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Howden-Chapman P, Crane J, Keall M, Pierse N, Baker MG, Cunningham C, Amore K, Aspinall C, Bennett J, Bierre S, Boulic M, Chapman R, Chisholm E, Davies C, Fougere G, Fraser B, Fyfe C, Grant L, Grimes A, Halley C, Logan-Riley A, Nathan K, Olin C, Ombler J, O’Sullivan K, Pehi T, Penny G, Phipps R, Plagman M, Randal E, Riggs L, Robson B, Ruru J, Shaw C, Schrader B, Teariki MA, Telfar Barnard L, Tiatia R, Toy-Cronin B, Tupara H, Viggers H, Wall T, Wilkie M, Woodward A, Zhang W. He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing. J R Soc N Z 2023. [DOI: 10.1080/03036758.2023.2170427] [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: 02/09/2023]
Affiliation(s)
- Philippa Howden-Chapman
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julian Crane
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael Keall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Kate Amore
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Clare Aspinall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julie Bennett
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Sarah Bierre
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Mikael Boulic
- School of the Built Environment, Massey University, Auckland, New Zealand
| | - Ralph Chapman
- School of Geography, Environment and Earth Sciences, Te Herenga Waka, Victoria University of Wellington, New Zealand
| | - Elinor Chisholm
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Wainuiomata, Lower Hutt, New Zealand
| | - Geoff Fougere
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Brodie Fraser
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Caro Fyfe
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Libby Grant
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Arthur Grimes
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Caroline Halley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Amber Logan-Riley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kim Nathan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Crystal Olin
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Jenny Ombler
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kimberley O’Sullivan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Tiria Pehi
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Guy Penny
- EMPlan Services Ltd, Wellington, New Zealand
| | - Robyn Phipps
- Faculty of Architecture and Design Innovation, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Manfred Plagman
- Building Research Association of New Zealand, Porirua, New Zealand
| | - Edward Randal
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lynn Riggs
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Bridget Robson
- Eru Pomare Māori Health Research Centre, University of Otago, Wellington, New Zealand
| | - Jacinta Ruru
- Faculty of Law, University of Otago, Dunedin, New Zealand
| | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ben Schrader
- Stout Research Centre, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Mary Anne Teariki
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Ramona Tiatia
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Hope Tupara
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Helen Viggers
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Marg Wilkie
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Wei Zhang
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
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Bola R, Sutherland J, Murphy RA, Leeies M, Grant L, Hayward J, Archambault P, Graves L, Rose T, Hohl C. Patient-reported health outcomes of SARS-CoV-2-tested patients presenting to emergency departments: a propensity score-matched prospective cohort study. Public Health 2023; 215:1-11. [PMID: 36587446 PMCID: PMC9712064 DOI: 10.1016/j.puhe.2022.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE This study aimed to compare the long-term physical and mental health outcomes of matched severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive and SARS-CoV-2-negative patients controlling for seasonal effects. STUDY DESIGN This was a retrospective cohort study. METHODS This study enrolled patients presenting to emergency departments participating in the Canadian COVID-19 Emergency Department Rapid Response Network. We enrolled consecutive eligible consenting patients who presented between March 1, 2020, and July 14, 2021, and were tested for SARS-CoV-2. Research assistants randomly selected four site and date-matched SARS-CoV-2-negative controls for every SARS-CoV-2-positive patient and interviewed them at least 30 days after discharge. We used propensity scores to match patients by baseline characteristics and used linear regression to compare Veterans RAND 12-item physical health component score (PCS) and mental health component scores (MCS), with higher scores indicating better self-reported health. RESULTS We included 1170 SARS-CoV-2-positive patients and 3716 test-negative controls. The adjusted mean difference for PCS was 0.50 (95% confidence interval [CI]: -0.36, 1.36) and -1.01 (95% CI: -1.91, -0.11) for MCS. Severe disease was strongly associated with worse PCS (β = -7.4; 95% CI: -9.8, -5.1), whereas prior mental health illness was strongly associated with worse MCS (β = -5.4; 95% CI: -6.3, -4.5). CONCLUSION Physical health, assessed by PCS, was similar between matched SARS-CoV-2-positive and SARS-CoV-2-negative patients, whereas mental health, assessed by MCS, was worse during a time when the public experienced barriers to care. These results may inform the development and prioritization of support programs for patients.
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Affiliation(s)
- R Bola
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - J Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada
| | - R A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - M Leeies
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada; Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - L Grant
- Department of Emergency Medicine, McGill University, Montreal, QC, Canada; Emergency Department, Jewish General Hospital, Montreal, QC, Canada
| | - J Hayward
- Department of Emergency Medicine, University of Alberta, AB, Canada
| | - P Archambault
- Université Laval, Department of Family Medicine and Emergency Medicine, QC, Canada
| | - L Graves
- Patient Partner, Canadian COVID-19 Emergency Department Rapid Response Network Patient Engagement Committee, Canada
| | - T Rose
- Patient Partner, Canadian COVID-19 Emergency Department Rapid Response Network Patient Engagement Committee, Canada
| | - C Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada; Emergency Department, Vancouver General Hospital, Vancouver, BC, Canada.
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Abstract
BACKGROUND Compassion, described as the act of providing care based on empathy, dignity and respect, is intrinsic to effective health and social care. Although delivering compassionate care has wide-ranging benefits for service users, more insight is needed into its effects on health and social care professionals. The emotional demands of 'helping' work can engender compassion fatigue that may impair well-being, whereas compassion satisfaction and feelings of compassion towards the self could be protective. AIMS To examine the effects (direct and indirect) of compassion satisfaction, compassion fatigue and self-compassion on mental health in a cohort of social workers. METHODS We used validated scales to measure emotional demands, compassion satisfaction and fatigue, and self-compassion and the General Health Questionnaire-12 to assess mental health. We tested the main and moderating effects of emotional demands and the three facets of compassion using hierarchical regression analysis. RESULTS The study sample comprised 306 social workers (79% female). Participants who reported higher levels of compassion satisfaction and self-compassion tended to report better mental health, whereas compassion fatigue was a significant risk factor for well-being. The models explained 44-53% of the variance in mental health symptoms. We found some evidence that compassion satisfaction and self-compassion buffer the negative effects of emotional demand on mental health, contributing 2 and 3%, respectively, to the incremental variance. CONCLUSIONS Our findings suggest that evidence-based interventions are needed to reduce compassion fatigue and enhance compassion satisfaction and self-compassion in social care work. We consider ways to accomplish this using targeted interventions.
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Affiliation(s)
- G Kinman
- School of Psychology, University of Bedfordshire, Park Square, Luton, Bedfordshire, UK
| | - L Grant
- School of Applied Social Studies, University of Bedfordshire, Park Square, Luton, Bedfordshire, UK
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Sehgal R, Birks T, Pindoria N, Grant L, Ajayi L, Ellis G. Computed tomography urography (CTU) findings as a predictor of the presence and grade of upper tract urothelial cancer (UTUC). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nicholson ML, Yong C, Trotter PB, Grant L, Hosgood SA. Risk factors for transplant renal artery stenosis after live donor transplantation. Br J Surg 2018; 106:199-205. [DOI: 10.1002/bjs.10997] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/07/2018] [Accepted: 08/09/2018] [Indexed: 11/05/2022]
Abstract
Abstract
Background
Renal transplant surgeons are making increasing use of live donor kidneys with multiple renal arteries. This study aimed to identify independent risk factors for the development of transplant renal artery stenosis (TRAS) in the modern era of complex arterial reconstruction for multiple vessels.
Methods
Multivariable logistic regression analysis with a stepwise variable deletion model was used to identify risk factors for the development of TRAS in a consecutive series of live donor kidney transplants.
Results
Of 506 kidney transplants, 19 (3·8 per cent) had evidence of significant TRAS on CT angiography. Functional TRAS, defined by improvement in BP control or renal function after correction of a stenosis by angioplasty, occurred in 13 of 506 patients (2·6 per cent). Independent risk factors for TRAS were: use of an explanted internal iliac artery graft from the recipient (odds ratio (OR) 4·95; P = 0·020) and total ischaemia time (OR 1·82; P = 0·010). TRAS was associated with a lower 5-year allograft survival rate (79 versus 88·7 per cent; P = 0·020) but only one graft loss was attributed directly to TRAS. The 5-year allograft survival rate after internal iliac artery grafting was 86 per cent.
Conclusion
Although use of an internal iliac artery graft is an independent risk factor for TRAS after live donor kidney transplantation, this technique is still a useful option for complex arterial reconstruction.
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Affiliation(s)
- M L Nicholson
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - C Yong
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - P B Trotter
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - L Grant
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - S A Hosgood
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Department of Surgery, University of Cambridge, Cambridge, UK
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Mukasahaha D, Uwinkindi F, Grant L, Downing J, Turyahikayo J, Leng M, Muhimpundu M. Assessment of Palliative Care Needs in Hospital Settings in Rwanda. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.78900] [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: 11/20/2022] Open
Abstract
Background: Rwanda is among the first African countries with a palliative care (PC) policy and implementation plan. A partnership with the Ministry of Health (MoH) through the Rwanda Biomedical Centre (RBC) and the University of Edinburgh has supported an integrated approach including expanding the evidence base. Aim: To assessing the need for (PC) to inform policy, service delivery and training. Methods: A point prevalence PC needs assessment was conducted in nine public hospitals (referral, provincial and district). A records census identified those with life-limiting illness (LLI) who were then invited to participate by interview. The assessment tool included the APCA African POS, POS S, WHO performance status and demographic information. Results: 608 case notes were reviewed, 152 eligible and 124 completed assessment. 25% of all patients admitted had LLI, of which 99.2% had evidence of unmet need determined by at least one score on the APCA POS ≥ 3. Diagnoses 29% cancer, 29% cardiovascular disease, 16.9% end-stage organ failure and 13.7% HIV. Symptoms with greatest impact; nausea and vomiting (34.7%) and pain (32.3%). 63.7% with WHO performance status 4 or 5. 8.1% seen by existing PC services. Conclusion: Although the MoH and RBC are making bold steps toward developing PC in Rwanda, there remains a significant amount of unmet PC needs. Meeting this need requires recognition of the scope of PC needs beyond cancer, feedback to the hospitals and health care workers, thinking strategically how to further strengthen the health system and further capacity building and training.
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Affiliation(s)
| | | | - L. Grant
- Rwandan Biomedical Centre, Kigali, Rwanda
| | - J. Downing
- Rwandan Biomedical Centre, Kigali, Rwanda
| | | | - M. Leng
- Rwandan Biomedical Centre, Kigali, Rwanda
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Mukasahaha D, Uwinkindi F, Grant L, Downing J, Turyahikayo J, Leng M, Muhimpundu M. Home-Based Care Practitioners: A Strategy for Continuum of Care for Very Ill Patient. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.78800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Rwanda Ministry of Health in collaboration with partners has initiated an innovative initiative named Home Based Care Practitioners (HBCPs) to respond to the burden of long-term hospitalization for end of life patients. Aim: The program aims at providing home-based care to accompany patients and their families in their home, reduce unnecessary pain and suffering for those with chronic or terminal conditions, provide counseling to the patients and their families, early diagnosis of NCDs and improve awareness on prevention of NCDs risk factors and effectively refer them to either health facilities or community-based resources that can be of further help. Methods: The HBCPs is implemented into phases; phase one has started with a pilot of 200 HBCPs in 100 cells surrounding nine provincial and referral hospitals of Rwanda; 2 practitioners for both gender in each cell, with a criteria of completion at least secondary school. They have undergone a training of 120 credits (900 hours), equivalent of four months for theory and two months of practice. After training they have been deployed into the community with a supervision of health centers in collaboration with hospitals and Rwanda Biomedical Center. Results: During the implementation period of 6 months, 1663 NCDs patients have been transferred from health facility (OPD) to HBCPs for routine follow-up, 482 palliative care patients have been reported on end of life care by HBCPs, there is a remarkable linkage between facilities and community care ensured by supervisory relationship between health services providers and home based care practitioners, long-term admission has reduced the cost for the family and the facility due to the discharge of care from hospital to home. Conclusion: In a limited setting of social and economic cost of providing frivolous care in an expensive hospital for chronic or terminal conditions that would be better managed through treatment or palliative care at home (or less acute setting) home based care effort can better meet the needs of Rwandans at the community level and has started to show the efficiency in providing quality care to people in need of palliative care.
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Affiliation(s)
| | | | - L. Grant
- University of Edinburgh, Global Health Academy, Edinburgh, United Kingdom,
| | - J. Downing
- Makerere University, Makerere and Mulago Palliative Care Unit, Kampala, Uganda,
| | | | - M. Leng
- Makerere University, Makerere and Mulago Palliative Care Unit, Kampala, Uganda,
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Bell J, Allerton L, Grant L, McLeman L, Tonna I, Okpo E. Learning lessons to improve blood borne virus testing in primary care in Scotland. Public Health 2018; 159:14-16. [PMID: 29679860 DOI: 10.1016/j.puhe.2018.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 02/06/2018] [Accepted: 02/14/2018] [Indexed: 11/30/2022]
Affiliation(s)
- J Bell
- Sexual Health and Blood Borne Viruses Managed Care Network (SH & BBV MCN), Public Health, NHS Grampian, UK.
| | - L Allerton
- Sexual Health and Blood Borne Viruses Managed Care Network (SH & BBV MCN), Public Health, NHS Grampian, UK
| | - L Grant
- Calsayseat Medical Group, Aberdeen, UK
| | - L McLeman
- SH & BBV MCN, Public Health, NHS Grampian; Aberdeen Royal Infirmary, UK
| | - I Tonna
- SH & BBV MCN, Public Health, NHS Grampian; Aberdeen Royal Infirmary, UK
| | - E Okpo
- Sexual Health and Blood Borne Viruses Managed Care Network (SH & BBV MCN), Public Health, NHS Grampian, UK
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Ward E, Gillies J, Armstrong D, Grant L, Elder A, Burton J, Ryan C, Quinn C. Cultivating Compassionate Care: Why Does it Matter and What Can We Do to Promote It? J R Coll Physicians Edinb 2018; 48:71-77. [DOI: 10.4997/jrcpe.2018.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - J Gillies
- Co-Director University of Edinburgh Compassion initiative
| | | | - L Grant
- Global Health Academy Co-Director Global Compassion Initiative
| | - A Elder
- Consultant Physician, NHS Lothian
| | - J Burton
- Geriatric Medicine, University of Edinburgh
| | - C Ryan
- Speciality Registrar Geriatric and General Medicine West of Scotland
| | - C Quinn
- Speciality Registrar Medicine of the Elderly, NHS Lothian
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Tanabalan C, Neves J, Patki P, Mumtaz F, Ramachandran N, Grant L, Walkden M, Aitchison M, Tran M, Barod R. Routine renal mass biopsy in diagnosis of renal cancer. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1569-9056(18)31145-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Affiliation(s)
- K N Kimani
- Primary Palliative Care Research Group, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - E Namukwaya
- Department of Medicine, Makerere Palliative Care Unit, Makerere University, Kampala, Uganda
| | - L Grant
- Primary Palliative Care Research Group, The Usher Institute, University of Edinburgh, Edinburgh, UK.,Global Health Academy, University of Edinburgh, Edinburgh, UK
| | - S A Murray
- Primary Palliative Care Research Group, The Usher Institute, University of Edinburgh, Edinburgh, UK
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Thompson D, Morrice N, Grant L, Le Sommer S, Ziegler K, Whitfield P, Mody N, Wilson HM, Delibegović M. Myeloid protein tyrosine phosphatase 1B (PTP1B) deficiency protects against atherosclerotic plaque formation in the ApoE -/- mouse model of atherosclerosis with alterations in IL10/AMPKα pathway. Mol Metab 2017; 6:845-853. [PMID: 28752048 PMCID: PMC5518727 DOI: 10.1016/j.molmet.2017.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/02/2017] [Accepted: 06/06/2017] [Indexed: 12/21/2022] Open
Abstract
Objective Cardiovascular disease (CVD) is the most prevalent cause of mortality among patients with Type 1 or Type 2 diabetes, due to accelerated atherosclerosis. Recent evidence suggests a strong link between atherosclerosis and insulin resistance due to impaired insulin receptor (IR) signaling. Moreover, inflammatory cells, in particular macrophages, play a key role in pathogenesis of atherosclerosis and insulin resistance in humans. We hypothesized that inhibiting the activity of protein tyrosine phosphatase 1B (PTP1B), the major negative regulator of the IR, specifically in macrophages, would have beneficial anti-inflammatory effects and lead to protection against atherosclerosis and CVD. Methods We generated novel macrophage-specific PTP1B knockout mice on atherogenic background (ApoE−/−/LysM-PTP1B). Mice were fed standard or pro-atherogenic diet, and body weight, adiposity (echoMRI), glucose homeostasis, atherosclerotic plaque development, and molecular, biochemical and targeted lipidomic eicosanoid analyses were performed. Results Myeloid-PTP1B knockout mice on atherogenic background (ApoE−/−/LysM-PTP1B) exhibited a striking improvement in glucose homeostasis, decreased circulating lipids and decreased atherosclerotic plaque lesions, in the absence of body weight/adiposity differences. This was associated with enhanced phosphorylation of aortic Akt, AMPKα and increased secretion of circulating anti-inflammatory cytokine interleukin-10 (IL-10) and prostaglandin E2 (PGE2), without measurable alterations in IR phosphorylation, suggesting a direct beneficial effect of myeloid-PTP1B targeting. Conclusions Here we demonstrate that inhibiting the activity of PTP1B specifically in myeloid lineage cells protects against atherosclerotic plaque formation, under atherogenic conditions, in an ApoE−/− mouse model of atherosclerosis. Our findings suggest for the first time that macrophage PTP1B targeting could be a therapeutic target for atherosclerosis treatment and reduction of CVD risk. PTP1B inhibition as therapy for atherosclerosis/cardiovascular disease is proposed. Myeloid-PTP1B mice on ApoE−/− background (ApoE−/−/LysM-PTP1B) were generated. ApoE−/−/LysM-PTP1B had improved glucose homeostasis with no body weight differences. ApoE−/−/LysM-PTP1B had lower lipids and protection against atherosclerotic plaques. Protection was via a PGE2/IL-10/AMPKα mechanism.
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Affiliation(s)
- D Thompson
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
| | - N Morrice
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - L Grant
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - S Le Sommer
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - K Ziegler
- Department of Diabetes and Cardiovascular Science, University of the Highlands and Islands, Centre for Health Science, Inverness, UK
| | - P Whitfield
- Department of Diabetes and Cardiovascular Science, University of the Highlands and Islands, Centre for Health Science, Inverness, UK
| | - N Mody
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - H M Wilson
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - M Delibegović
- Institute of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
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Grant L, Cain SW, Chang A, Saxena R, Czeisler CA, Anderson C. 0030 BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF) MET ALLELE CARRIERS SHOW IMPAIRED PERFORMANCE ON THE STROOP TASK DURING SLEEP DEPRIVATION. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.029] [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: 11/13/2022] Open
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Ftouni S, Zhou R, Grant L, Lockley SW, Cain S, Rajaratnam SW, Anderson C. 0078 INTER- AND INTRA-INDIVIDUAL RELATIONSHIPS BETWEEN PLASMA AND SALIVARY MELATONIN AND URINARY AMT6S. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.077] [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: 11/12/2022] Open
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Abstract
OBJECTIVE To assess the relationships between golf and health. DESIGN Scoping review. DATA SOURCES Published and unpublished reports of any age or language, identified by searching electronic databases, platforms, reference lists, websites and from consulting experts. REVIEW METHODS A 3-step search strategy identified relevant published primary and secondary studies as well as grey literature. Identified studies were screened for final inclusion. Data were extracted using a standardised tool, to form (1) a descriptive analysis and (2) a thematic summary. RESULTS AND DISCUSSION 4944 records were identified with an initial search. 301 studies met criteria for the scoping review. Golf can provide moderate intensity physical activity and is associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. There is limited evidence related to golf and mental health. The incidence of golfing injury is moderate, with back injuries the most frequent. Accidental head injuries are rare, but can have serious consequences. CONCLUSIONS Practitioners and policymakers can be encouraged to support more people to play golf, due to associated improved physical health and mental well-being, and a potential contribution to increased life expectancy. Injuries and illnesses associated with golf have been identified, and risk reduction strategies are warranted. Further research priorities include systematic reviews to further explore the cause and effect nature of the relationships described. Research characterising golf's contribution to muscular strengthening, balance and falls prevention as well as further assessing the associations and effects between golf and mental health are also indicated.
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Affiliation(s)
- A D Murray
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
- Sport and Exercise, University of Edinburgh, Edinburgh, UK
| | - L Daines
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - D Archibald
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - R A Hawkes
- European Tour Performance Institute, Virginia Water, UK
- Sports and Exercise Medicine, University College London, London, UK
| | - C Schiphorst
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - P Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - L Grant
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Global Health Academy, University of Edinburgh, Edinburgh, UK
| | - N Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
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Miller B, Bethune C, MacDonald S, McCarthy P, Grant L, O'Keefe D, Parsons E, Rourke J. Using an educational strategy to develop and sustain rural and remote communities of practice. Rural Remote Health 2016. [DOI: 10.22605/rrh4080] [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] Open
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Murray A, Daines L, Archibald D, Hawkes R, Grant L, Mutrie N. The relationship and effects of golf on physical and mental health: a scoping review protocol. Br J Sports Med 2016; 50:647-50. [PMID: 27130924 DOI: 10.1136/bjsports-2015-095914] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Golf is a sport played in 206 countries worldwide by over 50 million people. It is possible that participation in golf, which is a form of physical activity, may be associated with effects on longevity, the cardiovascular, metabolic and musculoskeletal systems, as well as on mental health and well-being. We outline our scoping review protocol to examine the relationships and effects of golf on physical and mental health. METHODS AND ANALYSIS Best practice methodological frameworks suggested by Arksey and O'Malley, Levac et al and the Joanna Briggs Institute will serve as our guide, providing clarity and rigour. A scoping review provides a framework to (1) map the key concepts and evidence, (2) summarise and disseminate existing research findings to practitioners and policymakers and (3) identify gaps in the existing research. A three-step search strategy will identify reviews as well as original research, published and grey literature. An initial search will identify suitable search terms, followed by a search using keyword and index terms. Two reviewers will independently screen identified studies for final inclusion. DISSEMINATION We will map key concepts and evidence, and disseminate existing research findings to practitioners and policymakers through peer-reviewed and non-peer reviewed publications, conferences and in-person communications. We will identify priorities for further study. This method may prove useful to examine the relationships and effects of other sports on health.
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Affiliation(s)
- A Murray
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - L Daines
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - D Archibald
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, UK
| | - R Hawkes
- European Tour Golf, Virginia Water, UK
| | - L Grant
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - N Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
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Meyer B, Byrne M, Collier C, Parletta N, Crawford D, Winberg P, Webster D, Chapman K, Thomas G, Dally J, Batterham M, Farquhar I, Grant L. Baseline omega-3 index correlates with aggressive and attention deficit behaviours in adult prisoners. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.022] [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: 10/23/2022] Open
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Tatlock S, Grant L, Arbuckle R, Khan I, Manvelian G, Sanchez R. Development And Content Validity Testing Of A Treatment Acceptance Measure For Use In Hypercholesterolemia Patients Receiving Treatment Via Subcutaneous Injection. Value Health 2014; 17:A569. [PMID: 27201898 DOI: 10.1016/j.jval.2014.08.1898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - L Grant
- Adelphi Values Ltd, Bollington, UK
| | | | - I Khan
- Sanofi, Bridgewater, NJ, USA
| | - G Manvelian
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - R Sanchez
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
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Holeman I, Evans J, Kane D, Grant L, Pagliari C, Weller D. Mobile health for cancer in low to middle income countries: priorities for research and development. Eur J Cancer Care (Engl) 2014; 23:750-6. [DOI: 10.1111/ecc.12250] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- I. Holeman
- Judge Business School; University of Cambridge; UK
- Global Health Academy; University of Edinburgh; UK
- Medic Mobile; San Francisco California USA
| | - J. Evans
- Global Health Academy; University of Edinburgh; UK
- Medic Mobile; San Francisco California USA
| | - D. Kane
- Medic Mobile; San Francisco California USA
| | - L. Grant
- Global Health Academy; University of Edinburgh; Centre for Population Health Sciences; University of Edinburgh Medical School Teviot Place; Edinburgh UK
| | - C. Pagliari
- Convener eHealth Interdisciplinary Research Group; Global Health Academy & Centre for Population Health Sciences; University of Edinburgh Medical School Teviot Place; Edinburgh UK
| | - D. Weller
- Centre for Population Health Sciences; University of Edinburgh Medical School Teviot Place; Edinburgh UK
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Owen C, Lees EK, Grant L, Zimmer DJ, Mody N, Bence KK, Delibegović M. Inducible liver-specific knockdown of protein tyrosine phosphatase 1B improves glucose and lipid homeostasis in adult mice. Diabetologia 2013; 56:2286-96. [PMID: 23832083 DOI: 10.1007/s00125-013-2992-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 06/14/2013] [Indexed: 12/19/2022]
Abstract
AIMS/HYPOTHESIS Protein tyrosine phosphatase 1B (PTP1B) is a key negative regulator of insulin signalling. Hepatic PTP1B deficiency, using the Alb-Cre promoter to drive Ptp1b deletion from birth in mice, improves glucose homeostasis, insulin sensitivity and lipid metabolism. The aim of this study was to investigate the therapeutic potential of decreasing liver PTP1B levels in obese and insulin-resistant adult mice. METHODS Inducible Ptp1b liver-specific knockout mice were generated using SA-Cre-ER(T2) mice crossed with Ptp1b floxed (Ptp1b(fl/fl)) mice. Mice were fed a high-fat diet (HFD) for 12 weeks to induce obesity and insulin resistance. Tamoxifen was administered in the HFD to induce liver-specific deletion of Ptp1b (SA-Ptp1b(-/-) mice). Body weight, glucose homeostasis, lipid homeostasis, serum adipokines, insulin signalling and endoplasmic reticulum (ER) stress were examined. RESULTS Despite no significant change in body weight relative to HFD-fed Ptp1b(fl/fl) control mice, HFD-fed SA-Ptp1b(-/-) mice exhibited a reversal of glucose intolerance as determined by improved glucose and pyruvate tolerance tests, decreased fed and fasting blood glucose and insulin levels, lower HOMA of insulin resistance, circulating leptin, serum and liver triacylglycerols, serum NEFA and decreased HFD-induced ER stress. This was associated with decreased glycogen synthase, eukaryotic translation initiation factor-2α kinase 3, eukaryotic initiation factor 2α and c-Jun NH2-terminal kinase 2 phosphorylation, and decreased expression of Pepck. CONCLUSIONS/INTERPRETATION Inducible liver-specific PTP1B knockdown reverses glucose intolerance and improves lipid homeostasis in HFD-fed obese and insulin-resistant adult mice. This suggests that knockdown of liver PTP1B in individuals who are already obese/insulin resistant may have relatively rapid, beneficial therapeutic effects.
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Affiliation(s)
- C Owen
- Institute of Medical Sciences, School of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
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Grant L, Lawton J, Hopkins D, Elliott J, Lucas S, Clark M, MacLellan I, Davies M, Heller S, Cooke D. Type 1 diabetes structured education: What are the core self-management behaviours? Diabet Med 2013; 30:724-30. [PMID: 23461799 DOI: 10.1111/dme.12164] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/20/2012] [Accepted: 02/15/2013] [Indexed: 11/27/2022]
Abstract
AIMS Study aims were to (1) describe and compare the way diabetes structured education courses have evolved in the UK, (2) identify and agree components of course curricula perceived as core across courses and (3) identify and classify self-care behaviours in order to develop a questionnaire assessment tool. METHODS Structured education courses were selected through the Type 1 diabetes education network. Curricula from five courses were examined and nine educators from those courses were interviewed. Transcripts were analysed using framework analysis. Fourteen key stakeholders attended a consensus meeting, to identify and classify Type 1 diabetes self-care behaviours. RESULTS Eighty-three courses were identified. Components of course curricula perceived as core by all diabetes educators were: carbohydrate counting and insulin dose adjustment, hypoglycaemia management, group work, goal setting and empowerment, confidence and control. The broad areas of self-management behaviour identified at the consensus meeting were carbohydrate counting and awareness, insulin dose adjustment, self-monitoring of blood glucose, managing hypoglycaemia, managing equipment and injection sites; and accessing health care. Specific self-care behaviours within each area were identified. CONCLUSIONS Planned future work will develop an updated questionnaire tool to access self-care behaviours. This will enable assessment of the effectiveness of existing structured education programmes at producing desired changes in behaviour. It will also help people with diabetes and their healthcare team identify areas where additional support is needed to initiate or maintain changes in behaviour. Provision of such support may improve glycaemia and reduce diabetes-related complications and severe hypoglycaemia.
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Affiliation(s)
- L Grant
- School of Translational Medicine, University of Manchester, Manchester, UK.
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Jordan LVM, Robertson M, Grant L, Peters REL, Cameron JT, Chisholm S, Voigt DJ, Matheson L, Kerr EJ, Maclean K, Macalpine RR, Wilson E, Mackie ADR, Summers NM, Vadiveloo T, Leese GP. The Tayside insulin management course: an effective education programme in type 1 diabetes. Int J Clin Pract 2013; 67:462-8. [PMID: 23510057 DOI: 10.1111/ijcp.12107] [Citation(s) in RCA: 11] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 12/01/2012] [Indexed: 12/19/2022] Open
Abstract
AIMS The Tayside insulin management (TIM) course is an intensive insulin management programme for adults with type 1 diabetes. The aim was to assess its effectiveness. METHODS Haemoglobin A1c (HbA1c) and body mass index (BMI) from individuals with type 1 diabetes were collected 3 months before, and 6 and 24 months after the programme. The programme involved a full day of education per week for 4 weeks in a row. Quality of life was assessed using the standardised Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire completed both before and 3 months after the course. Subjects were also asked to complete a pre- and postcourse questionnaire gathering information about aspects of their diabetes management. In addition, individual satisfaction with course content and delivery was recorded. RESULTS Participants had a median reduction in haemoglobin A1c (HbA1c) of 4 mmol/mol (0.4%) after 6 months and 5 mmol/mol (0.5%) 2 years after the course (p < 0.001). Mean daily dose of short-acting insulin decreased from 31.5 (1.9) units to 27.3 (1.9, p < 0.001). There was no significant change in BMI. There was an improvement in all 18 domains of the ADDQoL questionnaire. There was a decrease in hypoglycaemia unawareness from 34.3 ± 47.8% of patients to 8.6 ± 28% (p < 0.001), and a decrease in self-reported lipohypertrophy from 27.8% to 11.1% (p = 0.001). There was a significant reduction in the mean number of diabetic ketoacidosis and severe hypoglycaemic episodes. The number of blood glucose checks changed from 2.8 ± 2.1 to 3.2 ± 1.1 (p = 0.058) per day. Participant satisfaction with all aspects of course content and delivery was high. CONCLUSIONS TIM is an effective intensive education programme for patients with type 1 diabetes.
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Affiliation(s)
- L V M Jordan
- Department of Diabetes, Ninewells Hospital, Dundee, UK.
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Maltinsky W, Hall S, Grant L, Simpson K, MacRury S. Pilot project and evaluation of delivering diabetes work-based education using video conferencing. Rural Remote Health 2013; 13:2053. [PMID: 23414080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
CONTEXT Diabetes is a chronic long-term disease with an increasing incidence. There is a need to increase access to effective care and to ensure such care is delivered as locally as possible. The geographical spread of NHS Highland Scotland presents additional challenges to ensuring a skilled workforce given education is normally work-based tuition and assessment. The aim of this pilot project was to deliver teleconferenced diabetes training to healthcare and allied healthcare professionals who provide basic level care for, and management of, people with diabetes and to evaluate this training. ISSUE Work-based diabetes education was designed to be delivered by a diabetes educator through videoconferencing or face to face (F2F) for healthcare professionals in peripheral settings in the Scottish Highlands region over two half-days. The education covered theoretical and practical training in diabetes. The evaluation of the project was through post-course questionnaires and assessment instruments to capture views of the content and delivery mode, as well as student performance. LESSONS LEARNED Feedback from participants indicated that the educational content was relevant and that the use of videoconferencing (VC) could provide accessibility to training where distance, cost and other issues may make access difficult. Student performance on the assessment instruments did not differ between those who received the training through video conferencing and those who received the training through F2F delivery. Video conferencing can counteract the difficulties of accessing training for clinical peripherally based professionals. Training through VC did not compromise student acquisition of learning outcomes. Feedback indicates that VC can reduce the interactive nature of the learning and teaching experience.
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Affiliation(s)
- W Maltinsky
- University of the Highlands & Islands, Inverness, Scotland, UK.
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Malacova E, Butler T, Yap L, Grant L, Richards A, Smith AMA, Donovan B. Sexual coercion prior to imprisonment: prevalence, demographic and behavioural correlates. Int J STD AIDS 2012; 23:533-9. [DOI: 10.1258/ijsa.2011.011069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Little is known about experiences of sexual coercion among prisoners prior to incarceration. Prisoner populations are routinely excluded from national surveys of sexual health which also tend to under-represent marginalized groups. We surveyed 2351 randomly selected men and women, aged 18–64 years, in New South Wales and Queensland prisons who participated in a computer-assisted telephone interview. Around 60% of women and 14% of men self-reported having been sexually coerced prior to incarceration, with 60% of these experiences occurring before the age of 16 years. Factors independently associated with a self-reported history of sexual coercion were: homosexual and bisexual identity, being unable to work, separated marital status, higher level of education (among women), having been paid for sex, a past sexually transmissible infection (among men), drug use (among women) and a history of mental health problems. Prior sexual coercion was associated with unwanted sexual contact and physical assault while in prison. The high prevalence of sexual coercion reported by prisoners and its association with a range of factors indicates a need for a greater acknowledgement of the potential consequences of this within the criminal justice system. This could entail providing counselling and support services within the correctional setting.
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Affiliation(s)
- E Malacova
- National Drug Research Institute, Curtin University, Perth WA
| | - T Butler
- National Drug Research Institute, Curtin University, Perth WA
- The Kirby Institute, University of New South Wales, Sydney, NSW
| | - L Yap
- School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052
| | - L Grant
- New South Wales Department of Corrective Services, Sydney, NSW
| | - A Richards
- Queensland Department of Health, Brisbane, Queensland
| | - A M A Smith
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Victoria
| | - B Donovan
- The Kirby Institute, University of New South Wales, Sydney, NSW
- Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW, Australia
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Grant L, Appleby J, Griffin N, Adam A, Gishen P. Facing the future: the effects of the impending financial drought on NHS finances and how UK radiology services can contribute to expected efficiency savings. Br J Radiol 2011; 85:784-91. [PMID: 22167516 DOI: 10.1259/bjr/20359557] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The recent turmoil within the banking sector has led to the development of the most significant recession since the "great depression" of the 1930s. Although the coalition government has promised to "guarantee that health spending increases in real terms in each year of Parliament", this may still not be enough to meet future needs over the coming years due to increasing demand and cost pressures. The expected mismatch between actual National Health Service (NHS) funding post-2011 and that required to satisfy increasing demand has been estimated by the Department of Health to require efficiency savings representing up to one-fifth of the overall NHS budget. This paper explains the reasons behind the anticipated slowdown in the growth of real NHS funding, and how, as a discipline, radiology can increase the efficiency of the services it provides in anticipation of future financial austerity within the NHS.
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Affiliation(s)
- L Grant
- Department of Radiology, The Royal Free Hospital, London, UK.
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Grant L, Downing J, Namukwaya E, Leng M, Murray SA. Palliative care in Africa since 2005: good progress, but much further to go. BMJ Support Palliat Care 2011; 1:118-22. [DOI: 10.1136/bmjspcare-2011-000057] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Malacova E, Butler T, Richters J, Yap L, Grant L, Richards A, Smith AMA, Donovan B. Knowledge of sexually transmissible infections: a comparison of prisoners and the general population. Int J STD AIDS 2011; 22:381-6. [DOI: 10.1258/ijsa.2011.010408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The World Health Organization (WHO) has identified a failure to provide education for vulnerable populations such as prisoners as a contributing factor to the epidemic of sexually transmissible infections (STIs). Despite this recognition, little is known about prisoners' level of knowledge of STIs compared with the general population. Using computer-assisted telephone interviews, we compared a representative sample of 2289 Australian prisoners, aged 18–59 years from New South Wales and Queensland prisons with a representative community sample of 3536 participants from these two states. Prisoners had significantly better knowledge than the general community of chlamydia-related questions, while knowledge of herpes (genital and oral) was slightly better in the community sample. Prisoners who were aged over 25 years, not married, female, self-identified as either homosexual or bisexual and reported a history of STIs tended to have better STI knowledge levels. Despite their more disadvantaged backgrounds, prisoners demonstrated relatively good health literacy in relation to STIs. Ongoing education about the transmission risks of STIs for prisoners and the general community is needed.
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Affiliation(s)
- E Malacova
- National Drug Research Institute, Curtin University, Perth, WA
| | - T Butler
- National Drug Research Institute, Curtin University, Perth, WA
- The Kirby Institute, University of New South Wales, Coogee, NSW
| | - J Richters
- School of Public Health and Community Medicine, University of New South Wales, Sydney
| | - L Yap
- School of Public Health and Community Medicine, University of New South Wales, Sydney
| | - L Grant
- New South Wales Department of Corrective Services, Sydney, NSW
| | - A Richards
- Queensland Department of Health, Brisbane, Queensland
| | - A M A Smith
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria
| | - B Donovan
- The Kirby Institute, University of New South Wales, Coogee, NSW
- Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW, Australia
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Grant L, Downing J, Leng M, Namukaya L, Murray SA. Palliative care delivery in Kenya and Malawi: a review of models. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.63] [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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Evans C, Regan A, Grant L, Davies R, Whitehouse J. Use of the hospital anxiety and depression scale (HADS) in an adult cystic fibrosis (CF) centre. J Cyst Fibros 2008. [DOI: 10.1016/s1569-1993(08)60404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Harpagophytum procumbens (Hp), commonly known as Devil's Claw is a perennial plant which thrives in arid conditions. For centuries, it has been used as a traditional treatment for a variety of illnesses, including fevers, skin complaints, arthritis and diseases of the digestive tract as well as an appetite stimulant. Since its introduction to Europe in the early twentieth century, it has become a popular antiinflammatory and analgesic preparation amongst herbalists for supportive or adjuvant treatment of degenerative joint diseases, tendonitis, headache, backache and menstrual pain. The validity of Hp as an effective antiinflammatory and analgesic preparation, particularly in the relief of arthritic symptoms, has been investigated in numerous animal, clinical and in vitro studies. Although some contradictory evidence exists, the majority of animal studies appear to indicate Hp as an effective antiinflammatory and analgesic preparation in the treatment of acute and subacute inflammation. Clinical trials support Hp as a beneficial treatment for the alleviation of pain and improvement of mobility in a variety of musculoskeletal conditions. Analysis of the in vitro and ex vivo studies that currently exist, indicate that Hp has significant effects on numerous proinflammatory markers. However, the exact mechanism(s) by which Hp may reduce inflammation remain to be elucidated.
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Affiliation(s)
- L Grant
- Institute of Comparative Medicine, Faculty of Veterinary Medicine, University of Glasgow, Bearsden Road, Glasgow G61 1QH, Scotland
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Kariminia A, Butler TG, Corben SP, Levy MH, Grant L, Kaldor JM, Law MG. Extreme cause-specific mortality in a cohort of adult prisoners—1988 to 2002: a data-linkage study. Int J Epidemiol 2006; 36:310-6. [PMID: 17158524 DOI: 10.1093/ije/dyl225] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Describe the standardized mortality ratio (SMR) and its trend in adults who have served time in prison. DESIGN A retrospective cohort study of 85,203 adults imprisoned in New South Wales (NSW), Australia, between 1 January 1988 and 31 December 2002. METHODS We obtained information on deaths by record linkage with the Australian National Death Index (NDI). Mortality rates were estimated using the person-time method. SMRs were calculated using sex, age, and calendar-specific death rates from the NSW population. Time trends in SMRs were assessed using the test for linear trends. RESULTS The median overall follow-up of the cohort was 7.7 years. We identified 5137 deaths (4714 men, 423 women) among the cohort of which the vast majority (4834, 94%) occurred following release from custody. All-cause SMR was 3.7 (95% CI: 3.6-3.8) in men and 7.8 (95% CI: 7.1-8.5) in women. SMRs were substantially raised for deaths due to mental and behavioural disorders (men: 13.2, 95% CI: 12.3-14.0; women: 62.8, 95% CI: 52.7-74.9) and drug-related deaths (men: 12.8, 95% CI: 12.2-13.5; women: 50.3, 95% CI: 43.7-57.8). The SMR for death by homicide was 10.2 (95% CI: 8.9-11.7) in men and 26.3 (95% CI: 17.8-39.0) in women. Aboriginal men were 4.8 times, and Aboriginal women 12.6 times, more likely to die than the general NSW population. Over the study period on average all-cause SMR decreased significantly in men (p = 0.003) and women (p = 0.05) largely due to the decline in SMRs for drug-related deaths and suicide. CONCLUSION In the largest study so far reported, mortality of male and female offenders was far greater than expected for all major causes, especially deaths caused by drug overdose. Despite some indication of a reduction in excess mortality in recent years, there remains an overwhelming need for enhanced responses to mental health and drug problems for people who have been in prison.
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Affiliation(s)
- A Kariminia
- Centre for Health Research in Criminal Justice, Sydney, Australia.
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Boateng J, Verghese M, Shackelford L, Walker LT, Khatiwada J, Ogutu S, Williams DS, Jones J, Guyton M, Asiamah D, Henderson F, Grant L, DeBruce M, Johnson A, Washington S, Chawan CB. Selected fruits reduce azoxymethane (AOM)-induced aberrant crypt foci (ACF) in Fisher 344 male rats. Food Chem Toxicol 2006; 45:725-32. [PMID: 17321025 DOI: 10.1016/j.fct.2006.10.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Revised: 10/15/2006] [Accepted: 10/25/2006] [Indexed: 02/07/2023]
Abstract
Phytochemicals contribute to the vibrant colors of fruits and it is suggested that the darker the fruit the higher the antioxidative or anticarcinogenic properties. In this study we investigated the possible effects of blueberries (BLU), blackberries (BLK), plums (PLM), mangoes (MAN), pomegranate juice (POJ), watermelon juice (WMJ) and cranberry juice (CBJ) on azoxymethane (AOM)-induced aberrant crypt foci (ACF) in Fisher 344 male rats. Forty-eight male Fisher 344 rats were randomly assigned to eight groups (n=6). The groups were fed AIN-93G as a control (C) diet, the rats fed fruits received AIN-93G+5% fruits and the groups that were given fruits juices received 20% fruit juice instead of water. The rats received subcutaneous injections of AOM at 16 mg/kg body weight at seventh and eighth weeks of age. At 17th week of age, the rats were killed by CO(2) asphyxiation. Total ACF numbers (mean+/-SEM) in the rats fed CON, BLU, BLK, PLM, MNG, POJ, WMJ and CBJ were 171.67+/-5.6, 11.33+/-2.85, 24.0+/-0.58, 33.67+/-0.89, 28.67+/-1.33, 15.67+/-1.86, 24.33+/-3.92 and 39.0+/-15.31. Total glutathione-S-transferase (GST) activity (mICROmol/mg) in the liver of the rats fed fruits (except BLK) and fruit juices were significantly (p<0.05) higher in the rats fed fruits and fruit juices compared with the control. Our findings suggest that among the fruits and fruit juices, BLU and POJ contributed to significant (P<0.05) reductions in the formation of AOM-induced ACF.
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Affiliation(s)
- J Boateng
- Nutritional Biochemistry and Carcinogenesis Laboratory, Department of Food and Animal Sciences, Alabama A&M University, Normal, AL 35762, United States
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Abstract
OBJECTIVE To review weight loss and maintenance for severely obese individuals enrolled in intensive behavioral weight loss program using very-low or low-energy diets. DESIGN Chart review of consecutively treated patients between 1995 and 2002 seen at three weight loss centers. SUBJECTS One thousand five hundred and thirty one patients with severe obesity (>or=40 kg/m(2)) treated in three cities ('Study Group'). Of these, 1100 completed the 12-week core curriculum ('Completer Group'). Weight loss >or=100 lbs (>45 kg) was seen in 268 patients ('100-Pound Group'). MEASUREMENTS Charts were reviewed for baseline characteristics, weekly weights, follow-up weights and side effects. RESULTS In the Study Group, average weight loss+/-s.e. for 998 women was 23.9+/-0.6 kg (18.5% of initial body weight (IBW)) and for 533 men was 36.0+/-1.0 kg (22.5%) over 30 weeks. For Completers, average weight loss for women was 30.8+/-0.6 kg (23.9%) and for men was 42.6+/-1.1 kg (26.7%) over 39 weeks. In the 100-Pound Group, average weight loss for women was 58.2+/-1.2 kg (41.5%) in 65 weeks and for men was 65.7+/-1.5 kg (37.5%) in 51 weeks. Side effects, assessed in 100 patients losing >45 kg, were mild to moderate in severity. Severe adverse events unrelated to the diet were noted in 5% of patients and during weight loss 1% had elective cholecystectomies. Follow-up weights were available for 86% of Completers at an average of 72 weeks with average maintenance of 23 kg or 59% of weight loss; follow-up weights were available for 94% of the 100-Pound Group at an average of 95 weeks with average maintenance of 41 kg or 65% of weight loss maintained. CONCLUSIONS Intensive behavioral treatment with meal replacements is a safe and effective weight-loss strategy for selected severely obese individuals.
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Affiliation(s)
- J W Anderson
- Department of Internal Medicine, College of Medicine, University of Kentucky and Health Management Resources Weight Management Program at the University of Kentucky, Lexington, KY 40536-0298, USA.
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Johnson D, Morrison N, Grant L, Turner T, Fantes J, Connor JM, Murday V. Confirmation of CHD7 as a cause of CHARGE association identified by mapping a balanced chromosome translocation in affected monozygotic twins. J Med Genet 2006; 43:280-4. [PMID: 16118347 PMCID: PMC2563251 DOI: 10.1136/jmg.2005.032946] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Revised: 06/02/2005] [Accepted: 06/02/2005] [Indexed: 11/04/2022]
Abstract
BACKGROUND CHARGE syndrome has an estimated prevalence of 1/10,000. Most cases are sporadic which led to hypotheses of a non-genetic aetiology. However, there was also evidence for a genetic cause with reports of multiplex families with presumed autosomal dominant, possible autosomal recessive inheritance and concordant twin pairs. We identified a monozygotic twin pair with CHARGE syndrome and a de novo balanced chromosome rearrangement t(8;13)(q11.2;q22). METHODS Fluorescence in situ hybridisation was performed with BAC and PAC probes to characterise the translocation breakpoints. The breakpoint on chromosome 8 was further refined using 10 kb probes we designed and produced using sequence data for clone RP11 33I11, the Primer3 website, and a long range PCR kit. RESULTS BAC and PAC probe hybridisation redefined the breakpoints to 8q12.2 and 13q31.1. Probe RP11 33I11 spanned the breakpoint on chromosome 8. Using our 10 kb probes we demonstrated that the chromodomain gene CHD7 was disrupted by the translocation between exons 3 and 8. DISCUSSION Identifying that the translocation breakpoint in our patients occurred between exons 3 and 8 of CHD7 suggests that disruption of this gene is the cause of CHARGE syndrome in the twins and independently confirms the role of CHD7 in CHARGE syndrome.
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Abstract
OBJECTIVE To define the range of neonatal weight loss in a population relative to feeding method. DESIGN Prospective observational cohort study. SETTING Maternity service providing geographically defined, community based newborn follow up. PARTICIPANTS 971 consecutive term newborns of birth weight > or = 2500 g during the first 2-3 weeks of life; 34 excluded (inadequate data). 937 included: 45% breast fed, 42% formula fed, 13% breast and formula fed. OUTCOME MEASURES Maximum weight loss and timing, age on regaining birth weight. RESULTS Median weight loss: formula fed 3.5%, breast fed 6.6%. Upper centiles for maximum weight loss differ considerably (95th centiles: breast fed = 11.8%, formula fed = 8.4%; 97.5th centiles: breast fed = 12.8%, formula fed = 9.5%). Median time of maximum weight loss: 2.7 days for breast fed and formula fed. Recovery of birth weight: breast fed median 8.3 days, 95th centile 18.7 days, 97.5th centile 21.0 days; formula fed median 6.5 days, 95th centile 14.5 days, 97.5th centile 16.7 days. The time taken to regain birth weight correlates with both the degree and timing of initial weight loss for all groups. CONCLUSIONS Early neonatal weight loss is defined allowing identification of infants who merit closer assessment and support.
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Affiliation(s)
- P D Macdonald
- Southern General Hospital Neonatal Paediatric Department, South Glasgow University Hospitals NHS Trust, Glasgow G51 4TF, Scotland, UK.
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Tanzer JM, Grant L, Thompson A, Li L, Rogers JD, Haase EM, Scannapieco FA. Amylase-binding proteins A (AbpA) and B (AbpB) differentially affect colonization of rats' teeth by Streptococcus gordonii. Microbiology (Reading) 2003; 149:2653-2660. [PMID: 12949189 DOI: 10.1099/mic.0.26022-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Streptococcus gordonii produces two alpha-amylase-binding proteins, AbpA and AbpB, that have been extensively studied in vitro. Little is known, however, about their significance in oral colonization and cariogenicity (virulence). To clarify these issues, weanling specific pathogen-free Osborne-Mendel rats, TAN : SPFOM(OM)BR, were inoculated either with wild-type strains FAS4-S or Challis-S or with strains having isogenic mutations of abpA, abpB, or both, to compare their colonization abilities and persistence on the teeth. Experiments were done with rats fed a sucrose-rich diet containing low amounts of starch or containing only starch. The mutants and wild-types were quantified in vivo and carious lesions were scored. In 11 experiments, S. gordonii was a prolific colonizer of the teeth when rats were fed the sucrose (with low starch)-supplemented diet, often dominating the flora. Sucrose-fed rats had several-fold higher recoveries of inoculants than those eating the sucrose-free, starch-supplemented diet, regardless of inoculant type. The strain defective in AbpB could not colonize teeth of starch-only-eating rats, but could colonize rats if sucrose was added to the diet. Strains defective in AbpA surprisingly colonized better than their wild-types. A double mutant deficient in both AbpA and AbpB (abpA/abpB) colonized like its wild-type. Wild-types FAS4-S and Challis-S had no more than marginal cariogenicity. Notably, in the absence of AbpA, cariogenicity was slightly augmented. Both the rescue of colonization by the AbpB- mutant and the augmentation of colonization by AbpA- mutant in the presence of dietary sucrose suggested additional amylase-binding protein interactions relevant to colonization. Glucosyltransferase activity was greater in mutants defective in abpA and modestly increased in the abpB mutant. It was concluded that AbpB is required for colonization of teeth of starch-eating rats and its deletion is partially masked if rats eat a sucrose-starch diet. AbpA appears to inhibit colonization of the plaque biofilm in vivo. This unexpected effect in vivo may be associated with interaction of AbpA with glucosyltransferase or with other colonization factors of these cells. These data illustrate that the complex nature of the oral environment may not be adequately modelled by in vitro systems.
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Affiliation(s)
- J M Tanzer
- School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030-1605, USA
| | - L Grant
- School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030-1605, USA
| | - A Thompson
- School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030-1605, USA
| | - L Li
- School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - J D Rogers
- School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - E M Haase
- School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - F A Scannapieco
- School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
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Affiliation(s)
- L Grant
- Department of Paediatrics, Southern General Hospital, Glasgow, Scotland, UK
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40
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Grant L, Macdonald P. Rationing in child health services. Arch Dis Child Fetal Neonatal Ed 2000; 82:F259. [PMID: 10885939 PMCID: PMC1721077 DOI: 10.1136/fn.82.3.f257d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Davis KJ, Sloane PD, Mitchell CM, Preisser J, Grant L, Hawes MC, Lindeman D, Montgomery R, Long K, Phillips C, Koch G. Specialized dementia programs in residential care settings. Gerontologist 2000; 40:32-42. [PMID: 10750311 DOI: 10.1093/geront/40.1.32] [Citation(s) in RCA: 18] [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] [Indexed: 11/13/2022] Open
Abstract
The authors conducted a telephone survey in 7 states to determine the prevalence of residential care specialized dementia programs (RC-SDPs) and to identify a sample of homes (n = 56) for more detailed study. The 56 homes were site visited, and data were gathered on facility administration, therapeutic environment, and characteristics of 259 randomly selected residents. Comparison data from 138 nursing home Special Care Units (NH-SCUs) and 1,340 of their residents were obtained from 4 studies conducted in the same 7 states. RC-SDPs were smaller, provided a more homelike environment, and had a higher proportion of residents paying privately, compared with NH-SCUs. Mean levels of cognitive and physical impairment among residents were higher in NH-SCUs; prevalences of psychotropic medication use and problem behaviors were similar. Among RC facilities, small homes were more homelike, provided fewer structured activities, and charged less than larger facilities. RC-SDPs include 5 types: small, independently operated homes; multiple small homes with joint administration; larger, all-dementia facilities; SDPs operated within larger, exclusively RC facilities; and RC-SDPs in multilevel facilities.
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Affiliation(s)
- K J Davis
- Data Exploration Center, Glaxo Wellcome, Inc., Research Triangle Park, NC, USA
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Abstract
Recent epidemiological studies have consistently shown that the acute mortality effects of high concentrations of ambient particulate matter (PM), documented in historic air pollution episodes, may also be occurring at the low to moderate concentrations of ambient PM found in modern urban areas. In London in December 1952, the unexpected deaths due to PM exposure could be identified and counted as integers by the coroners. In modern times, the PM-related deaths cannot be as readily identified, and they can only be inferred as fractional average daily increases in mortality rates using sophisticated statistical filtering and analyses of the air quality and mortality data. The causality of the relationship between exposure to ambient PM and acute mortality at these lower modern PM concentrations has been questioned because of a perception that there is little significant correlation in time between the ambient PM concentrations and measured personal exposure to PM from all sources (ambient PM plus indoor-generated PM). This article shows that the critical factor supporting the plausibility of a linear PM mortality relationship is the expected high correlation in time of people's exposure to PM of ambient origin with measured ambient PM concentrations, as used in the epidemiological time series studies. The presence of indoor and personal sources of PM masks this underlying relationship, leading to confusion in the scientific literature about the strong underlying temporal relationship between personal exposure to PM of ambient origin and ambient PM concentration. The authors show that the sources of PM of non-ambient origin operate independently of the ambient PM concentrations, so that the mortality effect of non-ambient PM, if any, must be independent of the effects of the ambient PM exposures.
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Affiliation(s)
- D Mage
- U.S. Environmental Protection Agency, National Exposure Research Laboratory, Research Triangle Park, North Carolina, USA
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Skinner CJ, Estcourt CS, Grant L, Forster GE. Prevention of pelvic infection: room for improvement. Int J STD AIDS 1999; 10:351. [PMID: 10361928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Grant L. Medical equipment. Devices and desires. Health Serv J 1998; 108:34-5. [PMID: 10179464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
High-tech medical solutions need careful implementation to ensure optimum reliability and good patient care. Figures from the Medical Devices Agency show that a patient may be three to 10 times more at risk from user error than from faulty equipment. Informed equipment selection and user training is paying dividends in one trust.
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Affiliation(s)
- L Grant
- Medical Physics Department, Royal United Hospital Bath Trust
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Lieber RB, Grant L, Martin J. Now are you satisfied? The 1998 American Customer Satisfaction Index. Fortune 1998; 137:161-8. [PMID: 10176768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Abstract
The Family Stories Workshop (FSW) is a process through which family members and friends of persons with dementing disorders living in nursing homes develop stories of these residents' lives. The stories are meant to help staff members to develop a better, more deeply felt understanding of the lives of the residents, persons who can no longer tell their own stories. The workshop is product-oriented and is not meant as a support group and works best in organizations emphasizing individualized care. This article describes the process of the FSW as well as outcomes from preliminary implementation. It suggests ways of using elements of the process to more broadly accomplish the FSW purposes.
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Affiliation(s)
- K W Hepburn
- Department of Family Practice and Community Health, Minneapolis, MN 55414-3034, USA
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Grant L, Maddocks J, Yarger L. Community Respite Project. J Psychiatr Ment Health Nurs 1997; 4:380-1. [PMID: 9384113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- L Grant
- Oxleas NHS Trust, Greenwich District Hospital, London, UK
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Abstract
OBJECTIVE To assess sexually active adolescents' knowledge, attitudes, and behaviors associated with human immunodeficiency virus (HIV) testing and to determine the factors important in their decision to obtain voluntary HIV testing. DESIGN Anonymous, random, digit-dial telephone survey undertaken in 1993. SETTING Massachusetts households. PARTICIPANTS Adolescents, 16 to 19 years of age. RESULTS Of the 567 adolescents surveyed who had sexual intercourse within the past year, 127 (22%) had received HIV testing, with 54 (10%) stating that this testing was for personal reasons. A "great deal" or "some" worry about getting HIV/acquired immunodeficiency syndrome (AIDS) was expressed by 51%, and 56% felt that it was at least a little likely that they will get AIDS. Misconceptions were common about aspects of HIV testing: 35% did not believe or did not know that the HIV test results were kept in confidence, 19% thought that AIDS testers informed partners if the results were positive, and 30% did not think that the HIV test was very accurate. Although 92% (452/490) had seen a physician in the past year, only 30% (136/452) had ever discussed AIDS with a doctor. Multivariable analysis identified five factors as independently associated with voluntary adolescent HIV testing: 1) having had more than one sexual partner within the past year [odds ratio (OR): 2.9; 95% confidence interval (CI): 1.5, 5.5]; 2) believing that condoms are only somewhat effective at preventing the spread of AIDS (OR: 2. 6; 95% CI: 1.4, 4.8); 3) having discussed AIDS with a doctor (OR: 2. 6; 95% CI: 1.4, 4.8); 4) not having had a teacher discuss AIDS (OR: 2.2; 95% CI: 1.2, 4.2); and 5) believing that a positive test result means one has AIDS as opposed to carrying the virus (OR: 2.0; 95% CI: 1.1, 3.7). High-risk behavior of infrequent condom use and a history of a sexually transmitted disease were not significantly associated with voluntary HIV testing. CONCLUSION Among sexually active Massachusetts adolescents, voluntary HIV testing is uncommon. Teens who have had multiple sexual partners and who do not believe condoms are effective in preventing transmission were most likely to have been tested. Issues requiring clearer communication to patients include the testing process, its availability, and confidentiality. Physicians can play an influential role in the promotion of HIV testing by discussing HIV risk behaviors with patients and offering those at risk voluntary HIV counseling and testing.
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Affiliation(s)
- J H Samet
- Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
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