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Sarwar A, Syed L, Patel K, Reid I, Abonyi E, Banas N, Lowe G, Bryant L, Hoskin P. Image-guided Interstitial Brachytherapy in the Treatment of Primary and Recurrent Vulvovaginal Gynaecological Malignancies. Clin Oncol (R Coll Radiol) 2024; 36:6-11. [PMID: 37923687 DOI: 10.1016/j.clon.2023.10.051] [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: 09/22/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
AIMS To evaluate the use, outcomes and toxicities of high dose rate brachytherapy (HDRB) to the vulvovaginal region in previously irradiated and radiotherapy-naïve patients for primary or recurrent gynaecological malignancies. MATERIALS AND METHODS From January 2010 to December 2020, 94 women with a median age of 64 years (range 31-88 years) were treated with interstitial HDRB for vulvovaginal disease. Treatment details, including cumulative radiotherapy doses, were recorded together with reported toxicity, using Common Terminology Criteria for Adverse Events (CTCAE) grading. Dosimetric parameters, including D90, V100 and V150 together with treatment response at 3 months, overall survival, relapse-free survival and long-term toxicity data, were collated from referring centres. RESULTS The median follow-up was 78 months (range 2-301). Primary sites of disease included vagina (37), endometrium (29), vulva (16), ovary (7) and cervix (5). Eighty-six (91.5%) patients were treated with curative intent, eight (8.5%) were palliative treatments. Fifty patients received HDRB for recurrent disease, 39 patients for primary disease and five as part of adjuvant treatment. The anatomical site of disease treated with HDRB ranged from vagina (76), vulva (14) and peri-urethral sites (four). The 2- and 5-year local relapse-free survival rates were 76% and 72%, respectively; 15 patients experienced local failure only, whereas six patients had local and nodal/distant failure. The median time to local recurrence was 8 months (range 2-88 months). The 2- and 5-year overall survival rates for all patients were 67% and 47%, respectively; the median overall survival was 59 months. Seventy-nine (84%) patients had a complete response measured with imaging at 3 months. Grade 3 toxicity was reported in 14 patients (14.8%). CONCLUSION This retrospective series suggests the use of interstitial brachytherapy for vulvovaginal gynaecological malignancy to be an effective and safe treatment option. Good local control was achieved with a tolerable toxicity profile; it is a valuable treatment modality.
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Affiliation(s)
- A Sarwar
- Mount Vernon Cancer Centre, Northwood, UK.
| | - L Syed
- Mount Vernon Cancer Centre, Northwood, UK
| | - K Patel
- Mount Vernon Cancer Centre, Northwood, UK
| | - I Reid
- Mount Vernon Cancer Centre, Northwood, UK
| | - E Abonyi
- Mount Vernon Cancer Centre, Northwood, UK
| | - N Banas
- Mount Vernon Cancer Centre, Northwood, UK
| | - G Lowe
- Mount Vernon Cancer Centre, Northwood, UK
| | - L Bryant
- Mount Vernon Cancer Centre, Northwood, UK
| | - P Hoskin
- Mount Vernon Cancer Centre, Northwood, UK
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Kaur E, Arezina J, Bryant L, Pollak KI, Harrison G, Bender Atik R, Coates J, Hardicre NK, Sicklen R, Horwood K, Lardner T, Arnold J, Wallace R, Johnson J. Adapting a communication coaching intervention for obstetric sonographers delivering unexpected news: A qualitative study. Ultrasound 2023; 31:273-283. [PMID: 37929254 PMCID: PMC10621488 DOI: 10.1177/1742271x221147860] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/11/2022] [Indexed: 11/07/2023]
Abstract
Introduction Despite widespread recognition that communicating unexpected news during obstetric ultrasound examinations is challenging, there is a dearth of research investigating how to teach evidence-based communication to sonographers. Communication Coaching is a supportive, positive method that has previously been associated with improvements in communication, patient satisfaction, and reduced burnout in clinicians. However, to date, no study has coached sonographers. This study explored stakeholders' views on a proposed Communication Coaching intervention and used these data to adapt the intervention for use with qualified obstetric sonographers. Methods Semi-structured interviews were conducted with people who have a vested interest in unexpected news delivery and thematic analysis was conducted on the data. Eight sonographers, six people with lived experience of receiving unexpected news and six representatives from third-sector organisations who support expectant parents were recruited (18 women; 2 men, aged between 21 and 75 years). Results Participants viewed the planned Communication Coaching intervention favourably and suggested adaptations. The two main themes were (1) the practicalities of coaching, and (2) content. The first theme had four subthemes: (a) brief and flexible structure, (b) online modality, (c) sensitive and positive coach and (d) organisational awareness. The second theme had three subthemes: (a) specific language and behaviour recommendations, (b) adaptable to different service-users and situations and (c) confer relevant emotional skills and techniques. Conclusions Communication Coaching could be a feasible and acceptable intervention for qualified sonographers if specific, limited adaptations are made as recommended by the stakeholders. Further evaluation of the intervention in practice is necessary.
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Affiliation(s)
- Essie Kaur
- School of Psychology, University of Leeds, Leeds, UK
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Jane Arezina
- Specialist Science Education Department (SSED), Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Louise Bryant
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Kathryn I Pollak
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
| | - Gill Harrison
- Society and College of Radiographers (SCoR), London, UK
- School of Health & Psychological Sciences, City, University of London, London, UK
| | | | | | | | - Roxanne Sicklen
- Barnet Hospital, Royal Free London NHS Foundation Trust, Barnet, UK
| | | | - Teresa Lardner
- Fetal Anomaly Screening Programme, Public Health Commissioning and Operations, NHS England, UK
| | | | - Rebecca Wallace
- Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Bradford, UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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Alves CAPF, Sherbini O, D'Arco F, Steel D, Kurian MA, Radio FC, Ferrero GB, Carli D, Tartaglia M, Balci TB, Powell-Hamilton NN, Schrier Vergano SA, Reutter H, Hoefele J, Günthner R, Roeder ER, Littlejohn RO, Lessel D, Lüttgen S, Kentros C, Anyane-Yeboa K, Catarino CB, Mercimek-Andrews S, Denecke J, Lyons MJ, Klopstock T, Bhoj EJ, Bryant L, Vanderver A. Brain Abnormalities in Patients with Germline Variants in H3F3: Novel Imaging Findings and Neurologic Symptoms Beyond Somatic Variants and Brain Tumors. AJNR Am J Neuroradiol 2022; 43:1048-1053. [PMID: 35772801 DOI: 10.3174/ajnr.a7555] [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] [Received: 02/23/2022] [Accepted: 04/18/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Pathogenic somatic variants affecting the genes Histone 3 Family 3A and 3B (H3F3) are extensively linked to the process of oncogenesis, in particular related to central nervous system tumors in children. Recently, H3F3 germline missense variants were described as the cause of a novel pediatric neurodevelopmental disorder. We aimed to investigate patterns of brain MR imaging of individuals carrying H3F3 germline variants. MATERIALS AND METHODS In this retrospective study, we included individuals with proved H3F3 causative genetic variants and available brain MR imaging scans. Clinical and demographic data were retrieved from available medical records. Molecular genetic testing results were classified using the American College of Medical Genetics criteria for variant curation. Brain MR imaging abnormalities were analyzed according to their location, signal intensity, and associated clinical symptoms. Numeric variables were described according to their distribution, with median and interquartile range. RESULTS Eighteen individuals (10 males, 56%) with H3F3 germline variants were included. Thirteen of 18 individuals (72%) presented with a small posterior fossa. Six individuals (33%) presented with reduced size and an internal rotational appearance of the heads of the caudate nuclei along with an enlarged and squared appearance of the frontal horns of the lateral ventricles. Five individuals (28%) presented with dysgenesis of the splenium of the corpus callosum. Cortical developmental abnormalities were noted in 8 individuals (44%), with dysgyria and hypoplastic temporal poles being the most frequent presentation. CONCLUSIONS Imaging phenotypes in germline H3F3-affected individuals are related to brain features, including a small posterior fossa as well as dysgenesis of the corpus callosum, cortical developmental abnormalities, and deformity of lateral ventricles.
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Affiliation(s)
| | - O Sherbini
- Department of Neurology (O.S., A.V.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - D Steel
- Neurology (D.S., M.A.K.), Great Ormond Street Hospital for Children, London, UK.,Molecular Neurosciences (D.S., M.A.K.), Zayed Centre for Research into Rare Diseases in Children, UCL GOS-Institute of Child Health, London, UK
| | - M A Kurian
- Neurology (D.S., M.A.K.), Great Ormond Street Hospital for Children, London, UK.,Molecular Neurosciences (D.S., M.A.K.), Zayed Centre for Research into Rare Diseases in Children, UCL GOS-Institute of Child Health, London, UK
| | - F C Radio
- Genetics and Rare Diseases Research Division (F.C.R., M.T.), Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - G B Ferrero
- Department of Public Health and Pediatrics (G.B.F., D.C.), University of Torino, Turin, Italy
| | - D Carli
- Department of Public Health and Pediatrics (G.B.F., D.C.), University of Torino, Turin, Italy
| | - M Tartaglia
- Genetics and Rare Diseases Research Division (F.C.R., M.T.), Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - T B Balci
- Medical Genetics Programof Southwestern Ontario (T.B.B.), London Health Sciences Centre, London, Ontario, Canada.,Department of Paediatrics (T.B.B.), Western University, London, Ontario, Canada
| | - N N Powell-Hamilton
- Division of Medical Genetics (N.N.P.-H.), Nemours Children's Hospital, Wilmington, Delaware
| | - S A Schrier Vergano
- Division of Medical Genetics and Metabolism (S.A.S.V.), Children's Hospital of The King's Daughters, Norfolk, Virginia.,Department of Pediatrics (S.A.S.V.), Eastern Virginia Medical School, Norfolk, Virginia
| | - H Reutter
- Division of Neonatology and Pediatric Intensive Care (H.R.), Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander University Nürnberg-Erlangen, Erlangen, Germany
| | - J Hoefele
- Institute of Human Genetics (J.H., R.G.)
| | - R Günthner
- Institute of Human Genetics (J.H., R.G.).,Department of Nephrology (R.G.), Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - E R Roeder
- Department of Pediatrics and Molecular and Human Genetics (E.R.R., R.O.L.), Baylor College of Medicine, San Antonio, Texas
| | - R O Littlejohn
- Department of Pediatrics and Molecular and Human Genetics (E.R.R., R.O.L.), Baylor College of Medicine, San Antonio, Texas
| | - D Lessel
- Institute of Human Genetics (D.L., S.L.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Lüttgen
- Institute of Human Genetics (D.L., S.L.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Kentros
- Division of Clinical Genetics (C.K., K.A.-Y.), Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York
| | - K Anyane-Yeboa
- Division of Clinical Genetics (C.K., K.A.-Y.), Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York
| | - C B Catarino
- Friedrich-Baur-Institute (C.B.C., T.K.), Department of Neurology, University Hospital, Ludwig-Maximilian University Munich, Munich, Germany
| | - S Mercimek-Andrews
- Department of Medical Genetics (S.M.-A.), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Department of Medical Genetics (S.M.-A.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - J Denecke
- Department of Pediatrics (J.D.), University Medical Center Eppendorf, Hamburg, Germany
| | - M J Lyons
- Greenwood Genetic Center (M.J.L.), Greenwood, South Carolina
| | - T Klopstock
- Friedrich-Baur-Institute (C.B.C., T.K.), Department of Neurology, University Hospital, Ludwig-Maximilian University Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (T.K.), Munich, Germany.,Munich Cluster for Systems Neurology (T.K.), Munich, Germany
| | - E J Bhoj
- Department of Radiology, Division of Human Genetics (E.J.B., L.B.)
| | - L Bryant
- Department of Radiology, Division of Human Genetics (E.J.B., L.B.)
| | - A Vanderver
- Department of Pediatrics, and Division of Neurology (A.V.), Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Neurology (O.S., A.V.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Bryant L. What is so complicated about prenatal testing for Down syndrome? A personal view. Hum Genet 2021; 141:1013-1015. [PMID: 34002259 PMCID: PMC8128085 DOI: 10.1007/s00439-021-02292-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/06/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Louise Bryant
- School of Medicine, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9JT, UK.
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5
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Ngan OMY, Yi H, Bryant L, Sahota DS, Chan OYM, Ahmed S. Parental expectations of raising a child with disability in decision-making for prenatal testing and termination of pregnancy: A mixed methods study. Patient Educ Couns 2020; 103:2373-2383. [PMID: 32507714 DOI: 10.1016/j.pec.2020.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine attitudes toward prenatal testing and termination of pregnancy (TOP) among parents and obstetric providers in relation to their views on raising a child with disability. METHODS An explanatory sequential mixed methods study. A survey among 274 parents and 141 providers was followed by interviews with 26 parents and 10 providers. Using multivariate analysis, the relationships between attitudes were examined. Thematic analysis was used to identify the reasons behind the attitudes. RESULTS In comparison with providers, parents reported more positive attitudes toward raising a child with disability and more moral views about TOP. Providers reported more variations in attitudes toward offering prenatal testing and TOP. Significant associations were found between attitudes toward prenatal testing, raising a child with disability, reproductive autonomy, and TOP. Three major themes were identified: (1) meanings of parenthood from genetic tests; (2) views toward TOP and parental responsibility; and (3) implications of advanced extended prenatal genetic testing. CONCLUSIONS Perceived social-cultural norms of disabilities and parental expectations of raising a child with disability influence decision-making regarding TOP. PRACTICE IMPLICATIONS As more conditions of the fetus are able to be detected, the social-cultural implications of the technology and disabilities need to be addressed in antenatal care.
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Affiliation(s)
- Olivia Miu Yung Ngan
- CUHK Centre for Bioethics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
| | - Louise Bryant
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Daljit Singh Sahota
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region
| | - Olivia Yiu Man Chan
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region
| | - Shenaz Ahmed
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
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6
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Ayers S, Bryant L, Gannon K, Jomeen J. 2020 JRIP editorial: celebrating the 40 th anniversary of the Society for Reproductive & Infant Psychology. J Reprod Infant Psychol 2020; 38:351-353. [PMID: 32840138 DOI: 10.1080/02646838.2020.1809289] [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: 10/23/2022]
Affiliation(s)
- Susan Ayers
- School of Health Sciences, City, University of London , London, UK.,School of Medicine, University of Leeds , Leeds, UK.,School of Psychology, University of East London , London, UK.,School of Health and Human Sciences, Southern Cross University , Lismore, Australia
| | - Louise Bryant
- School of Health Sciences, City, University of London , London, UK.,School of Medicine, University of Leeds , Leeds, UK.,School of Psychology, University of East London , London, UK.,School of Health and Human Sciences, Southern Cross University , Lismore, Australia
| | - Ken Gannon
- School of Health Sciences, City, University of London , London, UK.,School of Medicine, University of Leeds , Leeds, UK.,School of Psychology, University of East London , London, UK.,School of Health and Human Sciences, Southern Cross University , Lismore, Australia
| | - Julie Jomeen
- School of Health Sciences, City, University of London , London, UK.,School of Medicine, University of Leeds , Leeds, UK.,School of Psychology, University of East London , London, UK.,School of Health and Human Sciences, Southern Cross University , Lismore, Australia
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7
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Johnson J, Arezina J, Tomlin L, Alt S, Arnold J, Bailey S, Beety H, Bender-Atik R, Bryant L, Coates J, Collinge S, Fishburn J, Fisher J, Fowler J, Glanville T, Hallett J, Harley-Roberts A, Harrison G, Horwood K, Hynes C, Kimm L, McGuinness A, Potter L, Powell L, Ramsay J, Shakes P, Sicklen R, Sims A, Stacey T, Sumra A, Thomas S, Todd K, Torrington J, Trueman R, Walsh L, Watkins K, Yaz G, Hardicre NK. UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework. Ultrasound 2020. [DOI: 10.1177/1742271x20935911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers ( n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group ( n = 39). Revisions were undertaken until consensus was reached. Results Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24 .
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Affiliation(s)
- Judith Johnson
- School of Psychology, University of Leeds, Leeds, UK
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
- University of New South Wales, Sydney, NSW, Australia
| | - Jane Arezina
- Specialist Science Education Department (SSED), Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, Worsley Building, University of Leeds, Leeds, UK
| | - Liz Tomlin
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - Siobhan Alt
- NHS Fetal Anomaly Screening Programme, Public Health England, London, UK
| | | | - Sarah Bailey
- University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Hannah Beety
- Nest Independent Midwifery, Kirkstall, Leeds, UK
| | | | - Louise Bryant
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Jen Coates
- SANDS (Stillbirth and Neonatal Death Society), London, UK
| | - Sam Collinge
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Jo Fishburn
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Jane Fisher
- ARC (Antenatal Results and Choices), London, UK
| | - Jan Fowler
- SOFT UK (Support Organisation for Trisomy 13/18), West Midlands, UK
| | - Tracey Glanville
- Leeds Teaching Hospitals Trust, Department of Fetal and Maternal Medicine, Leeds General Infirmary, Leeds, UK
| | | | | | | | | | - Catriona Hynes
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Lindsay Kimm
- Public Health England (PHE) Screening, London, UK
| | | | - Lucy Potter
- MVP (Maternity Voices Partnership), Leeds, UK
- Women’s Health Matters, Leeds, UK
| | - Liane Powell
- NHS Fetal Anomaly Screening Programme, Public Health England, London, UK
| | - Janelle Ramsay
- Independent Lay Expert, Huddersfield, West Yorkshire, UK
| | - Pieta Shakes
- School of Health and Human Sciences, Southern Cross University, New South Wales, Australia
| | - Roxanne Sicklen
- Royal Free London NHS Foundation Trust, Barnet Hospital, Barnet, UK
| | - Alexander Sims
- St Mary’s Hospital, Manchester University Foundation Trust, Manchester, UK
| | - Tomasina Stacey
- University of Huddersfield, Huddersfield, UK
- Calderdale and Huddersfield Foundation Trust, University of Huddersfield, Huddersfield, UK
| | - Anushka Sumra
- School of Health Sciences, Birmingham City University, Edgbaston, UK
| | - Samantha Thomas
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Karen Todd
- Department of Health and Social Care, London, UK
| | - Jacquie Torrington
- Division of Midwifery and Radiography, School of Health Sciences, City, University of London, London, UK
| | | | | | - Katherine Watkins
- Leeds Teaching Hospital Trust, Leeds General Infirmary, Antenatal Clinic, Leeds, UK
| | - Gill Yaz
- SHINE (Spina Bifida, Hydrocephalus, Information, Networking, Equality), Peterborough, UK
| | - Natasha K Hardicre
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
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8
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Nadolski A, Vieira JD, Sobrin JA, Kofman AM, Ade PAR, Ahmed Z, Anderson AJ, Avva JS, Basu Thakur R, Bender AN, Benson BA, Bryant L, Carlstrom JE, Carter FW, Cecil TW, Chang CL, Cheshire JR, Chesmore GE, Cliche JF, Cukierman A, de Haan T, Dierickx M, Ding J, Dutcher D, Everett W, Farwick J, Ferguson KR, Florez L, Foster A, Fu J, Gallicchio J, Gambrel AE, Gardner RW, Groh JC, Guns S, Guyser R, Halverson NW, Harke-Hosemann AH, Harrington NL, Harris RJ, Henning JW, Holzapfel WL, Howe D, Huang N, Irwin KD, Jeong O, Jonas M, Jones A, Korman M, Kovac J, Kubik DL, Kuhlmann S, Kuo CL, Lee AT, Lowitz AE, McMahon J, Meier J, Meyer SS, Michalik D, Montgomery J, Natoli T, Nguyen H, Noble GI, Novosad V, Padin S, Pan Z, Paschos P, Pearson J, Posada CM, Quan W, Rahlin A, Riebel D, Ruhl JE, Sayre JT, Shirokoff E, Smecher G, Stark AA, Stephen J, Story KT, Suzuki A, Tandoi C, Thompson KL, Tucker C, Vanderlinde K, Wang G, Whitehorn N, Yefremenko V, Yoon KW, Young MR. Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics. Appl Opt 2020; 59:3285-3295. [PMID: 32400613 DOI: 10.1364/ao.383921] [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] [Received: 12/05/2019] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Abstract
We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.
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9
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Bryant L. Tangled diagnoses. Prenatal testing, women and risk. J Reprod Infant Psychol 2020. [DOI: 10.1080/02646838.2019.1710120] [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: 10/25/2022]
Affiliation(s)
- Louise Bryant
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, University of Leeds,
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10
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Silbernagel KM, Lindberg KG, Beatty S, Bell K, Boylston T, Brock G, Bryant L, DeSmet M, Eifert J, Grzanek K, Pulasani S, Saunders L, Scantling M, Wilson P. 3M™ Petrifilm™ Enterobacteriaceae Count Plate Method for Enumeration of Enterobacteriaceae in Selected Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.4.802] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
The practice of detecting and enumerating all oxidase-negative, glucose-fermenting-Gram-negative rods (i.e., the family Enterobacteriaceae) isused to indicate unsanitary or inadequate food processing conditions. The objective of this interlaboratory collaborative study was to evaluate and compare the methods described in Standard Methods for the Examination of Dairy Products (SMEDP) and the Compendium of Methods for the Microbiological Examination of Foods (Compendium) with a commercial product, the 3M™ Petrifilm™ Enterobacteriaceae Count Plate, for the recovery of Enterobacteriaceae in foods. Six foods—cheddar cheese, milk, flour, frozen prepared meals, frozen broccoli, and nut pieces—were analyzed for Enterobacteriaceae by 12 collaborating laboratories. For each food tested, the collaborators received 8 blind test portions consisting of a control test portion and 3 levels of inoculated test portion, each in duplicate. Each test portion was tested by the Petrifilm Enterobacteriaceae Count Plate method as well as the SMEDP or Compendium methods. The precision estimates (repeat-ability or within-laboratory variation, and reproducibility or between-laboratory variation) were calculated with standard statistical techniques.
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House A, Bryant L, Russell AM, Wright-Hughes A, Graham L, Walwyn R, Wright JM, Hulme C, O'Dwyer JL, Latchford G, Meer S, Birtwistle JC, Stansfield A, Ajjan R, Farrin A. Managing with Learning Disability and Diabetes: OK-Diabetes - a case-finding study and feasibility randomised controlled trial. Health Technol Assess 2019; 22:1-328. [PMID: 29845932 DOI: 10.3310/hta22260] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity and type 2 diabetes are common in adults with a learning disability. It is not known if the principles of self-management can be applied in this population. OBJECTIVES To develop and evaluate a case-finding method and undertake an observational study of adults with a learning disability and type 2 diabetes, to develop a standardised supported self-management (SSM) intervention and measure of adherence and to undertake a feasibility randomised controlled trial (RCT) of SSM versus treatment as usual (TAU). DESIGN Observational study and an individually randomised feasibility RCT. SETTING Three cities in West Yorkshire, UK. PARTICIPANTS In the observational study: adults aged > 18 years with a mild or moderate learning disability, who have type 2 diabetes that is not being treated with insulin and who are living in the community. Participants had mental capacity to consent to research and to the intervention. In the RCT participants had glycated haemoglobin (HbA1c) levels of > 6.5% (48 mmol/mol), a body mass index (BMI) of > 25 kg/m2 or self-reported physical activity below national guideline levels. INTERVENTIONS Standardised SSM. TAU supported by an easy-read booklet. MAIN OUTCOME MEASURES (1) The number of eligible participants identified and sources of referral; (2) current living and support arrangements; (3) current health state, including level of HbA1c, BMI and waist circumference, blood pressure and lipids; (4) mood, preferences for change; (5) recruitment and retention in RCT; (6) implementation and adherence to the intervention; (7) completeness of data collection and values for candidate primary outcomes; and (8) qualitative data on participant experience of the research process and intervention. RESULTS In the observational study we identified 147 eligible consenting participants. The mean age was 54.4 years. In total, 130 out of 147 (88%) named a key supporter, with 113 supporters (77%) being involved in diabetes management. The mean HbA1c level was 54.5 mmol/mol [standard deviation (SD) 14.8 mmol/mol; 7.1%, SD 1.4%]. The BMI of 65% of participants was > 30 kg/m2 and of 21% was > 40 kg/m2. Many participants reported low mood, dissatisfaction with lifestyle and diabetes management and an interest in change. Non-response rates were high (45/147, 31%) for medical data requested from the primary care team. In the RCT, 82 participants were randomised. The mean baseline HbA1c level was 56 mmol/mol (SD 16.5 mmol/mol; 7.3%, SD 1.5%) and the mean BMI was 34 kg/m2 (SD 7.6 kg/m2). All SSM sessions were completed by 35 out of 41 participants. The adherence measure was obtained in 37 out of 41 participants. The follow-up HbA1c level and BMI was obtained for 75 out of 82 (91%) and 77 out of 82 (94%) participants, respectively. Most participants reported a positive experience of the intervention. A low response rate and difficulty understanding the EuroQol-5 Dimensions were challenges in obtaining data for an economic analysis. LIMITATIONS We recruited from only 60% of eligible general practices, and 90% of participants were on a general practice learning disability register, which meant that we did not recruit many participants from the wider population with milder learning disability. CONCLUSIONS A definitive RCT is feasible and would need to recruit 194 participants per arm. The main barrier is the resource-intensive nature of recruitment. Future research is needed into the effectiveness of obesity treatments in this population, particularly estimating the longer-term outcomes that are important for health benefit. Research is also needed into improving ways of assessing quality of life in adults with a learning disability. TRIAL REGISTRATION Current Controlled Trials ISRCTN41897033. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 26. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Allan House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Louise Bryant
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amy M Russell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Liz Graham
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Rebecca Walwyn
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Judy M Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Claire Hulme
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - John L O'Dwyer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Gary Latchford
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Shaista Meer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Ramzi Ajjan
- Division of Cardiovascular and Diabetes Research, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
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Murtagh S, Bryant L, Finucane L, McCrum C, Mercer C, Smith T. Exploring the psychometric properties of the Brighton musculoskeletal patient reported outcome measure. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.129] [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: 10/27/2022]
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Christensen SH, Bewick BM, Bryant L, Skriver MV, Høybye MT. Student and staff perceptions of alcohol as part of student life in Denmark: A Q methodology study. PLoS One 2018; 13:e0205923. [PMID: 30359407 PMCID: PMC6201902 DOI: 10.1371/journal.pone.0205923] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/03/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Intervening effectively to prevent students' harmful use of alcohol remains a challenge. Harmful alcohol use has been noted as the most dominant public health problem facing universities today. This study sought to investigate the diversity in staff and student perceptions of the contribution alcohol makes to student life in a Danish university setting. Increasing understanding of staff and students' perceptions of how alcohol fits into student life is required to amend future public health intervention for this population. MATERIALS AND METHODS This Q methodology study included 38 staff members and 105 students from Aarhus University, Denmark. Participants used online Q sorting software, to rank 40 statements about the contribution alcohol makes to the university student experience from strongly agree to disagree. To support the interpretation of the factors, self-reported alcohol consumption and demographic data were collected. In addition qualitative data was collected on the participant's reasons for the ranking of the items they most strongly agreed or disagreed with. RESULTS AND DISCUSSION Using principal components analysis, five statistically independent viewpoints for students and four for staff were identified. The findings provide evidence to inform approaches to prevent harmful alcohol use. Some viewpoints suggest a need for tailored secondary and tertiary prevention and intervention that focusses on individuals and/or sub-groups who are at risk of consuming alcohol at harmful levels. Other viewpoints suggest the need for primary universal prevention to support the maintenance of healthy norms which can prevent harmful alcohol behaviour. Public health campaigns need to ensure that interventions targeting harmful alcohol use at universities challenge problematic perceptions and attitudes while also bolstering exposure to positive norms.
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Affiliation(s)
| | - Bridgette M. Bewick
- Division of Psychological and Social Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Louise Bryant
- Division of Psychological and Social Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Mette Vinther Skriver
- Section of Health Services Research, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Mette Terp Høybye
- Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
- Interacting Minds Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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House A, Bryant L, Russell AM, Wright‐Hughes A, Graham L, Walwyn R, Wright JM, Hulme C, O'Dwyer JL, Latchford G, Stansfield A, Ajjan R, Farrin A. Randomized controlled feasibility trial of supported self-management in adults with Type 2 diabetes mellitus and an intellectual disability: OK Diabetes. Diabet Med 2018; 35:776-788. [PMID: 29575241 PMCID: PMC5969288 DOI: 10.1111/dme.13626] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2018] [Indexed: 01/21/2023]
Abstract
AIMS To undertake a feasibility randomized controlled trial of supported self-management vs treatment as usual in a population of adults with obesity, Type 2 diabetes and an intellectual disability. METHODS We conducted an individually randomized feasibility trial. Participants were adults aged >18 years with a mild or moderate intellectual disability, living in the community with Type 2 diabetes, on any therapy other than insulin. Participants had mental capacity to consent to research and the intervention. Inclusion criteria included HbA1c > 48 mmol/mol (6.5%), BMI >25 kg/m2 , or self-reported physical activity below national guideline levels. The experimental intervention was standardized supported self-management delivered by diabetes specialist nurses plus treatment as usual, compared with treatment as usual alone. Feasibility outcomes included: recruitment and retention; intervention acceptability and feasibility; data collection and completeness for physiological state and values for candidate primary outcomes (HbA1c and BMI). RESULTS A total of 82 participants (89% of those contacted and eligible) were randomized. All supported self-management sessions were completed by 35/41 participants (85%); only four completed no sessions. Data on the follow-up candidate primary outcomes HbA1c and BMI were obtained for 75/82 (91%) and 77/82 participants (94%), respectively. The mean baseline HbA1c was 56±16.5 mmol/mol (7.3±1.5%) and the mean BMI was 34±7.6 kg/m2 . CONCLUSIONS Adherence to supported self-management and willingness to have blood taken for outcome measurement was good. A definitive randomized controlled trial is feasible in this population. (Trial registration: Current Controlled Trials ISRCTN41897033).
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Affiliation(s)
- A. House
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - L. Bryant
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - A. M. Russell
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | | | - L. Graham
- Clinical Trials Research UnitUniversity of LeedsLeedsUK
| | - R. Walwyn
- Clinical Trials Research UnitUniversity of LeedsLeedsUK
| | - J. M. Wright
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - C. Hulme
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - J. L O'Dwyer
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - G. Latchford
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | | | - R. Ajjan
- Division of Cardiovascular and Diabetes ResearchUniversity of LeedsLeedsUK
| | - A. Farrin
- Clinical Trials Research UnitUniversity of LeedsLeedsUK
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House A, Latchford G, Russell AM, Bryant L, Wright J, Graham E, Stansfield A, Ajjan R. Development of a supported self-management intervention for adults with type 2 diabetes and a learning disability. Pilot Feasibility Stud 2018; 4:106. [PMID: 29862037 PMCID: PMC5975532 DOI: 10.1186/s40814-018-0291-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 05/09/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although supported self-management is a well-recognised part of chronic disease management, it has not been routinely used as part of healthcare for adults with a learning disability. We developed an intervention for adults with a mild or moderate learning disability and type 2 diabetes, building on the principles of supported self-management with reasonable adjustments made for the target population. METHODS In five steps, we:Clarified the principles of supported self-management as reported in the published literatureIdentified the barriers to effective self-management of type 2 diabetes in adults with a learning disabilityReviewed existing materials that aim to support self-management of diabetes for people with a learning disabilitySynthesised the outputs from the first three phases and identified elements of supported self-management that were (a) most relevant to the needs of our target population and (b) most likely to be acceptable and useful to themImplemented and field tested the intervention. RESULTS The final intervention had four standardised components: (1) establishing the participant's daily routines and lifestyle, (2) identifying supporters and their roles, (3) using this information to inform setting realistic goals and providing materials to the patient and supporter to help them be achieved and (4) monitoring progress against goals.Of 41 people randomised in a feasibility RCT, thirty five (85%) completed the intervention sessions, with over three quarters of all participants (78%) attending at least three sessions.Twenty-three out of 40 (58%) participants were deemed to be very engaged with the sessions and 12/40 (30%) with the materials; 30 (73%) participants had another person present with them during at least one of their sessions; 15/41 (37%) were reported to have a very engaged main supporter, and 18/41 (44%) had a different person who was not their main supporter but who was engaged in the intervention implementation. CONCLUSIONS The intervention was feasible to deliver and, as judged by participation and engagement, acceptable to participants and those who supported them. TRIAL REGISTRATION Current Controlled Trials ISRCTN41897033 (registered 21/01/2013).
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Affiliation(s)
- Allan House
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Leeds, LS2 9NL UK
| | - Gary Latchford
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Leeds, LS2 9NL UK
| | - Amy M. Russell
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Leeds, LS2 9NL UK
| | - Louise Bryant
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Leeds, LS2 9NL UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Leeds, LS2 9NL UK
| | - Elizabeth Graham
- Leeds Institute of Clinical Trials Research, University of Leeds, Worsley Building, Leeds, LS2 9NL UK
| | | | - Ramzi Ajjan
- Division of Cardiovascular and Diabetes Research, University of Leeds, Leeds, UK
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Alderson S, Foy R, Bryant L, Ahmed S, House A. Using Q-methodology to guide the implementation of new healthcare policies. BMJ Qual Saf 2018; 27:737-742. [DOI: 10.1136/bmjqs-2017-007380] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 02/28/2018] [Accepted: 03/15/2018] [Indexed: 11/04/2022]
Abstract
There are many challenges in the development, implementation and evaluation of healthcare policy. One challenge is understanding how different stakeholders view a particular policy and what impact these views may have during implementation. Q-methodology is one approach that can be used to help policy makers and researchers actively engage with those who are important in policy implementation, and anticipate their responses. Q-methodology combines qualitative and quantitative research methods to systematically explore and describe the range of viewpoints about a topic. Participants are required to rank a set of predefined statements relating to the topic, according to their own viewpoint. Factor analytic techniques then identify people who are like-minded in the way they view the topic and enable areas of consensus and divergence in viewpoint to be clearly defined. This mapping of viewpoints allows those working in policy implementation to anticipate likely barriers and levers in implementing new policies.
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17
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Bryant L. Hole in the heart: bringing up Beth. J Reprod Infant Psychol 2018. [PMID: 29517375 DOI: 10.1080/02646838.2017.1342788] [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: 10/19/2022]
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Affiliation(s)
- K. Tresemer
- Princeton Plasma Physics Laboratory P. O. Box 451, Princeton, NJ 08543-0451
| | - T. Stevenson
- Princeton Plasma Physics Laboratory P. O. Box 451, Princeton, NJ 08543-0451
| | - C. Priniski
- Princeton Plasma Physics Laboratory P. O. Box 451, Princeton, NJ 08543-0451
| | - J. Winkelman
- Princeton Plasma Physics Laboratory P. O. Box 451, Princeton, NJ 08543-0451
| | - L. Bryant
- Princeton Plasma Physics Laboratory P. O. Box 451, Princeton, NJ 08543-0451
| | - R. Wood
- Princeton Plasma Physics Laboratory P. O. Box 451, Princeton, NJ 08543-0451
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19
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Neumeyer C, Brooks A, Bryant L, Chrzanowski J, Feder R, Gomez M, Heitzenroeder P, Kalish M, Lipski A, Mardenfeld M, Simmons R, Titus P, Zatz I, Daly E, Martin A, Nakahira M, Pillsbury R, Feng J, Bohm T, Sawan M, Griffiths I, Schaffer M. Design of the ITER In-Vessel Coils. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a12333] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C. Neumeyer
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - A. Brooks
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - L. Bryant
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - J. Chrzanowski
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - R. Feder
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - M. Gomez
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | | | - M. Kalish
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - A. Lipski
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - M. Mardenfeld
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - R. Simmons
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - P. Titus
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - I. Zatz
- Princeton University, Plasma Physics Lab, Princeton, NJ, USA
| | - E. Daly
- ITER Organization, St. Paul-lez-Durance, France
| | - A. Martin
- ITER Organization, St. Paul-lez-Durance, France
| | - M. Nakahira
- ITER Organization, St. Paul-lez-Durance, France
| | | | - J. Feng
- MIT Plasma Science and Fusion Center, Cambridge, MA, USA
| | - T. Bohm
- Fusion Technology Institute, University of Wisconsin-Madison, Madison, WI, USA
| | - M. Sawan
- Fusion Technology Institute, University of Wisconsin-Madison, Madison, WI, USA
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Acharya S, Bryant L, Twiddy M. Altruism or obligation? The motivations and experience of women who donate oocytes to known recipients in assisted conception treatment: an interpretative phenomenological analysis study. J Psychosom Obstet Gynaecol 2017; 38:4-11. [PMID: 28136000 DOI: 10.1080/0167482x.2016.1233171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION This qualitative study was conducted to explore the motivations and experience of oocyte donors donating to women known to them. METHODS Three women who donated oocytes to a close relative were interviewed and data were analysed using an Interpretative Phenomenological Analysis approach. RESULTS The two key elements noted were "motivations for donation" and "coping with the consequences of oocyte donation". The motivation for donation was influenced by the familial bond that was strengthened by the donation process in some cases. The concept of altruistic oocyte donation stemmed from the narratives of giving the gift of motherhood and gaining a positive self-image and respect from others. Coping with the consequences of oocyte donation tests the donor identity, their wishes for a positive outcome, concerns regarding disclosure of biological motherhood and detachment from the egg and potential child. DISCUSSION Motivation is influenced by a combination of factors including the rewards of altruistic behaviour, the existence and potential strengthening of the relationship between donor and recipient, but possibly also, a sense of obligation and societal expectations. Oocyte donation can be variously viewed by donors as a unique way of reproductive empowerment or an example of acceding to subtle coercion and thus disempowerment. The study also highlights the clinical as well as ethical importance of providing support services for oocyte donors and recipients.
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Affiliation(s)
- Santanu Acharya
- a Ayrshire Fertility Unit , University Hospital Crosshouse , Kilmarnock , Scotland, UK
| | - Louise Bryant
- b Institute of Health Sciences, University of Leeds , Leeds , UK
| | - Maureen Twiddy
- b Institute of Health Sciences, University of Leeds , Leeds , UK
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Graham L, Wright J, Walwyn R, Russell AM, Bryant L, Farrin A, House A. Measurement of adherence in a randomised controlled trial of a complex intervention: supported self-management for adults with learning disability and type 2 diabetes. BMC Med Res Methodol 2016; 16:132. [PMID: 27716063 PMCID: PMC5052902 DOI: 10.1186/s12874-016-0236-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 09/29/2016] [Indexed: 01/18/2023] Open
Abstract
Background Reporting adherence to intervention delivery and uptake is a detailed way of describing what was actually delivered and received, in comparison to what was intended. Measuring and reporting adherence is not routinely done well in complex interventions. The OK Diabetes trial (ISRCTN41897033) aimed to develop and subsequently test the feasibility of implementing a supported self-management intervention in adults with a learning disability and type 2 diabetes. A key study objective was to develop a measure of adherence to the intervention. Methods We conducted a systematic review of published literature, extracting data from included papers using a standardised proforma. We undertook a narrative synthesis of papers to determine the form and content of methods for adherence measurement for self-management interventions in this population that had already been developed. We used the framework and data extraction form developed for the review as the basis for an adherence measurement tool that we applied in the OK Diabetes trial. Results The literature review found variability in the quality and content of adherence measurement and reporting, with no standardised approach. We were able to develop an adherence measure based upon the review, and populate it with data collected during the OK Diabetes trial. The adherence tool proved satisfactory for recording and measuring adherence in the trial. Conclusion There remains a need for a standardised approach to adherence measurement in the field of complex interventions. We have shown that it is possible to produce a simple, feasible measure for assessing adherence in the OK Diabetes trial. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0236-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liz Graham
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Rebecca Walwyn
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Amy M Russell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Louise Bryant
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Allan House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Abstract
Abstract. Emotion perception studies typically explore how judgments of facial expressions are influenced by invariant characteristics such as sex or by variant characteristics such as gaze. However, few studies have considered the importance of factors that are not easily categorized as invariant or variant. We investigated one such factor, attractiveness, and the role it plays in judgments of emotional expression. We asked 26 participants to categorize different facial expressions (happy, neutral, and angry) that varied with respect to facial attractiveness (attractive, unattractive). Participants were significantly faster when judging expressions on attractive as compared to unattractive faces, but there was no interaction between facial attractiveness and facial expression, suggesting that the attractiveness of a face does not play an important role in the judgment of happy or angry facial expressions.
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Affiliation(s)
- Alisdair J. G. Taylor
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Louise Bryant
- Department of Psychology, School of Science and Technology, Bournemouth University, UK
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Maloy C, Janes K, Bryant L, Tosh D, Jacobson K, Salvemini D. (336) A3 adenosine receptor agonists reverse established oxaliplatin-induced neuropathic pain through an IL-10 mediated mechanism of action in spinal cord. The Journal of Pain 2014. [DOI: 10.1016/j.jpain.2014.01.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bryant L. Non-invasive prenatal testing for Down’s syndrome: psychologically speaking, what else do we need to know? J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.874115] [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: 10/25/2022]
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Hoskin P, Rojas A, Ostler P, Hughes R, Bryant L, Lowe G. OC-0263: HDR brachytherapy dosimetric predictors of biochemical control of prostate cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32569-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Doyle T, Esposito E, Bryant L, Cuzzocrea S, Salvemini D. NADPH-oxidase 2 activation promotes opioid-induced antinociceptive tolerance in mice. Neuroscience 2013; 241:1-9. [PMID: 23454539 DOI: 10.1016/j.neuroscience.2013.02.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 02/04/2013] [Accepted: 02/18/2013] [Indexed: 12/18/2022]
Abstract
The analgesic effectiveness of long-term opioid therapies is compromised by the development of antinociceptive tolerance linked to the overt production of peroxynitrite (ONOO(-), PN), the product of the interaction between superoxide (O2(-), SO) and nitric oxide (NO), and to neuroinflammatory processes. We have recently reported that in addition to post-translational nitration and inactivation of mitochondrial manganese superoxide dismutase (MnSOD), activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase holoenzyme (NOX) in the spinal cord is a major source for the overt production of superoxide-derived PN during the development of morphine-induced antinociceptive tolerance. However, the NOX complex involved in these processes is not known. The objective of these studies is to identify a potential role for the NOX2 complex, an enzyme involved in inflammation. Mice lacking the catalytic subunit of NOX2 (Nox2(-/-)) or its regulatory subunit, p47(phox) (p47(phox)(-/-)), developed antinociceptive tolerance similar to wildtype (wt) mice after 3 days of continuous morphine. However, while wt mice continue to develop tolerance by day six, morphine analgesia was restored in both Nox2(-/-) and p47(phox)(-/-) mice. Moreover, the loss of Nox2 or p47 did not affect acute morphine analgesia in naïve mice. In wt mice, antinociceptive tolerance was associated with increased activation of NOX, nitration of MnSOD, and proinflammatory cytokines production in the spinal cord. These events were markedly attenuated in Nox2(-/-) and p47(phox)(-/-) mice and instead, there was enhanced formation of antiinflammatory cytokine (IL4 and IL10) production. These results suggest that NOX2 activity provides a significant source of superoxide-derived PN to undertake post-translational modifications of mitochondrial MnSOD and to engage neuroinflammatory signaling in the spinal cord associated with opioid-induced antinociceptive tolerance. Thus, NOX2 may provide a potential target for adjuvant therapy to protect opioid analgesia.
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Affiliation(s)
- T Doyle
- Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA
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Hoskin P, Rojas A, Ostler P, Hughes R, Alonzi R, Bryant L, Lowe G. OC-25 HIGH-DOSE RATE AFTERLOADING BRACHYTHERAPY USING ONE OR TWO FRACTIONS FOR LOCALISED PROSTATE CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71993-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dobbins A, Bryant L, Zotov A. Bistable Apparent Motion Axis Determined by Axis of Surrounding Object. J Vis 2011. [DOI: 10.1167/11.11.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Chen Z, Muscoli C, Doyle T, Bryant L, Cuzzocrea S, Mollace V, Mastroianni R, Masini E, Salvemini D. NMDA-receptor activation and nitroxidative regulation of the glutamatergic pathway during nociceptive processing. Pain 2010; 149:100-106. [PMID: 20167432 DOI: 10.1016/j.pain.2010.01.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 01/12/2010] [Accepted: 01/21/2010] [Indexed: 01/09/2023]
Abstract
The role of peroxynitrite (PN) as a mediator of nociceptive signaling is emerging. We recently reported that the development of central sensitization that follows the intraplantar injection of carrageenan in rats is associated with spinal PN synthesis. We now demonstrate that a significant pathway through which spinal PN modulates central sensitization is post-translational tyrosine nitration of key proteins involved in the glutamatergic pathway, namely glutamate transporter GLT-1 and glutamine synthetase (GS). We also reveal that spinal activation of the N-methyl-d-aspartate (NMDA) receptor provides a source of PN in this setting. Intraplantar injection of carrageenan led to the development of thermal hyperalgesia as well as nitration of GLT-1 and GS in dorsal horn tissues. Pretreatment with the PN decomposition catalyst FeTM-4-PyP(5+) [Fe(III)5,10,15,20-tetrakis(N-methylpyridinium-4-yl)porphyrin] or the NMDA receptor antagonist MK-801 blocked the development of hyperalgesia. Carrageenan-induced hyperalgesia was also associated with nitration and inactivation of spinal mitochondrial superoxide dismutase (MnSOD) known to provide a critical source of PN during central sensitization. Nitration of GLT-1 and GS contributes to central sensitization by enhancing glutamatergic neurotransmission. Our results support the critical role of nitroxidative stress in the development of hyperalgesia and suggest that post-translational nitration of enzymes and transporters linked to glutamatergic neurotransmission represent a novel mechanism of central sensitization.
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Affiliation(s)
- Zhoumou Chen
- Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, 1402 South Grand Blvd., St. Louis, MO 63104, USA IRCCS San Raffaele Pisana, Rome, Italy Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina, Italy Department of Preclinical and Clinical Pharmacology, University of Florence, Italy
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Lai W, Mahadavan L, Bryant L, Grice A, Daniels I. Reduced length of stay with rectus sheath analgesia compared to epidural in patients undergoing open colorectal cancer surgery. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Griffiths D, Bryant L, Arkuta S. I139 Marie Stopes International: Innovative reproductive health service delivery. Models for underserved communities. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60139-9] [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: 10/20/2022]
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Doyle T, Bryant L, Batinic-Haberle I, Little J, Cuzzocrea S, Masini E, Spasojevic I, Salvemini D. Supraspinal inactivation of mitochondrial superoxide dismutase is a source of peroxynitrite in the development of morphine antinociceptive tolerance. Neuroscience 2009; 164:702-10. [PMID: 19607887 DOI: 10.1016/j.neuroscience.2009.07.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 07/07/2009] [Accepted: 07/09/2009] [Indexed: 01/06/2023]
Abstract
Effective treatment of chronic pain with morphine is limited by decreases in the drug's analgesic action with chronic administration (antinociceptive tolerance). Because opioids are mainstays of pain management, restoring their efficacy has great clinical importance. We have recently reported that formation of peroxynitrite (ONOO(-), PN) in the dorsal horn of the spinal cord plays a critical role in the development of morphine antinociceptive tolerance and have further documented that nitration and enzymatic inactivation of mitochondrial superoxide dismutase (MnSOD) at that site provides a source for this nitroxidative species. We now report for the first time that antinociceptive tolerance in mice is also associated with the inactivation of MnSOD at supraspinal sites. Inactivation of MnSOD led to nitroxidative stress as evidenced by increased levels of products of oxidative DNA damage and activation of the nuclear factor poly (ADP-ribose) polymerase in whole brain homogenates. Co-administration of morphine with potent Mn porphyrin-based peroxynitrite scavengers, Mn(III) 5,10,15,20-tetrakis(N-ethylpyridinium-2-yl)porphyrin (MnTE-2-PyP5+) and Mn(III) 5,10,15,20-tetrakis(N-n-hexylpyridinium-2-yl)porphyrin (MnTnHex-2-PyP5+) (1) restored the enzymatic activity of MnSOD, (2) attenuated PN-derived nitroxidative stress, and (3) blocked the development of morphine-induced antinociceptive tolerance. The more lipophilic analogue, MnTnHex-2-PyP5+ was able to cross the blood-brain barrier at higher levels than its lipophylic counterpart MnTE-2-PyP5+ and was about 30-fold more efficacious. Collectively, these data suggest that PN-mediated enzymatic inactivation of supraspinal MnSOD provides a source of nitroxidative stress, which in turn contributes to central sensitization associated with the development of morphine antinociceptive tolerance. These results support our general contention that PN-targeted therapeutics may have potential as adjuncts to opiates in pain management.
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Affiliation(s)
- T Doyle
- Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA
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Hoskin P, Ostler P, Hughes R, Bryant L, Chapman C, Lowe G. 35 oral: Hig Dose Rate Brachytherapy as Monotherapy for Localised Prostate Cancer: A Phase II Dose Escalation Study. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(15)34293-6] [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]
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Anderson C, Hoskin P, Lowe G, Wills R, Inchley D, Beenstock V, Bryant L, Chapman C. 56 oral: Critical Structure Movement in Cervix Brachytherapy. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(15)34313-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Inchley D, Groom N, Lowe G, Bryant L, Chapman C, Aird E, Hoskin P. 116 poster: Investigation of the Dosimetry Close to an IR-192 HDR Source Using GAF Chromic Film. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(15)34373-5] [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]
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Ahmed S, Bryant L, Hewison J. 'Balance' is in the eye of the beholder: providing information to support informed choices in antenatal screening via Antenatal Screening Web Resource. Health Expect 2007; 10:309-20. [PMID: 17986068 DOI: 10.1111/j.1369-7625.2007.00455.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The Antenatal Screening Web Resource (AnSWeR) was designed to support informed prenatal testing choices by providing balanced information about disability, based on the testimonies of disabled people and their families. We were commissioned by the developers to independently evaluate the website. This paper focused on how participants evaluated AnSWeR in terms of providing balanced information. SETTING West Yorkshire. PARTICIPANTS A total of 69 people were drawn from three groups: health professionals, people with personal experience of tested-for conditions (Down's syndrome, cystic fibrosis and spina bifida) and people representing potential users of the resource. METHOD Data were collected via focus groups and electronic questionnaires. RESULTS Participants believed that information about the experience of living with the tested-for conditions and terminating a pregnancy for the conditions were important to support informed antenatal testing and termination decisions. However, there were differences in opinion about whether the information about the tested-for conditions was balanced or not. Some people felt that the inclusion of photographs of people with the tested-for conditions introduced biases (both positive and negative). Many participants were also of the opinion that AnSWeR presented insufficient information on termination of an affected pregnancy to support informed choice. CONCLUSION This study highlighted the difficulty of designing 'balanced' information about tested-for conditions and a lack of methodology for doing so. It is suggested that AnSWeR currently provides a counterbalance to other websites that focus on the medical aspects of disability. Its aim to provide 'balanced' information would be aided by increasing the number and range of case studies available on the website.
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Affiliation(s)
- Shenaz Ahmed
- Leeds Institute of Health Sciences, Academic Unit of Public Health, University of Leeds, Leeds, UK.
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Nguyen NQ, Mangoni AA, Fraser RJ, Chapman M, Bryant L, Burgstad C, Holloway RH. Prokinetic therapy with erythromycin has no significant impact on blood pressure and heart rate in critically ill patients. Br J Clin Pharmacol 2007; 63:498-500. [PMID: 17378798 PMCID: PMC2203248 DOI: 10.1111/j.1365-2125.2006.02772.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Keane B, Bryant L, Goyal U, Williams S, Kortering S, Lucia K, Richmond A, Solomon N. No effect of body condition at weaning on survival and reproduction in prairie voles. CAN J ZOOL 2007. [DOI: 10.1139/z07-054] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The physiological state of an animal may have a significant impact on its reproductive success because individuals in good body condition are generally considered to be competitively superior to individuals in poor body condition. In this study, we tested if body condition at weaning affected survival and reproduction of prairie voles ( Microtus ochrogaster (Wagner, 1842)) living under ecologically relevant conditions at two different initial population densities. We detected no evidence that better body condition at weaning was associated with either enhanced survival or reproduction. Moreover, genetic analysis of parentage found that mating between males and females was random with respect to body condition. Results of this study indicate body condition at weaning was not a reliable predictor of future survival or reproduction in prairie voles. This may be because body condition at weaning does not accurately forecast the energetic state of prairie voles at later ages, or because other factors have a greater effect on an individual’s survival and reproductive success at the densities observed in this study.
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Affiliation(s)
- B. Keane
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - L. Bryant
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - U. Goyal
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - S. Williams
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - S.L. Kortering
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - K.E. Lucia
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - A.R. Richmond
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
| | - N.G. Solomon
- Center for Animal Behavior and Department of Zoology, Miami University, Hamilton, OH 45011, USA
- Center for Animal Behavior and Department of Zoology, Miami University, Oxford, OH 45056, USA
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40
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Chin YS, Bullard J, Bryant L, Bownes P, Ostler P, Hoskin PJ. High Dose Rate Iridium-192 Brachytherapy as a Component of Radical Radiotherapy for the Treatment of Localised Prostate Cancer. Clin Oncol (R Coll Radiol) 2006; 18:474-9. [PMID: 16909971 DOI: 10.1016/j.clon.2006.04.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [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: 11/18/2022]
Abstract
AIMS To assess the treatment outcomes and toxicity of conformal high dose rate (HDR) brachytherapy boost as a means of radiation dose escalation in patients with localised prostate cancer. MATERIALS AND METHODS Between December 1998 and July 2004, 65 consecutive patients with localised prostate cancer (magnetic resonance imaging-staged T1-3 N0 M0) were treated with external beam radiation therapy (EBRT) followed by two fractions of HDR iridium-192 brachytherapy. The patients selected this treatment modality in preference to entering an ongoing randomised phase 3 trial. Any pre-treatment serum prostate-specific antigen (PSA) and Gleason score were included. The primary end point was biochemical disease-free progression. Late treatment-related morbidity was graded according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer criteria. RESULTS The median patient age was 67.3 years (range 47.9-80). Sixty patients (92.3%) had intermediate- to high-risk disease defined by clinical stage, presenting PSA and Gleason score/World Health Organisation (WHO) grade. With a median follow-up of 3.5 years (range 0.6-5.8), two patients had died of metastatic disease and another four patients had PSA relapse, giving a 3-year actuarial biochemical disease-free progression of 90.8%. Three patients (4.6%) had acute grade 3 genitourinary toxicity, in the form of urinary retention. Late grade 3 and 4 genitourinary toxicities occurred in four patients (6.2%) and one patient (1.5%), respectively. No late gastrointestinal toxicities were observed. CONCLUSIONS These results suggest that the combined modality of conformal HDR brachytherapy and EBRT is a feasible treatment modality with acceptable acute and late toxicities, comparable with those of EBRT alone. It offers an attractive conformal treatment modality with the potential of further dose escalation in the treatment of localised prostate cancer.
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Affiliation(s)
- Y S Chin
- Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex, UK
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41
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Nguyen N, Chapman M, Fraser R, Sharley V, Kong S, Bryant L, Holloway R. Erythromycin or metoclopramide for feed intolerance in the critically ill. Crit Care 2006; 10. [PMCID: PMC4092589 DOI: 10.1186/cc4561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- N Nguyen
- Royal Adelaide Hospital, Adelaide, Australia
| | - M Chapman
- Royal Adelaide Hospital, Adelaide, Australia
| | - R Fraser
- Repatriation General Hospital, Adelaide, Australia
| | - V Sharley
- Royal Adelaide Hospital, Adelaide, Australia
| | - S Kong
- Royal Adelaide Hospital, Adelaide, Australia
| | - L Bryant
- Royal Adelaide Hospital, Adelaide, Australia
| | - R Holloway
- Royal Adelaide Hospital, Adelaide, Australia
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42
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Chapman M, Fraser R, Vozzo R, Bryant L, Tam W, Nguyen N, Zacharakis B, Butler R, Davidson G, Horowitz M. Antro-pyloro-duodenal motor responses to gastric and duodenal nutrient in critically ill patients. Gut 2005; 54:1384-90. [PMID: 15923669 PMCID: PMC1774690 DOI: 10.1136/gut.2005.065672] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/30/2005] [Accepted: 04/12/2005] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastric emptying is frequently delayed in critical illness which compromises the success of nasogastric nutrition. The underlying motor dysfunctions are poorly defined. AIMS To characterise antro-pyloro-duodenal motility during fasting, and in response to gastric and duodenal nutrient, as well as to evaluate the relationship between gastric emptying and motility, in the critically ill. SUBJECTS Fifteen mechanically ventilated patients from a mixed intensive care unit; 10 healthy volunteers. METHODS Antro-pyloro-duodenal pressures were recorded during fasting, after intragastric administration (100 ml; 100 kcal), and during small intestinal infusion of liquid nutrient (6 hours; 1 kcal/min). Gastric emptying was measured using a (13)C octanoate breath test. RESULTS In healthy subjects, neither gastric nor small intestinal nutrient affected antro-pyloro-duodenal pressures. In patients, duodenal nutrient infusion reduced antral activity compared with both fasting and healthy subjects (0.03 (0-2.47) waves/min v 0.14 (0-2.2) fasting (p = 0.016); and v 0.33 (0-2.57)/min in healthy subjects (p = 0.005)). Basal pyloric pressure and the frequency of phasic pyloric pressure waves were increased in patients during duodenal nutrient infusion (3.12 (1.06) mm Hg; 0.98 (0.13)/min) compared with healthy subjects (-0.44 (1.25) mm Hg; p<0.02 after 120 minutes; 0.29 (0.15)/min; p = 0.0002) and with fasting (-0.06 (1.05) mm Hg; p<0.03 after 160 minutes; 0.49 (0.13)/min; (p = 0.0001). Gastric emptying was delayed in patients (gastric emptying coefficient 2.99 (0.2) v 3.47 (0.1); p = 0.015) and inversely related to the number of pyloric pressure waves (r = -0.563, p = 0.029). CONCLUSIONS Stimulation of pyloric and suppression of antral pressures by duodenal nutrient are enhanced in the critically ill and related to decreased gastric emptying.
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Affiliation(s)
- M Chapman
- Intensive Care Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia.
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43
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Bryant L, Hewison JD, Green JM. Attitudes towards prenatal diagnosis and termination in women who have a sibling with Down's syndrome. J Reprod Infant Psychol 2005. [DOI: 10.1080/02646830500129214] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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44
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Pilichiewicz A, O'Donovan D, Feinle C, Lei Y, Wishart JM, Bryant L, Meyer JH, Horowitz M, Jones KL. Effect of lipase inhibition on gastric emptying of, and the glycemic and incretin responses to, an oil/aqueous drink in type 2 diabetes mellitus. J Clin Endocrinol Metab 2003; 88:3829-34. [PMID: 12915676 DOI: 10.1210/jc.2003-030199] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [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] [Indexed: 02/07/2023]
Abstract
This study examined the effects of the lipase inhibitor, orlistat, on gastric emptying of, and the glycemic and incretin hormone responses to, a drink containing oil and glucose components in patients with type 2 diabetes. Seven patients (aged 58 +/- 5 yr), managed by diet alone, consumed 60 ml olive oil (labeled with 20 MBq (99m)Tc-V-thiocyanate) and 300 ml water containing 75 g glucose (labeled with 6 MBq (67)Ga-EDTA), on two occasions, with and without 120 mg orlistat, positioned in the left lateral decubitus position with their back against a gamma camera. Venous blood samples, for measurement of blood glucose and plasma insulin, glucagon-like peptide-1 and glucose-dependent insulintropic polypeptide were obtained immediately before, and after, the drink. Gastric emptying of both oil (P < 0.001) and glucose (P < 0.0005) was faster after orlistat compared with control. Postprandial blood glucose (P < 0.001) and plasma insulin (P < 0.05) were substantially greater after orlistat compared with control. In contrast, plasma glucagon-like peptide-1 (P < 0.005) and glucose-dependent insulintropic polypeptide (P < 0.05) were less after orlistat. In conclusion, inhibition of fat digestion, by orlistat, may exacerbate postprandial glycemia, as a result of more rapid gastric emptying and a diminished incretin response.
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Affiliation(s)
- A Pilichiewicz
- University of Adelaide, Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
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Abstract
An expert panel of female rural and remote doctors have nominated updating professional skills as the most important strategy for sustainable rural general practice for women. The panel was comprised of members of the Australian College of Rural and Remote Medicine (ACRRM). The panel was asked to identify and prioritise strategies they had used to make rural practice work for them. They identified and ranked the following eight groups of strategies: (i) structure medical practice to work for you; (ii) implement personal strategies; (iii) obtain and update professional skills; (iv) establish professional and personal boundaries; (v) gain exposure to rural practice; (vi) engage with the community; (vii) implement professional strategies; and (viii) engage with women. Detailed strategies within these groups have been identified and will form the basis of grounded knowledge about how to structure rural and remote practice to work for women. This will complement the work of ACRRM, the Rural Doctors Association and workforce agencies in developing models of sustainable rural medical practice.
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Affiliation(s)
- J Wainer
- Monash University School of Rural Health, Box 424 Traralgon, Victoria 3844, Australia.
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46
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Sinclair J, Baillie J, Bryant L, Caswell R. Human cytomegalovirus mediates cell cycle progression through G(1) into early S phase in terminally differentiated cells. J Gen Virol 2000; 81:1553-65. [PMID: 10811939 DOI: 10.1099/0022-1317-81-6-1553] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Terminal differentiation of embryonal carcinoma cells and monocytes has been shown to be important for their permissiveness for human cytomegalovirus (HCMV) infection, even though such terminally differentiated cells have withdrawn from the cell cycle and are, essentially, in G(0) arrest. Recently, data from a number of laboratories have shown that productive infection with HCMV of quiescent fibroblasts held reversibly in G(0) of the cell cycle can result in cell cycle progression, which results eventually in cycle arrest. In contrast to quiescent fibroblasts, the effect of HCMV on cells that have withdrawn irreversibly from the cell cycle due to terminal differentiation has not, so far, been addressed. Here, it is shown that, in cells that have arrested in G(0) as a result of terminal differentiation, HCMV is able to induce cell functions associated with progression of the cell cycle through G(1) into early S phase. This progression is correlated with a direct physical and functional interaction between the HCMV 86 kDa major immediate-early protein (IE86) and the cyclin-dependent kinase inhibitor p21(Cip1).
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Affiliation(s)
- J Sinclair
- Department of Medicine, University of Cambridge, Level 5, Addenbrookes Hospital, Hills Road, Cambridge CB2 2QQ, UK.
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47
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Affiliation(s)
- L Bryant
- University of Colorado Health Sciences Center, Denver, USA
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Bobowski BR, Hole D, Wolf PG, Bryant L. Identification of roots of woody species using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. Mol Ecol 1999; 8:485-91. [PMID: 10199009 DOI: 10.1046/j.1365-294x.1999.00603.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [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]
Abstract
Within the last two decades, substantial progress has been made in understanding seed-bank dynamics and the contribution of the soil seed bank to a postdisturbance plant community. There has been relatively little progress, however, in understanding perennial bud-bank dynamics and the contribution of the soil bud bank to secondary succession. This lack of information is due primarily to the inability to reliably identify roots, rhizomes and lignotubers that lie dormant beneath the soil surface. This investigation addressed the issue of identification of below-ground woody structures. The first objective was to develop a method that used molecular tools to identify woody plant species from subsoil tissue samples. The second objective was to develop a key in which molecular markers served as criteria for the identification and differentiation of selected tree and shrub species common to the mountains of northeast Oregon and southeast Washington. Application of restriction fragment length polymorphism (RFLP) analysis of polymerase chain reaction (PCR)-amplified rbcL appears to be a reliable method to identify and differentiate 15 plants to the genus level. Two restriction enzymes, DpnII and HhaI, provided restriction site polymorphisms in the PCR product. The fragment number and length were used to develop an identification key. However, plants not analysed in this 'exploratory key' might share the same banding patterns, resulting in a false identification of unknowns.
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Affiliation(s)
- BR Bobowski
- Department of Rangeland Resources, Utah State University, Logan 84322-5305, USA
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Abstract
OBJECTIVES The validity (sensitivity and specificity) of a preschool vision screening program was measured over a 3-year period to determine how well strabismus and significant refractive errors could be detected. METHODS Public health nurses were trained to administer tests of visual acuity, stereoacuity, and ocular alignment. Failure on any test, visual acuity of 6/9 or less, stereoacuity of less than 100 seconds of arc, or an apparent misalignment of the eyes resulted in referral to an eye care practitioner. An age-matched control was also referred. Analysis of practitioner reports used predefined study-based criteria for ocular abnormalities. RESULTS More than 1100 children were screened each year. The annually calculated prevalence of vision problems ranged between 10.5% and 13.8%. The estimated sensitivity varied from 60.4% to 70.9% (specificity, 69.6% to 79.9%). The yield indicated that a very high percentage of children with vision problems were identified for the first time. CONCLUSIONS The validity of this screening is comparable to that of other school screenings. The limitations are predictable. Consideration should be given to replacing visual acuity tests with a rapid, objective measure of refractive error and ocular alignment.
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Affiliation(s)
- B Robinson
- School of Optometry, University of Waterloo, Ontario, Canada
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Thompson MP, Kaslow NJ, Kingree JB, King M, Bryant L, Rey M. Psychological symptomatology following parental death in a predominantly minority sample of children and adolescents. J Clin Child Psychol 1998; 27:434-41. [PMID: 9866080 DOI: 10.1207/s15374424jccp2704_7] [Citation(s) in RCA: 27] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Examined the psychological correlates related to experiencing the death of a parent, the main and interactive effects of sex, race, and age on youth distress and the degree of cross-informant correspondence on the outcome measures. The predominately minority sample included 80 bereaved youth and 45 nonbereaved youth. Youth and their legal guardians completed a battery of questionnaires, including measures assessing the youth's psychological symptomatology. Results revealed that bereaved youth manifested greater psychological and behavior problems than their nonbereaved counterparts on guardian-reported measures (Child Behavior Checklist [CBCL]). The clinical significance of parental death experienced during childhood is indicated by the magnitude of distress exhibited by the bereaved sample; almost one quarter of bereaved youth scored in the clinical distress range (T score > or = 63) on the CBCL Externalizing and Internalizing Distress scales. The effect of parental death on guardian-reported externalizing distress was moderated by race, such that distress levels did not significantly differ between bereaved and nonbereaved minority youth but did differ significantly among bereaved and nonbereaved nonminority youth. Finally, the degree of cross-informant agreement was relatively low but consistent with prior studies. Study implications for interventions with bereaved youth and directions for future research are discussed.
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Affiliation(s)
- M P Thompson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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