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Hayes H, Stokes J, Sutton M, Meacock R. How do hospitals respond to payment unbundling for diagnostic imaging of suspected cancer patients? Health Econ 2024; 33:823-843. [PMID: 38233916 DOI: 10.1002/hec.4804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
Payments for some diagnostic scans undertaken in outpatient settings were unbundled from Diagnosis Related Group based payments in England in April 2013 to address under-provision. Unbundled scans attracted additional payments of between £45 and £748 directly following the reform. We examined the effect on utilization of these scans for patients with suspected cancer. We also explored whether any detected effects represented real increases in use of scans or better coding of activity. We applied difference-in-differences regression to patient-level data from Hospital Episodes Statistics for 180 NHS hospital Trusts in England, between April 2010 and March 2018. We also explored heterogeneity in recorded use of scans before and after the unbundling at hospital Trust-level. Use of scans increased by 0.137 scans per patient following unbundling, a 134% relative increase. This increased annual national provider payments by £79.2 million. Over 15% of scans recorded after the unbundling were at providers that previously recorded no scans, suggesting some of the observed increase in activity reflected previous under-coding. Hospitals recorded substantial increases in diagnostic imaging for suspected cancer in response to payment unbundling. Results suggest that the reform also encouraged improvements in recording, so the real increase in testing is likely lower than detected.
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Affiliation(s)
- Helen Hayes
- Office of Health Economics (OHE), London, UK
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Jonathan Stokes
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
- MRC/CSO Social & Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Rachel Meacock
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
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Silbert B, Shah A, Dembo L, Hayes H, Larbalestier R, Baumwol J. Left ventricular assist devices for treatment of refractory advanced heart failure: the Western Australian experience. Intern Med J 2024; 54:438-445. [PMID: 37615052 DOI: 10.1111/imj.16212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Left ventricular (LV) assist devices (LVADs) can prolong survival and improve quality of life in end-stage heart failure. AIMS Review outcomes of the Western Australian LVAD programme. METHODS Retrospective database and medical record review. RESULTS One hundred forty-seven LVADs have been implanted in 23 years, of which 95 were newer-generation devices (HeartWare HVAD [HW], HeartMate II and HeartMate 3). Presented data refer to these devices only. Most patients (94%) were classed as bridge-to-transplant or -candidacy/decision, with the remainder classed as 'destination therapy' (DT). Mean LV ejection fraction was 20%, and 36% had severe right ventricular dysfunction. Sixty-two percent of patients had a nonischaemic cardiomyopathy. Following LVAD implant, the median length of stay in intensive care was 2 days, and in the hospital overall was 23 days. Ninety-six percent of patients survived to hospital discharge, and, following discharge, 98% of days with LVAD were spent as an outpatient. The median number of hospital readmissions was 1.5 per patient per year. LVAD-associated infection requiring admission or intravenous antibiotics at any time after implant occurred in 36%, significant gastrointestinal bleeding in 19% and stroke in 11%. The percentage of patients alive with LVAD still in situ at 1, 2 and 5 years was 94%, 88% and 62% respectively, which exceeds current international registry outcomes. All DT patients survived at least 4 years, spending 97% of days with LVAD as an outpatient. The two longest-surviving HW DT patients worldwide (11.3 and 10.5 years) are among this cohort. CONCLUSIONS Excellent outcomes can be achieved with LVADs in appropriately selected patients.
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Affiliation(s)
- Benjamin Silbert
- Intensive Care Unit, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Amit Shah
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Lawrence Dembo
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Helen Hayes
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Robert Larbalestier
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jay Baumwol
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
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Lawitz E, Parmar D, Momin T, Shaikh F, Patel H, Hayes H, Swint K. Pharmacokinetics and Safety Evaluation of Single-Dose Saroglitazar Magnesium in Subjects with Hepatic Impairment. Clin Pharmacol Drug Dev 2023; 12:1142-1155. [PMID: 37909052 DOI: 10.1002/cpdd.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/01/2023] [Indexed: 11/02/2023]
Abstract
Saroglitazar magnesium, a dual peroxisome proliferator-activated receptor agonist, is under evaluation for treating various liver conditions. While the pharmacokinetics (PK) of saroglitazar have been extensively studied in diverse preclinical models and healthy subjects, a comprehensive assessment of its PK behavior under conditions of hepatic impairment is lacking. In this Phase 1, open-label, parallel-group study, the PK of a single dose of 4-mg saroglitazar magnesium was investigated in subjects having varying degrees of hepatic impairment with and without portal hypertension compared with appropriately matched individuals having normal hepatic function. Treatment-emergent adverse events for safety were also evaluated. Thirty-two subjects were enrolled in the hepatic-impaired groups and 23 subjects in the normal hepatic function group. Mild and moderate hepatic impairment did not significantly affect the PK of saroglitazar, compared with normal hepatic function. Although severe hepatic impairment did not alter maximum observed plasma concentration and half-life; saroglitazar exposure (area under the plasma concentration-time curve from time 0 to infinity) increased 3-fold, while the clearance was 61% lower compared to the subjects with normal hepatic function. This may require close monitoring or dose adjustments in individuals with severe hepatic impairment. A single oral dose of saroglitazar magnesium 4 mg was found to be safe and well tolerated in subjects with varying degrees of hepatic function.
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Affiliation(s)
- Eric Lawitz
- Clinical Professor of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Deven Parmar
- Zydus Therapeutics Inc., Clinical Research and Development, Pennington, NJ, USA
| | - Taufik Momin
- Zydus Lifesciences Ltd., Ahmedabad, Gujarat, India
| | - Farheen Shaikh
- Zydus Therapeutics Inc., Clinical Research and Development, Pennington, NJ, USA
| | | | - Helen Hayes
- Zydus Therapeutics Inc., Clinical Research and Development, Pennington, NJ, USA
| | - Kimberly Swint
- Zydus Therapeutics Inc., Clinical Research and Development, Pennington, NJ, USA
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Hayes H, Meacock R, Stokes J, Sutton M. How do family doctors respond to reduced waiting times for cancer diagnosis in secondary care? Eur J Health Econ 2023:10.1007/s10198-023-01626-2. [PMID: 37787842 DOI: 10.1007/s10198-023-01626-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 08/09/2023] [Indexed: 10/04/2023]
Abstract
Reducing waiting times is a priority in public health systems. Efforts of healthcare providers to shorten waiting times could be negated if they simultaneously induce substantial increases in demand. However, separating out the effects of changes in supply and demand on waiting times requires an exogenous change in one element. We examine the impact of a pilot programme in some English hospitals to shorten waiting times for urgent diagnosis of suspected cancer on family doctors' referrals. We examine referrals from 6,666 family doctor partnerships to 145 hospitals between 1st April 2012 and 31st March 2019. Five hospitals piloted shorter waiting times initiatives in 2017. Using continuous difference-in-differences regression, we exploit the pilot as a 'supply shifter' to estimate the effect of waiting times on referral volumes for two suspected cancer types: bowel and lung. The proportion of referred patients breaching two-week waiting times targets for suspected bowel cancer fell by 3.9 percentage points in pilot hospitals in response to the policy, from a baseline of 4.8%. Family doctors exposed to the pilot increased their referrals (demand) by 10.8%. However, the pilot was not successful for lung cancer, with some evidence that waiting times increased, and a corresponding reduction in referrals of -10.5%. Family doctor referrals for suspected cancer are responsive at the margin to waiting times. Healthcare providers may struggle to achieve long-term reductions in waiting times if supply-side improvements are offset by increases in demand.
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Affiliation(s)
- Helen Hayes
- Office of Health Economics (OHE), London, UK.
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK.
| | - Rachel Meacock
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Jonathan Stokes
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
- MRC/CSO Social & Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
- Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, The University of Melbourne, Parkville, VIC, Australia
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Hahn R, Alarcon L, Hayes H, Dembo L, Lawrence S, Musk M, Larbalestier R, Pavey W. Attitudes Toward Donated Organ Research. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1299] [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: 04/05/2023] Open
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Condon M, Hayes H, Wedel U. 201 AVAILABILITY AND APPROPRIATENESS OF STROKE SURVIVORS’ FOOTWEAR ON AN ACUTE STROKE UNIT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.173] [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: 11/14/2022] Open
Abstract
Abstract
Background
Stroke Survivors (SSs) often present with an increased fall risk due to physical, sensory, cognitive and visual impairments. Footwear has the potential to positively impact the gait and balance of SSs, while poorly fitting or unsupportive footwear is associated with falls. Research to date has focused on older adult populations. Little is known about the type of footwear SSs wear on an Acute Stroke Unit (ASU). The aim of this study was to identify the type and suitability of footwear available to SSs on an ASU.
Methods
Consecutive inpatients (>18) on a 31-bed ASU were assessed on one day in May 2022. Footwear available to SSs was assessed for suitability using the Footwear Assessment Tool, a six-item tool with established inter- and intra-rater reliability. Descriptive statistics were employed to examine results.
Results
In all, 38 pairs of footwear were available to 31 patients with a median age of 72 and 61% (19/31) were male. Two or more types of footwear were available to 29% (9/31) of patients, 61% (19/31) had one type of footwear available, while 10% (3/31) had no footwear. The most common type of footwear were slippers with backs (36%; 14/38) followed by athletic shoes (21%; 8/31) and backless slippers were the last common type (3%; 1/38). Based on the Footwear Assessment Tool, less than half (47%; 18/38) of the footwear available were appropriate.
Conclusion
This study highlights the large number of SSs in an ASU who have inappropriate footwear to support their rehabilitation and safety. Ensuring SSs have suitable footwear is a simple way of promoting safety and improving mobility. Healthcare professions have a responsibility to consider footwear characteristics in the management of SSs. Evidence-based advice to patients and families on safe and appropriate footwear could improve rehabilitation outcomes while minimising falls risk.
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Affiliation(s)
- M Condon
- Cork University Hospital Department of Physiotherapy, , Cork, Ireland
| | - H Hayes
- University College Cork Discipline of Physiotherapy, , Cork, Ireland
| | - U Wedel
- University College Cork Discipline of Physiotherapy, , Cork, Ireland
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Cassidy T, Grimsrud A, Keene C, Lebelo K, Hayes H, Orrell C, Zokufa N, Mutseyekwa T, Voget J, Gerstenhaber R, Wilkinson L. Twenty-four-month outcomes from a cluster-randomized controlled trial of extending antiretroviral therapy refills in ART adherence clubs. J Int AIDS Soc 2021; 23:e25649. [PMID: 33340284 PMCID: PMC7749539 DOI: 10.1002/jia2.25649] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 03/02/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The antiretroviral therapy (ART) adherence club (AC) model has supported clinically stable HIV patients' retention with group ART refills and psychosocial support. Reducing visit frequency by increasing ART refills to six months could further benefit patients and unburden health systems. We conducted a pragmatic non-inferiority cluster randomized trial comparing standard of care (SoC) ACs and six-month refill intervention ACs in a primary care facility in Khayelitsha, South Africa. METHODS Existing community-based and facility-based ACs were randomized to either SoC or intervention ACs. SoC ACs met five times annually, receiving two-month refills with a four-month refill over year-end. Blood was drawn at one AC visit with a clinical assessment at the next. Intervention ACs met twice annually receiving six-month refills, with an individual blood collection visit before the annual clinical assessment AC visit. The first study visits were in October and November 2017 and participants followed for 27 months. We report retention in care, viral load completion and viral suppression (<400 copies/mL) 24 months after enrolment and calculated intention-to-treat risk differences for the primary outcomes using generalized estimating equations specifying for clustering by AC. RESULTS Of 2150 participants included in the trial, 977 were assigned to the intervention arm (40 ACs) and 1173 to the SoC (48 ACs). Patient characteristics at enrolment were similar across groups. Retention in care at 24 months was similarly high in both arms: 93.6% (1098/1173) in SoC and 92.6% (905/977) in the intervention arm, with a risk difference of -1.0% (95% CI: -3.2 to 1.3). The intervention arm had higher viral load completion (90.8% (999/1173) versus 85.1% (887/977)) and suppression (87.3% (969 /1173) versus 82.6% (853/977)) at 24 months, with a risk difference for completion of 5.5% (95% CI: 1.5 to 9.5) and suppression of 4.6% (95% CI: 0.2 to 9.0). CONCLUSIONS Intervention AC patients receiving six-month ART refills showed non-inferior retention in care, viral load completion and viral load suppression to those in SoC ACs, adding to a growing literature showing good outcomes with extended ART dispensing intervals.
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Affiliation(s)
- Tali Cassidy
- Médecins Sans Frontières, Khayelitsha, South Africa.,Department of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Claire Keene
- Médecins Sans Frontières, Khayelitsha, South Africa
| | | | - Helen Hayes
- Western Cape Government Department of Health, Cape Town, South Africa
| | - Catherine Orrell
- Department of Medicine, Faculty of Health Sciences, Cape Town, South Africa.,The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | | | | | - Jacqueline Voget
- Western Cape Government Department of Health, Cape Town, South Africa
| | | | - Lynne Wilkinson
- International AIDS Society, Cape Town, South Africa.,Center for Infectious Disease and Epidemiological Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Hayes H, Stokes J, Kristensen SR, Sutton M. The effect of payment method and multimorbidity on health and healthcare utilisation. J Health Organ Manag 2021. [DOI: 10.1108/jhom-05-2020-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThree types of payment methods have been introduced across European countries in attempts to encourage better, more integrated care of persons with multimorbidity: pay-for-performance; pay-for-coordination; and an all-inclusive payment method. We examine whether there are differences in the way these payment methods affect health and healthcare use in persons with multimorbidity.Design/methodology/approachUsing individual-level survey data from twenty European countries, we examine unadjusted differences in average outcomes for the years 2011–2015 by whether countries adopted new payment methods for integrated care. We then test for a differential effect for multimorbid persons using linear, individual random effects regressions, including country and time fixed effects and clustering standard errors at the country level.FindingsWe find little effect of varying payment methods on key outcomes for multimorbid individuals despite the theoretical predictions and the rhetoric in many policy documents.Research limitations/implicationsPolicymakers should bear in mind that the success of the payment method relies on the specific design of the incentives and their implementation. New effective models of care and how to incentivise these for multimorbid patients is an ongoing research priority.Originality/valueThis paper is the first to study the effects of payments for integration on the dimensions and populations these schemes intend to affect; health and healthcare use at the individual level for multimorbid individuals.
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Carter G, Govindan RB, Brown G, Heimann C, Hayes H, Thostenson JC, Dornhoffer J, Brozoski T, Kimbrell TA, Hayar A, Shihabuddin B, James GA, Garcia-Rill E, Padala PR, Mennemeier M. Change in EEG Activity is Associated with a Decrease in Tinnitus Awareness after rTMS. Front Neurol Neurosci Res 2021; 2:100010. [PMID: 34263262 PMCID: PMC8277104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine how 1Hz and 10Hz rTMS temporarily influence ratings of tinnitus loudness, annoyance, and awareness. The thalamocortical dysrhythmia (TCD) model of tinnitus was tested by examining changes in spectral power and coherence of resting state EEGs from baseline to each phase of treatment and correlating these data with change in tinnitus. METHODS Nineteen participants completed a double-blind, placebo (sham rTMS) controlled, within-subjects study with crossover between the two active rTMS treatment conditions. An imposed order effect, sham rTMS first, eliminated drift of active treatment into the placebo condition. The primary outcome measures were analogue ratings of tinnitus loudness, annoyance, and awareness, assessed repeatedly at baseline and during treatment, and 64 channel, resting state EEGs collected at baseline and the end of each treatment phase. Active rTMS consisted of 1800 pulses at 110% of motor threshold over temporal cortex delivered at 1Hz and 10Hz over four days. The research design also examined the effect of rTMS immediately following stimulation, regression to the mean in tinnitus ratings made over multiple days, and differences between treatment responders and non-responders. RESULTS There was no immediate effect of rTMS on tinnitus during a single rTMS session. Regression to the mean in tinnitus ratings occurred over three days of baseline and four days of treatment (both sham and active rTMS). After accounting for regression to the mean in the statistical model, 1Hz rTMS led to a significant decrease in tinnitus awareness from baseline and 10Hz rTMS trended in the same direction, whereas sham rTMS showed little change from baseline other than regression to the mean. Changes from baseline in spectral power of the resting state EEG provided partial support for predictions based on TCD model of tinnitus for active 1 and 10Hz rTMS but not sham rTMS. However, only an increase in beta coherence correlated significantly with a decrease in tinnitus awareness. Changes in the EEG were robust in treatment responders but absent among non-responders and during sham rTMS. CONCLUSIONS A positive response to rTMS for tinnitus is associated with an rTMS-induced change in beta coherence of the EEG. Increased beta coherence may be a biomarker of the rTMS effect; a "top-down" modulation of the EEG that promotes habituation to tinnitus. Participants whose tinnitus did not improve after rTMS did not show any changes in the EEG.
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Affiliation(s)
- G Carter
- Department of Anatomy and Physiology, National Park College, USA
| | - RB Govindan
- Prenatal Pediatrics Institute, Children’s National Hospital, USA
| | - G Brown
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences USA
| | - C Heimann
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences USA
| | - H Hayes
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences USA
| | - JC Thostenson
- Department of Biostatistics, University of Arkansas for Medical Sciences, USA
| | - J Dornhoffer
- Department of Otolaryngology, University of Arkansas for Medical Sciences, USA
| | - T Brozoski
- Division of Otolaryngology, Southern Illinois University School of Medicine, USA
| | - TA Kimbrell
- Section of Psychiatry, Central Arkansas Veterans Healthcare System, USA
| | - A Hayar
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences USA
| | - B Shihabuddin
- Department of Neurology, University of Arkansas for Medical Sciences, USA,Section of Neurology, Central Arkansas Healthcare System, USA
| | - GA James
- Department of Psychiatry, University of Arkansas for Medical Sciences, USA
| | - E Garcia-Rill
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences USA
| | - PR Padala
- Central Arkansas Veterans Healthcare System, Geriatric Research Education and Clinical Center, USA
| | - M Mennemeier
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences USA
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Hayes H, Gibson J, Fitzpatrick B, Checkland K, Guthrie B, Sutton M, Gillies J, Mercer SW. Working lives of GPs in Scotland and England: cross-sectional analysis of national surveys. BMJ Open 2020; 10:e042236. [PMID: 33127639 PMCID: PMC7604859 DOI: 10.1136/bmjopen-2020-042236] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The UK faces major problems in retaining general practitioners (GPs). Scotland introduced a new GP contract in April 2018, intended to better support GPs. This study compares the career intentions and working lives of GPs in Scotland with GPs in England, shortly after the new Scotland contract was introduced. DESIGN AND SETTING Comparison of cross-sectional analysis of survey responses of GPs in England and Scotland in 2017 and 2018, respectively, using linear regression to adjust the differences for gender, age, ethnicity, urbanicity and deprivation. PARTICIPANTS 2048 GPs in Scotland and 879 GPs in England. MAIN OUTCOME MEASURES Four intentions to reduce work participation (5-point scales: 1='none', 5='high'): reducing working hours; leaving medical work entirely; leaving direct patient care; or continuing medical work but outside the UK. Four domains of working life: job satisfaction (7-point scale: 1='extremely dissatisfied', 7='extremely satisfied'); job stressors (5-point-scale: 1='no pressure', 5='high pressure); positive and negative job attributes (5-point scales: 1='strongly disagree', 5='strongly agree'). RESULTS Compared with England, GPs in Scotland had lower intention to reduce work participation, including a lower likelihood of reducing work hours (2.78 vs 3.54; adjusted difference=-0.52; 95% CI -0.64 to -0.41), a lower likelihood of leaving medical work entirely (2.11 vs 2.76; adjusted difference=-0.32; 95% CI -0.42 to -0.22), a lower likelihood of leaving direct patient care (2.23 vs 2.93; adjusted difference=-0.37; 95% CI -0.47 to -0.27), and a lower likelihood of continuing medical work but outside of the UK (1.41 vs 1.61; adjusted difference=-0.2; 95% CI -0.28 to -0.12). GPs in Scotland reported higher job satisfaction, lower job stressors, similar positive job attributes and lower negative job attributes. CONCLUSION Following the introduction of the new contract in Scotland, GPs in Scotland reported significantly better working lives and lower intention to reduce work participation than England.
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Affiliation(s)
- Helen Hayes
- Health Organisation, Policy and Economics Research Group, Centre for Primary Care & Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jonathan Gibson
- Health Organisation, Policy and Economics Research Group, Centre for Primary Care & Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Kath Checkland
- Health Organisation, Policy and Economics Research Group, Centre for Primary Care & Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - Bruce Guthrie
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics Research Group, Centre for Primary Care & Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - John Gillies
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Stewart W Mercer
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
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Forsyth K, Heathcote L, Senior J, Malik B, Meacock R, Perryman K, Tucker S, Domone R, Carr M, Hayes H, Webb R, Archer-Power L, Dawson A, Leonard S, Challis D, Ware S, Emsley R, Sanders C, Karim S, Fazel S, Hayes A, Burns A, Piper M, Shaw J. Dementia and mild cognitive impairment in prisoners aged over 50 years in England and Wales: a mixed-methods study. Health Serv Deliv Res 2020. [DOI: 10.3310/hsdr08270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
People aged ≥ 50 years constitute the fastest-growing group in the prison population of England and Wales. This population has complex health and social care needs. There is currently no national strategy to guide the development of the many-faceted services required for this vulnerable population; therefore, prisons are responding to the issue with a range of local initiatives that are untested and often susceptible to failure if they are not fully embedded in and securely funded as part of commissioned services.
Objectives
The objectives were to establish the prevalence of dementia and mild cognitive impairment in prisoners in England and Wales and their health and social care needs; validate the six-item cognitive impairment test for routine use in prisons to aid early and consistent identification of older prisoners with possible dementia or mild cognitive impairment; identify gaps in current service provision; understand the first-hand experiences of prisoners living with dementia and mild cognitive impairment; develop a care pathway for prisoners with dementia and mild cognitive impairment; develop dementia and mild cognitive impairment training packages for staff and prisoners; and produce health economic costings for the care pathway and training packages.
Design
This was a mixed-methods study.
Setting
The study setting was prisons in England and Wales.
Participants
Prisoners aged ≥ 50 years and multiagency staff working in prison discipline and health and social care services took part.
Results
Quantitative research estimated that the prevalence rate of suspected dementia and mild cognitive impairment in the prison population of England and Wales is 8%. This equates to 1090 individuals. Only two people (3%) in our sample had a relevant diagnosis in their health-care notes, suggesting current under-recognition of these conditions. The prevalence rate in prisons was approximately two times higher among individuals aged 60–69 years and four times higher among those aged ≥ 70 years than among those in the same age groups living in the community. The Montreal Cognitive Assessment screening test was found to be more effective than the six-item cognitive impairment test assessment in the older prisoner population. Qualitative research determined that staff and prisoners lacked training in knowledge and awareness of dementia and mild cognitive impairment, and this leads to problematic behaviour being viewed as a disciplinary issue rather than a health issue. Local initiatives to improve the lives of prisoners with dementia and mild cognitive impairment are often disadvantaged by not being part of commissioned services, making them difficult to sustain. Multidisciplinary working is hampered by agencies continuing to work in silos, with inadequate communication across professional boundaries. A step-by-step care pathway for prisoners with dementia and mild cognitive impairment was developed, and two tiers of training materials were produced for staff and prisoners.
Limitations
Our prevalence rate was based on the results of a standardised assessment tool, rather than on clinical diagnosis by a mental health professional, and therefore it may represent an overestimation. Furthermore, we were unable to distinguish subcategories of dementia. We were also unable to distinguish between a likely diagnosis of dementia and other conditions presenting with mild cognitive impairment, including learning disability, severe depression and hearing impairment. Questionnaires regarding current service provision were collected over an extended period of time, so they do not reflect a ‘snapshot’ of service provision at a particular point.
Conclusions
We hypothesise that implementing the step-by-step care pathway and the training resources developed in this study will improve the care of older prisoners with dementia and mild cognitive impairment.
Future work
The care pathway and training materials should be evaluated in situ. Alternatives to prison for those with dementia or mild cognitive impairment should be developed and evaluated.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 27. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Katrina Forsyth
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Leanne Heathcote
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Jane Senior
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Baber Malik
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Rachel Meacock
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Katherine Perryman
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Sue Tucker
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Rachel Domone
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| | - Matthew Carr
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Helen Hayes
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Roger Webb
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Laura Archer-Power
- Cheshire and Greater Manchester Community Rehabilitation Company, Manchester, UK
| | - Alice Dawson
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Sarah Leonard
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - David Challis
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Stuart Ware
- Restore Support Network, Exeter Council for Voluntary Service, Exeter, UK
| | - Richard Emsley
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Caroline Sanders
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Salman Karim
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Adrian Hayes
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Alistair Burns
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Mary Piper
- Restore Support Network, Exeter Council for Voluntary Service, Exeter, UK
| | - Jenny Shaw
- Offender Health Research Network, University of Manchester, Manchester, UK
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McClelland S, Hayes H, Barber J, Hort A, Baumwol J. Use of Thalidomide for Refractory GI Bleeding in Patients with Continuous Flow Left Ventricular Assist Device (cfLVAD) - The Western Australian (WA) Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.136] [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: 10/24/2022] Open
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13
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Raikos V, Hayes H, Ni H. Aquafaba from commercially canned chickpeas as potential egg replacer for the development of vegan mayonnaise: recipe optimisation and storage stability. Int J Food Sci Technol 2019. [DOI: 10.1111/ijfs.14427] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Vassilios Raikos
- Rowett Institute University of Aberdeen Foresterhill, Aberdeen AB25 2ZD Scotland, UK
| | - Helen Hayes
- Rowett Institute University of Aberdeen Foresterhill, Aberdeen AB25 2ZD Scotland, UK
| | - He Ni
- Guangdong Provincial Key Lab of Biotechnology for Plant Development School of Life Sciences South China Normal University Guangzhou 510631 China
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14
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Ni H, Hayes H, Stead D, Liu G, Yang H, Li H, Raikos V. Interaction of whey protein with polyphenols from salal fruits (
Gaultheria shallon
) and the effects on protein structure and hydrolysis pattern by Flavourzyme
®. Int J Food Sci Technol 2019. [DOI: 10.1111/ijfs.14394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- He Ni
- Guangdong Provincial Key Laboratory of Biotechnology for Plant Development School of Life Sciences South China Normal University Guangzhou 510631 China
| | - Helen Hayes
- Rowett Institute University of Aberdeen Aberdeen Foresterhill AB25 2ZD UK
| | - David Stead
- Rowett Institute University of Aberdeen Aberdeen Foresterhill AB25 2ZD UK
| | - Guang Liu
- Sericultural and Agri‐Food Research Institute Guangdong Academy of Agricultural Sciences Key Laboratory of Functional Foods Ministry of Agriculture and Rural Affairs/Guangdong Key Laboratory of Agricultural Products Processing Guangzhou 510610 China
| | - Huaijie Yang
- School of Food Science and Engineering Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety South China University of Technology Guangzhou 510640 China
| | - Haihang Li
- Guangdong Provincial Key Laboratory of Biotechnology for Plant Development School of Life Sciences South China Normal University Guangzhou 510631 China
| | - Vassilios Raikos
- Rowett Institute University of Aberdeen Aberdeen Foresterhill AB25 2ZD UK
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15
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Wilkinson L, Grimsrud A, Cassidy T, Orrell C, Voget J, Hayes H, Keene C, Steele SJ, Gerstenhaber R. A cluster randomized controlled trial of extending ART refill intervals to six-monthly for anti-retroviral adherence clubs. BMC Infect Dis 2019; 19:674. [PMID: 31362715 PMCID: PMC6664572 DOI: 10.1186/s12879-019-4287-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 07/05/2019] [Accepted: 07/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The antiretroviral therapy (ART) adherence club (AC) differentiated service delivery model, where clinically stable ART patients receive their ART refills and psychosocial support in groups has supported clinically stable patients' retention and viral suppression. Patients and health systems could benefit further by reducing visit frequency and increasing ART refills. We designed a cluster-randomized control trial comparing standard of care (SoC) ACs and six-month ART refill (Intervention) ACs in a large primary care facility in Khayelitsha, South Africa. METHODS Existing ACs were randomized to either the control (SOC ACs) or intervention (Intervention ACs) arm. SoC ACs meet five times annually, receiving two-month ART refills with a four-month ART refill over year-end. Blood is drawn at the AC visit ahead of the clinical assessment visit. Intervention ACs meet twice annually receiving six-month ART refills, with a third individual visit for routine blood collection anytime two-four weeks before the annual clinical assessment AC visit. Primary outcomes will be retention in care, annual viral load assessment completion and viral load suppression. (<400copies/mL) after 2 years. Ethics approval has been granted by the University of Cape Town (HREC 652/2016) and the Medecins Sans Frontieres (MSF) Ethics Review Board (#1639). Results will be published in peer-reviewed journals and made widely available through presentations and briefing documents. DISCUSSION Evaluation of an extended ART refill interval in adherence clubs will provide evidence towards novel model adaptions that can be made to further improve convenience for patients and leverage health system efficiencies. TRIAL REGISTRATION Registered with the Pan African Clinical Trial Registry: PACTR201810631281009. Registered 11 September 2018.
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Affiliation(s)
- Lynne Wilkinson
- Center for Infectious Disease and Epidemiological Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Tali Cassidy
- Medécins Sans Frontières, Cape Town, South Africa. .,Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Isivivana Centre, 8 Mzala Street, Khayelitsha, Cape Town, South Africa.
| | - Catherine Orrell
- Department of Medicine, Faculty of Health Sciences, Cape Town, South Africa.,The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Jacqueline Voget
- Western Cape Government Department of Health, Cape Town, South Africa
| | - Helen Hayes
- Western Cape Government Department of Health, Cape Town, South Africa
| | - Claire Keene
- Medécins Sans Frontières, Cape Town, South Africa
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16
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Raikos V, Hayward N, Hayes H, Meroni E, Ranawana V. Optimising the ratio of long‐ to short‐chain triglycerides of the lipid phase to enhance physical stability and bioaccessibility of lycopene‐loaded beverage emulsions. Int J Food Sci Technol 2018. [DOI: 10.1111/ijfs.14024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Vassilios Raikos
- Rowett Institute University of Aberdeen Foresterhill Aberdeen AB25 2ZD UK
| | - Nick Hayward
- Rowett Institute University of Aberdeen Foresterhill Aberdeen AB25 2ZD UK
| | - Helen Hayes
- Rowett Institute University of Aberdeen Foresterhill Aberdeen AB25 2ZD UK
| | - Erika Meroni
- Human Nutrition Unit Department of Food, Environmental and Nutritional Sciences (DeFENS) – University of Milan Via Celoria, 2 20133 Milan Italy
| | - Viren Ranawana
- Rowett Institute University of Aberdeen Foresterhill Aberdeen AB25 2ZD UK
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Redondo-Cuevas L, Hayes H, Nicol F, Raikos V. Rosemary powder filtrate improves the oxidative stability and antioxidant properties of rapeseed oil: potential applications for domestic cooking. Int J Food Sci Technol 2018. [DOI: 10.1111/ijfs.13955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Lucía Redondo-Cuevas
- Rowett Institute; University of Aberdeen; Foresterhill Aberdeen AB25 2ZD UK
- Departamento de Ciencias Experimentales y Matemáticas; Facultad de Veterinaria y Ciencias Experimentales; Universidad Católica de Valencia San Vicente Mártir; Valencia 46001 Spain
| | - Helen Hayes
- Rowett Institute; University of Aberdeen; Foresterhill Aberdeen AB25 2ZD UK
| | - Fergus Nicol
- Rowett Institute; University of Aberdeen; Foresterhill Aberdeen AB25 2ZD UK
| | - Vassilios Raikos
- Rowett Institute; University of Aberdeen; Foresterhill Aberdeen AB25 2ZD UK
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Doyle N, Gainty M, Doyle J, Levy M, DeCherney A, Hayes H, Caswell W, Tucker M, Graham J, Lim J, Hill M. Do donor oocyte recipients benefit from preimplantation genetic testing for aneuploidy(PGT-A) to improve pregnancy outcomes? Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.219] [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: 10/28/2022]
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Størdal K, McArdle HJ, Hayes H, Tapia G, Viken MK, Lund-Blix NA, Haugen M, Joner G, Skrivarhaug T, Mårild K, Njølstad PR, Eggesbø M, Mandal S, Page CM, London SJ, Lie BA, Stene LC. Prenatal iron exposure and childhood type 1 diabetes. Sci Rep 2018; 8:9067. [PMID: 29899542 PMCID: PMC5998022 DOI: 10.1038/s41598-018-27391-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/23/2018] [Indexed: 02/06/2023] Open
Abstract
Iron overload due to environmental or genetic causes have been associated diabetes. We hypothesized that prenatal iron exposure is associated with higher risk of childhood type 1 diabetes. In the Norwegian Mother and Child cohort study (n = 94,209 pregnancies, n = 373 developed type 1 diabetes) the incidence of type 1 diabetes was higher in children exposed to maternal iron supplementation than unexposed (36.8/100,000/year compared to 28.6/100,000/year, adjusted hazard ratio 1.33, 95%CI: 1.06-1.67). Cord plasma biomarkers of high iron status were non-significantly associated with higher risk of type 1 diabetes (ferritin OR = 1.05 [95%CI: 0.99-1.13] per 50 mg/L increase; soluble transferrin receptor: OR = 0.91 [95%CI: 0.81-1.01] per 0.5 mg/L increase). Maternal but not fetal HFE genotypes causing high/intermediate iron stores were associated with offspring diabetes (odds ratio: 1.45, 95%CI: 1.04, 2.02). Maternal anaemia or non-iron dietary supplements did not significantly predict type 1 diabetes. Perinatal iron exposures were not associated with cord blood DNA genome-wide methylation, but fetal HFE genotype was associated with differential fetal methylation near HFE. Maternal cytokines in mid-pregnancy of the pro-inflammatory M1 pathway differed by maternal iron supplements and HFE genotype. Our results suggest that exposure to iron during pregnancy may be a risk factor for type 1 diabetes in the offspring.
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Affiliation(s)
- Ketil Størdal
- Department of non-communicable diseases, Norwegian Institute of Public Health, Oslo, Norway.
- Pediatric Department, Ostfold Hospital Trust, Fredrikstad, Norway.
| | - Harry J McArdle
- The Rowett Institute of Nutrition and Health, University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK
| | - Helen Hayes
- The Rowett Institute of Nutrition and Health, University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK
| | - German Tapia
- Department of non-communicable diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Marte K Viken
- Department of Medical Genetics, University of Oslo, Oslo University Hospital, Ullevål, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Nicolai A Lund-Blix
- Department of non-communicable diseases, Norwegian Institute of Public Health, Oslo, Norway
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Margaretha Haugen
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Joner
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Torild Skrivarhaug
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karl Mårild
- Department of non-communicable diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål R Njølstad
- Department of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Siddhartha Mandal
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian M Page
- Department of non-communicable diseases, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Stephanie J London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Benedicte A Lie
- Department of Medical Genetics, University of Oslo, Oslo University Hospital, Ullevål, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Lars C Stene
- Department of non-communicable diseases, Norwegian Institute of Public Health, Oslo, Norway
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20
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Raikos V, Grant SB, Hayes H, Ranawana V. Use of β-glucan from spent brewer's yeast as a thickener in skimmed yogurt: Physicochemical, textural, and structural properties related to sensory perception. J Dairy Sci 2018; 101:5821-5831. [PMID: 29705412 DOI: 10.3168/jds.2017-14261] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 12/08/2017] [Accepted: 03/20/2018] [Indexed: 01/18/2023]
Abstract
Powdered β-glucan extracted from brewer's yeast (Yestimun, Leiber GmbH, Bramsche, Germany) was incorporated into skimmed-milk yogurt at varying concentrations (0.2-0.8% wt/wt) to investigate its potential application as a thickener. The effect of β-glucan fortification on the nutritional profile, microstructure, physicochemical properties, and texture of freshly prepared yogurts was investigated. Sensory evaluation was also conducted and was correlated with instrumental analysis. The addition of Yestimun significantly reduced the fermentation time of the yogurt mix from 4 h to 3 h. Scanning electron microscopy revealed that β-glucan particles formed small spherical clusters within the yogurt matrix. The majority of the physicochemical properties (syneresis, viscosity, color, and titratable acidity) remained unaffected by the incorporation of Yestimun in the recipe. Textural properties showed a gradual increment with increasing β-glucan concentration. Hardness, total work done, adhesive force, and adhesiveness increased by 19.27, 23.3, 21.53, and 20.76%, respectively, when using the highest amount of Yestimun powder. Sensory analysis (n = 40) indicated that fortifying yogurt with Yestimun at 0.8% (wt/wt) concentration may affect overall acceptance ratings, which was attributed to adverse flavor and aftertaste effects. However, the overall liking score of the yogurt (5.0/9.0) shows potential for commercialization of the product.
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Affiliation(s)
- Vassilios Raikos
- Rowett Institute, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland.
| | - Shannon B Grant
- Rowett Institute, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland
| | - Helen Hayes
- Rowett Institute, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland
| | - Viren Ranawana
- Rowett Institute, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland
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21
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Hayes H, Barber J, Dembo L, Lam K, Shah A, Dias P, Lambert J, Larbalestier R, Baumwol. J. The World’s Longest-Supported HeartWare TM Ventricular Assist Device Patient 10 Years & Counting: The Western Australian Experience. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Asokendaran M, AL-Ogaili Z, Njue F, Barber J, Hayes H, Lam K. The Role of Gallium Scans in the Diagnosis of Clinically Suspected Left Ventricular Assist Device Infections in Western Australia. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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23
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Njue F, Collins K, Hayes H, Barber J, Lam K. Neurohormonal Blockade with Sacubitril/Valsartan in Left Ventricular Assist Device (LVAD) Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1261] [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: 11/30/2022] Open
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25
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Lim J, Doyle N, Stratton M, Doyle J, Graham J, DeCherney A, Hayes H, Caswell W, Levy M, Tucker M. Donor egg banking & egg efficiency: what is an optimum number per egg lot? Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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James GA, Thostenson JD, Brown G, Carter G, Hayes H, Tripathi SP, Dobry DJ, Govindan RB, Dornhoffer JL, Williams DK, Kilts CD, Mennemeier MS. Neural activity during attentional conflict predicts reduction in tinnitus perception following rTMS. Brain Stimul 2017. [PMID: 28629874 DOI: 10.1016/j.brs.2017.05.009] [Citation(s) in RCA: 12] [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] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Subjective idiopathic tinnitus is an intrusive, distracting, and potentially disabling disorder characterized by phantom perception of sounds. Although tinnitus has no approved pharmacologic treatment, recent evidence supports the use of repetitive transcranial magnetic stimulation (rTMS) to alleviate tinnitus symptoms. OBJECTIVE/HYPOTHESIS Repetitive TMS delivered over the middle superior temporal gyrus (STG) may alter ratings of tinnitus awareness and annoyance more than loudness due to change in attentional processing. STG has reciprocal connections to regions of the prefrontal cortex that mediate attention. To probe the hypothesized influence of STG stimulation on attention, a subset of patients with tinnitus enrolled in an rTMS clinical trial [n = 12, 9 male, mean (sd) age = 49 (15) years] underwent an attentional conflict task before and after rTMS treatment in a repeated-measures functional magnetic resonance imaging (fMRI) study. METHODS The Multi-Source Interference Task (MSIT), a Stroop-based visual attentional conflict fMRI task, was used to map participants' neural processing of attentional conflict prior to rTMS intervention (Baseline) and after three rTMS intervention arms: Sham, 1 Hz, and 10 Hz (four sessions per arm, 1800 pulses per session, delivered @110% of the motor threshold over the posterior superior temporal gyrus). RESULTS All measures of tinnitus severity (awareness, loudness, and annoyance) improved with 1 Hz rTMS intervention; however, the greatest and most robust changes were observed for ratings of tinnitus awareness (mean 16% reduction in severity from Baseline, p < 0.01). The MSIT elicited a similar pattern of neural activation among tinnitus participants at Baseline compared to an independent sample of 43 healthy comparison adults (r = 0.801, p = 0.001). Linear regression with bootstrap resampling showed that greater recruitment of bilateral prefrontal and bilateral parietal regions by MSIT at Baseline corresponded with poorer treatment response. Individual regions' activities explained 37-67% variance in participant treatment response, with left dorsolateral prefrontal cortex's MSIT activity at Baseline explaining the greatest reduction in tinnitus awareness following 1 Hz stimulation. Although left dorsolateral prefrontal cortex activity at Baseline also predicted reduction in tinnitus loudness and annoyance (∼50% variance explained), these symptoms were more strongly predicted by right middle occipital cortex (∼70% variance explained) - suggesting that the neural predictors of symptom-specific treatment outcomes may be dissociable. CONCLUSION These candidate neural reactivity markers of treatment response have potential clinical value in identifying tinnitus sufferers who would or would not therapeutically benefit from rTMS intervention.
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Affiliation(s)
- G A James
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States.
| | - J D Thostenson
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - G Brown
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - G Carter
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - H Hayes
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - S P Tripathi
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - D J Dobry
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - R B Govindan
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - J L Dornhoffer
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - D K Williams
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - C D Kilts
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
| | - M S Mennemeier
- University of Arkansas for Medical Sciences, 4301 W. Markham St #554, Little Rock, AR 72205-7199, United States
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27
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Tobin JM, Liu J, Hayes H, Demleitner M, Ellis D, Arrighi V, Xu Z, Vilela F. BODIPY-based conjugated microporous polymers as reusable heterogeneous photosensitisers in a photochemical flow reactor. Polym Chem 2016. [DOI: 10.1039/c6py01393g] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Production of singlet oxygen at 530 nm in a flow reactor using novel BODIPY-based polymers as heterogeneous photosensitisers.
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Affiliation(s)
- J. M. Tobin
- School of Engineering and Physical Sciences
- Heriot-Watt University
- Edinburgh
- UK
| | - J. Liu
- Department of Biology and Chemistry
- City University of Hong Kong
- Kowloon
- China
| | - H. Hayes
- School of Engineering and Physical Sciences
- Heriot-Watt University
- Edinburgh
- UK
| | - M. Demleitner
- School of Engineering and Physical Sciences
- Heriot-Watt University
- Edinburgh
- UK
| | - D. Ellis
- School of Engineering and Physical Sciences
- Heriot-Watt University
- Edinburgh
- UK
| | - V. Arrighi
- School of Engineering and Physical Sciences
- Heriot-Watt University
- Edinburgh
- UK
| | - Z. Xu
- Department of Biology and Chemistry
- City University of Hong Kong
- Kowloon
- China
| | - F. Vilela
- School of Engineering and Physical Sciences
- Heriot-Watt University
- Edinburgh
- UK
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Rhodes C, Hayes H. PARE0011 An Insight into Membership of Involve from the Patient and Organisational Perspective. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2942] [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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Critoph C, Green G, Hayes H, Baumwol J, Lam K, Larbalestier R, Chih S. Clinical Outcomes of Patients Treated With Pulmonary Vasodilators Early and in High Dose After Left Ventricular Assist Device Implantation. Artif Organs 2015; 40:106-14. [DOI: 10.1111/aor.12502] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Christopher Critoph
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
| | - Gillian Green
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
| | - Helen Hayes
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
| | - Jay Baumwol
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
| | - Kaitlyn Lam
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
| | - Robert Larbalestier
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
| | - Sharon Chih
- Advanced Heart Failure and Cardiac Transplantation; Royal Perth Hospital; Wellington Street Perth Western Australia Australia
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Dias P, Hayes H, Baumwol J. The Use of Octreotide to Treat Refractory Gastrointestinal Bleeding in Patients Supported With a Continuous-Flow Left Ventricular Assist Device. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Garcia-Valdes L, Campoy C, Hayes H, Florido J, Rusanova I, Miranda MT, McArdle HJ. The impact of maternal obesity on iron status, placental transferrin receptor expression and hepcidin expression in human pregnancy. Int J Obes (Lond) 2015; 39:571-8. [PMID: 25614087 DOI: 10.1038/ijo.2015.3] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [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] [Received: 08/27/2014] [Revised: 11/08/2014] [Accepted: 12/16/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND Obesity is associated with decreased iron status, possibly due to a rise in hepcidin, an inflammatory protein known to reduce iron absorption. In animals, we have shown that maternal iron deficiency is minimised in the foetus by increased expression of placental transferrin receptor (pTFR1), resulting in increased iron transfer at the expense of maternal iron stores. OBJECTIVE This study examines the effect of obesity during pregnancy on maternal and neonatal iron status in human cohorts and whether the placenta can compensate for decreased maternal iron stores by increasing pTFR1 expression. SUBJECTS/METHODS A total of 240 women were included in this study. One hundred and fifty-eight placentas (Normal: 90; Overweight: 37; Obese: 31) were collected at delivery. Maternal iron status was measured by determining serum transferrin receptor (sTFR) and ferritin levels at 24 and 34 weeks and at delivery. Hepcidin in maternal and cord blood was measured by ELISA and pTFR1 in placentas by western blotting and real-time RT-PCR. RESULTS Low iron stores were more common in obese women. Hepcidin levels (ng ml(-1)) at the end of the pregnancy were higher in obese than normal women (26.03±12.95 vs 18.00±10.77, P<0.05). Maternal hepcidin levels were correlated with maternal iron status (sTFR r=0.2 P=0.025), but not with neonatal values. mRNA and protein levels of pTFR1 were both inversely related to maternal iron status. For mRNA and all women, sTFR r=0.2 P=0.044. Ferritin mRNA levels correlated only in overweight women r=-0.5 P=0.039 with hepcidin (r=0.1 P=0.349), irrespective of maternal body mass index (BMI). CONCLUSIONS The data support the hypothesis that obese pregnant women have a greater risk of iron deficiency and that hepcidin may be a regulatory factor. Further, we show that the placenta responds to decreased maternal iron status by increasing pTFR1 expression.
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Affiliation(s)
- L Garcia-Valdes
- 1] The Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen, UK [2] Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
| | - C Campoy
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
| | - H Hayes
- The Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen, UK
| | - J Florido
- Department Obstetrics and Gynaecology, School of Medicine, University of Granada, Granada, Spain
| | - I Rusanova
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
| | - M T Miranda
- Department of Biostatistics, School of Medicine, University of Granada, Granada, Spain
| | - H J McArdle
- The Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen, UK
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Lenartowicz M, Kennedy C, Hayes H, McArdle HJ. Transcriptional regulation of copper metabolism genes in the liver of fetal and neonatal control and iron-deficient rats. Biometals 2014; 28:51-9. [PMID: 25349135 PMCID: PMC4300417 DOI: 10.1007/s10534-014-9802-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 10/16/2014] [Indexed: 12/25/2022]
Abstract
Copper and iron metabolism have been known to interact for many years. We have previously shown, during pregnancy, that copper levels in the maternal liver rise as a consequence of iron deficiency, but that levels in the fetal liver decrease. In this paper, we measure expression of genes involved in copper metabolism in fetal and postnatal liver, to test whether alterations can explain this observation. Additionally, we study the extent to which gene expression changes in the latter stages of pregnancy and in the perinatal period. Ctr1 expression levels dropped to term, rising again thereafter. There was no difference in gene expression between control and iron deficient animals. Atox1 expression remained approximately stable until term, and then there was a rise to a maximum at about Day 8. Atp7a expression levels remained constant, except for a brief drop at term. Atp7b levels, in contrast, decreased from a maximum early in gestation to low levels in the term and post-natal livers. Ceruloplasmin expression appeared to be diametrically opposite to Atp7b. The other two metallochaperones showed the same pattern of expression as Atox1, with a decrease to term, a rise at Day 1, or a rise after birth followed by a brief decrease at about Day 3. None of the genes were significantly affected by iron deficiency, suggesting that changes in expression cannot explain the altered copper levels in the fetal and neonatal liver.
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Affiliation(s)
- Malgorzata Lenartowicz
- Department of Genetics and Evolution, Institute of Zoology, Jagiellonian University, Gronostajowa 9, 30-387, Kraków, Poland
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Cox J, Fru K, Lim J, Earl T, Hayes H, Richter K, Kaplan B, Frattarelli J, DeCherney A, Levy M. Import and export of frozen donor oocyte bank: does transportation affect survival and pregnancy rates? Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.147] [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]
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Fru K, Cox J, Lim J, Berger B, Hayes H, Segars J, Hoffman D. Banked frozen donor oocytes demonstrate high efficiency in conversion to live born infants; a collaborative multi-site experience. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Davies D, Malak S, Jensen J, Akhter N, Beneš H, Childs G, Daniel J, Hayes H, Kandavalli N, Phelan K, Stanley L, Syed M. Medical gross anatomy: conversion of a traditional discipline‐based course to a briefer and more clinically focused foundational module in a revamped preclinical curriculum (532.1). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.532.1] [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)
- David Davies
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Sharp Malak
- Radiology University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Joseph Jensen
- Surgery University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Noor Akhter
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Helen Beneš
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Gwen Childs
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Joseph Daniel
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Helen Hayes
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Naveen Kandavalli
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Kevin Phelan
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Laura Stanley
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Mohsin Syed
- Neurobiol. and Devel. SciencesUniversity of Arkansas for Medical SciencesLITTLE RocKARUnited States
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Critoph C, Lam K, Baumwol J, Dembo L, Shah A, Hayes H, Barber J, Larbalestier R, Chih S. Pulmonary Vasodilators Early and in High Dose Improve Outcomes and Reduce Right Ventricular Failure After Left Ventricular Device Implantation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Syed M, Akhter N, Hayes H, Davies D. Methods used in the gross anatomy lab to facilitate learning by first‐year students in a new Physician Assistant Program (722.1). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.722.1] [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)
- Mohsin Syed
- Neurobiology & Developmental Sciences Univ. Of Arkansas for Med. SciencesLITTLE RocKARUnited States
| | - Noor Akhter
- Neurobiology & Developmental Sciences Univ. Of Arkansas for Med. SciencesLITTLE RocKARUnited States
| | - Helen Hayes
- Neurobiology & Developmental Sciences Univ. Of Arkansas for Med. SciencesLITTLE RocKARUnited States
| | - David Davies
- Neurobiology & Developmental Sciences Univ. Of Arkansas for Med. SciencesLITTLE RocKARUnited States
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Staley K, Buckland SA, Hayes H, Tarpey M. 'The missing links': understanding how context and mechanism influence the impact of public involvement in research. Health Expect 2012; 17:755-64. [PMID: 23107054 DOI: 10.1111/hex.12017] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2012] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION It is now more widely recognized that public involvement in research increases the quality and relevance of the research. However, there are also more questions as to exactly how and when involvement brings added value. THE NATURE OF THE CURRENT EVIDENCE OF IMPACT Based on the findings of recent literature reviews, most reports of public involvement that discuss impact are based on observational evaluations. These usefully describe the context, the type of involvement and the impact. However, the links between these factors are rarely considered. The findings are therefore limited to identifying the range of impacts and general lessons for good practice. Reflecting on the links between context, mechanism and outcome in these observational evaluations identifies which aspects of the context and mechanism could be significant to the outcome. Studies that are more in line with the principles of realistic evaluation can test these links more rigorously. Building on the evidence from observational evaluations to design research that explores the 'missing links' will help to address the question 'what works best, for whom and when'. CONCLUSIONS We conclude that a more intentional and explicit exploration of the links between context, mechanism and outcome, applying the principles of realistic evaluation to public involvement in research, should lead to a more sophisticated understanding of the factors that increase or decrease the likelihood of positive outcomes. This will support the development of more strategic approaches to involvement maximizing the benefits for all involved.
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Lam K, Hayes H, Barber J, Green G, Dembo L, O'Driscoll G. 118 Effectiveness of Platelet Aggregation Inhibitor (Tirofiban) in Treating Continuous Flow Ventricular Assist Device (VAD) Thrombus. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Swali A, McMullen S, Hayes H, Gambling L, McArdle HJ, Langley-Evans SC. Cell cycle regulation and cytoskeletal remodelling are critical processes in the nutritional programming of embryonic development. PLoS One 2011; 6:e23189. [PMID: 21858025 PMCID: PMC3157362 DOI: 10.1371/journal.pone.0023189] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 07/11/2011] [Indexed: 01/22/2023] Open
Abstract
Many mechanisms purport to explain how nutritional signals during early development are manifested as disease in the adult offspring. While these describe processes leading from nutritional insult to development of the actual pathology, the initial underlying cause of the programming effect remains elusive. To establish the primary drivers of programming, this study aimed to capture embryonic gene and protein changes in the whole embryo at the time of nutritional insult rather than downstream phenotypic effects. By using a cross-over design of two well established models of maternal protein and iron restriction we aimed to identify putative common “gatekeepers” which may drive nutritional programming. Both protein and iron deficiency in utero reduced the nephron complement in adult male Wistar and Rowett Hooded Lister rats (P<0.05). This occurred in the absence of damage to the glomerular ultrastructure. Microarray, proteomic and pathway analyses identified diet-specific and strain-specific gatekeeper genes, proteins and processes which shared a common association with the regulation of the cell cycle, especially the G1/S and G2/M checkpoints, and cytoskeletal remodelling. A cell cycle-specific PCR array confirmed the down-regulation of cyclins with protein restriction and the up-regulation of apoptotic genes with iron deficiency. The timing and experimental design of this study have been carefully controlled to isolate the common molecular mechanisms which may initiate the sequelae of events involved in nutritional programming of embryonic development. We propose that despite differences in the individual genes and proteins affected in each strain and with each diet, the general response to nutrient deficiency in utero is perturbation of the cell cycle, at the level of interaction with the cytoskeleton and the mitotic checkpoints, thereby diminishing control over the integrity of DNA which is allowed to replicate. These findings offer novel insight into the primary causes and mechanisms leading to the pathologies which have been identified by previous programming studies.
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Affiliation(s)
- Angelina Swali
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, United Kingdom.
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Lim TS, O’Driscoll G, Freund J, Peterson V, Hayes H, Heywood J. Short-course Total Lymphoid Irradiation for Refractory Cardiac Transplantation Rejection. J Heart Lung Transplant 2007; 26:1249-54. [DOI: 10.1016/j.healun.2007.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Revised: 08/29/2007] [Accepted: 09/12/2007] [Indexed: 10/22/2022] Open
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Hayes H, Dembo L, Larbalestier R, O'Driscoll G. Successful treatment of ventricular assist device associated ventricular thrombus with systemic tenecteplase. Heart Lung Circ 2007; 17:253-5. [PMID: 17581787 DOI: 10.1016/j.hlc.2007.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Revised: 04/17/2007] [Accepted: 04/18/2007] [Indexed: 11/26/2022]
Abstract
We report a case of intracardiac thrombus in a patient supported by the Jarvik 2000 Flowmaker successfully treated with a single dose of peripherally administered TNK-tissue plasminogen activator (Tenecteplase, Metalyse, Boehringer Ingelheim). This strategy may be considered in the case of life-threatening VAD associated thrombosis to avoid the need for intracardiac drug delivery or VAD replacement. We also discuss the apparent increased thrombotic risk in patients receiving a VAD for chemotherapy induced cardiomyopathy and the implications this may have for the choice of VAD.
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Affiliation(s)
- H Hayes
- Advanced Heart Failure & Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, Australia.
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Hayes H. A Scottish enlightenment. Library Management 2007. [DOI: 10.1108/01435120710744173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to describe the experience of working in Scotland as Vice Principal for Knowledge Management and Librarian to the University.Design/methodology/approachThe paper addresses some of the reasons for moving and the differences in approach to the job as well as some of the major library and management milestones achieved. It is also a personal view of the issues that were faced in changing countries and cultures.FindingsThe paper gives some findings on what one might expect by making a move of this kind and hopefully will encourage others to do so too.Originality/valueThe world is increasingly international and more accessible. This paper advocates a more international approach to career development.
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Di Meo GP, Perucatti A, Floriot S, Hayes H, Schibler L, Rullo R, Incarnato D, Ferretti L, Cockett N, Cribiu E, Williams JL, Eggen A, Iannuzzi L. An advanced sheep (Ovis aries, 2n = 54) cytogenetic map and assignment of 88 new autosomal loci by fluorescence in situ hybridization and R-banding. Anim Genet 2007; 38:233-40. [PMID: 17433010 PMCID: PMC2063634 DOI: 10.1111/j.1365-2052.2007.01598.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Presented herein is an updated sheep cytogenetic map that contains 452 loci (291 type I and 161 type II) assigned to specific chromosome bands or regions on standard R-banded ideograms. This map, which significantly extends our knowledge of the physical organization of the ovine genome, includes new assignments for 88 autosomal loci, including 74 type I loci (known genes) and 14 type II loci (SSRs/microsatellite marker/STSs), by FISH-mapping and R-banding. Comparison of the ovine map to the cattle and goat cytogenetic maps showed that common loci were located within homologous chromosomes and chromosome bands, confirming the high level of conservation of autosomes among ruminant species. Eleven loci that were FISH-mapped in sheep (B3GAT2, ASCC3, RARSL, BRD2, POLR1C, PPP2R5D, TNRC5, BAT2, BAT4, CDC5L and OLA-DRA) are unassigned in cattle and goat. Eleven other loci (D3S32, D1S86, BMS2621, SFXN5, D5S3, D5S68, CSKB1, D7S49, D9S15, D9S55 and D29S35) were assigned to specific ovine chromosome (OAR) bands but have only been assigned to chromosomes in cattle and goat.
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Affiliation(s)
- G P Di Meo
- Laboratory of Animal Cytogenetics and Gene Mapping, National Research Council (CNR), ISPAAM, Naples, Italy
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Chantry-Darmon C, Urien C, de Rochambeau H, Allain D, Pena B, Hayes H, Grohs C, Cribiu EP, Deretz-Picoulet S, Larzul C, Save JC, Neau A, Chardon P, Rogel-Gaillard C. A first-generation microsatellite-based integrated genetic and cytogenetic map for the European rabbit (Oryctolagus cuniculus) and localization of angora and albino. Anim Genet 2006; 37:335-41. [PMID: 16879342 DOI: 10.1111/j.1365-2052.2006.01462.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although the European rabbit (Oryctolagus cuniculus) is used both in agronomics and in research, genomic resources for this species are still limited and no microsatellite-based genetic map has been reported. Our aim was to construct a rabbit genetic map with cytogenetically mapped microsatellites so as to build an integrated genetic and cytogenetic map. A reference population of 187 rabbits comprising eight three-generation families with 10-25 offspring per family was produced. One hundred and ninety-four of 305 previously identified microsatellites were included in this study. Of these, 158 were polymorphic with two to seven alleles. The map reported here comprises 111 markers, including 104 INRA microsatellites, five microsatellites from another source and two phenotypic markers (angora and albino). Ninety markers were integrated into 20 linkage groups. The remaining 21 microsatellites mapped to separate linkage groups, 19 with a precise cytogenetic position and two with only a chromosomal assignment. The genetic map spans 2766.6 cM and covers 20 rabbit chromosomes, excluding chromosomes 20, 21 and X. The density of this map is limited, but we used it to verify the location of angora and albino on chromosomes 15q and 1q, respectively, in agreement with previously published data. This first generation genetic/cytogenetic map will help gene identification and quantitative trait loci mapping projects in rabbit.
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Affiliation(s)
- C Chantry-Darmon
- Laboratoire de Radiobiologie et Etude du Génome, UMR INRA CEA 314, Domaine de Vilvert, 78350 Jouy-en-Josas, France
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Abstract
BACKGROUND Communities across the United States have become more involved in enhancing school readiness. Many of the predictors of school readiness relate to conditions prior to and following the birth of the child, including a child's birthweight. Shortened birth intervals are related to a variety of health and social consequences that affect child development, yet no formal research has examined the association between birth intervals and school readiness. METHODS This study was a secondary data analysis of de-identified pregnancy-related vital record information, matched to selected items from the Department of Health and Human Services Medicaid records on mothers and children and to the Cognitive Skills Assessment Battery score in South Carolina for the year 2000 for the child of interest (N = 6915). Analysis of covariance and logistic regression were used to determine if there was a statistically significant relationship between birth interval and school readiness. RESULTS Results showed that birth interval is a significant predictor of school readiness with a P-value <0.001 even after controlling for various socio-demographic factors. Children born with inadequate birth intervals (less than 24 months) are more likely to fail the Cognitive Skills Assessment Battery compared with those with adequate birth intervals. Potential implications of this research include promoting optimal birth spacing to improve the likelihood that future first graders will come to school ready to learn.
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Affiliation(s)
- H Hayes
- South Carolina Chapter, March of Dimes, Columbia, SC, USA.
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Chantry-Darmon C, Bertaud M, Urien C, Chadi-Taourit S, Perrocheau M, Rogel-Gaillard C, Hayes H. Expanded comparative mapping between man and rabbit and detection of a new conserved segment between HSA22 and OCU4. Cytogenet Genome Res 2006; 111:134-9. [PMID: 16103654 DOI: 10.1159/000086382] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2004] [Accepted: 01/19/2005] [Indexed: 11/19/2022] Open
Abstract
Rabbit, a domestic species exploited both in animal production and medical research has only recently begun to be included in gene mapping projects, in particular by the French National Institute of Agronomics. By 2002, less than 60 genes had been precisely localised on rabbit chromosomes, which led us to start a large-scale project on gene mapping in rabbit with the publication of 133 gene localisations in 2003 (Chantry-Darmon et al., 2003). Here, we report the localisation of 102 new genes resulting in good coverage of the rabbit genome and an eight-fold enrichment of the gene map. In addition, we have detected a new conserved segment between rabbit chromosome 4q15.3 and part of human chromosome 22 and thus improved the comparative map with the human genome.
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Affiliation(s)
- C Chantry-Darmon
- Laboratoire de Génétique biochimique et Cytogénétique, INRA, Jouy-en-Josas, France
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Affiliation(s)
- L Ordovás
- Laboratorio de Genética Bioquímica, Facultad de Veterinaria, Universidad de Zaragoza, Zaragoza 50013, Spain.
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Abstract
BACKGROUND The lymphatic endothelium is important to the functioning of the lymphatic system, including lymphatic remodeling, control of vessel tone, and lymphatic movement of fluids, macromolecules, and cells. Many of these events occur principally at the level of the microlymphatics. To evaluate the role of the microlymphatic endothelium, a suitable cultured cell line would be useful. We have developed a technique to isolate and culture endothelial cells from microscopic lymphatics, approximately 100 microm in diameter. METHODS AND RESULTS To isolate the rat mesenteric lymphatic endothelial cells (RMLEC), the rat was anesthetized and the mesentery carefully exteriorized. A suitable microlymphatic was located and carefully microdissected from the surrounding mesentery. The vessel was carefully cleaned, cannulated, everted, and then incubated on a gelatin-coated plastic culture dish until small patches of cells migrated off of the vessel (3-4 days later.) The explanted vessel was then removed. The remaining cells were cultured and screened for endothelial phenotype. Nonendothelial cells were destroyed. The endothelial nature of the remaining cells was verified by: 1) morphology, 2) uptake of fluorescent acetylated-LDL, 3) staining for von Wille-brand factor, PECAM-1, ecNOS, LYVE-1, VEGFR-3, and 4) essentially negative alpha-vascular smooth muscle actin staining. The defined RMLEC were passed and the profile of adhesion molecules present on the RMLEC was then determined using PCR and immunofluorescence. CONCLUSIONS We developed and partially characterized a line of cultured microlymphatic endothelium. RMLEC express known endothelial- and lymphatic-specific markers as well as the following adhesion molecules: N-cadherin, E-cadherin, PECAM-1, alpha-catenin, beta-catenin, gamma-catenin, p120, and a variety of integrins.
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Affiliation(s)
- H Hayes
- Department of Medical Physiology, Cardiovascular Research Institute, The Texas A&M University System Health Science Center, College Station, Texas, 77843-1114, USA
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