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Wong M, Azvee Z, Wong C, Duffy R. An Observational Study on the Walking Proximity between Off licenses plus Bookmakers and Community Mental Health Facilities in County Dublin. Eur Psychiatry 2022. [PMCID: PMC9565556 DOI: 10.1192/j.eurpsy.2022.871] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Dual diagnosis is commonly treated by Community Mental Health Team (CMHT). Addiction is a common complicating factor in individuals with major mental illnesses. It is established that businesses on high streets impact on the public’s health.
Objectives
We hope to generate discussion about the planning and the placement of community mental health services.
Methods
The location of County Dublin community mental health teams’ outpatient clinics’ and day hospitals’ were obtained from the Health Service Executive directory website. All off licenses’ and bookmakers’ addresses in County Dublin were obtained from the Irish Revenue Commissioners website. The distances were measured using Google Maps and a programming script to generate a matrix under one-kilometre radius walking distances between the locations. No ethical approval is required. All Data are sought from publicly available websites.
Results
On average, there are 6.29 (SD 4.20; Median 5.) off-licenses and 2.4 (SD 2.28; Median 2) bookmarkers offices per mental health facility within1 km walking distance. The Central Dublin Mental Health Service has the highest prevalence of off-licenses (45, 34.4%), and the Central South Dublin Service(20, 39.2%) has the highest prevalence of bookmakers. Southeast Dublin Service has the lowest in both businesses. The closest distance to an off-license from mental health facilities was 0 meters.
Conclusions
Psychiatrists have a role in advocating the needs of individuals with dual diagnoses. The Department of Health and Health Service Executive (HSE) should develop a guideline and protocol for the community health services in the structuring and planning mental health services in the community health outpatient service setup.
Disclosure
No significant relationships.
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Alexopoulos AS, Duffy R, Kobe EA, German J, Moylan CA, Soliman D, Jeffreys AS, Coffman CJ, Crowley MJ. Underrecognition of Nonalcoholic Fatty Liver Disease in Poorly Controlled Diabetes: A Call to Action in Diabetes Care. J Endocr Soc 2021; 5:bvab155. [PMID: 34755002 PMCID: PMC8570418 DOI: 10.1210/jendso/bvab155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Indexed: 11/19/2022] Open
Abstract
Individuals with type 2 diabetes (T2DM) are at high risk for nonalcoholic fatty liver disease (NAFLD), and evidence suggests that poor glycemic control is linked to heightened risk of progressive NAFLD. We conducted an observational study based on data from a telehealth trial conducted in 2018-2020. Our objectives were to (1) characterize patterns of NAFLD testing/care in a cohort of individuals with poorly controlled T2DM; and (2) explore how laboratory based measures of NAFLD (eg, liver enzymes, fibrosis-4 [FIB-4]) vary by glycemic control. We included individuals with poorly controlled T2DM (n = 228), defined as hemoglobin A1c (HbA1c) ≥ 8.5% despite clinic-based care. Two groups of interest were (1) T2DM without known NAFLD; and (2) T2DM with known NAFLD. Demographics, medical history, medication use, glycemic control (HbA1c), and NAFLD testing/care patterns were obtained by chart review. Among those without known NAFLD (n = 213), most were male (78.4%) and self-identified as Black race (68.5%). Mean HbA1c was 9.8%. Most had liver enzymes (85.4%) and platelets (84.5%) ordered in the outpatient department over a 2-year period that would allow for FIB-4 calculation, yet only 2 individuals had FIB-4 documented in clinical notes. Approximately one-third had abnormal liver enzymes at least once over a 2-year period, yet only 7% had undergone liver ultrasound and 4.7% had referral to hepatology. Among those with known NAFLD (n = 15), mean HbA1c was 9.5%. Only 4 individuals had undergone transient elastography, half of whom had advanced fibrosis. NAFLD is underrecognized in poorly controlled T2DM, even though this is a high-risk group for NAFLD and its complications.
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Affiliation(s)
- Anastasia-Stefania Alexopoulos
- Durham Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC 27705, USA.,Department of Medicine, Division of Endocrinology, Duke University, Durham NC 27710, USA
| | - Ryan Duffy
- Department of Medicine, Duke University Medical Center, Durham NC 27710, USA
| | - Elizabeth A Kobe
- Department of Medicine, Duke University Medical Center, Durham NC 27710, USA
| | - Jashalynn German
- Department of Medicine, Division of Endocrinology, Duke University, Durham NC 27710, USA
| | - Cynthia A Moylan
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, NC 27710, USA.,Department of Medicine, Division of Gastroenterology, Duke University, Durham NC 27710, USA
| | - Diana Soliman
- Department of Medicine, Division of Endocrinology, Duke University, Durham NC 27710, USA
| | - Amy S Jeffreys
- Durham Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC 27705, USA
| | - Cynthia J Coffman
- Durham Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC 27705, USA.,Department of Biostatistics and Bioinformatics, Duke University, Durham, NC 27710, USA
| | - Matthew J Crowley
- Durham Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC 27705, USA.,Department of Medicine, Division of Endocrinology, Duke University, Durham NC 27710, USA
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Goštautaitė B, Bučiūnienė I, Dalla Rosa A, Duffy R, Kim HJ. Healthcare professionals with calling are less likely to be burned out: the role of social worth and career stage. CDI 2020. [DOI: 10.1108/cdi-10-2018-0255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PurposeThe association of calling with burnout is not well understood. This study investigates how calling influences burnout and what the roles of social worth and career stage are in this relation. Drawing from the Conservation of Resources Theory, we expect that calling may be negatively associated with burnout through increased social worth and that career stage moderates these relationships.Design/methodology/approachBased on a sample of 566 healthcare professionals, we conducted regression analyses with bootstrapping procedures to test the proposed hypotheses.FindingsThe findings show that social worth mediates the negative relation between calling and burnout. Additionally, the positive relation between calling and social worth was more pronounced for late-career employees; yet, the negative relation between social worth and burnout was stronger for early-career employees.Practical implicationsThe findings suggest that searching and pursuing a professional calling is beneficial for individuals. Additionally, social worth is crucial in this relation and could be used to actively prevent burnout.Originality/valueThe study advances our understanding of the consequences of calling for employees by explaining the underlying mechanism between calling and burnout and its importance at different career stages.
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Blustein DL, Kenny ME, Autin K, Duffy R. The Psychology of Working in Practice: A Theory of Change for a New Era. The Career Development Quarterly 2019. [DOI: 10.1002/cdq.12193] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- David L. Blustein
- Department of Counseling, Developmental, and Educational PsychologyBoston College
| | - Maureen E. Kenny
- Department of Counseling, Developmental, and Educational PsychologyBoston College
| | - Kelsey Autin
- Department of Educational Psychology and CounselingUniversity of Wisconsin–Milwaukee
| | - Ryan Duffy
- Department of PsychologyUniversity of Florida
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5
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Manuel R, Zaidi N, Duffy R, Borges N. Multiple Mini Interview Performance and Career Maturity related to Medicine. MedEdPublish (2016) 2018; 7:284. [PMID: 38089247 PMCID: PMC10711951 DOI: 10.15694/mep.2018.0000284.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Introduction: Multiple Mini Interview (MMI) is used to determine the most suitable candidates for the medical profession. It is also important to ensure students have the career maturity necessary to cope with the developmental tasks associated with medical training. This study explored if students stronger in their career decision of medicine perform better on the MMI. Methods: 119 students (72% response rate) completed a career maturity measure. Student MMI scores were matched to career maturity responses. Results: A significant positive correlation (p <.05) existed between MMI score and specify physician as a career preference (r =.177, N =112, p <.031). There was no significant correlation with the MMI score and crystalize a career preference (r =.046, N =119, p =.31) or implement physician as career choice (r =.039, N =114, p =.34). Mean scores for both crystalize career preference ( M = 18.91) and implement physician as career choice ( M = 17.46) indicate that students performing lower on the MMI continue coping with those tasks as compared to specify (M=20.65). Conclusion: Findings suggest a relation between medical student's career maturity and interview performance as measured using the MMI, with students in the intermediate stages of career development having higher MMI scores.
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Wen Y, Trinh HV, Linton CE, Tani C, Norais N, Martinez-Guzman D, Ramesh P, Sun Y, Situ F, Karaca-Griffin S, Hamlin C, Onkar S, Tian S, Hilt S, Malyala P, Lodaya R, Li N, Otten G, Palladino G, Friedrich K, Aggarwal Y, LaBranche C, Duffy R, Shen X, Tomaras GD, Montefiori DC, Fulp W, Gottardo R, Burke B, Ulmer JB, Zolla-Pazner S, Liao HX, Haynes BF, Michael NL, Kim JH, Rao M, O’Connell RJ, Carfi A, Barnett SW. Generation and characterization of a bivalent protein boost for future clinical trials: HIV-1 subtypes CR01_AE and B gp120 antigens with a potent adjuvant. PLoS One 2018; 13:e0194266. [PMID: 29698406 PMCID: PMC5919662 DOI: 10.1371/journal.pone.0194266] [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] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/28/2018] [Indexed: 01/23/2023] Open
Abstract
The RV144 Phase III clinical trial with ALVAC-HIV prime and AIDSVAX B/E subtypes CRF01_AE (A244) and B (MN) gp120 boost vaccine regime in Thailand provided a foundation for the future development of improved vaccine strategies that may afford protection against the human immunodeficiency virus type 1 (HIV-1). Results from this trial showed that immune responses directed against specific regions V1V2 of the viral envelope (Env) glycoprotein gp120 of HIV-1, were inversely correlated to the risk of HIV-1 infection. Due to the low production of gp120 proteins in CHO cells (2–20 mg/L), cleavage sites in V1V2 loops (A244) and V3 loop (MN) causing heterogeneous antigen products, it was an urgent need to generate CHO cells harboring A244 gp120 with high production yields and an additional, homogenous and uncleaved subtype B gp120 protein to replace MN used in RV144 for the future clinical trials. Here we describe the generation of Chinese Hamster Ovary (CHO) cell lines stably expressing vaccine HIV-1 Env antigens for these purposes: one expressing an HIV-1 subtype CRF01_AE A244 Env gp120 protein (A244.AE) and one expressing an HIV-1 subtype B 6240 Env gp120 protein (6240.B) suitable for possible future manufacturing of Phase I clinical trial materials with cell culture expression levels of over 100 mg/L. The antigenic profiles of the molecules were elucidated by comprehensive approaches including analysis with a panel of well-characterized monoclonal antibodies recognizing critical epitopes using Biacore and ELISA, and glycosylation analysis by mass spectrometry, which confirmed previously identified glycosylation sites and revealed unknown sites of O-linked and N-linked glycosylations at non-consensus motifs. Overall, the vaccines given with MF59 adjuvant induced higher and more rapid antibody (Ab) responses as well as higher Ab avidity than groups given with aluminum hydroxide. Also, bivalent proteins (A244.AE and 6240.B) formulated with MF59 elicited distinct V2-specific Abs to the epitope previously shown to correlate with decreased risk of HIV-1 infection in the RV144 trial. All together, these results provide critical information allowing the consideration of these candidate gp120 proteins for future clinical evaluations in combination with a potent adjuvant.
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Affiliation(s)
- Yingxia Wen
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Hung V. Trinh
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
- Henry Jackson Foundation for the Advancement of Military Medicine, Silver Spring, MD, United States of America
| | | | | | | | | | - Priyanka Ramesh
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Yide Sun
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Frank Situ
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | | | - Christopher Hamlin
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
- Henry Jackson Foundation for the Advancement of Military Medicine, Silver Spring, MD, United States of America
| | - Sayali Onkar
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
- Henry Jackson Foundation for the Advancement of Military Medicine, Silver Spring, MD, United States of America
| | - Sai Tian
- GSK, Rockville, MD, United States of America
| | - Susan Hilt
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Padma Malyala
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Rushit Lodaya
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Ning Li
- GSK, Rockville, MD, United States of America
| | - Gillis Otten
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Giuseppe Palladino
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | | | - Yukti Aggarwal
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Celia LaBranche
- Department of Surgery, Duke University Medical Center, Durham, NC, United States of America
| | - Ryan Duffy
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States of America
| | - Xiaoying Shen
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States of America
| | - Georgia D. Tomaras
- Department of Surgery, Duke University Medical Center, Durham, NC, United States of America
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States of America
| | - David C. Montefiori
- Department of Surgery, Duke University Medical Center, Durham, NC, United States of America
| | - William Fulp
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Raphael Gottardo
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Brian Burke
- Novartis Vaccines and Diagnostics, Cambridge, MA, United States of America
| | - Jeffrey B. Ulmer
- GSK, Rockville, MD, United States of America
- * E-mail: (SWB); (AC); (JBU)
| | - Susan Zolla-Pazner
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Hua-Xin Liao
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States of America
- Biomedine Institute, College of Life Science, Jinan University, Guangzhou, China
| | - Barton F. Haynes
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States of America
| | - Nelson L. Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Jerome H. Kim
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Mangala Rao
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Robert J. O’Connell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Andrea Carfi
- GSK, Rockville, MD, United States of America
- * E-mail: (SWB); (AC); (JBU)
| | - Susan W. Barnett
- GSK, Rockville, MD, United States of America
- * E-mail: (SWB); (AC); (JBU)
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Wiehe K, Nicely NI, Lockwood B, Kuraoka M, Anasti K, Arora S, Bowman CM, Stolarchuk C, Parks R, Lloyd KE, Xia SM, Duffy R, Shen X, Kyratsous CA, Macdonald LE, Murphy AJ, Scearce RM, Moody MA, Alam SM, Verkoczy L, Tomaras GD, Kelsoe G, Haynes BF. Immunodominance of Antibody Recognition of the HIV Envelope V2 Region in Ig-Humanized Mice. J Immunol 2016; 198:1047-1055. [PMID: 28011932 DOI: 10.4049/jimmunol.1601640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/18/2016] [Indexed: 12/13/2022]
Abstract
In the RV144 gp120 HIV vaccine trial, decreased transmission risk was correlated with Abs that reacted with a linear epitope at a lysine residue at position 169 (K169) in the HIV-1 envelope (Env) V2 region. The K169 V2 response was restricted to Abs bearing Vλ rearrangements that expressed aspartic acid/glutamic acid in CDR L2. The AE.A244 gp120 in AIDSVAX B/E also bound to the unmutated ancestor of a V2-glycan broadly neutralizing Ab, but this Ab type was not induced in the RV144 trial. In this study, we sought to determine whether immunodominance of the V2 linear epitope could be overcome in the absence of human Vλ rearrangements. We immunized IgH- and Igκ-humanized mice with the AE.A244 gp120 Env. In these mice, the V2 Ab response was focused on a linear epitope that did not include K169. V2 Abs were isolated that used the same human VH gene segment as an RV144 V2 Ab but paired with a mouse λ L chain. Structural characterization of one of these V2 Abs revealed how the linear V2 epitope could be engaged, despite the lack of aspartic acid/glutamic acid encoded in the mouse repertoire. Thus, despite the absence of the human Vλ locus in these humanized mice, the dominance of Vλ pairing with human VH for HIV-1 Env V2 recognition resulted in human VH pairing with mouse λ L chains instead of allowing otherwise subdominant V2-glycan broadly neutralizing Abs to develop.
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Affiliation(s)
- Kevin Wiehe
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710; .,Department of Medicine, Duke University School of Medicine, Durham, NC 27710
| | - Nathan I Nicely
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Bradley Lockwood
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | | | - Kara Anasti
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Sabrina Arora
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Cindy M Bowman
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Christina Stolarchuk
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Robert Parks
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Krissey E Lloyd
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Shi-Mao Xia
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Ryan Duffy
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - Xiaoying Shen
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | | | | | | | - Richard M Scearce
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710
| | - M Anthony Moody
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710.,Department of Immunology, Duke University, Durham, NC 27710.,Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710
| | - S Munir Alam
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710.,Department of Pathology, Duke University School of Medicine, Durham, NC 27710; and
| | - Laurent Verkoczy
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710.,Department of Pathology, Duke University School of Medicine, Durham, NC 27710; and
| | - Georgia D Tomaras
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710.,Department of Surgery, Duke University School of Medicine, Durham, NC 27710
| | - Garnett Kelsoe
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710.,Department of Immunology, Duke University, Durham, NC 27710
| | - Barton F Haynes
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710.,Department of Medicine, Duke University School of Medicine, Durham, NC 27710.,Department of Immunology, Duke University, Durham, NC 27710
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8
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Hale S, Nimmo DG, Cooke R, Holland G, James S, Stevens M, De Bondi N, Woods R, Castle M, Campbell K, Senior K, Cassidy S, Duffy R, Holmes B, White JG. Fire and climatic extremes shape mammal distributions in a fire-prone landscape. DIVERS DISTRIB 2016. [DOI: 10.1111/ddi.12471] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Susannah Hale
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Dale G. Nimmo
- Institute for Land; Water and Society; School of Environmental Science; Charles Sturt University; Albury NSW 2640 Australia
| | - Raylene Cooke
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Greg Holland
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
- Department of Ecology; Environment and Evolution; La Trobe University; Bundoora VIC 3086 Australia
| | - Simon James
- School of Information Technology; Deakin University; Geelong VIC 3220 Australia
| | - Michael Stevens
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
- Parks Victoria; Halls Gap VIC 3381 Australia
| | - Natasha De Bondi
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Rachel Woods
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Michael Castle
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Kristin Campbell
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Katharine Senior
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Simon Cassidy
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
| | - Ryan Duffy
- Parks Victoria; Halls Gap VIC 3381 Australia
| | - Ben Holmes
- Parks Victoria; Halls Gap VIC 3381 Australia
| | - John G. White
- School of Life and Environmental Sciences; Centre for Integrative Ecology; Deakin University; Geelong VIC 3220 Australia
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Santra S, Tomaras GD, Warrier R, Nicely NI, Liao HX, Pollara J, Liu P, Alam SM, Zhang R, Cocklin SL, Shen X, Duffy R, Xia SM, Schutte RJ, Pemble IV CW, Dennison SM, Li H, Chao A, Vidnovic K, Evans A, Klein K, Kumar A, Robinson J, Landucci G, Forthal DN, Montefiori DC, Kaewkungwal J, Nitayaphan S, Pitisuttithum P, Rerks-Ngarm S, Robb ML, Michael NL, Kim JH, Soderberg KA, Giorgi EE, Blair L, Korber BT, Moog C, Shattock RJ, Letvin NL, Schmitz JE, Moody MA, Gao F, Ferrari G, Shaw GM, Haynes BF. Human Non-neutralizing HIV-1 Envelope Monoclonal Antibodies Limit the Number of Founder Viruses during SHIV Mucosal Infection in Rhesus Macaques. PLoS Pathog 2015; 11:e1005042. [PMID: 26237403 PMCID: PMC4523205 DOI: 10.1371/journal.ppat.1005042] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/23/2015] [Indexed: 11/19/2022] Open
Abstract
HIV-1 mucosal transmission begins with virus or virus-infected cells moving through mucus across mucosal epithelium to infect CD4+ T cells. Although broadly neutralizing antibodies (bnAbs) are the type of HIV-1 antibodies that are most likely protective, they are not induced with current vaccine candidates. In contrast, antibodies that do not neutralize primary HIV-1 strains in the TZM-bl infection assay are readily induced by current vaccine candidates and have also been implicated as secondary correlates of decreased HIV-1 risk in the RV144 vaccine efficacy trial. Here, we have studied the capacity of anti-Env monoclonal antibodies (mAbs) against either the immunodominant region of gp41 (7B2 IgG1), the first constant region of gp120 (A32 IgG1), or the third variable loop (V3) of gp120 (CH22 IgG1) to modulate in vivo rectal mucosal transmission of a high-dose simian-human immunodeficiency virus (SHIV-BaL) in rhesus macaques. 7B2 IgG1 or A32 IgG1, each containing mutations to enhance Fc function, was administered passively to rhesus macaques but afforded no protection against productive clinical infection while the positive control antibody CH22 IgG1 prevented infection in 4 of 6 animals. Enumeration of transmitted/founder (T/F) viruses revealed that passive infusion of each of the three antibodies significantly reduced the number of T/F genomes. Thus, some antibodies that bind HIV-1 Env but fail to neutralize virus in traditional neutralization assays may limit the number of T/F viruses involved in transmission without leading to enhancement of viral infection. For one of these mAbs, gp41 mAb 7B2, we provide the first co-crystal structure in complex with a common cyclical loop motif demonstrated to be critical for infection by other retroviruses.
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Affiliation(s)
- Sampa Santra
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (SS); (GDT); (BFH)
| | - Georgia D. Tomaras
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
- * E-mail: (SS); (GDT); (BFH)
| | - Ranjit Warrier
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Nathan I. Nicely
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Hua-Xin Liao
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Justin Pollara
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Pinghuang Liu
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - S. Munir Alam
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Ruijun Zhang
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Sarah L. Cocklin
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xiaoying Shen
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Ryan Duffy
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Shi-Mao Xia
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Robert J. Schutte
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Charles W. Pemble IV
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - S. Moses Dennison
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Hui Li
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Andrew Chao
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Kora Vidnovic
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Abbey Evans
- Department of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Katja Klein
- Department of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Amit Kumar
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - James Robinson
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Gary Landucci
- Division of Infectious Diseases, Department of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - Donald N. Forthal
- Division of Infectious Diseases, Department of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - David C. Montefiori
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | | | - Sorachai Nitayaphan
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | | | | | - Merlin L. Robb
- US Military Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Nelson L. Michael
- US Military Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Jerome H. Kim
- US Military Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Kelly A. Soderberg
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Elena E. Giorgi
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Lily Blair
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Bette T. Korber
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Christiane Moog
- U1109, INSERM University of Strasbourg, Strasbourg, Alsace, France
| | - Robin J. Shattock
- Department of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Norman L. Letvin
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Joern E. Schmitz
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - M. A. Moody
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Feng Gao
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - Guido Ferrari
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
| | - George M. Shaw
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Barton F. Haynes
- Duke Human Vaccine Institute, Duke School of Medicine, Durham, North Carolina, United States of America
- * E-mail: (SS); (GDT); (BFH)
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10
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Chakma S, Picard J, Duffy R, Constantinoiu C, Gummow B. A Survey of Zoonotic Pathogens Carried by Non-Indigenous Rodents at the Interface of the Wet Tropics of North Queensland, Australia. Transbound Emerg Dis 2015; 64:185-193. [PMID: 25906923 DOI: 10.1111/tbed.12360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Indexed: 11/29/2022]
Abstract
In 1964, Brucella was isolated from rodents trapped in Wooroonooran National Park (WNP), in Northern Queensland, Australia. Genotyping of bacterial isolates in 2008 determined that they were a novel Brucella species. This study attempted to reisolate this species of Brucella from rodents living in the boundary area adjacent to WNP and to establish which endo- and ecto-parasites and bacterial agents were being carried by non-indigenous rodents at this interface. Seventy non-indigenous rodents were trapped [Mus musculus (52), Rattus rattus (17) and Rattus norvegicus (1)], euthanized and sampled on four properties adjacent to the WNP in July 2012. Organ pools were screened by culture for Salmonella, Leptospira and Brucella species, real-time PCR for Coxiella burnetii and conventional PCR for Leptospira. Collected ecto- and endo-parasites were identified using morphological criteria. The percentage of rodents carrying pathogens were Leptospira (40%), Salmonella choleraesuis ssp. arizonae (14.29%), ectoparasites (21.42%) and endoparasites (87%). Brucella and C. burnetii were not identified, and it was concluded that their prevalences were below 12%. Two rodent-specific helminthic species, namely Syphacia obvelata (2.86%) and Nippostrongylus brasiliensis (85.71%), were identified. The most prevalent ectoparasites belonged to Laelaps spp. (41.17%) followed by Polyplax spp. (23.53%), Hoplopleura spp. (17.65%), Ixodes holocyclus (17.64%) and Stephanocircus harrisoni (5.88%), respectively. These ectoparasites, except S. harrisoni, are known to transmit zoonotic pathogens such as Rickettsia spp. from rat to rat and could be transmitted to humans by other arthropods that bite humans. The high prevalence of pathogenic Leptospira species is of significant public health concern. This is the first known study of zoonotic agents carried by non-indigenous rodents living in the Australian wet-tropical forest interface.
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Affiliation(s)
- S Chakma
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - J Picard
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - R Duffy
- College of Marine and Environmental Sciences, James Cook University, Townsville, Qld, Australia
| | - C Constantinoiu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - B Gummow
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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11
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Moody MA, Easterhoff D, Gurley TC, Whitesides JF, Marshall DJ, Foulger A, Lloyd KE, Parks R, Pollara J, Duffy R, Shen S, Kim JH, Michael NL, Robb ML, O'Connell RJ, Vasan S, Excler JL, Rerks-Ngarm S, Kaewkungwal J, Pitisuttithum P, Nitayaphan S, Sinangil F, Francis D, Lee C, Kepler TB, Alam SM, Ferrari G, Montefiori DC, Liao HX, Tomaras GD, Haynes BF. Induction of Antibodies with Long Variable Heavy Third Complementarity Determining Regions by Repetitive Boosting with AIDSVAX® B/E in RV144 Vaccinees. AIDS Res Hum Retroviruses 2014. [DOI: 10.1089/aid.2014.5057a.abstract] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michael Anthony Moody
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - David Easterhoff
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Thaddeus C. Gurley
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - John F. Whitesides
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Dawn J. Marshall
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Andrew Foulger
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Krissey E. Lloyd
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Robert Parks
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Justin Pollara
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Ryan Duffy
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Shaunna Shen
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Jerome H. Kim
- US Military HIV Research Program, Rockville, MD, United States
| | | | - Merlin L. Robb
- US Military HIV Research Program, Rockville, MD, United States
| | | | | | | | | | | | | | | | - Faruk Sinangil
- Global Solutions for Infectious Diseases, South San Francisco, CA, United States
| | - Donald Francis
- Global Solutions for Infectious Diseases, South San Francisco, CA, United States
| | - Carter Lee
- Global Solutions for Infectious Diseases, South San Francisco, CA, United States
| | | | - S. Munir Alam
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Guido Ferrari
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - David C. Montefiori
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Hua-Xin Liao
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Georgia D. Tomaras
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
| | - Barton F. Haynes
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States
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12
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Affiliation(s)
- T Humle
- Durrell Institute of Conservation and Ecology, School of Anthropology and Conservation, University of Kent, Canterbury CT2 7NR, UK.
| | - R Duffy
- Department of Development Studies, SOAS, University of London, London WC1H 0XG, UK
| | - D L Roberts
- Durrell Institute of Conservation and Ecology, School of Anthropology and Conservation, University of Kent, Canterbury CT2 7NR, UK. Interdisciplinary Centre for Cyber Security Research, University of Kent, Canterbury, Kent, CT2 7NF, UK
| | - C Sandbrook
- United Nations Environment Programme World Conservation Monitoring Centre, 219 Huntingdon Road, Cambridge, CB3 0DL, UK. Department of Geography, University of Cambridge, Cambridge CB2 3EN, UK
| | - F A V St John
- Durrell Institute of Conservation and Ecology, School of Anthropology and Conservation, University of Kent, Canterbury CT2 7NR, UK
| | - R J Smith
- Durrell Institute of Conservation and Ecology, School of Anthropology and Conservation, University of Kent, Canterbury CT2 7NR, UK
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Sun Y, Duffy R, Lee A, Feinberg AW. Optimizing the structure and contractility of engineered skeletal muscle thin films. Acta Biomater 2013; 9:7885-94. [PMID: 23632372 DOI: 10.1016/j.actbio.2013.04.036] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 04/20/2013] [Accepted: 04/22/2013] [Indexed: 11/16/2022]
Abstract
An experimental system was developed to tissue engineer skeletal muscle thin films with well-defined tissue architecture and to quantify the effect on contractility. Using the C2C12 cell line, the authors tested whether tailoring the width and spacing of micropatterned fibronectin lines can be used to increase myoblast differentiation into functional myotubes and maximize uniaxial alignment within a 2-D sheet. Using a combination of image analysis and the muscular thin film contractility assay, it was demonstrated that a fibronectin line width of 100μm and line spacing of 20μm is able to maximize the formation of anisotropic, engineered skeletal muscle with consistent contractile properties at the millimeter length scale. The engineered skeletal muscle exhibited a positive force-frequency relationship, could achieve tetanus and produced a normalized peak twitch stress of 9.4±4.6kPa at 1Hz stimulation. These results establish that micropatterning technologies can be used to control skeletal muscle differentiation and tissue architecture and, in combination with the muscular thin film contractility, assay can be used to probe structure-function relationships. More broadly, an experimental platform is provided with the potential to examine how a range of microenvironmental cues such as extracellular matrix protein composition, micropattern geometries and substrate mechanics affect skeletal muscle myogenesis and contractility.
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Affiliation(s)
- Y Sun
- Regenerative Biomaterials and Therapeutics Group, Department of Biomedical Engineering, Carnegie Mellon University, 700 Technology Dr., Pittsburgh, PA 15219, USA
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14
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Colombeau B, Smith A, Cowern N, Pawlak B, Cristiano F, Duffy R, Claverie A, Ortiz C, Pichler P, Lampin E, Zechner C. Current Understanding and Modeling of B Diffusion and Activation Anomalies in Preamorphized Ultra-Shallow Junctions. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-810-c3.6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTThe formation of ultra-shallow junctions (USJs) for future integrated circuit technologies requires preamorphization and high dose boron doping to achieve high activation levels and abrupt profiles. To achieve the challenging targets set out in the semiconductor roadmap, it is crucial to reach a much better understanding of the basic physical processes taking place during USJ processing. In this paper we review current understanding of dopant-defect interactions during thermal processing of device structures – interactions which are at the heart of the dopant diffusion and activation anomalies seen in USJs. First, we recall the formation and thermal evolution of End of Range (EOR) defects upon annealing of preamorphized implants (PAI). It is shown that various types of extended defect can be formed: clusters, {113} defects and dislocation loops. During annealing, these defects exchange Si interstitial atoms and evolve following an Ostwald ripening mechanism. We review progress in developing models based on these concepts, which can accurately predict EOR defect evolution and interstitial transport between the defect layer and the surface. Based on this physically based defect modelling approach, combined with fully coupled multi-stream modelling of dopant diffusion, one can perform highly predictive simulations of boron diffusion and de/re-activation in Ge-PAI boron USJs. Agreement between simulations and experimental data is found over a wide range of experimental conditions, clearly indicating that the driving mechanism that degrades boron junction depth and activation is the dissolution of the interstitial defect band. Finally, we briefly outline some promising methods, such as co-implants and/or vacancy engineering, for further down-scaling of source-drain resistance and junction depth.
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15
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Abstract
If it is accepted that new doctors must be 'Fit to Practice' in a standard clinical house job, they should be competent in basic communication skills. Although these skills may be assessed as part of a routine OSCE-style exam in the course of the curriculum, the question is raised whether students who fail to demonstrate a minimal level of competence in this area should to be allowed to progress to the next stage of the course and eventually graduate. This paper describes our experiences with introducing 'barrier' stations in communication skills into the OSCE. Students who failed these stations, irrespective of their overall exam performance, undertook remedial studies in a compulsory two-week directed study module followed by a four-station OSCE.
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Affiliation(s)
- J Dowell
- University of Dundee Medical School, UK
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16
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Robertson R, Campbell NC, Smith S, Donnan PT, Sullivan F, Duffy R, Ritchie LD, Millar D, Cassidy J, Munro A. Factors influencing time from presentation to treatment of colorectal and breast cancer in urban and rural areas. Br J Cancer 2004. [PMID: 15083172 DOI: 10.1038/sj.bjc.6601756601753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Stage at diagnosis and survival from cancer vary according to where people live, suggesting some may have delays in diagnosis. The aim of this study was to determine if time from presentation to treatment was longer for colorectal and breast cancer patients living further from cancer centres, and identify other important factors in delay. Data were collected on 1097 patients with breast and 1223 with colorectal cancer in north and northeast Scotland. Women with breast cancer who lived further from cancer centres were treated more quickly than those living closer to cancer centres (P=0.011). Multilevel modelling found that this was largely due to them receiving earlier treatment at hospitals other than cancer centres. Breast lump, change in skin contour, lymphadenopathy, more symptoms and signs, and increasing age predicted faster treatment. Screen detected cancers and private referrals were treated more quickly. For colorectal cancer, time to treatment was similar for people in rural and urban areas. Quicker treatment was associated with palpable rectal or abdominal masses, tenesmus, abdominal pain, frequent GP consultations, age between 50 and 74 years, tumours of the transverse colon, and iron medication at presentation. Delay was associated with past anxiety or depression. There was variation between general practices and treatment appeared quicker at practices with more female general practitioners.
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Affiliation(s)
- R Robertson
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK
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17
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Robertson R, Campbell NC, Smith S, Donnan PT, Sullivan F, Duffy R, Ritchie LD, Millar D, Cassidy J, Munro A. Factors influencing time from presentation to treatment of colorectal and breast cancer in urban and rural areas. Br J Cancer 2004; 90:1479-85. [PMID: 15083172 PMCID: PMC2409724 DOI: 10.1038/sj.bjc.6601753] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Stage at diagnosis and survival from cancer vary according to where people live, suggesting some may have delays in diagnosis. The aim of this study was to determine if time from presentation to treatment was longer for colorectal and breast cancer patients living further from cancer centres, and identify other important factors in delay. Data were collected on 1097 patients with breast and 1223 with colorectal cancer in north and northeast Scotland. Women with breast cancer who lived further from cancer centres were treated more quickly than those living closer to cancer centres (P=0.011). Multilevel modelling found that this was largely due to them receiving earlier treatment at hospitals other than cancer centres. Breast lump, change in skin contour, lymphadenopathy, more symptoms and signs, and increasing age predicted faster treatment. Screen detected cancers and private referrals were treated more quickly. For colorectal cancer, time to treatment was similar for people in rural and urban areas. Quicker treatment was associated with palpable rectal or abdominal masses, tenesmus, abdominal pain, frequent GP consultations, age between 50 and 74 years, tumours of the transverse colon, and iron medication at presentation. Delay was associated with past anxiety or depression. There was variation between general practices and treatment appeared quicker at practices with more female general practitioners.
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Affiliation(s)
- R Robertson
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK
| | - N C Campbell
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK. E-mail:
| | - S Smith
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK
| | - P T Donnan
- Tayside Centre for General Practice, Kirsty Semple Way, DD2 4AD Dundee, UK
| | - F Sullivan
- Tayside Centre for General Practice, Kirsty Semple Way, DD2 4AD Dundee, UK
| | - R Duffy
- Tayside Centre for General Practice, Kirsty Semple Way, DD2 4AD Dundee, UK
| | - L D Ritchie
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK
| | - D Millar
- Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, AB25 2AY Aberdeen, UK
| | - J Cassidy
- The Beatson Oncology Centre, Dumbarton Road, G11 6NT Glasgow, UK
| | - A Munro
- Raigmore Hospital, Old Perth Road, IV2 3UJ Inverness, UK
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18
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Abstract
RATIONALE Soya foods are rich in isoflavone phytoestrogens with weak agonist activity at oestrogen receptors. Oestrogen treatment has been found to improve memory in men awaiting gender reassignment and in post-menopausal women. OBJECTIVE To examine the effects of supervised high versus low soya diets on attention, memory and frontal lobe function in young healthy adults of both sexes. METHODS Student volunteers were randomly allocated to receive, under supervision, a high soya (100 mg total isoflavones/day) or a low soya (0.5 mg total isoflavones/day) diet for 10 weeks. They received a battery of cognitive tests at baseline and then after 10 weeks of diet. RESULTS Those receiving the high soya diet showed significant improvements in short-term (immediate recall of prose and 4-s delayed matching to sample of patterns) and long-term memory (picture recall after 20 min) and in mental flexibility (rule shifting and reversal). These improvements were found in males and females. In a letter fluency test and in a test of planning (Stockings of Cambridge), the high soya diet improved performance only in females. There was no effect of diet on tests of attention or in a category generation task. Those on the high soya diet rated themselves as more restrained and, after the tests of memory and attention, they became less tense than did those on the control diet. CONCLUSIONS Significant cognitive improvements can arise from a relatively brief dietary intervention, and the improvements from a high soya diet are not restricted to women or to verbal tasks.
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Affiliation(s)
- S E File
- Psychopharmacology Research Unit, Centre for Neuroscience, Hodgkin Building, King's College London, Guy's Campus, London SE1 1UL, UK.
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19
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Abstract
Steroids and related compounds are important in disease development and prevention, via steroid receptor-mediated and receptor-independent mechanisms. Interaction of endogenous oestrogens with the oestrogen receptor has unfortunate mitogenic effects in breast cancer. However, dietary consumption of non-steroidal weak oestrogens, such as the soy isoflavone phytoestrogens genistein and diadzein, is associated with a decreased breast cancer risk. This may arise in part from the suboptimal configuration induced in the transactivation helix of oestrogen receptor-beta.
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Affiliation(s)
- H Wiseman
- Department of Nutrition and Dietetics, Nutrition, Food and Health Research Centre. King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NN, U.K.
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20
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Duffy R. Book Review: Research Approaches in Primary care. Scott Med J 2001. [DOI: 10.1177/003693300104600314] [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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21
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Greenlee W, Clader J, Asberom T, McCombie S, Ford J, Guzik H, Kozlowski J, Li S, Liu C, Lowe D, Vice S, Zhao H, Zhou G, Billard W, Binch H, Crosby R, Duffy R, Lachowicz J, Coffin V, Watkins R, Ruperto V, Strader C, Taylor L, Cox K. Muscarinic agonists and antagonists in the treatment of Alzheimer's disease. Farmaco 2001; 56:247-50. [PMID: 11421251 DOI: 10.1016/s0014-827x(01)01102-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease characterized by cognitive impairment and personality changes. The development of drugs for the treatment of the cognitive deficits of AD has focused on agents which counteract loss in cholinergic activity. Although symptoms of AD have been successfully treated with acetylcholinesterase inhibitors (tacrine, donepezil. rivastigmine, galanthamine), limited success has been achieved with direct M1 agonists, probably due to their lack of selectivity versus other muscarinic receptor subtypes. Muscarinic M2 antagonists have been reported to increase synaptic levels of acetylcholine after oral administration to rats (e.g. BIBN-99, SCH-57790), but their selectivity versus other muscarinic receptor subtypes is modest. Exploration of a series of piperidinylpiperidines has yielded the potent and selective M2 antagonist SCH-217443. This antagonist has excellent bioavailability in rats and dogs and shows activity in a rat model of cognition.
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Affiliation(s)
- W Greenlee
- Schering-Plough Research Institute, Kenilworth, NJ 07033-0539, USA.
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22
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Shulman JD, Niessen LC, Kress GC, DeSpain B, Duffy R. Dental public health for the 21st century: implications for specialty education and practice. J Public Health Dent 2001; 58 Suppl 1:75-83. [PMID: 9661106 DOI: 10.1111/j.1752-7325.1998.tb02532.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/27/2022]
Abstract
A panel of public health practitioners sponsored by the Health Resources and Services Administration met December 6-8, 1994, to examine current roles and responsibilities for dental public health workers and to recommend changes in education and training to meet challenges posed by an evolving health care system. Overall, at least the same number, if not more, dental public health personnel will be needed in the future. While some new roles were identified, the panel felt that only small numbers of personnel will be needed to fill these new roles. Not all of these roles necessarily require a dental degree. The panel felt that a need exists for more academicians for dental schools, schools of public health, dental public health residencies, and dental hygiene programs; oral epidemiologists and health services researchers; health educators; and specialists in utilization review/outcomes assessment, dental informatics, nutrition, program evaluation, and prevention. To meet these personnel needs: (1) dental public health residency programs should be structured to meet the educational needs of working public health dentists with MPH degrees through on-the-job residency programs; (2) the standards for advanced specialty education programs in dental public health should be made sufficiently flexible to include dentists who have advanced education and the requisite core public health courses; (3) flexible MPH degree programs must be available because of the rising debt of dental students and the decreased numbers of graduating dentists; (4) loan repayment should be available for dentists who have pursued public health training and are working in state or local health departments; and (5) standards for advanced education in dental public health should be developed for dental hygienists.
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MESH Headings
- Certification
- Dental Hygienists/education
- Dental Hygienists/standards
- Dental Hygienists/statistics & numerical data
- Education, Dental, Graduate/economics
- Education, Dental, Graduate/standards
- Epidemiology/statistics & numerical data
- Faculty, Dental/statistics & numerical data
- Forecasting
- Health Education, Dental/statistics & numerical data
- Health Services Research/statistics & numerical data
- Humans
- Inservice Training
- Internship and Residency/statistics & numerical data
- Medical Informatics Applications
- Nutritional Physiological Phenomena
- Outcome Assessment, Health Care
- Preventive Dentistry/statistics & numerical data
- Professional Practice/trends
- Program Evaluation
- Public Health Dentistry/economics
- Public Health Dentistry/education
- Public Health Dentistry/statistics & numerical data
- Public Health Dentistry/trends
- Schools, Dental
- Specialties, Dental/education
- Specialties, Dental/trends
- Students, Dental
- Training Support
- United States/epidemiology
- United States Health Resources and Services Administration
- Utilization Review
- Workforce
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Affiliation(s)
- J D Shulman
- Department of Public Health Sciences, TAMUS-Baylor College of Dentistry, Dallas, TX 75266-0677, USA.
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23
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Duffy R, Tomashek K, Spangenberg M, Spry L, Dwyer D, Safranek TJ, Ying C, Portesi D, Divan H, Kobrenski J, Arduino M, Tokars J, Jarvis W. Multistate outbreak of hemolysis in hemodialysis patients traced to faulty blood tubing sets. Kidney Int 2000; 57:1668-74. [PMID: 10760102 DOI: 10.1046/j.1523-1755.2000.00011.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hemolysis associated with hemodialysis is rare. The most frequent causes of hemodialysis-associated hemolysis are chemical contamination, heat, or mechanical injury of erythrocytes from occluded or kinked hemodialysis blood lines. When patients in three states developed hemolysis while undergoing hemodialysis between May 13 and 23, 1998, an investigation was initiated. METHODS A case-patient was defined as any patient at healthcare facilities A (Nebraska), B (Maryland), or C (Massachusetts) during May 13 through 23, 1998 (epidemic period), who had hemolysis diagnosed > or =48 hours after undergoing hemodialysis. To identify case-patients and to determine background rates, the medical records of patients from facilities A, B, and C who were undergoing hemodialysis during the epidemic and pre-epidemic (that is, May 5 through 19, 1998) periods were reviewed. Experiments simulating hemodialysis with the same lot numbers of hemodialysis blood tubing cartridge sets used on case- and control-patients were conducted. RESULTS The rates of hemolysis among patients at facilities A, B, and C were significantly higher during the epidemic than the pre-epidemic period (13 out of 118 vs. 0 out of 118, P < 0.001; 12 out of 298 vs. 0 out of 298, P = 0.001; and 5 out of 62 vs. 0/65, P = 0.03, respectively). All case-patients had hemolysis. Twenty (66%) had hypertension. Eighteen (60%) had abdominal pain, and 10 (36%) were admitted to an intensive care unit. There were two deaths. The only commonality among the three outbreaks was the use of the same lot of disposable hemodialysis blood tubing from one manufacturer. Examination of the implicated hemodialysis blood tubing cartridge sets revealed narrowing of an aperture through which blood was pumped before entering the dialyzers. In vitro experiments with the hemodialysis blood tubing revealed that hemolysis was caused by increased pressure on erythrocytes as they passed through the partially occluded hemodialysis blood tubing. CONCLUSIONS Our investigation traced the multiple hemolysis outbreaks to partially occluded hemodialysis blood tubing produced by a single manufacturer. On May 25, 1998, the manufacturer issued a voluntary nationwide recall of the implicated lots of hemodialysis blood tubing cartridge sets.
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Affiliation(s)
- R Duffy
- Hospital Infections Program and National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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McLeod RL, Aslanian R, del Prado M, Duffy R, Egan RW, Kreutner W, McQuade R, Hey JA. Sch 50971, an orally active histamine H3 receptor agonist, inhibits central neurogenic vascular inflammation and produces sedation in the guinea pig. J Pharmacol Exp Ther 1998; 287:43-50. [PMID: 9765320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
We studied the actions of Sch 50971, a novel histamine H3 receptor agonist, in an experimental neurogenic model of migraine and characterized its sedative and respiratory actions. Sch 50971 (i.v. and p.o) inhibited plasma protein extravasation in the dura mater of guinea pigs after electrical stimulation of the trigeminal ganglia. The minimum effective doses of Sch 50971 were 3.0 mg/kg i.v. and 10 mg/kg p.o., which produced a 40% and 42% decrease in plasma protein extravasation, respectively. The effects of Sch 50971 (3.0 mg/kg i.v. ) were blocked by the histamine H3 antagonist thioperamide (3.0 mg/kg i.v.). The 5-HT1D agonist, sumatriptan (0.3 mg/kg i.v.), and the histamine H3 agonist, (R)-alpha-methylhistamine (0.3 mg/kg), also inhibited plasma extravasation by 40 and 46%. In sedation studies, Sch 50971 (1-100 mg/kg p.o.) potentiated pentobarbital-induced sleep. The ED40 min for Sch 50971, the benzodiazepines triazolam and diazepam, the histamine H1 antagonist diphenhydramine and the H3 receptor agonist (R)-alpha-methylhistamine were 7.0, 0.5, 2.3, 14.1 and 23.4 mg/kg p. o., respectively. The sedative effects of oral Sch 50971 was blocked by thioperamide (10 microgram i.c.v.). The sedative activity of Sch 50971 was also examined using EEG activity, locomotor activity and sleep. In conscious guinea pigs, Sch 50971 (10 mg/kg p.o.) depressed locomotor activity, increased total sleep time and produced EEG patterns consistent with physiological sleep. Sch 50971 decreased beta wave activity but had no effects on delta wave activity, theta activity or alpha wave activity. In contrast, triazolam (1.0 mg/kg p. o.) depressed delta and theta wave activity and produced large increases in alpha and beta wave activity. In conclusion, Sch 50971 is an orally active, potent and selective agonist of histamine H3 receptors that may act to ameliorate the sequelae of migraine headaches, where activation of histamine H3 receptors may be beneficial. Sch 50971 also decreases motor activity and promotes EEG activity consistent with physiological sleep.
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Affiliation(s)
- R L McLeod
- Schering-Plough Research Institute, Kenilworth, New Jersey, USA
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Abstract
The opportunities for public health training have declined over the years while the need for public health skills is likely to increase. This paper reports the results of a project, sponsored by the Health Resources and Services Administration, which answers the question of "how best to invest in the dental public health education system so as to fulfill the profession's responsibilities to protect and improve the oral health of individuals and society." An information base on dental public health education, practice, and specialization was developed from an extensive review of the literature and a survey of dentists concerning employment and practice requirements for public health dentists. An advisory group considered this information, met to discuss the issues involved in dental public health training, and provided advice to the project staff. Based on the information gathered as part of the project, recommendations were made to: (1) develop a grant program to support advanced education in dental public health; (2) increase the competencies of dentists who are working in public health positions and not eligible for board certification via off-site residencies; (3) develop model programs in areas of great need, such as general public health, management, policy, prevention, environmental health and research, that in conjunction with a basic public health core, could satisfy the eligibility requirements of the American Board of Dental Public Health; (4) develop student loan forgiveness programs for dentists and dental hygienists working in public health; and (5) develop additional credential recognition programs for dental public health workers.
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Affiliation(s)
- S Wotman
- School of Dentistry, Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106, USA.
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Abstract
The Ethical Principles exhort psychologists "to encourage ethical behavior by students, supervisees, employees, and colleagues, as appropriate" (American Psychological Association, 1992, p. 1599). In spite of a clear directive to attempt resolution of unethical conduct by colleagues, research indicates that satisfactory resolution or actual reporting of misconduct is infrequent. This paper will address some of the forces that discourage psychologists from dealing responsibly and appropriately with professional misconduct by colleagues. The goals of this paper are to promote understanding of factors that interfere with the effective resolution of ethical misconduct, to identify possible signs of reluctance to address misconduct, and to propose strategies to combat those forces that keep us in silent collusion with colleagues who engage in unethical practices. A flowchart of steps for addressing possible misconduct by a colleague is provided, and educational, organizational, and professional considerations are discussed.
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Affiliation(s)
- M Biaggio
- School of Professional Psychology, Pacific University, Forest Grove, OR 97116, USA.
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27
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Abstract
A first-of-its-kind resource-sharing agreement between the US Department of Defense and a civilian hospital was undertaken with resounding success. This article discusses how Sacred Heart Medical Center, Spokane, Wash, and the 92nd Medical Group at Fairchild Air Force Base, Spokane, Wash, developed the project and accomplished the integration, which continues to benefit each organization.
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Affiliation(s)
- R Duffy
- Department of Surgical Services, Sacred Heart Medical Center, Spokane, WA, USA
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Duffy R, Weaver RG, Hayes KL. General dentistry grant program: 1976-1996. J Dent Educ 1997; 61:804-12. [PMID: 9385323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The federal general dentistry grant program supports the development of new programs and first-year positions in postdoctoral general dentistry (PGD) education. One hundred and fifteen institutions have participated in the grant program since awards were first made in 1978. The grant program assisted in establishing 59 new PGD programs and 560 new positions. Eighty-eight percent of the new programs are still in operation; 69 percent of the positions are still being filled. These retained programs and positions represent 72 percent and 77 percent of the net growth in PGD programs and positions, respectively, that has occurred since 1977.
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Affiliation(s)
- R Duffy
- National Center of Infectious Diseases, Center of Disease Control and Prevention
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Abstract
Attention must be redirected toward health promotion as nursing evaluates the goal of health for all. Confusion regarding health promotion behavior is illustrated by terms with diverse meanings and uses. In a process of critical analysis, five multidisciplinary experts in health promotion responded to a survey targeting the distinction of health promotion, health promotion behavior, health protection behavior, disease prevention behavior, preventive health behavior, health behavior, and healthy lifestyle. Descriptors of health promotion were derived from a multidimensional conception of well-being. Disagreement existed concerning health protection and health behavior. Nursing interventions are linked to reflective discourse regarding health promotion behavior.
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Affiliation(s)
- P A Kulbok
- University of Virginia Health Sciences Center, School of Nursing, Charlottesville, USA
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McDiarmid MA, Agnew J, Lees PS, Duffy R, Melius J. Pregnant firefighter performance. J Occup Med 1991; 33:446-7, 449-50. [PMID: 2037899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
Studies of the health of fire fighters have historically focused on non-malignant respiratory disease and cancer. More recently, concerns have surfaced about reproductive health effects in many areas of the workforce, including fire fighting. These concerns prompted this review of chemical exposures that may contribute to adverse reproductive health outcomes in male as well as female fire fighters. A review of the industrial hygiene literature was undertaken to identify agents commonly found in fire smoke. These agents were then examined for evidence of reproductive toxicity or mutagenicity/carcinogenicity. This profile of chemical agents and their reproductive toxicities permits a qualitative determination that fire fighters are exposed to potential reproductive toxicants as a part of their normal fire fighting duties. Considerations for mitigating these risks are also discussed.
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Affiliation(s)
- M A McDiarmid
- Department of Environmental Health Sciences, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, MD 21205
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Abstract
Fire fighters are regularly exposed to chemical and non-chemical agents that have known or suspected adverse effects on reproductive health. Although chemical agents have received some attention, non-chemical hazards such as heat, noise, and physical exertion have only recently been examined for their reproductive effects. There is evidence that heat, noise, and physical exertion may affect various endpoints of reproductive health, including fertility, fetal loss, and growth parameters of the offspring. In particular, hyperthermia, a major fire fighting hazard, has been shown to impair male fertility and may also be teratogenic. Further study of the potential reproductive effects of this and other common non-chemical agents in the fire environment is needed to ensure the reproductive health of male and female fire fighters.
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Affiliation(s)
- J Agnew
- Department of Environmental Health Sciences, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205
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