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Cunanan B, Muppa H, Orellana L, Bates S, McGain F. Blood gas sampling in the intensive care unit: A prospective before-and-after interventional study on the effect of an educational program on blood gas testing frequency. Aust Crit Care 2024:S1036-7314(24)00025-0. [PMID: 38580484 DOI: 10.1016/j.aucc.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/11/2023] [Accepted: 01/20/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Blood gas analysis is the most commonly ordered test in the intensive care unit. Each investigation, however, comes with risks and costs to the patient and healthcare system. Evidence suggests that many tests are performed with no appropriate clinical indication. OBJECTIVES The primary aim of our prospective interventional study was to investigate the proportion of blood gases undertaken with a valid clinical indication before and after an educational intervention. A secondary aim was to examine sleep interruption secondary to blood gas sampling. METHODS A prospective, before-and-after interventional study was conducted across two metropolitan intensive care units in Melbourne, Australia. Adults aged ≥18 years who were admitted to intensive care were eligible for inclusion. Two observation periods were conducted across a 2-week period in May and September 2022 (Periods 1 and 2), where clinicians were encouraged to record the purpose of blood gas sampling and other relevant data via an electronic questionnaire. These data were reviewed with corresponding electronic medical records. In between these periods, an interventional educational program to inform the clinical rationale for blood gas testing was delivered during July and August 2022, including introduction of a clinical guideline. RESULTS There were 68 patients with 688 tests included in Period 1 compared to 69 patients with 756 tests in Period 2. There was no significant difference between the median number of blood gas analyses performed per patient before and after the educational intervention (6.0 tests per patient vs 5.0 tests per patient, p = 0.609). However, there was a significant increase in the percentage of tests with a valid clinical indication (49.0% vs 59.7%, p = 0.0025). The most common indications selected were routine measurement, monitoring a clinical value, change in ventilator settings/oxygen therapy, and clinical deterioration. In addition, there were a large number of patients who were awakened upon drawing of a blood sample for analysis (26.1% for Period 1 and 37.6% for Period 2, p = 0.06). CONCLUSION The implementation of an educational program resulted in a significant increase in the proportion of blood gases performed with an appropriate clinical indication. There was, however, no reduction in the overall number of blood gases performed.
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Affiliation(s)
- Benjamin Cunanan
- Department of Intensive Care, Western Health, Footscray, Victoria, Australia.
| | - Haindavi Muppa
- Department of Intensive Care, Western Health, Footscray, Victoria, Australia
| | - Liliana Orellana
- Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Samantha Bates
- Department of Intensive Care, Western Health, Footscray, Victoria, Australia; Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Forbes McGain
- Department of Intensive Care, Western Health, Footscray, Victoria, Australia; Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
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Bates S, Harrell DR. COVID-19 School Closures: Disruptions in School-Based Support Services and Socioemotional Loss Among Middle School Students. J Sch Health 2024; 94:209-218. [PMID: 38097524 DOI: 10.1111/josh.13421] [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] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND In the United States (U.S.), 77% of school district leaders reported that their students had fallen behind in their social-emotional development due to COVID-19 school closures. Although research has measured indicators of social-emotional well-being from the perspective of other informants, little is known about student perceptions of perceived changes in their socioemotional competencies and, to a lesser degree, their nonacademic needs. AIMS The current study examined middle school students' nonacademic needs, perceptions of socioemotional competencies, and predictors of "socioemotional loss." MATERIALS & METHODS The authors utilized secondary data from 395 middle school students gathered in August 2020 and November 2020 in one large middle school in the southern region of the U.S. Multivariate and linear regression analyses explored students' nonacademic needs, assessed changes in perceptions of their socioemotional competencies over time, and identified predictors of "socioemotional loss" during the "return to learn" period. RESULTS Our findings indicated that 3% to 14% of students reported nonacademic needs, with the greatest needs related to food, housing, and healthcare. Further, 48% of students reported perceived losses in their socioemotional competencies, and students formerly receiving school-based support services were those most affected (71% vs. 46%, p = .01). Among the subgroup reporting losses, living in a single-parent household significantly predicted socioemotional loss (β = -.16, p = .02). DISCUSSION School-based practitioners, including educators, policymakers, social workers, and mental health providers, can utilize these findings to deliver interventions to students that experienced hardships during the pandemic. CONCLUSION Responding to these risks will be critical as schools adapt and intervene in response to the COVID-19 pandemic.
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Affiliation(s)
- Samantha Bates
- College of Social Work, The Ohio State University, Columbus, OH
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Rollinson TC, McDonald LA, Rose J, Eastwood G, Costa-Pinto R, Modra L, Maeda A, Bacolas Z, Anstey J, Bates S, Bradley S, Dumbrell J, French C, Ghosh A, Haines K, Haydon T, Hodgson C, Holmes J, Leggett N, McGain F, Moore C, Nelson K, Presneill J, Rotherham H, Said S, Young M, Zhao P, Udy A, Chaba A, Bellomo R, Neto AS. Magnitude and time to peak oxygenation effect of prone positioning in ventilated adults with COVID-19 related acute hypoxemic respiratory failure. Acta Anaesthesiol Scand 2024; 68:361-371. [PMID: 37944557 DOI: 10.1111/aas.14356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/14/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Prone positioning may improve oxygenation in acute hypoxemic respiratory failure and was widely adopted in COVID-19 patients. However, the magnitude and timing of its peak oxygenation effect remain uncertain with the optimum dosage unknown. Therefore, we aimed to investigate the magnitude of the peak effect of prone positioning on the PaO2 :FiO2 ratio during prone and secondly, the time to peak oxygenation. METHODS Multi-centre, observational study of invasively ventilated adults with acute hypoxemic respiratory failure secondary to COVID-19 treated with prone positioning. Baseline characteristics, prone positioning and patient outcome data were collected. All arterial blood gas (ABG) data during supine, prone and after return to supine position were analysed. The magnitude of peak PaO2 :FiO2 ratio effect and time to peak PaO2 :FIO2 ratio effect was measured. RESULTS We studied 220 patients (mean age 54 years) and 548 prone episodes. Prone positioning was applied for a mean (±SD) 3 (±2) times and 16 (±3) hours per episode. Pre-proning PaO2 :FIO2 ratio was 137 (±49) for all prone episodes. During the first episode. the mean PaO2 :FIO2 ratio increased from 125 to a peak of 196 (p < .001). Peak effect was achieved during the first episode, after 9 (±5) hours in prone position and maintained until return to supine position. CONCLUSIONS In ventilated adults with COVID-19 acute hypoxemic respiratory failure, peak PaO2 :FIO2 ratio effect occurred during the first prone positioning episode and after 9 h. Subsequent episodes also improved oxygenation but with diminished effect on PaO2 :FIO2 ratio. This information can help guide the number and duration of prone positioning episodes.
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Affiliation(s)
- Thomas C Rollinson
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Melbourne, Victoria, Australia
| | - Luke A McDonald
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
| | - Joleen Rose
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
| | - Glenn Eastwood
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Data Analytics Research and Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Rahul Costa-Pinto
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lucy Modra
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Akinori Maeda
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
| | - Zoe Bacolas
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
| | - James Anstey
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Samantha Bates
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Intensive Care, Western Health, Melbourne, Victoria, Australia
| | - Scott Bradley
- Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Jodi Dumbrell
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Craig French
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Intensive Care, Western Health, Melbourne, Victoria, Australia
| | - Angaj Ghosh
- Department of Intensive Care, Northern Health, Melbourne, Victoria, Australia
| | - Kimberley Haines
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Intensive Care, Western Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | - Tim Haydon
- Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Carol Hodgson
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Jennifer Holmes
- Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nina Leggett
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Intensive Care, Western Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | - Forbes McGain
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Intensive Care, Western Health, Melbourne, Victoria, Australia
| | - Cara Moore
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kathleen Nelson
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Jeffrey Presneill
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Hannah Rotherham
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Simone Said
- Department of Intensive Care, Northern Health, Melbourne, Victoria, Australia
| | - Meredith Young
- Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia
| | - Peinan Zhao
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Andrew Udy
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia
| | - Anis Chaba
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Data Analytics Research and Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Ary Serpa Neto
- Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
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Haines KJ, Hibbert E, Skinner EH, Leggett N, Holdsworth C, Ali Abdelhamid Y, Bates S, Bicknell E, Booth S, Carmody J, Deane AM, Emery K, Farley KJ, French C, Krol L, MacLeod-Smith B, Maher L, Paykel M, Iwashyna TJ. In-person peer support for critical care survivors: The ICU REcovery Solutions cO-Led through surVivor Engagement (ICURESOLVE) pilot randomised controlled trial. Aust Crit Care 2024:S1036-7314(24)00022-5. [PMID: 38360469 DOI: 10.1016/j.aucc.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Peer support is a promising intervention to mitigate post-ICU disability, however there is a paucity of rigorously designed studies. OBJECTIVES The objective of this study was to establish feasibility of an in-person, co-designed, peer-support model. METHODS Prospective, randomised, adaptive, single-centre pilot trial with blinded outcome assessment, conducted at a university-affiliated hospital in Melbourne, Australia. Intensive care unit survivors (and their nominated caregiver, where survivor and caregiver are referred to as a dyad), >18 years of age, able to speak and understand English and participate in phone surveys, were eligible. Participants were randomised to the peer-support model (six sessions, fortnightly) or usual care (no follow-up or targeted information). Two sequential models were piloted: 1. Early (2-3 weeks post hospital discharge) 2. Later (4-6 weeks post hospital discharge). Primary outcome was feasibility of implementation measured by recruitment, intervention attendance, and outcome completion. Secondary outcomes included post-traumatic stress and social support. RESULTS Of the 231 eligible patients, 80 participants were recruited. In the early model we recruited 38 participants (28 patients, 10 carers; 18 singles, 10 dyads), with an average (standard deviation) age of 60 (18) years; 55 % were female. Twenty-two participants (58 %) were randomised to intervention. Participants in the early intervention model attended a median (interquartile range) of 0 (0-1) sessions (total 24 sessions), with 53% (n = 20) completing the main secondary outcome of interest (Impact of Event Scale) at the baseline and 37 % (n = 14) at the follow-up. For the later model we recruited 42 participants (32 patients, 10 carers; 22 singles, 10 dyads), with an average (standard deviation) age of 60.4 (15.4) years; 50 % were female. Twenty-one participants (50 %) were randomised to intervention. The later intervention model attended a median (interquartile range) of 1 (0-5) sessions (total: 44 sessions), with the main secondary outcome impact of events scale (IES-R) completed by 41 (98 %) participants at baseline and 29 (69 %) at follow-up. CONCLUSIONS In this pilot trial, a peer-support model that required in-person attendance delivered in a later posthospital phase of recovery appeared more feasible than an early model. Further research should investigate alternative modes of intervention delivery to improve feasibility (ACTRN12621000737831).
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Affiliation(s)
- Kimberley J Haines
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Australia.
| | - Elizabeth Hibbert
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | | | - Nina Leggett
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Australia
| | - Clare Holdsworth
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | - Yasmine Ali Abdelhamid
- Department of Intensive Care, Melbourne Health, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Australia
| | - Samantha Bates
- Department of Intensive Care, Western Health, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Australia
| | - Erin Bicknell
- Department of Physiotherapy, Melbourne Health, Melbourne, Australia
| | - Sarah Booth
- Department of Social Work, Western Health, Melbourne, Australia
| | - Jacki Carmody
- Department of Psychology, Western Health, Melbourne, Australia
| | - Adam M Deane
- Department of Intensive Care, Melbourne Health, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Australia
| | - Kate Emery
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | - K J Farley
- Department of Intensive Care, Western Health, Melbourne, Australia
| | - Craig French
- Department of Intensive Care, Western Health, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Australia
| | - Lauren Krol
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | | | - Lynne Maher
- Ko Awatea, Health System Innovation and Improvement, Counties Manukau Health, Auckland, New Zealand
| | - Melanie Paykel
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
| | - Theodore J Iwashyna
- Pulmonary and Critical Care Medicine, School of Medicine, John Hopkins University, Baltimore, MD, United States
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5
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Rollinson TC, McDonald LA, Rose J, Eastwood G, Costa-Pinto R, Modra L, Maeda A, Bacolas Z, Anstey J, Bates S, Bradley S, Dumbrell J, French C, Ghosh A, Haines K, Haydon T, Hodgson CL, Holmes J, Leggett N, McGain F, Moore C, Nelson K, Presneill J, Rotherham H, Said S, Young M, Zhao P, Udy A, Neto AS, Chaba A, Bellomo R. Neuromuscular blockade and oxygenation changes during prone positioning in COVID-19. J Crit Care 2024; 79:154469. [PMID: 37992464 DOI: 10.1016/j.jcrc.2023.154469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
PURPOSE Neuromuscular blockers (NMBs) are often used during prone positioning to facilitate mechanical ventilation in COVID-19 related ARDS. However, their impact on oxygenation is uncertain. METHODS Multi-centre observational study of invasively ventilated COVID-19 ARDS adults treated with prone positioning. We collected data on baseline characteristics, prone positioning, NMB use and patient outcome. We assessed arterial blood gas data during supine and prone positioning and after return to the supine position. RESULTS We studied 548 prone episodes in 220 patients (mean age 54 years, 61% male) of whom 164 (75%) received NMBs. Mean PaO2:FiO2 (P/F ratio) during the first prone episode with NMBs reached 208 ± 63 mmHg compared with 161 ± 66 mmHg without NMBs (Δmean = 47 ± 5 mmHg) for an absolute increase from baseline of 76 ± 56 mmHg versus 55 ± 56 mmHg (padj < 0.001). The mean P/F ratio on return to the supine position was 190 ± 63 mmHg in the NMB group versus 141 ± 64 mmHg in the non-NMB group for an absolute increase from baseline of 59 ± 58 mmHg versus 34 ± 56 mmHg (padj < 0.001). CONCLUSION During prone positioning, NMB is associated with increased oxygenation compared to non-NMB therapy, with a sustained effect on return to the supine position. These findings may help guide the use of NMB during prone positioning in COVID-19 ARDS.
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Affiliation(s)
- Thomas C Rollinson
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia; Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia.
| | - Luke A McDonald
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia
| | - Joleen Rose
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia
| | - Glenn Eastwood
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Data Analytics Research and Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Rahul Costa-Pinto
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
| | - Lucy Modra
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
| | - Akinori Maeda
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia
| | - Zoe Bacolas
- Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia
| | - James Anstey
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Samantha Bates
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Western Health, VIC, Australia
| | - Scott Bradley
- Department of Intensive Care, Alfred Health, VIC, Australia; Department of Physiotherapy, Alfred Health, VIC, Australia
| | - Jodi Dumbrell
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Craig French
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Western Health, VIC, Australia
| | - Angaj Ghosh
- Department of Intensive Care, Northern Health, VIC, Australia
| | - Kimberley Haines
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Western Health, VIC, Australia; Department of Physiotherapy, Western Health, VIC, Australia
| | - Tim Haydon
- Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Carol L Hodgson
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Alfred Health, VIC, Australia; Department of Physiotherapy, Alfred Health, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Jennifer Holmes
- Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Nina Leggett
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Western Health, VIC, Australia; Department of Physiotherapy, Western Health, VIC, Australia
| | - Forbes McGain
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Western Health, VIC, Australia
| | - Cara Moore
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | - Jeffrey Presneill
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Hannah Rotherham
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Simone Said
- Department of Intensive Care, Northern Health, VIC, Australia
| | - Meredith Young
- Department of Intensive Care, Alfred Health, VIC, Australia
| | - Peinan Zhao
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Andrew Udy
- Department of Intensive Care, Alfred Health, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Ary Serpa Neto
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Anis Chaba
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia; Data Analytics Research and Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
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Bates S, Endacott R. Building critical care nursing research capacity. Intensive Crit Care Nurs 2023; 79:103531. [PMID: 37647762 DOI: 10.1016/j.iccn.2023.103531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Samantha Bates
- Dept of Intensive Care, Western Health, Melbourne, VIC, Australia; Dept of Critical Care, The University of Melbourne, Melbourne, VIC, Australia.
| | - Ruth Endacott
- National Institute for Health and Care Research, Minerva House, London, UK
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Litton E, French C, Herschtal A, Stanworth S, Pellicano S, Palermo AM, Bates S, Van Der Laan S, Eroglu E, Griffith D, Shah A. Iron and erythropoietin to heal and recover after intensive care (ITHRIVE): A pilot randomised clinical trial. CRIT CARE RESUSC 2023; 25:201-206. [PMID: 38236513 PMCID: PMC10790015 DOI: 10.1016/j.ccrj.2023.10.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 01/19/2024]
Abstract
Objective To determine the feasibility of a pivotal randomised clinical trial of intravenous (IV) iron and erythropoietin in adult survivors of critical illness with anaemia requiring treatment in the intensive care unit. Design An investigator-initiated, parallel group, placebo-controlled, randomised feasibility trial. Setting A tertiary intensive care unit (ICU) in Perth, Western Australia. Participants Adults with anaemia (haemoglobin <100 g/L), requiring ICU-level care for more than 48 h, and likely to be ready for ICU discharge within 24 h. Interventions A single dose of IV ferric carboxymaltose and Epoetin alfa (active group) or an equal volume of 0.9% saline (placebo group). Main outcome measures Study feasibility was considered met if the pilot achieved a recruitment rate of ≥2 participants per site per month, ≥90% of participants received their allocated study treatment, and≥ 90% of participants were followed up for the proposed pivotal trial primary outcome - days alive and at home to day 90 (DAH90). Results The 40-participant planned sample size included twenty in each group and was enrolled between 1/9/2021 and 2/3/2022. Participants spent a median of 3.4 days (interquartile range 2.8-5.1) in the ICU prior to enrolment and had a mean baseline haemoglobin of 83.7 g/L (standard deviation 6.7). The recruitment rate was 6.7 participants per month [95% confidence interval (CI) 4.8-9.0], DAH90 follow-up was 100% (95% CI 91.2%-100%), and 39 (97.5%, 95% CI 86.8%-99.9%) participants received the allocated study intervention. No serious adverse events were reported. Conclusion The iron and erythropoietin to heal and recover after intensive care (ITHRIVE) pilot demonstrated feasibility based on predefined participant recruitment, study drug administration, and follow-up thresholds.
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Affiliation(s)
- Edward Litton
- Intensive Care Unit, Fiona Stanley Hospital, Perth 6150, WA, Australia
- School of Medicine, University of Western Australia, 6009, WA, Australia
| | - Craig French
- Intensive Care Unit, Western Health, Melbourne, 3021, VIC, Australia
| | - Alan Herschtal
- School of Public Health and Preventative Medicine, Monash University, 4/553 St Kilda Road, Melbourne, VIC, Australia
| | - Simon Stanworth
- Haematology & Transfusion Medicine, John Radcliffe Hospital, Oxford UK
| | - Susan Pellicano
- Intensive Care Unit, Fiona Stanley Hospital, Perth 6150, WA, Australia
| | | | - Samantha Bates
- Intensive Care Unit, Western Health, Melbourne, 3021, VIC, Australia
| | | | - Ege Eroglu
- Intensive Care Unit, Fiona Stanley Hospital, Perth 6150, WA, Australia
| | - David Griffith
- Critical Care and Anaesthesia, Usher Institute, Edinburgh Medical School, Molecular, Genetic, and Population Health Sciences, The University of Edinburgh, UK
| | - Akshay Shah
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Wang YT, Harrison CA, Skinner EH, Haines KJ, Holdsworth C, Lang JK, Hibbert E, Scott D, Eynon N, Tiruvoipati R, French CJ, Stepto NK, Bates S, Walton KL, Crozier TM, Haines TP. Activin A level is associated with physical function in critically ill patients. Aust Crit Care 2023; 36:702-707. [PMID: 36517331 DOI: 10.1016/j.aucc.2022.10.019] [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: 06/15/2021] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Activin A is a potent negative regulator of muscle mass elevated in critical illness. It is unclear whether muscle strength and physical function in critically ill humans are associated with elevated activin A levels. OBJECTIVES The objective of this study was to investigate the relationship between serum activin A levels, muscle strength, and physical function at discharge from the intensive care unit (ICU) and hospital. METHODS Thirty-six participants were recruited from two tertiary ICUs in Melbourne, Australia. Participants were included if they were mechanically ventilated for >48 h and expected to have a total ICU stay of >5 days. The primary outcome measure was the Six-Minute Walk Test distance at hospital discharge. Secondary outcome measures included handgrip strength, Medical Research Council Sum Score, Physical Function ICU Test Scored, Six-Minute Walk Test, and Timed Up and Go Test assessed throughout the hospital admission. Total serum activin A levels were measured daily in the ICU. RESULTS High peak activin A was associated with worse Six-Minute Walk Test distance at hospital discharge (linear regression coefficient, 95% confidence interval, p-value: -91.3, -154.2 to -28.4, p = 0.007, respectively). Peak activin A concentration was not associated with the secondary outcome measures. CONCLUSIONS Higher peak activin A may be associated with the functional decline of critically ill patients. Further research is indicated to examine its potential as a therapeutic target and a prospective predictor for muscle wasting in critical illness. STUDY REGISTRATION ACTRN12615000047594.
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Affiliation(s)
- Yi Tian Wang
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia; Department of Physiotherapy, Peninsula Health, Melbourne, Australia.
| | - Craig A Harrison
- Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia.
| | - Elizabeth H Skinner
- Emergency and Trauma Centre, Alfred Health, Melbourne, Australia; Department of Physiotherapy, Western Health, Melbourne, Australia; Australian Institute of Musculoskeletal Science, The University of Melbourne, Melbourne, Australia.
| | - Kimberley J Haines
- Department of Physiotherapy, Western Health, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
| | - Clare Holdsworth
- Department of Physiotherapy, Western Health, Melbourne, Australia.
| | - Jenna K Lang
- Department of Physiotherapy, Western Health, Melbourne, Australia.
| | | | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
| | - Nir Eynon
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Ravindranath Tiruvoipati
- Department of Intensive Care, Peninsula Health, Melbourne, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Peninsula Clinical School, Monash University, Frankston, VIC, Australia.
| | - Craig J French
- Department of Intensive Care, Western Health, Melbourne, Australia.
| | - Nigel K Stepto
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Samantha Bates
- Department of Intensive Care, Western Health, Melbourne, Australia.
| | - Kelly L Walton
- Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Department of Physiology, Monash University, Australia.
| | - Tim M Crozier
- Department of Intensive Care, Monash Health, Melbourne, Australia; Southern Clinical School, Monash University, Melbourne, Australia.
| | - Terry P Haines
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Melbourne, Australia.
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Alonso C, Keppard B, Bates S, Cortez D, Amaya F, Dinakar K. The Chelsea Project: Turning Research and Wastewater Surveillance on COVID-19 Into Health Equity Action, Massachusetts, 2020-2021. Am J Public Health 2023; 113:627-630. [PMID: 37023385 PMCID: PMC10186821 DOI: 10.2105/ajph.2023.307253] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 04/08/2023]
Abstract
Chelsea, Massachusetts, had one of the highest COVID-19 transmission rates in New England in the summer of 2020. The Chelsea Project was a collaborative effort in which government entities, local nonprofit organizations, and startups partnered to deploy wastewater analysis, targeted polymerase chain reaction testing and vaccine outreach, and a community-led communications strategy. The strategy helped increase both testing rates and vaccination rates in Chelsea. Today Chelsea has one of the highest vaccination rates among US cities with comparable demographics. (Am J Public Health. 2023;113(6):627-630. https://doi.org/10.2105/AJPH.2023.307253).
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Affiliation(s)
- Cristina Alonso
- Cristina Alonso is with the Harvard T. H. Chan School of Public Health, Boston, MA; La Colaborativa, Chelsea, MA; and the Center of Complex Interventions, Wellesley, MA. Barry Keppard is with the Metropolitan Area Planning Council, Boston. Samantha Bates is with the Center of Complex Interventions, Boston. Dan Cortez is with the Chelsea Police Department, Chelsea. Flor Amaya is with the Chelsea Department of Public Health, Chelsea. Karthik Dinakar is with Brigham and Women's Hospital, Boston; Massachusetts General Hospital, Boston; and the Massachusetts Institute of Technology Media Lab, Cambridge
| | - Barry Keppard
- Cristina Alonso is with the Harvard T. H. Chan School of Public Health, Boston, MA; La Colaborativa, Chelsea, MA; and the Center of Complex Interventions, Wellesley, MA. Barry Keppard is with the Metropolitan Area Planning Council, Boston. Samantha Bates is with the Center of Complex Interventions, Boston. Dan Cortez is with the Chelsea Police Department, Chelsea. Flor Amaya is with the Chelsea Department of Public Health, Chelsea. Karthik Dinakar is with Brigham and Women's Hospital, Boston; Massachusetts General Hospital, Boston; and the Massachusetts Institute of Technology Media Lab, Cambridge
| | - Samantha Bates
- Cristina Alonso is with the Harvard T. H. Chan School of Public Health, Boston, MA; La Colaborativa, Chelsea, MA; and the Center of Complex Interventions, Wellesley, MA. Barry Keppard is with the Metropolitan Area Planning Council, Boston. Samantha Bates is with the Center of Complex Interventions, Boston. Dan Cortez is with the Chelsea Police Department, Chelsea. Flor Amaya is with the Chelsea Department of Public Health, Chelsea. Karthik Dinakar is with Brigham and Women's Hospital, Boston; Massachusetts General Hospital, Boston; and the Massachusetts Institute of Technology Media Lab, Cambridge
| | - Dan Cortez
- Cristina Alonso is with the Harvard T. H. Chan School of Public Health, Boston, MA; La Colaborativa, Chelsea, MA; and the Center of Complex Interventions, Wellesley, MA. Barry Keppard is with the Metropolitan Area Planning Council, Boston. Samantha Bates is with the Center of Complex Interventions, Boston. Dan Cortez is with the Chelsea Police Department, Chelsea. Flor Amaya is with the Chelsea Department of Public Health, Chelsea. Karthik Dinakar is with Brigham and Women's Hospital, Boston; Massachusetts General Hospital, Boston; and the Massachusetts Institute of Technology Media Lab, Cambridge
| | - Flor Amaya
- Cristina Alonso is with the Harvard T. H. Chan School of Public Health, Boston, MA; La Colaborativa, Chelsea, MA; and the Center of Complex Interventions, Wellesley, MA. Barry Keppard is with the Metropolitan Area Planning Council, Boston. Samantha Bates is with the Center of Complex Interventions, Boston. Dan Cortez is with the Chelsea Police Department, Chelsea. Flor Amaya is with the Chelsea Department of Public Health, Chelsea. Karthik Dinakar is with Brigham and Women's Hospital, Boston; Massachusetts General Hospital, Boston; and the Massachusetts Institute of Technology Media Lab, Cambridge
| | - Karthik Dinakar
- Cristina Alonso is with the Harvard T. H. Chan School of Public Health, Boston, MA; La Colaborativa, Chelsea, MA; and the Center of Complex Interventions, Wellesley, MA. Barry Keppard is with the Metropolitan Area Planning Council, Boston. Samantha Bates is with the Center of Complex Interventions, Boston. Dan Cortez is with the Chelsea Police Department, Chelsea. Flor Amaya is with the Chelsea Department of Public Health, Chelsea. Karthik Dinakar is with Brigham and Women's Hospital, Boston; Massachusetts General Hospital, Boston; and the Massachusetts Institute of Technology Media Lab, Cambridge
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10
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Araujo D, Greystoke A, Bates S, Bayle A, Calvo E, Castelo-Branco L, de Bono J, Drilon A, Garralda E, Ivy P, Kholmanskikh O, Melero I, Pentheroudakis G, Petrie J, Plummer R, Ponce S, Postel-Vinay S, Siu L, Spreafico A, Stathis A, Steeghs N, Yap C, Yap TA, Ratain M, Seymour L. Oncology phase I trial design and conduct: time for a change - MDICT Guidelines 2022. Ann Oncol 2023; 34:48-60. [PMID: 36182023 DOI: 10.1016/j.annonc.2022.09.158] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/18/2022] [Indexed: 02/03/2023] Open
Abstract
In 2021, the Food and Drug Administration Oncology Center of Excellence announced Project Optimus focusing on dose optimization for oncology drugs. The Methodology for the Development of Innovative Cancer Therapies (MDICT) Taskforce met to review and discuss the optimization of dosage for oncology trials and to develop a practical guide for oncology phase I trials. Defining a single recommended phase II dose based on toxicity may define doses that are neither the most effective nor the best tolerated. MDICT recommendations address the need for robust non-clinical data which are needed to inform trial design, as well as an expert team including statisticians and pharmacologists. The protocol must be flexible and adaptive, with clear definition of all endpoints. Health authorities should be consulted early and regularly. Strategies such as randomization, intrapatient dose escalation, and real-world eligibility criteria are encouraged whereas serial tumor sampling is discouraged in the absence of a strong rationale and appropriately validated assay. Endpoints should include consideration of all longitudinal toxicity. The phase I dose escalation trial should define the recommended dose range for later testing in randomized phase II trials, rather than a single recommended phase II dose, and consider scenarios where different populations may require different dosages. The adoption of these recommendations will improve dosage selection in early clinical trials of new anticancer treatments and ultimately, outcomes for patients.
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Affiliation(s)
- D Araujo
- Hospital de Base, Sao Jose do Rio Preto, Brazil
| | - A Greystoke
- Northern Centre for Cancer Care, Newcastle, UK
| | - S Bates
- Division of Hematology and Oncology, Department of Medicine, Columbia University, New York, USA
| | - A Bayle
- Institut Gustave Roussy, Paris, France
| | - E Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - L Castelo-Branco
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - J de Bono
- Institute of Cancer Research, University of London, London; The Royal Marsden Hospital, London, UK
| | - A Drilon
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - E Garralda
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - P Ivy
- National Cancer Institute, USA Cancer Therapy Evaluation Program Investigational Drug Branch (NCI/CTEP/IDB), Bethesda, USA
| | - O Kholmanskikh
- European Medicines Agency, Amsterdam, Netherlands; Federal Agency for Medicines and Health Products, Brussels, Belgium
| | - I Melero
- CUN and CIMA, University of Navarra, Pamplona, Spain
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - J Petrie
- Canadian Cancer Trials Group, Queen's University, Kingston
| | - R Plummer
- Northern Centre for Cancer Care, Newcastle, UK
| | - S Ponce
- Institut Gustave Roussy, Paris, France
| | | | - L Siu
- Princess Margaret Cancer Centre, Toronto, Canada
| | - A Spreafico
- Princess Margaret Cancer Centre, Toronto, Canada
| | - A Stathis
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - N Steeghs
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Yap
- Institute of Cancer Research, University of London, London
| | - T A Yap
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston
| | - M Ratain
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, USA
| | - L Seymour
- Canadian Cancer Trials Group, Queen's University, Kingston.
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11
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Yarad E, Bates S, Butler M, Byrne K, Eastwood G, Grattan S, Miller J, Morrison L, Murray L, Palermo A, Sherring C, Soar N, Tian DH, Towns M, Hammond NE. Job satisfaction and symptoms of depression, anxiety, stress, and burnout: A survey of Australian and New Zealand intensive care research coordinators. Aust Crit Care 2023; 36:35-43. [PMID: 36210280 DOI: 10.1016/j.aucc.2022.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/05/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Intensive care unit clinical research is often implemented by specialised research coordinators (RCs). Clinical research activity within Australian and New Zealand intensive care units has escalated, particularly during the COVID-19 pandemic. Growth of the intensive care RC workforce to match research demand is poorly understood. AIM The aim of this study was to repeat an Intensive Care Research Coordinator Interest Group workforce survey conducted in 2004 and 2009 to describe the current workforce and role satisfaction and also to determine reported symptoms of depression, anxiety, stress, and burnout in Australian and New Zealand intensive care RCs. METHODS In April 2021, an online anonymised survey was distributed to intensive care RCs to complete demographic and workforce questions, the McCloskey/Mueller Satisfaction Scale, the Depression Anxiety Stress Scales-21, and the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. RESULTS Of 128 Intensive Care Research Coordinator Interest Group eligible members, 98 (77%) completed the survey. Respondents were mainly women (91%), the median age was 47 years, 37% have a postgraduate qualification, and a third have over 10 years of RCC experience (31%). Half do not have permanent employment (52%). The mean Depression Anxiety Stress Scales-21 scores were within the normal range, and respondents reported symptoms of depression (21 [21%]), anxiety (23 [23%]), and stress (26 [27%]). Nearly half of the respondents (44%) exhibited an early symptom of burnout by reporting problematic experiences of work. The overall role satisfaction score was 3.5/5 (neutral; neither satisfied nor dissatisfied). CONCLUSIONS Intensive care RCs are an experienced group of professionals with limited satisfaction in the role. One-fifth of the ICU RCs experienced depression, anxiety, or stress symptoms, with close to half reporting signs of burnout. These results highlight the need to address areas of concern to ensure retention of this specialised intensive care workforce.
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Affiliation(s)
- Elizabeth Yarad
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia.
| | - Samantha Bates
- Departments of Intensive Care, Anaesthesia & Pain Medicine, Footscray & Sunshine Hospitals, Western Health, Victoria, Australia; Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Magdalena Butler
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Kathleen Byrne
- Intensive Care Unit, The Royal Melbourne Hospital, Melbourne, Australia
| | - Glenn Eastwood
- Intensive Care Unit, Austin Hospital, Melbourne, Australia
| | - Sarah Grattan
- Critical Care Program, The George Institute for Global Health and UNSW Sydney, Australia
| | - Jennene Miller
- Intensive Care Unit, Liverpool Hospital, Sydney, Australia
| | - Lynette Morrison
- Intensive Care Unit, Logan Hospital, Meadowbrook, Queensland, Australia
| | - Lauren Murray
- Intensive Care Unit, Sunshine Coast University Hospital, Queensland, Australia
| | - Annamaria Palermo
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Intensive Care Unit, St John of God Murdoch Hospital, Murdoch, Western Australia, Australia
| | - Claire Sherring
- Paediatric Intensive Care Unit, Starship Hospital, Auckland, New Zealand
| | - Natalie Soar
- Intensive Care Unit, Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - David H Tian
- Department of Anaesthesia and Perioperative Medicine, Westmead Hospital, Sydney, Australia; Critical Care Program, The George Institute for Global Health and UNSW Sydney, Australia
| | - Miriam Towns
- Departments of Intensive Care, Anaesthesia & Pain Medicine, Footscray & Sunshine Hospitals, Western Health, Victoria, Australia
| | - Naomi E Hammond
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia; Critical Care Program, The George Institute for Global Health and UNSW Sydney, Australia; NHMRC Emerging Leader Fellow and Associate Professor, Faculty of Medicine, UNSW Sydney, Australia
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12
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Parke R, Bates S, Carey M, Cavadino A, Ferguson A, Hammond N, Joyce F, Kirby S, Moeke-Maxwell T, Nona F, Mason K. Bullying, discrimination, and sexual harassment among intensive care unit nurses in Australia and New Zealand: An online survey. Aust Crit Care 2023; 36:10-18. [PMID: 36210282 DOI: 10.1016/j.aucc.2022.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Bullying, discrimination, and sexual harassment are significant problems within healthcare organisations but are often under-reported. Consequences of these behaviours within a healthcare setting are wide ranging, affecting workplace environments, personal well-being, and patient care and leading to increased staff turnover and quality of patient care and outcomes. Whilst there has been some work undertaken in the general nursing workforce, there is a dearth of evidence regarding the extent and impact of these behaviours on the nursing workforce in intensive care units (ICUs) in Australia and New Zealand. OBJECTIVE We aimed to determine self-reported occurrences of bullying, discrimination, and sexual harassment amongst ICU nurses in Australia and New Zealand. METHODS A prospective, cross-sectional, online survey of ICU nurses in Australia and New Zealand was undertaken in May-June 2021, distributed through formal colleges, societies, and social media. Questions included demographics and three separate sections addressing bullying, sexual harassment, and discrimination. RESULTS In 679 survey responses, the overall reported occurrences of bullying, discrimination, and sexual harassment in the last 12 months were 57.1%, 32.6%, and 1.9%, respectively. Perpetrators of bullying were predominantly nurses (59.6%, with 57.9% being ICU nurses); perpetrators of discrimination were nurses (51.7%, with 49.3% being ICU nurses); and perpetrators of sexual harassment were patients (34.6%). Respondents most commonly (66%) did not report these behaviours as they did not feel confident that the issue would be resolved or addressed. CONCLUSIONS Determining the true extent of bullying, discrimination, and sexual harassment behaviours within the ICU nursing community in Australia and New Zealand is difficult; however, it is clear a problem exists. These behaviours require recognition, reporting, and an effective resolution, rather than normalisation within healthcare professions and workplace settings in order to support and retain ICU nursing staff.
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Affiliation(s)
- Rachael Parke
- School of Nursing, The University of Auckland, Auckland, New Zealand; Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, New Zealand, Auckland, New Zealand.
| | - Samantha Bates
- Dept of Intensive Care, Anaesthesia, Pain & Perioperative Medicine, Western Health, Melbourne, Australia; Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Melissa Carey
- School of Nursing, The University of Auckland, Auckland, New Zealand; School of Nursing, University of Southern Queensland, Australia
| | - Alana Cavadino
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Adele Ferguson
- ICU/ED, Bay of Plenty District Health Board, New Zealand
| | - Naomi Hammond
- Critical Care Division, The George Institute for Global Health and UNSW Sydney, Sydney, NSW, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Fiona Joyce
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, New Zealand, Auckland, New Zealand
| | - Steve Kirby
- Critical Care Complex, Middlemore Hospital, Auckland, New Zealand
| | | | - Francis Nona
- School of Public Health, The University of Queensland, Australia
| | - Kathleen Mason
- School of Nursing, The University of Auckland, Auckland, New Zealand
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13
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Daza JF, Cuthbertson BH, Myles PS, Shulman MA, Wijeysundera DN, Wijeysundera DN, Pearse RM, Myles PS, Abbott TEF, Shulman MA, Torres E, Ambosta A, Melo M, Mamdani M, Thorpe KE, Wallace S, Farrington C, Croal BL, Granton JT, Oh P, Thompson B, Hillis G, Beattie WS, Wijeysundera HC, Ellis M, Borg B, Kerridge RK, Douglas J, Brannan J, Pretto J, Godsall MG, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Kirabiyik Y, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter TW, Macklin S, Elliott A, Carrera AM, Terblanche NCS, Pitt S, Samuels J, Wilde C, Leslie K, MacCormick A, Bramley D, Southcott AM, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney CJL, Choi S, Somascanthan P, Flores K, Karkouti K, Clarke HA, Jerath A, McCluskey SA, Wasowicz M, Day L, Pazmino-Canizares J, Belliard R, Lee L, Dobson K, Stanbrook M, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, McAllister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G. Measurement properties of the WHO Disability Assessment Schedule 2.0 for evaluating functional status after inpatient surgery. Br J Surg 2022; 109:968-976. [PMID: 35929065 DOI: 10.1093/bjs/znac263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/17/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Expert recommendations propose the WHO Disability Assessment Schedule (WHODAS) 2.0 as a core outcome measure in surgical studies, yet data on its long-term measurement properties remain limited. These were evaluated in a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) prospective cohort. METHODS Participants were adults (40 years of age or older) who underwent inpatient non-cardiac surgery. The 12-item WHODAS and EQ-5DTM-3L questionnaires were administered preoperatively (in person) and 1 year postoperatively (by telephone). Responsiveness was characterized using standardized response means (SRMs) and correlation coefficients between change scores. Construct validity was evaluated using correlation coefficients between 1-year scores and comparisons of WHODAS scores across clinically relevant subgroups. RESULTS The analysis included 546 patients. There was moderate correlation between changes in WHODAS and various EQ-5DTM subscales. The strongest correlation was between changes in WHODAS and changes in the functional domains of the EQ-5D-3L-for example, mobility (Spearman's rho 0.40, 95 per cent confidence interval [c.i.] 0.32 to 0.48) and usual activities (rho 0.45, 95 per cent c.i. 0.30 to 0.52). When compared across quartiles of EQ-5D index change, median WHODAS scores followed expected patterns of change. In subgroups with expected functional status changes, the WHODAS SRMs ranged from 'small' to 'large' in the expected directions of change. At 1 year, the WHODAS demonstrated convergence with the EQ-5D-3L functional domains, and good discrimination between patients with expected differences in functional status. CONCLUSION The WHODAS questionnaire has construct validity and responsiveness as a measure of functional status at 1 year after major surgery.
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Affiliation(s)
- Julian F Daza
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Brian H Cuthbertson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Mark A Shulman
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Duminda N Wijeysundera
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
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Slack RJ, French C, McGain F, Bates S, Gao A, Knowles S, Yang Y. Violence in intensive care: a point prevalence study. CRIT CARE RESUSC 2022; 24:272-279. [PMID: 38046215 PMCID: PMC10692600 DOI: 10.51893/2022.3.oa7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Violence in the intensive care unit (ICU) is poorly characterised and its incidence is largely extrapolated from studies in the emergency department. Policy requirements vary between jurisdictions and have not been formally evaluated. Methods: A multisite, single-time point observational study was conducted across Australasian ICUs which focused on the incidence of violence in the previous 24 hours, the characteristics of patients displaying violent behaviour, the perceived contributors, and the management strategies implemented. Unit policies were surveyed across a range of domains relevant to violence management. Results: Data were available for 627 patients admitted to 44 ICUs on one of 2 days in June 2019. Four per cent (25/627) displayed at least one episode of violent behaviour in the previous 24 hours. Violent behaviour was more likely in individuals after a greater length of stay in hospital (incidence, 2%, 4% and 7% for day 0-2, 3-7 and > 7 days respectively; P = 0.01) and in the ICU (2%, 4% and 9% for day 0-2, 3-7 and > 7 of ICU stay respectively; P < 0.01). The most common perceived contributors to violence were confusion (64%), physical illness (40%), and psychiatric illness (34%). Management with chemical sedation (72%) and physical restraint (28%) was commonly required. Clinicians assessed an additional 53 patients (53/627, 9%) as at risk of displaying violence in the next 24 hours. Of the 44 participating ICUs, 30 (68%) had a documented violence procedure. Conclusion: Violence in the ICU was common and frequently required intervention. In this study, one-third of ICUs did not have formal violence procedures, and in those with violence procedures, considerable variation was observed.
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Affiliation(s)
| | - Craig French
- Western Health, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
- Australian and New Zealand Intensive Care Society (ANZICS), Melbourne, VIC, Australia
| | | | - Samantha Bates
- Western Health, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
| | - Annie Gao
- The George institute for Global Health, Sydney, NSW, Australia
| | - Serena Knowles
- The George institute for Global Health, Sydney, NSW, Australia
| | - Yang Yang
- Western Health, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
- Australian and New Zealand Intensive Care Society (ANZICS), Melbourne, VIC, Australia
- Monash University, Melbourne, Victoria, Australia
| | - For the George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG)
- Western Health, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
- Australian and New Zealand Intensive Care Society (ANZICS), Melbourne, VIC, Australia
- The George institute for Global Health, Sydney, NSW, Australia
- Monash University, Melbourne, Victoria, Australia
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15
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Bates S, Zhang Y. Exploring the Relationships Among Student Outcomes and Case Management Services Delivered by School Social Workers. Child Adolesc Social Work J 2022:1-10. [PMID: 35600321 PMCID: PMC9111944 DOI: 10.1007/s10560-022-00850-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 06/15/2023]
Abstract
Purpose School social workers (SSWs) deliver case management (CM) services to connect students to an array of supports that meet their academic and non-academic needs. However, gaps exist in understanding the profiles of students receiving CM services delivered by SSWs, and the relationships between dosage and receipt of CM services and student outcomes. Method Researchers utilized secondary data from three large middle schools to explore the demographics of students (N = 3,012) receiving CM services and students not receiving CM services. Among students receiving CM services (n = 238), binary and multinomial regression analyses explored relationships among students' demographic characteristics, dosage of CM services, and non-academic and academic outcomes. Student outcomes were also compared among a demographically matched subsample of 181 students receiving CM services and 181 students not receiving CM services. Results Students receiving CM services were more likely to be at-risk, Hispanic/Latino, and limited English proficiency status than students not receiving CM services. Regression analyses indicated a higher dosage of CM services was associated with higher odds of receiving two or more behavioral referrals and failing 60% or more courses. Moreover, among a demographically matched subsample, students receiving CM services were significantly more likely to have two or more behavioral referrals and fail 60% or more courses than students not receiving CM services. Discussion Our findings suggest SSWs provide CM services to students with significant academic and behavioral risks. We discuss the implications of our results concerning SSW practice, education, research, and policy.
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Affiliation(s)
- Samantha Bates
- College of Social Work, The Ohio State University, 1947 N. College Rd, 43210 Columbus, USA
| | - Yan Zhang
- College of Nursing and Health Sciences, Texas Christian University, Fort Worth, USA
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16
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Kelly AM, Bates S, Klim S, French C. Arteriovenous blood gas agreement for ICU patients with COVID-19. Emerg Med Australas 2021; 34:299-300. [PMID: 34957685 DOI: 10.1111/1742-6723.13930] [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] [Received: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research @ Western Health, Sunshine, Australia.,Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Samantha Bates
- Dept of Intensive Care, Anaesthesia, Pain & Perioperative Medicine, Western Health and Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne
| | - Sharon Klim
- Joseph Epstein Centre for Emergency Medicine Research @ Western Health, Sunshine, Australia.,The University of Melbourne, Parkville, Australia
| | - Craig French
- Intensive Care Unit, Western Health and Clinical Associate Professor, Department of Critical Care, Melbourne Medical School, The University of Melbourne
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17
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Bates S, Anderson-Butcher D, Hoffman J, Rooney L, Ramsey C. Addressing infant mortality through positive youth development opportunities for adolescent girls. Health Soc Care Community 2021; 29:1260-1274. [PMID: 32893446 DOI: 10.1111/hsc.13158] [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] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/19/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
Adolescent girls experience risks prior to pregnancy and giving birth that influence their overall health, and development, as well as community rates of infant mortality. Supporting adolescent girls through positive youth development (PYD) opportunities offers a potential long-term strategy to preventing infant mortality and improving maternal health outcomes. The current study sought to assess state-wide needs, resources and opportunities related to PYD supports for adolescent girls, especially among those most at risk for early pregnancy. A strengths, weaknesses, opportunities and threats (SWOT) analysis guided nine community forums in counties with the highest rates of infant mortality in one large Midwestern state. In total, 368 stakeholders attended the forums and provided insights related to the context of PYD for adolescent girls. Researchers also conducted three focus group with 19 parents/guardians and three focus groups with 25 adolescent girls aged 11-14 to validate the findings from the SWOT analysis. Content analysis was utilised to synthesise the qualitative results. Strengths and opportunities related to PYD for adolescent girls included access to afterschool programming and access to health and mental health services. Weaknesses brought awareness to more systemic problems as all nine counties reported a lack of communication and coordination among youth programs and a need for greater collaboration among youth agencies. Threats included challenges associated with technology and social media, unsafe neighbourhood conditions, and issues of racism, sexism, poverty and discrimination. Findings support the need for a continued focus and priority on improving access, services and supports for adolescent girls to prevent infant mortality and improve their health and well-being. Local, state and national leaders can use the results of this study to promote additional strategies for addressing infant mortality through PYD for adolescent girls.
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Affiliation(s)
- Samantha Bates
- Department of Social Work, Texas Christian University, Fort Worth, TX, USA
| | | | - Jill Hoffman
- School of Social Work, Portland State University, Portland, OR, USA
| | | | - Catelen Ramsey
- College of Social Work, The Ohio State University, Columbus, OH, USA
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18
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Adjodah D, Dinakar K, Chinazzi M, Fraiberger SP, Pentland A, Bates S, Staller K, Vespignani A, Bhatt DL. Association between COVID-19 outcomes and mask mandates, adherence, and attitudes. PLoS One 2021; 16:e0252315. [PMID: 34161332 PMCID: PMC8221503 DOI: 10.1371/journal.pone.0252315] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [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: 03/04/2021] [Accepted: 05/13/2021] [Indexed: 01/08/2023] Open
Abstract
We extend previous studies on the impact of masks on COVID-19 outcomes by investigating an unprecedented breadth and depth of health outcomes, geographical resolutions, types of mask mandates, early versus later waves and controlling for other government interventions, mobility testing rate and weather. We show that mask mandates are associated with a statistically significant decrease in new cases (-3.55 per 100K), deaths (-0.13 per 100K), and the proportion of hospital admissions (-2.38 percentage points) up to 40 days after the introduction of mask mandates both at the state and county level. These effects are large, corresponding to 14% of the highest recorded number of cases, 13% of deaths, and 7% of admission proportion. We also find that mask mandates are linked to a 23.4 percentage point increase in mask adherence in four diverse states. Given the recent lifting of mandates, we estimate that the ending of mask mandates in these states is associated with a decrease of -3.19 percentage points in mask adherence and 12 per 100K (13% of the highest recorded number) of daily new cases with no significant effect on hospitalizations and deaths. Lastly, using a large novel survey dataset of 847 thousand responses in 69 countries, we introduce the novel results that community mask adherence and community attitudes towards masks are associated with a reduction in COVID-19 cases and deaths. Our results have policy implications for reinforcing the need to maintain and encourage mask-wearing by the public, especially in light of some states starting to remove their mask mandates.
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Affiliation(s)
- Dhaval Adjodah
- Connection Science, MIT, Cambridge, MA, United States of America
- Center of Complex Interventions, Wellesley, MA, United States of America
| | | | - Matteo Chinazzi
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, United States of America
| | - Samuel P. Fraiberger
- Connection Science, MIT, Cambridge, MA, United States of America
- Development Data Group, World Bank, Washington, DC, United States of America
- Department of Computer Science, New York University, New York, NY, United States of America
| | - Alex Pentland
- Media Lab, MIT, Cambridge, MA, United States of America
| | - Samantha Bates
- Center of Complex Interventions, Wellesley, MA, United States of America
| | - Kyle Staller
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Harvard University Boston, MA, United States of America
| | - Alessandro Vespignani
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, United States of America
| | - Deepak L. Bhatt
- Heart & Vascular Center, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Harvard University Boston, MA, United States of America
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19
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Anderson-Butcher D, Bates S. Social Work and Youth Sport. Child Adolesc Social Work J 2021; 38:359-365. [PMID: 34075276 PMCID: PMC8162155 DOI: 10.1007/s10560-021-00777-6] [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] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Dawn Anderson-Butcher
- College of Social Work, The Ohio State University, 1947 N College Rd College of Social Work Columbus, Columbus, OH 43210 USA
| | - Samantha Bates
- College of Social Work, The Ohio State University, 1947 N College Rd College of Social Work Columbus, Columbus, OH 43210 USA
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20
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Hammond NE, Bates S. Protecting the role of the intensive care research coordinator during pandemics. Aust Crit Care 2021; 34:119. [PMID: 33712179 PMCID: PMC7943059 DOI: 10.1016/j.aucc.2020.11.002] [Citation(s) in RCA: 1] [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] [Received: 10/30/2020] [Accepted: 11/15/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Naomi E Hammond
- Vice-Chair, IRCIG, Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
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21
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Bates S, Greene D, O’Quinn L. Virtual Sport-Based Positive Youth Development During the COVID-19 Pandemic. Child Adolesc Social Work J 2021; 38:437-448. [PMID: 34025014 PMCID: PMC8123928 DOI: 10.1007/s10560-021-00774-9] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
Sport is a foundational context for social, emotional, physical, and psychological development. The COVID-19 pandemic displaced many youth from their normative sport activities. As a result, sport-based positive-youth development (PYD) programs, typically delivered in person, had to reimagine ways to reach and engage youth in sport and life skill development. In fall 2020, The Los Angeles Football Club Youth Leadership Program (LAFC YLP) developed seven virtual sport-based PYD videos and one workshop for 120 socially vulnerable youth and their families. All virtual activities were designed to teach life skills through sport and play. Our study sought to explore the accessibility of the virtual sport-based PYD activities, the lived experiences of youth participants during lockdown, and learning outcomes of youth and families who participated in the program. We developed a mixed methods study using an online survey and virtual platform to allow youth to share photos, draw pictures, and leave comments about their lived experiences. Our findings indicated 53 youth and their families participated in the virtual sport-based PYD program and reported the activities were accessible, enjoyable, and challenging for the youth participants. In addition, 26 youth shared photos, images, or posts about their lived experiences. Our thematic analysis of the photos, images, and posts indicated the virtual sport-based PYD activities facilitated positive emotional responses, positive peer interaction, engagement with family, and utilization of environmental resources during the COVID-19 pandemic. Importantly, our findings also suggest virtual sport-based PYD activities may facilitate life skill transfer; an important developmental mechanism for learning in lieu of the decreased opportunities for sport and social interaction during the COVID-19 pandemic.
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Affiliation(s)
- Samantha Bates
- College of Social Work, The Ohio State University, 1947 College Rd N, Columbus, OH 43210 USA
| | - Dekia Greene
- Department of Social Work, Texas Christian University, Fort Worth, TX USA
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22
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Bates S, Anderson-Butcher D, Ferrari T, Clary C. A Comparative Examination of How Program Design Components Influence Youth Leadership-Skill Development. JYD 2020. [DOI: 10.5195/jyd.2020.868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A growing interest in how adolescents can prepare for the workforce has contributed to the development of positive youth development (PYD) programs focused on youth leadership. This study explored what mechanisms and design components support leadership skill development among youth participating in 3 different PYD leadership programs. All of these programs involve high school students, have a focus on leadership, and emphasize college and workforce readiness. The aims of the study were to (a) examine what commonalities and differences in program design components contribute to skill development, (b) identify what leadership skills youth develop by participating in PYD leadership programs, and (c) explore what underlying mechanisms youth perceive contribute to their skill development over time. A total of 3 focus groups were conducted, each lasting 90 minutes, with a total of 18 youth (i.e., 6 youth per program). Nvivo, a qualitative software, and thematic analysis were used to distill common and differential themes related to the program design components the participants recognized as integral parts of the programs that contributed to their leadership skill development. Common skills developed across all 3 programs included working in groups, public speaking, and problem solving, yet differences in skills were also reported and linked to differences in program design. Additional findings showed several underlying mechanisms supported leadership skill development among youth participants. Findings can inform the development of effective youth leadership PYD programs, thereby further supporting youth in achieving their goals; avoiding harmful behaviors; and developing the competencies, confidence, and values youth need to successfully transition to adulthood.
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23
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Evans RL, Bates S, Marriott RE, Arnold DS. The impact of different hair-removal behaviours on the biophysical and biochemical characteristics of female axillary skin. Int J Cosmet Sci 2020; 42:436-443. [PMID: 32638392 PMCID: PMC7984395 DOI: 10.1111/ics.12648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/12/2020] [Revised: 06/24/2020] [Accepted: 07/02/2020] [Indexed: 11/28/2022]
Abstract
Objective The impact of hair removal on the biophysical and biochemical characteristics of human axillary skin is not fully understood. This study investigated the effect of different hair‐removal techniques on biophysical parameters and the concentrations of key inflammatory biomarkers in the axillae of female Thai subjects. Axillary hair was removed by shaving, plucking or waxing. Methods Following a 2‐week washout phase without hair removal, subjects underwent visual assessment for erythema and skin dryness in one (randomized) axilla, then, hair was removed from the axilla by shaving, plucking or waxing according to each subject’s established habit. Erythema and dryness were assessed again 30 min after hair removal, and buffer scrubs collected from depilated and non‐depilated axillae and analysed for inflammatory cytokines; after a further 48 h, erythema, dryness and post‐inflammatory hyperpigmentation (PIHP) were assessed in the depilated axilla. Biophysical assessments (skin hydration, barrier integrity, elasticity and roughness) were made in depilated and non‐depilated axillae. Results All three hair‐removal techniques induced an increase in axillary erythema and skin dryness. Shaving was associated with significantly less erythema (P < 0.01), but significantly greater skin dryness (P < 0.05) versus the other techniques 30 min after hair removal. There were no between‐technique differences in PIHP or biophysical parameters. Interleukins IL‐1α and IL‐1RA concentrations increased, and IL‐8 concentration decreased following hair removal by each technique. Conclusion This is the first study to identify the principal cytokines associated with the inflammatory process triggered by axillary hair removal. A single hair‐removal treatment did not appear to induce PIHP or further biophysical changes to the skin.
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Affiliation(s)
- R L Evans
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
| | - S Bates
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
| | - R E Marriott
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
| | - D S Arnold
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
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24
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Fujii T, Luethi N, Young PJ, Frei DR, Eastwood GM, French CJ, Deane AM, Shehabi Y, Hajjar LA, Oliveira G, Udy AA, Orford N, Edney SJ, Hunt AL, Judd HL, Bitker L, Cioccari L, Naorungroj T, Yanase F, Bates S, McGain F, Hudson EP, Al-Bassam W, Dwivedi DB, Peppin C, McCracken P, Orosz J, Bailey M, Bellomo R. Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial. JAMA 2020; 323:423-431. [PMID: 31950979 PMCID: PMC7029761 DOI: 10.1001/jama.2019.22176] [Citation(s) in RCA: 294] [Impact Index Per Article: 73.5] [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: 12/25/2022]
Abstract
IMPORTANCE It is unclear whether vitamin C, hydrocortisone, and thiamine are more effective than hydrocortisone alone in expediting resolution of septic shock. OBJECTIVE To determine whether the combination of vitamin C, hydrocortisone, and thiamine, compared with hydrocortisone alone, improves the duration of time alive and free of vasopressor administration in patients with septic shock. DESIGN, SETTING, AND PARTICIPANTS Multicenter, open-label, randomized clinical trial conducted in 10 intensive care units in Australia, New Zealand, and Brazil that recruited 216 patients fulfilling the Sepsis-3 definition of septic shock. The first patient was enrolled on May 8, 2018, and the last on July 9, 2019. The final date of follow-up was October 6, 2019. INTERVENTIONS Patients were randomized to the intervention group (n = 109), consisting of intravenous vitamin C (1.5 g every 6 hours), hydrocortisone (50 mg every 6 hours), and thiamine (200 mg every 12 hours), or to the control group (n = 107), consisting of intravenous hydrocortisone (50 mg every 6 hours) alone until shock resolution or up to 10 days. MAIN OUTCOMES AND MEASURES The primary trial outcome was duration of time alive and free of vasopressor administration up to day 7. Ten secondary outcomes were prespecified, including 90-day mortality. RESULTS Among 216 patients who were randomized, 211 provided consent and completed the primary outcome measurement (mean age, 61.7 years [SD, 15.0]; 133 men [63%]). Time alive and vasopressor free up to day 7 was 122.1 hours (interquartile range [IQR], 76.3-145.4 hours) in the intervention group and 124.6 hours (IQR, 82.1-147.0 hours) in the control group; the median of all paired differences was -0.6 hours (95% CI, -8.3 to 7.2 hours; P = .83). Of 10 prespecified secondary outcomes, 9 showed no statistically significant difference. Ninety-day mortality was 30/105 (28.6%) in the intervention group and 25/102 (24.5%) in the control group (hazard ratio, 1.18; 95% CI, 0.69-2.00). No serious adverse events were reported. CONCLUSIONS AND RELEVANCE In patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor administration over 7 days. The finding suggests that treatment with intravenous vitamin C, hydrocortisone, and thiamine does not lead to a more rapid resolution of septic shock compared with intravenous hydrocortisone alone. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03333278.
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Affiliation(s)
- Tomoko Fujii
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nora Luethi
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Paul J. Young
- Intensive Care Unit, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Daniel R. Frei
- Department of Anaesthesia and Pain Medicine, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Glenn M. Eastwood
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia
| | - Craig J. French
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Anaesthesia, Pain, and Perioperative Medicine, Footscray Hospital, Western Health, Footscray, Melbourne, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
| | - Adam M. Deane
- Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville, Australia
| | - Yahya Shehabi
- Critical Care and Perioperative Services, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
- Clinical School of Medicine, University of New South Wales, Sydney, Australia
| | | | - Gisele Oliveira
- Cancer Institute of the State of Sao Paulo, Sao Paulo, Brazil
| | - Andrew A. Udy
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Neil Orford
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia
| | - Samantha J. Edney
- Intensive Care Unit, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Anna L. Hunt
- Intensive Care Unit, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Harriet L. Judd
- Intensive Care Unit, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Laurent Bitker
- Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia
- Service de médecine intensive et réanimation, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Luca Cioccari
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Intensive Care Medicine, University Hospital, University of Bern, Bern, Switzerland
| | - Thummaporn Naorungroj
- Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Intensive Care, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Fumitaka Yanase
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia
| | - Samantha Bates
- Department of Intensive Care, Anaesthesia, Pain, and Perioperative Medicine, Footscray Hospital, Western Health, Footscray, Melbourne, Victoria, Australia
| | - Forbes McGain
- Department of Intensive Care, Anaesthesia, Pain, and Perioperative Medicine, Footscray Hospital, Western Health, Footscray, Melbourne, Victoria, Australia
| | - Elizabeth P. Hudson
- Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Wisam Al-Bassam
- Critical Care and Perioperative Services, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Dhiraj Bhatia Dwivedi
- Critical Care and Perioperative Services, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Chloe Peppin
- Critical Care and Perioperative Services, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Phoebe McCracken
- Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Judit Orosz
- Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Michael Bailey
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
| | - Rinaldo Bellomo
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
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25
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Kleivdal H, Kristiansen SI, Nilsen MV, Goksyr A, Briggs L, Holland P, McNabb P, Aasheim A, Aune T, Bates S, Bavington C, Caron D, Doucette G, Gago-Martinez A, Gallacer S, Grieve M, Haley S, Hess P, Hughes P, Léger C, Macaillou-Le Baut C, Myrland C, Neil T, Nguyen L, Ross K, Samdal I, Schaffner R, Smith E, Sosa S, Towers N, Tubaro A, Vaquero E, Wells M, Werner M, White P. Determination of Domoic Acid Toxins in Shellfish by Biosense ASP ELISAA Direct Competitive Enzyme-Linked Immunosorbent Assay: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/90.4.1011] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted on the Biosense amnesic shellfish poisoning (ASP) enzyme-linked immunosorbent assay (ELISA) for the determination of domoic acid (DA) toxins in shellfish in order to obtain interlaboratory validation data for the method. In addition, a method comparison study was performed to evaluate the ASP ELISA as an alternative to the current liquid chromatography (LC) reference method for DA determination. The study material comprised 16 shellfish samples, including blue mussels, Pacific oysters, and king scallops, spiked with contaminated mussel homogenates to contain 0.120 mg DA/kg shellfish flesh. The shellfish samples were extracted with 50% aqueous methanol, and the supernatants were directly analyzed. Sixteen participating laboratories in 10 countries reported data from the ASP ELISA, and 4 of these laboratories also reported data from instrumental LC analysis. The participating laboratories achieved interlaboratory precision estimates for the 8 Youden paired shellfish samples in the range of 1020% for RSDr (mean 14.8 4%), and 1329% for RSDR (mean 22.7 6%). The precision estimates for the ELISA data did not show a strong dependence on the DA concentration in the study samples, and the overall precision achieved was within the acceptable range of the Horwitz guideline with HorRat values ranging from 1.1 to 2.4 (mean HorRat 1.7 0.5). The analysis of shellfish samples spiked with certified reference material (CRM)-ASP-MUS-b gave recoveries in the range of 88122%, with an average recovery of 104 10%. The estimate on method accuracy was supported by a correlation slope of 1.015 (R2 = 0.992) for the determined versus the expected DA values. Furthermore, the correlation of the ASP ELISA results with those for the instrumental LC analyses of the same sample extracts gave a correlation slope of 1.29 (R2 = 0.984). This indicates some overestimation of DA levels in shellfish by the ELISA, but it is also a result of apparent low recoveries for the LC methods. This interlaboratory study demonstrates that the ASP ELISA is suitable for the routine determination and monitoring of DA toxins in shellfish, and that it offers a rapid and cost-effective methodology with high sample throughput.
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Affiliation(s)
- Hans Kleivdal
- Biosense Laboratories AS, HIB-Thormhlensgate 55, NO-5008 Bergen, Norway
| | | | - Mona V Nilsen
- Biosense Laboratories AS, HIB-Thormhlensgate 55, NO-5008 Bergen, Norway
| | - Anders Goksyr
- Biosense Laboratories AS, HIB-Thormhlensgate 55, NO-5008 Bergen, Norway
| | - Lyn Briggs
- AgResearch Ltd, Ruakura, East St, Hamilton, New Zealand
| | | | - Paul McNabb
- Cawthron Institute, 98 Halifax St East, Nelson, New Zealand
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Bates S, Anderson-Butcher D, Niewoehner-Green J, Provenzano J. Exploration of a College and Career Readiness Leadership Program for Urban Youth. JYD 2019. [DOI: 10.5195/jyd.2019.664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Urban youth living in poverty are less socially and academically prepared to access postsecondary education compared to their more affluent peers. College and career readiness (CCR) programs traditionally focus on skill-building to assist with college and financial aid applications, test taking, and career exploration. The Youth Leadership Academy (YLA) program includes these components, but also incorporates positive youth development (PYD) and leadership skill development strategies to further prepare urban youth for college and career through internship, service, and leadership opportunities. Using a mixed methods approach, this study explored youth perceptions of the YLA, evaluating the influence of the program on youth outcomes and distilling what, if any, program design components contributed to their growth and learning. Qualitative findings suggest participation in the YLA was perceived to support growth in communication skills, social skills, readiness for leadership roles, and preparation and knowledge for future college and career opportunities. Additionally, quantitative results demonstrate positive, significant increases from pre- to post-program test in leadership, communication, problem-solving, and teamwork skills for youth. Program design components shown to support positive outcomes included positive relationships with peer and adults, skill-building sessions, and applied internship experiences. Findings suggest that PYD approaches with CCR and leadership skill development programming may promote positive social outcomes for vulnerable youth. Implications for intervention, practice, and future research are discussed.
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McGain F, Lam K, Bates S, Towns M, French C. An audit of propofol administration in the intensive care unit: Infusion pump-recorded versus electronically documented amounts. Aust Crit Care 2019; 33:25-29. [PMID: 30770268 DOI: 10.1016/j.aucc.2018.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/16/2018] [Accepted: 12/28/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although propofol is widely used for sedation in intensive care units around Australia, evaluation of bedside nursing practices of the administration of propofol have been limited. We investigated whether there was a discrepancy between the amount of propofol delivered by the infusion pump and that recorded electronically and consequently patient exposure to avoidable harms. AIMS The aim of this research was to compare the total amount of propofol administered to intensive care patients via a programmable infusion pump with that documented in the electronic medical record (EMR). Secondary objectives were to ascertain the percentage of 1) patients exposed to a propofol dose greater than recommended and 2) daily energy requirements administered as propofol infusion. METHODS This was a prospective, observational study of total propofol delivered to 50 patients in a 14-bed metropolitan, Australian intensive care unit. Infusion pump data and entries from the EMR were collated. RESULTS Propofol sedation was administered for a median 18 (interquartile range: 14-47) hours with median total propofol 3025 mg (interquartile range: 1840-7755 mg) by pump and 3250 mg (interquartile range: 1915-6960 mg) by EMR, i.e. 1.9 (interquartile range: 1.3-2.3) mg/kg/hour by pump (correlation coefficient = 0.99). The total bolus propofol documented in the EMR was a median 330 mg (interquartile range: -838 to -124) less than the pump amount. Nineteen (38%) patients had no EMR-documented propofol boluses yet had received at least one bolus via the pump. In two of 50 (4%) patients, the pump propofol infusion dose was above the recommended maximum safe dose of 4 mg/kg/h. CONCLUSION In this cohort of patients, the bolus administration of propofol was frequently not documented, potentially placing some patients at risk of drug-related toxicity. Further research to develop and implement strategies to improve the documentation of propofol administration is indicated.
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Affiliation(s)
- Forbes McGain
- Departments of Anaesthesia and Intensive Care, Western Health, Melbourne, Australia; Planetary Health Platform, Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Kelvin Lam
- Department of Anaesthesia, Dandenong Hospital, Melbourne, Australia.
| | - Samantha Bates
- Departments of Anaesthesia and Intensive Care, Western Health, Melbourne, Australia.
| | - Miriam Towns
- Departments of Anaesthesia and Intensive Care, Western Health, Melbourne, Australia.
| | - Craig French
- Departments of Anaesthesia and Intensive Care, Western Health, Melbourne, Australia; Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
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McPeake J, Hirshberg EL, Christie LM, Drumright K, Haines K, Hough CL, Meyer J, Wade D, Andrews A, Bakhru R, Bates S, Barwise JA, Bastarache J, Beesley SJ, Boehm LM, Brown S, Clay AS, Firshman P, Greenberg S, Harris W, Hill C, Hodgson C, Holdsworth C, Hope AA, Hopkins RO, Howell DCJ, Janssen A, Jackson JC, Johnson A, Kross EK, Lamas D, MacLeod-Smith B, Mandel R, Marshall J, Mikkelsen ME, Nackino M, Quasim T, Sevin CM, Slack A, Spurr R, Still M, Thompson C, Weinhouse G, Wilcox ME, Iwashyna TJ. Models of Peer Support to Remediate Post-Intensive Care Syndrome: A Report Developed by the Society of Critical Care Medicine Thrive International Peer Support Collaborative. Crit Care Med 2019; 47:e21-e27. [PMID: 30422863 PMCID: PMC6719778 DOI: 10.1097/ccm.0000000000003497] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Patients and caregivers can experience a range of physical, psychologic, and cognitive problems following critical care discharge. The use of peer support has been proposed as an innovative support mechanism. DESIGN We sought to identify technical, safety, and procedural aspects of existing operational models of peer support, among the Society of Critical Care Medicine Thrive Peer Support Collaborative. We also sought to categorize key distinctions between these models and elucidate barriers and facilitators to implementation. SUBJECTS AND SETTING Seventeen Thrive sites from the United States, United Kingdom, and Australia were represented by a range of healthcare professionals. MEASUREMENTS AND MAIN RESULTS Via an iterative process of in-person and email/conference calls, members of the Collaborative defined the key areas on which peer support models could be defined and compared, collected detailed self-reports from all sites, reviewed the information, and identified clusters of models. Barriers and challenges to implementation of peer support models were also documented. Within the Thrive Collaborative, six general models of peer support were identified: community based, psychologist-led outpatient, models-based within ICU follow-up clinics, online, groups based within ICU, and peer mentor models. The most common barriers to implementation were recruitment to groups, personnel input and training, sustainability and funding, risk management, and measuring success. CONCLUSIONS A number of different models of peer support are currently being developed to help patients and families recover and grow in the postcritical care setting.
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Affiliation(s)
- Joanne McPeake
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
- University of Glasgow, Glasgow, United Kingdom
| | - Eliotte L Hirshberg
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, UT
- Division of Pulmonary and Critical Care, Department of Medicine, University of Utah, Salt Lake City, UT
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Leeann M Christie
- Dell Children's Medical Centre, Austin, TX
- VA Tennessee Valley Healthcare System, Nashville, TN
| | | | - Kimberley Haines
- Western Health, Melbourne, VIC, Australia
- Australia and New Zealand Intensive Care Society Research Centre, Monash University, Melbourne, VIC, Australia
| | - Catherine L Hough
- Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA
| | - Joel Meyer
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Dorothy Wade
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Rita Bakhru
- Pulmonary, Critical Care, Allergy & Immunologic Diseases, Wake Forest School of Medicine, Winston Salem, NC
| | | | - John A Barwise
- VA Tennessee Valley Healthcare System, Nashville, TN
- Vanderbilt University Medical Center, Nashville, TN
| | - Julie Bastarache
- VA Tennessee Valley Healthcare System, Nashville, TN
- Vanderbilt University Medical Center, Nashville, TN
| | - Sarah J Beesley
- Intermountain Medical Center, Division of Pulmonary and Critical Care, Murray, UT
- Division of Pulmonary and Critical Care, University of Utah, Salt Lake City, UT
| | - Leanne M Boehm
- Vanderbilt University School of Nursing, Nashville, TN
- VA Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center, Nashville, TN
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University, Nashville, TN
| | | | | | - Penelope Firshman
- Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA
| | - Steven Greenberg
- Evanston Hospital, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Chicago, IL
| | - Wendy Harris
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Carol Hodgson
- Australia and New Zealand Intensive Care Society Research Centre, Monash University, Melbourne, VIC, Australia
- Alfred Health, Melbourne, VIC, Australia
| | | | | | - Ramona O Hopkins
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, UT
- Intermountain Medical Center, Division of Pulmonary and Critical Care, Murray, UT
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT
| | - David C J Howell
- Critical Care Unit, University College London NHS Foundation Trust, London, United Kingdom
| | - Anna Janssen
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | | | - Erin K Kross
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA
| | - Daniela Lamas
- Division of Pulmonary and Critical Care Medicine, Brigham & Women's Hospital, Boston, MA
| | | | - Ruth Mandel
- NorthShore University Health System - Evanston Hospital, Chicago, IL
| | | | - Mark E Mikkelsen
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA
| | - Megan Nackino
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Tara Quasim
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
- University of Glasgow, Glasgow, United Kingdom
| | - Carla M Sevin
- Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Andrew Slack
- Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA
| | - Rachel Spurr
- Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA
| | - Mary Still
- Emory University Hospital (Emory Healthcare), Atlanta, GA
| | - Carol Thompson
- College of Nursing, University of Kentucky, Lexington, KY
| | - Gerald Weinhouse
- Division of Pulmonary and Critical Care Medicine, Brigham & Women's Hospital, Boston, MA
| | - M Elizabeth Wilcox
- Division of Respirology, Department of Medicine, Toronto Western Hospital, Toronto, ON, Canada
| | - Theodore J Iwashyna
- Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, MI
- Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
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Shulman M, Cuthbertson B, Wijeysundera D, Pearse R, Thompson B, Torres E, Ambosta A, Wallace S, Farrington C, Myles P, Wallace S, Thompson B, Ellis M, Borg B, Kerridge R, Douglas J, Brannan J, Pretto J, Godsall M, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter T, Macklin S, Elliott A, Carrera A, Terblanche N, Pitt S, Samuels J, Wilde C, MacCormick A, Leslie K, Bramley D, Southcott A, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney C, Choi S, Somascanthan P, Flores K, Beattie W, Karkouti K, Clarke H, Jerath A, McCluskey S, Wasowicz M, Granton J, Day L, Pazmino-Canizares J, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, Mcallister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G, Melo M, Mamdani M, Hillis G, Wijeysundera H. Using the 6-minute walk test to predict disability-free survival after major surgery. Br J Anaesth 2019; 122:111-119. [DOI: 10.1016/j.bja.2018.08.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022] Open
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Bates S, Li A. Quality of Life Outcomes in a Cohort of Women Undergoing Surgical Oophorectomy for the Treatment of Medical Oophorectomy-Responsive Chronic Pelvic Pain. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.552] [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: 11/27/2022]
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Reeves T, Bates S, Sharp T, Richardson K, Bali S, Plumb J, Anderson H, Prentis J, Swart M, Levett DZH. Correction to: Cardiopulmonary exercise testing (CPET) in the United Kingdom-a national survey of the structure, conduct, interpretation and funding. Perioper Med (Lond) 2018; 7:8. [PMID: 29757298 PMCID: PMC5934859 DOI: 10.1186/s13741-018-0087-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/16/2022] Open
Affiliation(s)
- T Reeves
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bates
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Sharp
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Richardson
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bali
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Plumb
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Anderson
- 4Department of Anaesthesia and Critical Care Medicine, Plymouth Hospitals NHS trust Hospital, Plymouth, UK
| | - J Prentis
- 5Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,6Departments of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Swart
- 7Department of Anaesthesia and Critical Care Medicine, Torbay Hospital, Torquay, UK
| | - D Z H Levett
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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McGain F, Durie ML, Bates S, Polmear CM, Meyer J, French CJ. Smoking cessation therapy in Australian and New Zealand intensive care units: a multicentre point prevalence study. CRIT CARE RESUSC 2018; 20:68-73. [PMID: 29458324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To obtain an accurate estimate of smoking prevalence and smoking cessation support practices, including nicotine replacement therapy (NRT), in Australian and New Zealand intensive care units (ICUs). DESIGN, SETTING AND PARTICIPANTS Cross-sectional, observational study using data obtained from adult ICUs participating in the Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Program in 2016. MAIN OUTCOME MEASURES Prevalence and intensity of current smoking, baseline characteristics of smokers in comparison with non-smokers and frequency of NRT use while admitted to the ICU. RESULTS Smoking data were present for 551 of 671 adult ICU patients from 47 ICUs on 2 study days in 2016. Of these 551 patients, 112 were current smokers (20.3%; 95% CI, 17.0-23.9%). No significant differences in severity of illness or mortality were observed between smokers and non-smokers. NRT was prescribed to 30/112 smokers (26.8%), and in 28 of those 30 patients (93%) it was administered via nicotine patch alone. Routine prescribing of NRT was practised in 28/47 ICUs (60%), and 24/47 ICUs (51%) had formal protocols or guidelines in place related to supporting smoking cessation. CONCLUSIONS The prevalence of smoking in Australian and New Zealand ICUs patients is high. Over half of participating ICUs reported the routine prescription of NRT despite uncertainty regarding the practice. Further research evaluating the safety and efficacy of NRT is required.
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Affiliation(s)
| | | | | | | | - Jason Meyer
- George Institute for Global Health, Sydney, NSW, Australia
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Polmear CM, Nathan H, Bates S, French C, Odisho J, Skinner E, Karahalios A, McGain F. The effect of intensive care unit admission on smokers' attitudes and their likelihood of quitting smoking. Anaesth Intensive Care 2018; 45:720-726. [PMID: 29137583 DOI: 10.1177/0310057x1704500612] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post-ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent. A purpose-designed questionnaire which included the Fagerstrom test for nicotine dependence and evaluation of patients' attitude towards smoking cessation was completed by participants following ICU discharge and prior to hospital discharge. Participants were re-interviewed over the phone at six months post-ICU discharge. Of the 1,062 patients admitted to ICU, 253 (23%) were current smokers and 100 were enrolled. Six months post-ICU discharge, 28 (33%) of the 86 participants who were alive and contactable had quit smoking and 35 (41%) had reduced smoking. The median number of reported cigarettes smoked per day reduced by 40%. Participants who initially believed their ICU admission was smoking-related were more likely to have quit six months post-ICU discharge (odds ratio 2.98; 95% confidence interval 1.07 to 8.26; <i>P</i>=0.036). Six months post-ICU discharge, 63/86 (74%) of participants had quit or reduced their smoking. Further research into targeted smoking cessation counselling for ICU survivors is indicated.
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Affiliation(s)
| | | | | | | | | | | | - A Karahalios
- Research Fellow, Biostatistics Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria
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Turan N, Edwards MJ, Bates S, Shaw D, Chung KF, Loza MJ, James A, Van Oosterhout A. IL-6 pathway upregulation in subgroup of severe asthma is associated with neutrophilia and poor lung function. Clin Exp Allergy 2018; 48:475-478. [PMID: 29315928 DOI: 10.1111/cea.13085] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- N Turan
- GlaxoSmithKline, Respiratory R&D, Stevenage, UK
| | - M J Edwards
- GlaxoSmithKline, Respiratory R&D, Stevenage, UK
| | - S Bates
- GlaxoSmithKline, Respiratory R&D, Stevenage, UK
| | - D Shaw
- Respiratory Research Unit, University of Nottingham, Nottingham, UK
| | - K F Chung
- National Heart & Lung Institute, Imperial College, London, UK
| | - M J Loza
- Janssen Research & Development, Spring House, PA, USA
| | - A James
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Reeves T, Bates S, Sharp T, Richardson K, Bali S, Plumb J, Anderson H, Prentis J, Swart M, Levett DZH. Cardiopulmonary exercise testing (CPET) in the United Kingdom-a national survey of the structure, conduct, interpretation and funding. Perioper Med (Lond) 2018; 7:2. [PMID: 29423173 PMCID: PMC5787286 DOI: 10.1186/s13741-017-0082-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/26/2017] [Indexed: 12/13/2022] Open
Abstract
Background Cardiopulmonary exercise testing (CPET) is an exercise stress test with concomitant expired gas analysis that provides an objective, non-invasive measure of functional capacity under stress. CPET-derived variables predict postoperative morbidity and mortality after major abdominal and thoracic surgery. Two previous surveys have reported increasing utilisation of CPET preoperatively in England. We aimed to evaluate current CPET practice in the UK, to identify who performs CPET, how it is performed, how the data generated are used and the funding models. Methods All anaesthetic departments in trusts with adult elective surgery in the UK were contacted by telephone to obtain contacts for their pre-assessment and CPET service leads. An online survey was sent to all leads between November 2016 and March 2017. Results The response rate to the online survey was 73.1% (144/197) with 68.1% (98/144) reporting an established clinical service and 3.5% (5/144) setting up a service. Approximately 30,000 tests are performed a year with 93.0% (80/86) using cycle ergometry. Colorectal surgical patients are the most frequently tested (89.5%, 77/86). The majority of tests are performed and interpreted by anaesthetists. There is variability in the methods of interpretation and reporting of CPET and limited external validation of results. Conclusions This survey has identified the continued expansion of perioperative CPET services in the UK which have doubled since 2011. The vast majority of CPET tests are performed and reported by anaesthetists. It has highlighted variation in practice and a lack of standardised reporting implying a need for practice guidelines and standardised training to ensure high-quality data to inform perioperative decision making.
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Affiliation(s)
- T Reeves
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bates
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Sharp
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Richardson
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bali
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Plumb
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Anderson
- 4Department of Anaesthesia and Critical Care Medicine, Plymouth Hospitals NHS trust Hospital, Plymouth, UK
| | - J Prentis
- 5Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,6Departments of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Swart
- 7Department of Anaesthesia and Critical Care Medicine, Torbay Hospital, Torquay, UK
| | - D Z H Levett
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Ball A, Bates S, Amorose A, Anderson-Butcher D. The Parent Perceptions of Overall School Experiences Scale: Initial Development and Validation. Journal of Psychoeducational Assessment 2017. [DOI: 10.1177/0734282917742310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Parent engagement in schools is often precipitated by a thorough and genuine assessment of parents’ needs, priorities, and perceptions of their children’s schools. This study reports on the development and validation of the Parent Perceptions of Overall School Experiences Scale. Confirmatory factor analyses (CFAs) examined the factorial validity of the measure using cross-sectional survey data from 2,643 parents. In addition, a series of CFAs was conducted to explore the language invariance of the measurement model across Spanish and English versions of the scale. Predictive validity also was determined using correlational analyses. Results revealed that the five-item Parent Perceptions of Overall School Experiences Scale is a brief, universal measure of parents’ perceptions of their overall experiences with their children’s schools. Schools, parents, and community members may use this measure to assess parents’ needs and to advocate for necessary programmatic changes that serve parents and their children.
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Stolper DA, Love GD, Bates S, Lyons TW, Young E, Sessions AL, Grotzinger JP. Paleoecology and paleoceanography of the Athel silicilyte, Ediacaran-Cambrian boundary, Sultanate of Oman. Geobiology 2017; 15:401-426. [PMID: 28387009 DOI: 10.1111/gbi.12236] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 02/27/2017] [Indexed: 05/22/2023]
Abstract
The Athel silicilyte is an enigmatic, hundreds of meters thick, finely laminated quartz deposit, in which silica precipitated in deep water (>~100-200 m) at the Ediacaran-Cambrian boundary in the South Oman Salt Basin. In contrast, Meso-Neoproterozoic sinks for marine silica were dominantly restricted to peritidal settings. The silicilyte is known to contain sterane biomarkers for demosponges, which today are benthic, obligately aerobic organisms. However, the basin has previously been described as permanently sulfidic and time-equivalent shallow-water carbonate platform and evaporitic facies lack silica. The Athel silicilyte thus represents a unique and poorly understood depositional system with implications for late Ediacaran marine chemistry and paleoecology. To address these issues, we made petrographic observations, analyzed biomarkers in the solvent-extractable bitumen, and measured whole-rock iron speciation and oxygen and silicon isotopes. These data indicate that the silicilyte is a distinct rock type both in its sedimentology and geochemistry and in the original biology present as compared to other facies from the same time period in Oman. The depositional environment of the silicilyte, as compared to the bounding shales, appears to have been more reducing at depth in sediments and possibly bottom waters with a significantly different biological community contributing to the preserved biomarkers. We propose a conceptual model for this system in which deeper, nutrient-rich waters mixed with surface seawater via episodic mixing, which stimulated primary production. The silica nucleated on this organic matter and then sank to the seafloor, forming the silicilyte in a sediment-starved system. We propose that the silicilyte may represent a type of environment that existed elsewhere during the Neoproterozoic. These environments may have represented an important locus for silica removal from the oceans.
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Affiliation(s)
- D A Stolper
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - G D Love
- Department of Earth Sciences, University of California, Riverside, CA, USA
| | - S Bates
- Department of Earth Sciences, University of California, Riverside, CA, USA
| | - T W Lyons
- Department of Earth Sciences, University of California, Riverside, CA, USA
| | - E Young
- Department of Earth and Space Sciences, University of California, Los Angeles, CA, USA
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, CA, USA
| | - A L Sessions
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - J P Grotzinger
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
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Takach Lapner S, Julian JA, Linkins LA, Bates S, Kearon C. Questioning the use of an age-adjusted D-dimer threshold to exclude venous thromboembolism: analysis of individual patient data from two diagnostic studies: reply. J Thromb Haemost 2016; 14:2555-2556. [PMID: 27661781 DOI: 10.1111/jth.13512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S Takach Lapner
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - J A Julian
- Ontario Clinical Oncology Group, Juravinski Hospital, Hamilton, ON, Canada
| | - L-A Linkins
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
| | - S Bates
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
| | - C Kearon
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
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Moore P, Miley J, Bates S. New Uses For Highly Miscible Liquid Polymeric Colorants in the Manufacture of Colored Urethane Systems. J CELL PLAST 2016. [DOI: 10.1177/0021955x8301900403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P.D. Moore
- Milliken Chemical PO Box 1927 Spartanburg, SC 29304
| | - J.W. Miley
- Milliken Chemical PO Box 1927 Spartanburg, SC 29304
| | - S. Bates
- Milliken Chemical PO Box 1927 Spartanburg, SC 29304
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Abstract
The National Health Service (NHS) cervical-screening programme has recently produced guidelines specifically for HIV-positive women. This includes annual cervical cytology screening and colposcopy to follow national guidelines. The case notes of all women attending Sheffield genitourinary clinic were audited. Of the 46 notes available, there was no documentation that annual screening has been offered in 26, and 10% of women did not have appropriate management of an abnormal smear. Information on the cytology form could result in a breach in confidentiality in cases where general practitioners are not aware of a patient's HIV status.
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Affiliation(s)
- E J Morris
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
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Tang SC, Bates S, Kesari S, Brenner AJ, Anders CK, Garcia A, Ibrahim NK, Tkaczuk KHR, Kumthekar P. Abstract P6-17-04: A phase II, open-label, multi-center study of ANG1005, a novel brain-penetrant taxane derivative, in breast cancer patients with recurrent CNS metastases. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-17-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Treatment options for brain metastases are limited to local therapies due to the inability of most anti-cancer agents to cross the blood brain barrier (BBB). ANG1005 is a novel taxane derivative, being developed for targeted treatment of brain metastases. It consists of 3 paclitaxel molecules covalently linked to Angiopep-2 designed to cross the BBB and to penetrate malignant cells, regardless of location, via the low density lipoprotein (LDL) receptor related protein-1 (LRP-1) transport system.
Methods: Adult patients with measurable recurrent brain metastases from breast cancer with, or without, leptomeningeal disease are currently being enrolled in this multi-center, open-label study (planned n=56). ANG1005 is administered IV at 600 mg/m2 every three weeks (one cycle) until disease progression, unacceptable toxicity or consent withdrawal. HER2+ patients are allowed to continue HER2 targeted therapies. The primary endpoint is intracranial objective response rate, as assessed by MRI using CNS RECIST 1.1. Secondary endpoints include duration of intracranial response, median progression-free survival, 3/6/12-month progression-free survival rate, overall survival at 6 months, extracranial objective response rate, safety and tolerability. Extracranial response is also assessed by CT using RECIST 1.1. An imaging sub-study, evaluating the use of 18F-FLT-PET in comparison to MRI, is also ongoing in 10 patients with measurable brain metastases from breast cancer, receiving ANG1005 IV at 550 mg/m2.
Results: Accrual is ongoing and to date, 48 patients have been treated with a range of 1-18 cycles of ANG1005. Median age is 47 years (range: 26-65). Safety profile is similar to that of paclitaxel with myelosuppression as the predominating toxicity. Based on data from patients evaluated to date for intracranial response, 6/30 (20%) patients had a partial response (PR) and 17/30 (57%) had a stable disease (SD), as best response. A sub-analysis, based on breast cancer sub-type is presented below:
Intracranial Response by Breast Cancer SubsetOutcome by CNS RECISTHER2- (n=13)HER2+ (n=17)TNBC (n=6)LMD (n=11)PR, n (%)1 (8%)5 (29%)1 (17%)4 (36%)SD, n (%)6 (46%)10 (59%)2 (33%)5 (45%)PD, n (%)6 (46%)2 (12%)3 (50%)2 (18%)TNBC, triple-negative breast cancer, a sub-group of HER2-; LMD, leptomeningeal disease, including 3 HER2- and 8 HER2+ patients
The longest duration on treatment is for 18 cycles, seen in a patient with an intracranial PR that sustained for 10 cycles; the treatment is still ongoing.
Extracranial tumor evaluations were completed in 14 patients, all showing disease control including in those previously treated with paclitaxel. One (7%) patient had a PR and 13 (93%) patients had an SD.
Conclusions: CNS activity was observed in all subsets of breast cancer, suggesting that ANG1005 is a promising therapy for treatment of brain and leptomeningeal metastases from breast cancer. ANG1005 treatment also resulted in disease control in extracranial lesions, including patients previously treated with paclitaxel. The dose and treatment regimen were well tolerated with a safety profile similar to paclitaxel. Updated efficacy and safety data will be presented at the meeting.
Citation Format: Tang S-C, Bates S, Kesari S, Brenner AJ, Anders CK, Garcia A, Ibrahim NK, Tkaczuk KHR, Kumthekar P. A phase II, open-label, multi-center study of ANG1005, a novel brain-penetrant taxane derivative, in breast cancer patients with recurrent CNS metastases. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-17-04.
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Affiliation(s)
- S-C Tang
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - S Bates
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - S Kesari
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - AJ Brenner
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - CK Anders
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - A Garcia
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - NK Ibrahim
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - KHR Tkaczuk
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - P Kumthekar
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
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Hynes D, Bates S, Loughman A, Klim S, French C, Kelly AM. Arteriovenous blood gas agreement in intensive care patients with varying levels of circulatory compromise: a pilot study. CRIT CARE RESUSC 2015; 17:253-256. [PMID: 26640060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Venous blood gas (VBG) analysis is suggested as an alternative to arterial blood gas (ABG) analysis. In haemodynamically stable patients, there is clinically acceptable arteriovenous (AV) agreement for pH and bicarbonate (HCO3-) concentration, but in haemodynamically unstable patients, evidence is conflicting. We aimed to evaluate the level of AV agreement for the values of pH, PCO2, base excess, HCO3- and lactate between ABGs and VBGs in critically ill patients with varying degrees of hypotension. DESIGN AND SETTING A prospective cohort study of a convenience sample of patients in an intensive care unit of a metropolitan teaching hospital. INTERVENTION Paired ABG and central VBG samples were drawn within 5 minutes of each other from existing arterial lines and central venous lines, and analysed for AV agreement of pH, PCO2, base excess, HCO3- and lactate. The outcome of interest was AV agreement with varying levels of blood pressure (BP). Analysis was by descriptive statistics, box whisker plot and Bland-Altman bias plot analysis. RESULTS We studied 50 patients with 117 paired ABG and VBG samples. The AV differences (venous-arterial) were: pH, -0.04; HCO3-, -0.37 mmmol/L; base excess, 0.08 mEq/ L; and lactate, 0.16 mmol/L. There was not a clinically relevant deterioration in agreement for these parameters with falling BP. CONCLUSION In critically ill patients with varying degrees of hypotension in the ICU, there is clinically acceptable AV agreement for the values of pH, HCO3-, base excess and lactate, an agreement that does not deteriorate significantly with falling blood pressure.
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Affiliation(s)
- Daniel Hynes
- Joseph Epstein Centre For Emergency Medicine Research, Western Health, Melbourne, VIC, Australia
| | - Samantha Bates
- Intensive Care Unit, Western Health, Melbourne, VIC, Australia
| | - Ashley Loughman
- Department of Emergency Medicine, Western Health, Melbourne, VIC, Australia
| | - Sharon Klim
- Joseph Epstein Centre For Emergency Medicine Research, Western Health, Melbourne, VIC, Australia
| | - Craig French
- Intensive Care Unit, Western Health, Melbourne, VIC, Australia
| | - Anne-Maree Kelly
- Joseph Epstein Centre For Emergency Medicine Research, Western Health, Melbourne, VIC, Australia
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Padro D, Eisch R, Bates S, Simone C, Ning H, Smart D, Jones J, Krauze A, Citrin D, Kesarwala A, Camphausen K, Kaushal A. Salvage Radiation Therapy for Chemotherapy Refractory Cutaneous Mycosis Fungoides. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kubicki MA, McGain F, O'Shea CJ, Bates S. Auditing an intensive care unit recycling program. CRIT CARE RESUSC 2015; 17:135-140. [PMID: 26017132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The provision of health care has significant direct environmental effects such as energy and water use and waste production, and indirect effects, including manufacturing and transport of drugs and equipment. Recycling of hospital waste is one strategy to reduce waste disposed of as landfill, preserve resources, reduce greenhouse gas emissions, and potentially remain fiscally responsible. We began an intensive care unit recycling program, because a significant proportion of ICU waste was known to be recyclable. OBJECTIVES To determine the weight and proportion of ICU waste recycled, the proportion of incorrect waste disposal (including infectious waste contamination), the opportunity for further recycling and the financial effects of the recycling program. METHODS We weighed all waste and recyclables from an 11-bed ICU in an Australian metropolitan hospital for 7 non-consecutive days. As part of routine care, ICU waste was separated into general, infectious and recycling streams. Recycling streams were paper and cardboard, three plastics streams (polypropylene, mixed plastics and polyvinylchloride [PVC]) and commingled waste (steel, aluminium and some plastics). ICU waste from the waste and recycling bins was sorted into those five recycling streams, general waste and infectious waste. After sorting, the waste was weighed and examined. Recycling was classified as achieved (actual), potential and total. Potential recycling was defined as being acceptable to hospital protocol and local recycling programs. Direct and indirect financial costs, excluding labour, were examined. RESULTS During the 7-day period, the total ICU waste was 505 kg: general waste, 222 kg (44%); infectious waste, 138 kg (27%); potentially recyclable waste, 145 kg (28%). Of the potentially recyclable waste, 70 kg (49%) was actually recycled (14% of the total ICU waste). In the infectious waste bins, 82% was truly infectious. There was no infectious contamination of the recycling streams. The PVC waste was 37% contaminated (primarily by other plastics), but there was less than 1% contamination of other recycling streams. The estimated cost of the recycling program was about an additional $1000/year. CONCLUSION In our 11-bed ICU, we recycled 14% of the total waste produced over 7-days, which was nearly half of the potentially recyclable waste. There was no infectious contamination of recyclables and minimal contamination with other waste streams, except for the PVC plastic. The estimated annual cost of the recycling program was $1000, reflecting the greater cost of disposal of some recyclables (paper and cardboard v most plastic types).
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Affiliation(s)
- Mark A Kubicki
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia.
| | - Forbes McGain
- Departments of Anaesthesia and Intensive Care, Western Hospital, Melbourne, VIC, Australia
| | | | - Samantha Bates
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
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Laser H, Hockwin O, Müller-Breitenkamp U, Dobbs R, Bates S, Strack C. Risk factor diabetes: long-term follow-up Scheimpflug slit image analysis of lens transparency of diabetic patients. Dev Ophthalmol 2015; 21:70-7. [PMID: 1868953 DOI: 10.1159/000419938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- H Laser
- Department of Experimental Ophthalmology, University of Bonn, FRG
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Mackow RC, Winchester JF, Argy WP, Andrews PM, Fields PA, Bates S, Rakowski TA, Schreiner GE. Sclerosing encapsulating peritonitis in rats: an experimental study with intraperitoneal antiseptics. Contrib Nephrol 2015; 57:213-8. [PMID: 3677695 DOI: 10.1159/000414285] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- R C Mackow
- Georgetown University Medical Center, Washington, D.C
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Bates S, Lindenberg M, Bryla C, Patronas N, Amiri-Kordestani L, Fojo T, Balasubramaniam S, Choyke P. ANG-1005 in Patients with Brain Metastases from Breast Cancer: Correlative Imaging with 18F-FLT-PET/CT. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv091.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bates S, Syrett A, Namazie A. The Effect of Trendelenburg Position and Pneumoperitoneum on Ventilation Pressures during Laparoscopic Hysterectomy: A Randomised Controlled Trial (RCT) of an Inflatable Buttock Elevator. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.152] [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: 11/29/2022]
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Amiri-Kordestani L, Mena E, Lindenberg ML, Kurdziel K, Choyke P, Patronas N, Frye R, Lin N, Bala S, Fojo T, Bates S. Abstract P4-01-09: 18F-FLT-PET/CT for the prediction of response to ANG-1005 therapy in patients with brain metastases from breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-01-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: ANG1005 (formerly called GRN1005) is a peptide-drug conjugate being developed for targeted treatment of brain metastases. It consists of 3 molecules of paclitaxel covalently linked to Angiopep-2 designed to cross the blood brain barrier (BBB) via the low density lipoprotein (LDL) receptor-related protein-1 (LRP1)-mediated trancytosis. This drug was evaluated in a multi-center, open-label single-arm study (GRABMB study). An interim analysis determined that the agent met the futility endpoint based on MRI assessment (SABC 2012). However, centrally confirmed responses were achieved in the study, and a biomarker substudy enrolling patients (pts) to evaluate the utility of FLT-PET in assessing response to treatment with ANG1005 suggested sufficient activity of the agent to allow continuation of the study. 18F-FLT (3’-Fluoro-3’ deoxythymidine)-PET imaging is a novel imaging modality which provides a tool for measuring in vivo tumor cell proliferation. FLT is an analog of thymidine; cellular retention of FLT reflects DNA synthesis.
Methods: Adult pts with measurable BMBC were eligible with or without history of prior WBRT. We compared 18F-FLT-PET/CT with MRI-gadolinium contrast images for brain metastases detection and for assessment of whether treatment with ANG1005 was associated with significant change in intracranial tumor uptake of 18F-FLT.
ANG1005 therapy was administered intravenously at 550 mg/m2 q 21d until progression of intra-cranial disease or unacceptable toxicity. All pts underwent 18F-FLT PET/CT imaging before and after 1 cycle of therapy with ANG1005. Pts were scanned dynamically over 30 min followed by a static whole body PET image at 1 hour post-injection. We calculated the% of change before and after therapy, with change > 20% considered significant.
Results: 5/10 planned pts have been accrued to the substudy to date, and 12 metastatic brain lesions have been analyzed. The maximum standard uptake value (SUVmax) ranged from 0.8 to 4.0, mean 1.8 for baseline scans. Tumor to normal brain background ratios ranged from 3.2 to 22.3, mean 9.4. 7/12 lesions showed >20% change between pre and post therapy. The average% change was (-) 42.39% ± 12.77, range: 29.2 to 66.8% (using SUVmax), and (-) 38.7% ± 14.3, range: 20.12 to 57.10% (using tumor to normal ratios). Based on brain MRI evaluation per RECIST 1.1 criteria, 1 pt had intra-cranial partial response (PR) and 3 patients had stable disease (SD). These pts remained on therapy for an average of 7 cycles, range: 5 to 9 cycles. 1 pt withdrew consent after 2 cycles of therapy and opted to receive whole brain radiation therapy. 5/42 pts achieved a confirmed investigator-assessed PR by MRI at 550 mg/m2, and 4/13 pts achieved a PR at 650 mg/m2, a dose not progressed due to toxicity.
Conclusion: This pilot study using 18F-FLT-PET imaging of brain metastases suggests that it is a promising tool for detection and measurement of CNS disease. Given that contrast-enhanced MRI detection of brain metastases represent gadolinium leakage through the BBB rather than actual tumor volume measurements, better approaches are needed to assess efficacy of therapies. Accrual to this study is ongoing. Updated results with ANG1005 will be presented during the meeting.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-01-09.
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Affiliation(s)
- L Amiri-Kordestani
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - E Mena
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - ML Lindenberg
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - K Kurdziel
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - P Choyke
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - N Patronas
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - R Frye
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - N Lin
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - S Bala
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - T Fojo
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - S Bates
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
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Bates S, Jonaitis D, Nail S. Sucrose lyophiles: A semi-quantitative study of residual water content by total X-ray diffraction analysis. Eur J Pharm Biopharm 2013; 85:184-8. [DOI: 10.1016/j.ejpb.2013.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/14/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
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