Collapse
|
44
|
Hay DF, Pawlby S, Sharp D, Schmücker G, Mills A, Allen H, Kumar R. Parents' judgements about young children's problems: why mothers and fathers might disagree yet still predict later outcomes. J Child Psychol Psychiatry 1999; 40:1249-58. [PMID: 10604403] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Correlates of parents' ratings of behavioural problems were explored in a sample of 93 British families, in which mothers and fathers rated their children at the time of the fourth birthday on the Achenbach Child Behavior Checklist. As in other samples, there was moderate convergence in mothers' and fathers' total problem scores, but also signs that they were reporting different sorts of problems linked to different influences. The father's rating was primarily associated with the child's cognitive ability. The mother's rating was primarily affected by her own mental state and view of her marriage. The father's but not the mother's rating provided unique information that predicted teachers' reports of the children's problems 7 years later. In general, parents' ratings of preschool children's problems reflect particular informants' perspectives on family life.
Collapse
Affiliation(s)
- D F Hay
- Faculty of Social and Political Sciences, University of Cambridge, UK
| | | | | | | | | | | | | |
Collapse
|
45
|
Shah A, Allen H. Is improvement possible in the measurement of behaviour disturbance in dementia? Int J Geriatr Psychiatry 1999; 14:512-9. [PMID: 10440970] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
|
46
|
Abstract
OBJECTIVE To measure the incidence of childhood fractures in a defined population. SETTING Accident and emergency (A&E) departments covering the Swansea and Neath Port Talbot areas of South Wales in 1996. METHODS Linkage of data from A&E departments with population data to produce fracture incidence rates by anatomical site and cause in children aged 0-14 years. RESULTS During 1996, 2463 new fractures occurred in 2399 residents yielding a fracture rate of 36.1/1000 children. Fractures were more common in boys than girls and increased with age in both groups. Sports and leisure activities accounted for 36% of fractures, assaults for 3.5%, and road traffic accidents 1.4%. Fractures of the radius/ulna were most frequent (36%). CONCLUSIONS The fracture rate in South Wales children is twice the rate reported in previous studies. Further research is required to elucidate the reasons behind this high rate. Many fractures could be prevented by the use of safer surfaces in school playgrounds, and wrist protection in in-line skaters and possibly in soccer players.
Collapse
Affiliation(s)
- R A Lyons
- Welsh Combined Centres for Public Health, University of Wales College of Medicine.
| | | | | | | | | | | | | |
Collapse
|
47
|
Abstract
BACKGROUND Organic brain disease such as dementia or stroke is associated with depression. In dementia, depressive symptoms are common where there is evidence of vascular disease and in Alzheimer's disease they often coexist with extrapyramidal signs. METHOD In a study of 60 patients with Alzheimer's disease and 39 patients with vascular dementia, depressive symptoms were rated using the Cornell Scale for Depression in Dementia. Neurological signs were assessed and severity of cognitive impairment was measured with the Mini-Mental State Examination. RESULTS Depressive symptoms were more severe in vascular dementia. Pyramidal tract signs had no relationship to depression in either type of dementia. In vascular dementia, extrapyramidal and grasp reflexes were strongly related to the severity of depression, and were associated with neurovegetative features. In Alzheimer's disease, extrapyramidal signs were the strongest independent predictor of the severity of depression. CONCLUSION Depressive symptoms are more severe in vascular dementia compared to Alzheimer's disease and were related to neurological abnormalities.
Collapse
Affiliation(s)
- S Simpson
- Forston Clinic, Herrison, Dorchester, United Kingdom
| | | | | | | |
Collapse
|
48
|
Abstract
OBJECTIVE A central assumption underlying managed care is that plan switching is a viable option for enrollees when they are dissatisfied. The authors used a national employee survey to test the hypothesis that this mechanism is less effective for enrollees with high levels of depressive symptoms than for the remainder of the population. METHOD The study used data from the Employee Health Care Value Survey, a 1993 survey of 20,283 employees of three major corporations. The authors used the Medical Outcomes Study 36-Item Short-Form Health Survey to identify individuals with the highest decile of depressive and physical symptoms. They examined the relationship between symptoms and dissatisfaction and, for dissatisfied individuals, how symptoms predicted plan switching. Multivariate models were used to control for potential demographic, health, and health coverage confounders. RESULTS Depressive and physical symptoms were both associated with dissatisfaction with care. Unlike physical symptoms, depressive symptoms were associated with a significantly lower likelihood of actually disenrolling among people who were dissatisfied or who intended to disenroll. This effect was most pronounced for satisfaction with administrative aspects of care (e.g., gatekeeping, utilization review). CONCLUSIONS People with high levels of depressive symptoms appeared to be less willing or able to act on their dissatisfaction by switching plans. In particular, they were willing to tolerate higher rates of dissatisfaction with the administrative aspects of their health coverage without disenrolling. Plan switching is an essential mechanism underpinning a health care system predicated on competition; it may be less effective for people with depressive disorders.
Collapse
Affiliation(s)
- B Druss
- Department of Psychiatry, Yale University, West Haven, CT 06516, USA
| | | | | | | |
Collapse
|
49
|
|
50
|
Abstract
OBJECTIVE To assess guidelines, set by the National Committee for Quality Assurance, for the Health Plan Employer Data and Information Set (HEDIS) 1999 CAHPS 2.0H Survey (formerly the HEDIS 1999 Consumer Survey) in the light of user's needs to monitor health plan performance over time, monitor sick enrollees, and prioritize determinants (drivers) of enrollee experience. DESIGN A two-wave, cross-sectional/longitudinal panel design, consisting of national surveys mailed to employees of three major USA corporations in 1993 and 1995. STUDY PARTICIPANTS Samples included employees selected to represent 23 major managed care and indemnity plans in five regions of the USA. In 1993, 14 587 employees responded and in 1995 9018 employees responded (response rates: 51 and 52%). The longitudinal panel sample included 5729 employees who completed both surveys and stayed in the same plan for both years. STUDY MEASURES: The main 1993 and 1995 surveys consisted of 154 and 116 items, respectively. Panel survey content assessed care delivery, plan administration, functional status, well being, and chronic disease. RESULTS CAHPS 2.0H's point-in-time, cross-sectional design was unable to detect selection bias and led to an inaccurate view of change in performance. CAHPS 2.0H's use of aggregate samples masked key differences between healthy and sick enrollees; e.g. the sick became less satisfied over time. The association-based, statistical techniques that many survey users will employ to prioritize the 'drivers' of enrollee experience in the absence of CAHPS 2.0H guidelines yielded a less efficient account of change than the multi-method/multi-trait approach developed for this project. CONCLUSION Consumer experience of plan performance is best understood when the separate contributions of longitudinal membership and movement in and out of plans are clarified, changes in health are identified, changes for sick and healthy enrollees are compared, and plan performance on satisfaction criteria is probed to give confirmation and detail. Changes to the CAHPS 2.0H approach in HEDIS 1999 will facilitate user application of these principles.
Collapse
Affiliation(s)
- H Allen
- Harris Allen Associates, Boston, MA 02116, USA.
| |
Collapse
|