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Pedersen K, van Schalkwyk J, Brewerton M, Jordan A, Cooke P. Penicillin cross-sensitivity in patients with confirmed peri-operative allergic hypersensitivity reactions to cefazolin: a retrospective observational study. Anaesthesia 2024; 79:208-210. [PMID: 37989486 DOI: 10.1111/anae.16185] [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] [Accepted: 11/07/2023] [Indexed: 11/23/2023]
Affiliation(s)
- K Pedersen
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - J van Schalkwyk
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - M Brewerton
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - A Jordan
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - P Cooke
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
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Pedersen K, van Schalkwyk J, Brewerton M, Jordan A, Cooke P. Retrospective observational study of the incidence of peri-operative allergic hypersensitivity reactions to cefazolin. Anaesthesia 2023; 78:1502-1504. [PMID: 37451258 DOI: 10.1111/anae.16101] [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] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Affiliation(s)
- K Pedersen
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - J van Schalkwyk
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - M Brewerton
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - A Jordan
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
| | - P Cooke
- Te Toka Tumai Auckland, Auckland City Hospital, Auckland, New Zealand
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Jordan A, Wilson AD. A comprehensive overview by region of condoms, natural family planning, and spermicide as a contraceptive method among men aged 13-54 years attending contraceptive services in England. Public Health 2023; 219:110-116. [PMID: 37163786 DOI: 10.1016/j.puhe.2023.03.023] [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: 08/25/2022] [Revised: 02/20/2023] [Accepted: 03/27/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES This study aimed to (1) provide a comprehensive overview of contraceptive methods self-reported by men in England, over 5 years, focusing on condoms in comparison to any male method; and (2) explore condom as a contraceptive method by region and ethnicity. STUDY DESIGN Data were from the Sexual and Reproductive Health Services (Contraception) England census data set from 2014/15 to 2018/19. Once missing data were removed, this left a total of 365,292 men. Two binomial logistic regression models were performed. Model 1 examined ethnicity, region, and time on condom as a method of contraception; and Model 2 examined ethnicity, region, and time by any male contraceptive. Descriptive statistics were run for natural family planning and spermicide. RESULTS Model 1 revealed a significant model, χ2 (15) = 30,976, P < 0.001, and predicted that condoms as a method decreased in London with a greater decrease in Midlands. London saw the lowest rate of decline among the non-White ethnic group, whereas North and South regions increased probability over time. The North started at a higher probability and the South at the lowest. Model 2 also revealed a significant model, χ2 (15) = 32,472, P < 0.001, with a similar pattern to Model 1. Contingency tables showed natural family planning and spermicide were the least reported methods and decreased over time. CONCLUSIONS As any male contraceptive method appears to be decreasing in both models, reproductive health promotion is required. This study has implications for commissioning funds and for identifying regional areas of further investigation.
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Affiliation(s)
- A Jordan
- Psychology, De Montfort University, UK
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Adashek JJ, Jordan A, Redwine LS, Tyson DM, Thompson Z, Pabbathi S. Pan-cancer analysis of fear of cancer recurrence among cancer survivors. ESMO Open 2022; 7:100528. [PMID: 35780591 PMCID: PMC9463169 DOI: 10.1016/j.esmoop.2022.100528] [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: 04/18/2022] [Revised: 05/19/2022] [Accepted: 06/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background Fear of cancer recurrence (FCR) is a phenomenon estimated to affect a large portion of cancer survivors. This study sought to determine whether patients from a National Cancer Institute-designated institution had their clinical needs met relating to FCR. Patients and methods Patients referred to the survivorship clinic completed The Clinical Needs Assessment Tool for Cancer Survivors (CNAT-CS). Correlations between responses were calculated and univariable and multivariable logistic regression was used to identify predictors of met or unmet needs related to FCR. Results Of 647 patients, 241 (37.2%) reported they did not have clinical needs related to FCR and 386 (59.7%) reported they had clinical needs related to FCR but that the needs had been met. Only 20 (3.09%) reported that clinical needs relating to FCR were unmet. According to univariate logistic regression, sex had no impact on FCR (P = 0.8427), nor did years since diagnosis (P = 0.1014). Results of multivariable regression indicate that the odds ratio of reported FCR as an unmet need (versus not a need) is 0.939; the odds decreased by 6% (P = 0.0023) for every year increase in age. For each unit increase in distress score, the odds of reporting FCR as an unmet need increased by 32% (P = 0.0007). Conclusions This study is unique in not only examining the presence of FCR but also whether patients reported that their needs were met for FCR. The study found that most patients had clinical needs for FCR, but the needs were met at the time of the survey. Patients who report higher distress scores are more likely to report FCR as an unmet need. Therefore, cancer survivors reporting high distress scores in clinic visits should be evaluated for FCR. FCR is common among cancer survivors; it can be seen as a met or unmet need by each patient. Identifying factors that influence fear of cancer recurrence as a need met or not include age and distress score. Recognizing FCR as an unmet need is paramount to develop clinics and mitigation strategies to ameliorate this need.
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Affiliation(s)
- J J Adashek
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
| | - A Jordan
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - L S Redwine
- Department of Family Medicine and Community Health, University of Miami, Miami, USA
| | - D Martinez Tyson
- College of Public Health, University of South Florida, Tampa, USA
| | - Z Thompson
- Departments of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - S Pabbathi
- Individualized Cancer Management, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA.
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Chapman S, Jordan A, Tillett W. POS1574-PARE PATIENTS REPORT HIGH LEVELS OF CONCERNS ABOUT MEDICATION FOR PSORIATIC AND RHEUMATOID ARTHRITIS: UNMET NEEDS REVEALED BY A UK PILOT WEB SURVEY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are often nonadherent to prescribed symptom-modifying drugs. [1] Concerns about the potential negative effects of medication have been implicated in medication nonadherence. Few evidence-based interventions to address concerns about medication and support medication-taking are available in the UK context.ObjectivesTo inform the development of intervention to support people with RA and PsA to manage medication we conducted a survey of unmet needs relating to perceptions of arthritis and arthritis medication, medication-taking behaviour and experience of side effects.MethodsWe recruited people with arthritis via local and national patient groups for participation in an online survey. The survey included clinical and demographic questions, validated measures of treatment (Beliefs about Medication Questionnaire; BMQ) and illness perceptions (brief Illness Perception Questionnaire; bIPQ), medication adherence (Compliance Questionnaire Rheumatology; CQR), and patient-reported side effects. Participants were asked about consequences of taking and not taking their arthritis medication as free text to contextualize scores.ResultsQuestionnaire responses from 98 participants (42 with PsA, 56 with RA, 89.8% female) indicated participants typically viewed arthritis negatively with ratings on the bIPQ indicating high emotional impacts, symptoms and affects on everyday life, and doubts about their ability to control their arthritis. Analysis of the BMQ indicated ambivalence about RA/PsA medications; while few people expressed doubts about their personal need for medication, concerns about RA/PsA medications were common, see Figure 1). Most, 85.7% (n=84), reported a side effect in the last month, with a mean of 10 ‘moderately severe’ or ‘very severe’ side effects (m=10.02, sd = 5.98). Just over a quarter (26.0%, n=25) were classed as low adherers using the CQR with 54.6% reporting they had missed some of their arthritis medication over the last year. Free text responses indicated that some participants had additional concerns about medication (e.g. worries about impact on life expectancy) not addressed in the questionnaire measures.ConclusionIn this pilot survey, many participants reported concerns about medication, doubts about whether medication controls arthritis symptoms, severe side effects and medication nonadherence. Although our small sample is unlikely to be generalizable to all arthritis patients, these findings suggest potential targets for intervention and indicate that some patients have needs for support with medication that are not currently being addressed.References[1]Van Den Bemt BJ, Zwikker HE, Van Den Ende CH. Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature. Expert review of clinical immunology. 2012 May 1;8(4):337-51.AcknowledgementsWe acknowledge the financial assistance of Bath Institute of Rheumatic Diseases, the people who volunteered their time to respond to this survey and the efforts of Elena Mut and Kishwar Khanum in assisting with data collection.Disclosure of InterestsSarah Chapman: None declared, Abbie Jordan: None declared, William Tillett Speakers bureau: Abbvie, Amgen, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Pfizer and UCB, Consultant of: Abbvie, Amgen, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Pfizer and UCB, Grant/research support from: Abbvie, Celgene, Eli-Lilly, Janssen, and UCB
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Flood E, Browne L, Kurian S, Lynch C, Doyle M, Jordan A, Varghese R, Mello S. 132 GERIATRIC REHABILITATION IN THE COVID-19 ERA: SERVICE INNOVATION AND PATIENT OUTCOMES. Age Ageing 2021. [PMCID: PMC8689995 DOI: 10.1093/ageing/afab219.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- E Flood
- Peamount Healthcare, Dublin, Ireland
| | - L Browne
- Peamount Healthcare, Dublin, Ireland
| | - S Kurian
- Peamount Healthcare, Dublin, Ireland
| | - C Lynch
- Peamount Healthcare, Dublin, Ireland
| | - M Doyle
- Peamount Healthcare, Dublin, Ireland
| | - A Jordan
- Peamount Healthcare, Dublin, Ireland
| | | | - S Mello
- Peamount Healthcare, Dublin, Ireland,Tallaght University Hospital, Dublin, Ireland
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Ameratunga R, Jordan A, Cavadino A, Ameratunga S, Hills T, Steele R, Hurst M, McGettigan B, Chua I, Brewerton M, Kennedy N, Koopmans W, Ahn Y, Barker R, Allan C, Storey P, Slade C, Baker A, Huang L, Woon ST. Bronchiectasis is associated with delayed diagnosis and adverse outcomes in the New Zealand Common Variable Immunodeficiency Disorders cohort study. Clin Exp Immunol 2021; 204:352-360. [PMID: 33755987 DOI: 10.1111/cei.13595] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/19/2021] [Accepted: 03/13/2021] [Indexed: 02/06/2023] Open
Abstract
Common variable immunodeficiency disorders (CVID) are multi-system disorders where target organ damage is mediated by infective, autoimmune and inflammatory processes. Bronchiectasis is probably the most common disabling complication of CVID. The risk factors for bronchiectasis in CVID patients are incompletely understood. The New Zealand CVID study (NZCS) is a nationwide longitudinal observational study of adults, which commenced in 2006. In this analysis, the prevalence and risk factors for bronchiectasis were examined in the NZCS. After informed consent, clinical and demographic data were obtained with an interviewer-assisted questionnaire. Linked electronic clinical records and laboratory results were also reviewed. Statistical methods were applied to determine if variables such as early-onset disease, delay in diagnosis and increased numbers of infections were associated with greater risk of bronchiectasis. One hundred and seven adult patients with a diagnosis of CVID are currently enrolled in the NZCS, comprising approximately 70% of patients known to have CVID in New Zealand. Fifty patients (46·7%) had radiologically proven bronchiectasis. This study has shown that patients with compared to those without bronchiectasis have an increased mortality at a younger age. CVID patients with bronchiectasis had a greater number of severe infections consequent to early-onset disease and delayed diagnosis. Indigenous Māori have a high prevalence of CVID and a much greater burden of bronchiectasis compared to New Zealand Europeans. Diagnostic latency has not improved during the study period. Exposure to large numbers of infections because of early-onset disease and delayed diagnosis was associated with an increased risk of bronchiectasis. Earlier diagnosis and treatment of CVID may reduce the risk of bronchiectasis and premature death in some patients.
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Affiliation(s)
- R Ameratunga
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand.,Department of Virology and Immunology, Auckland City Hospital, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - A Jordan
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - A Cavadino
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - S Ameratunga
- School of Population Health, University of Auckland, Auckland, New Zealand.,Population Health Directorate, Counties Manukau Health, Auckland, New Zealand
| | - T Hills
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - R Steele
- Department of Virology and Immunology, Auckland City Hospital, Auckland, New Zealand
| | - M Hurst
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - B McGettigan
- Department of Clinical Immunology, Fiona Stanley Hospital, Perth, WA, Australia
| | - I Chua
- Department of Clinical Immunology, Christchurch Hospital, Christchurch, New Zealand
| | - M Brewerton
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - N Kennedy
- Department of Respiratory Medicine, Wellington Hospital, Wellington, New Zealand
| | - W Koopmans
- Department of Virology and Immunology, Auckland City Hospital, Auckland, New Zealand
| | - Y Ahn
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand.,Department of Virology and Immunology, Auckland City Hospital, Auckland, New Zealand
| | - R Barker
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - C Allan
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - P Storey
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - C Slade
- Walter and Eliza Hall Institute, Melbourne, VIC, Australia
| | - A Baker
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand
| | - L Huang
- Department of Virology and Immunology, Auckland City Hospital, Auckland, New Zealand
| | - S-T Woon
- Department of Clinical Immunology, Auckland City Hospital, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
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Knott NA, Williams J, Harasti D, Malcolm HA, Coleman MA, Kelaher BP, Rees MJ, Schultz A, Jordan A. A coherent, representative, and bioregional marine reserve network shows consistent change in rocky reef fish assemblages. Ecosphere 2021. [DOI: 10.1002/ecs2.3447] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N. A. Knott
- Fisheries Research NSW Department of Primary Industries Huskisson New South Wales2540Australia
| | - J. Williams
- New South Wales Department of Primary Industries Port Stephens Fisheries Institute Taylors Beach Road Taylors Beach New South Wales2316Australia
| | - D. Harasti
- New South Wales Department of Primary Industries Port Stephens Fisheries Institute Taylors Beach Road Taylors Beach New South Wales2316Australia
| | - H. A. Malcolm
- Fisheries Research NSW Department of Primary Industries Coffs Harbour New South Wales2800Australia
| | - M. A. Coleman
- Fisheries Research NSW Department of Primary Industries Coffs Harbour New South Wales2800Australia
| | - B. P. Kelaher
- National Marine Science Centre and Marine Ecology Research Centre Southern Cross University Coffs Harbour New South Wales2450Australia
| | - M. J. Rees
- Fisheries Research NSW Department of Primary Industries Huskisson New South Wales2540Australia
| | - A. Schultz
- Fisheries Research NSW Department of Primary Industries Coffs Harbour New South Wales2800Australia
| | - A. Jordan
- New South Wales Department of Primary Industries Port Stephens Fisheries Institute Taylors Beach Road Taylors Beach New South Wales2316Australia
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Williams M, Jordan A, Scott J, Jones M. Pharmacy professionals’ views regarding the future of NHS patient medicines helpline services: A multimethod qualitative study. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.032] [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: 11/13/2022]
Abstract
Abstract
Introduction
Patient medicines helpline services (PMHS) have been established at some National Health Service (NHS) hospitals in England, to provide medicines-related support to recently discharged hospital patients and carers. However, findings suggest that, due to a lack of resources, considerable variation exists in the operation of PMHS, and that their access, availability, and promotion do not meet national standards regarding helpline provision (1, 2). To develop recommendations for service improvement, this qualitative study sought to examine pharmacy professionals’ views regarding the future of PMHS.
Aim
To examine pharmacy professionals’ perceptions of the future of PMHS, and develop recommendations for service improvement.
Methods
University ethics and Health Research Authority approval were obtained before commencement. Participants comprised pharmacy professionals from acute, mental health, specialist, and community NHS Trusts that provided a PMHS. Invitations to participate in an online qualitative survey and subsequent semi-structured telephone interview were sent via email to pharmacy services at all Trusts that provided a PMHS. Within the survey and the interview schedule was one question “How do you see patient medicines helplines at NHS Trusts developing in the future?” and only the data generated from this open-ended question were analysed for this study. Survey data were collected via SurveyMonkey (n=100). Individuals interested in participating in an interview contacted the research team, resulting in 34 interviews. Interviews were conducted from May-October 2018, and ranged from 16 to 53 minutes. Braun and Clarke’s inductive reflexive thematic analysis was used to analyse the data. Guidelines for enhancing the validity and trustworthiness of qualitative research were used.
Results
Two themes were generated from the survey and interviews. Enhancing value for service users identifies suggestions for improving the value of PMHS for service users. These include providing access methods beyond the telephone, and providing patients/carers with post-discharge follow-up calls from a pharmacist. Improving efficiency identifies that, in the future, and in line with NHS plans for efficiency and shared resources, PMHS may become centralised or provided by community pharmacies. Centralised services were considered to likely have more resources available to provide a patient medicines information service compared to hospital pharmacies. Participants often referred to the Carter report and sustainability and transformation plans, which promote the sharing of resources within regions. However, such a change was perceived to only increase efficiency if patient information can be shared between relevant healthcare settings.
Conclusion
PMHS are perceived by pharmacy professionals as likely to become centralised in the future (i.e., provided regionally or nationally) or provided by community pharmacies. This is dependent upon patients’ information being shared between hospitals and the centralised PMHS or pharmacies. To enhance the value of PMHS for service users, providers could establish other methods of access, such as email and video consultation. A limitation of this study is that it did not seek the perspectives of pharmacy professionals who do not provide a PMHS, other healthcare professionals, nor patients and carers. Considering the uncertainty around the future of PMHS, research should establish the best way to support all patients and carers regarding medicines following hospital discharge.
References
1. Williams MJ, Jones MD, Jordan AL, Scott JA. Operating a patient medicines helpline. A survey study exploring current practice in England using the RE-AIM evaluation framework. BMC Health Serv Res. 2018; doi:10.1186/s12913-018-3690-9
2. Williams M, Jordan A, Scott J, Jones MD. Pharmacy professionals’ experiences and perceptions of providing NHS patient medicines helpline services: a qualitative study. BMC Health Serv Res. 2020; doi.org/10.1186/s12913-020-05182-w.
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Affiliation(s)
- M Williams
- Department of Pharmacy & Pharmacology, University of Bath, Bath, United Kingdom
| | - A Jordan
- Department of Psychology & Centre for Pain Research, University of Bath, Bath, United Kingdom
| | - J Scott
- Department of Pharmacy & Pharmacology, University of Bath, Bath, United Kingdom
| | - M Jones
- Department of Pharmacy & Pharmacology, University of Bath, Bath, United Kingdom
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Jordan A, Dougherty M, Mukherjee M, Timmerman M, Woscyna G, Hanson C. The Use of an Eye-Tracking Technology Tool in Analyzing and Assessing the Nutrition Focused Physical Exam Performance between Novice Nutrition Students and Expert Registered Dietitians. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tolson J, Barnes M, Bartlett D, Rochford P, Jordan A, Trinder J, Jackson M. CPAP usage is increased after a psychoeducation program at 1 month, but not at 4 months. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1078] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Khan B, Duncan I, Saad M, Schaefer D, Jordan A, Smith D, Neaigus A, Des Jarlais D, Hagan H, Dombrowski K. Combination interventions for Hepatitis C and Cirrhosis reduction among people who inject drugs: An agent-based, networked population simulation experiment. PLoS One 2018; 13:e0206356. [PMID: 30496209 PMCID: PMC6264850 DOI: 10.1371/journal.pone.0206356] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 10/11/2018] [Indexed: 01/17/2023] Open
Abstract
Hepatitis C virus (HCV) infection is endemic in people who inject drugs (PWID), with prevalence estimates above 60% for PWID in the United States. Previous modeling studies suggest that direct acting antiviral (DAA) treatment can lower overall prevalence in this population, but treatment is often delayed until the onset of advanced liver disease (fibrosis stage 3 or later) due to cost. Lower cost interventions featuring syringe access (SA) and medically assisted treatment (MAT) have shown mixed results in lowering HCV rates below current levels. However. little is known about the potential cumulative effects of combining DAA and MAT treatment. While simulation experiments can reveal likely long-term effects, most prior simulations have been performed on closed populations of model agents—a scenario quite different from the open, mobile populations known to most health agencies. This paper uses data from the Centers for Disease Control’s National HIV Behavioral Surveillance project, IDU round 3, collected in New York City in 2012 to parameterize simulations of open populations. To test the effect of combining DAA treatment with SA/MAT participation, multiple, scaled implementations of the two intervention strategies were simulated. Our results show that, in an open population, SA/MAT by itself has only small effects on HCV prevalence, while DAA treatment by itself can lower both HCV and HCV-related advanced liver disease prevalence. More importantly, the simulation experiments suggest that combinations of the two strategies can, when implemented together and at sufficient levels, dramatically reduce HCV incidence. We conclude that adopting SA/MAT implementations alongside DAA interventions can play a critical role in reducing the long-term consequences of ongoing HCV infection.
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Affiliation(s)
- Bilal Khan
- Department of Sociology, University of Nebraska, Lincoln NE, United States of America
| | - Ian Duncan
- Department of Sociology, University of Nebraska, Lincoln NE, United States of America
| | - Mohamad Saad
- Department of Sociology, University of Nebraska, Lincoln NE, United States of America
| | - Daniel Schaefer
- Department of Sociology, University of Nebraska, Lincoln NE, United States of America
| | - Ashly Jordan
- Rory Meyers College of Nursing, New York University, New York, NY, United States of America
- Center for Drug Use and HIV Research, New York University, New York, NY, United States of America
| | - Daniel Smith
- Rory Meyers College of Nursing, New York University, New York, NY, United States of America
| | - Alan Neaigus
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Don Des Jarlais
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Holly Hagan
- Rory Meyers College of Nursing, New York University, New York, NY, United States of America
- Center for Drug Use and HIV Research, New York University, New York, NY, United States of America
| | - Kirk Dombrowski
- Department of Sociology, University of Nebraska, Lincoln NE, United States of America
- * E-mail:
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Platt L, Minozzi S, Reed J, Vickerman P, Hagan H, French C, Jordan A, Degenhardt L, Hope V, Hutchinson S, Maher L, Palmateer N, Taylor A, Bruneau J, Hickman M. Needle and syringe programmes and opioid substitution therapy for preventing HCV transmission among people who inject drugs: findings from a Cochrane Review and meta-analysis. Addiction 2018; 113:545-563. [PMID: 28891267 PMCID: PMC5836947 DOI: 10.1111/add.14012] [Citation(s) in RCA: 214] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/19/2017] [Accepted: 08/21/2017] [Indexed: 12/20/2022]
Abstract
AIMS To estimate the effects of needle and syringe programmes (NSP) and opioid substitution therapy (OST), alone or in combination, for preventing acquisition of hepatitis C virus (HCV) in people who inject drugs (PWID). METHODS Systematic review and meta-analysis. Bibliographic databases were searched for studies measuring concurrent exposure to current OST (within the last 6 months) and/or NSP and HCV incidence among PWID. High NSP coverage was defined as regular NSP attendance or ≥ 100% coverage (receiving sufficient or greater number of needles and syringes per reported injecting frequency). Studies were assessed using the Cochrane risk of bias in non-randomized studies tool. Random-effects models were used in meta-analysis. RESULTS We identified 28 studies (n = 6279) in North America (13), United Kingdom (five), Europe (four), Australia (five) and China (one). Studies were at moderate (two), serious (17) critical (seven) and non-assessable risk of bias (two). Current OST is associated with 50% [risk ratio (RR) =0.50, 95% confidence interval (CI) = 0.40-0.63] reduction in HCV acquisition risk, consistent across region and with low heterogeneity (I2 = 0, P = 0.889). Weaker evidence was found for high NSP coverage (RR = 0.79, 95% CI = 0.39-1.61) with high heterogeneity (I2 = 77%, P = 0.002). After stratifying by region, high NSP coverage in Europe was associated with a 56% reduction in HCV acquisition risk (RR = 0.44, 95% CI = 0.24-0.80) with low heterogeneity (I2 = 12.3%, P = 0.337), but not in North America (RR = 1.58, I2 = 89.5%, P = < 0.001). Combined OST/NSP is associated with a 74% reduction in HCV acquisition risk (RR = 0.26, 95% CI = 0.07-0.89, I2 = 80% P = 0.007). According to Grades of Recommendation Assessment, Development and Evaluation (GRADE) criteria, the evidence on OST and combined OST/NSP is low quality, while NSP is very low. CONCLUSIONS Opioid substitution therapy reduces risk of hepatitis C acquisition and is strengthened in combination with needle and syringe programmes (NSP). There is weaker evidence for the impact of needle syringe programmes alone, although stronger evidence that high coverage is associated with reduced risk in Europe.
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Affiliation(s)
- Lucy Platt
- Centre for Research on Drugs and Health Behaviour, Department of Social and Environmental Health ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Silvia Minozzi
- Department of EpidemiologyLazio Regional Health ServiceRomeItaly
| | - Jennifer Reed
- New York University, College of NursingNew YorkNYUSA
| | - Peter Vickerman
- School of Social and Community MedicineUniversity of BristolBristolUK
| | - Holly Hagan
- New York University, College of NursingNew YorkNYUSA
| | - Clare French
- School of Social and Community MedicineUniversity of BristolBristolUK
| | - Ashly Jordan
- New York University, College of NursingNew YorkNYUSA
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUniversity of New South WalesRandwickAustralia
| | - Vivian Hope
- Public Health InstituteLiverpool John Moores UniversityLiverpoolUK
| | - Sharon Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian UniversityGlasgow and Health Protection ScotlandGlasgowUK
| | - Lisa Maher
- Kirby InstituteUniversity of New South Wales, SydneySydneyAustralia
| | - Norah Palmateer
- School of Health and Life Sciences, Glasgow Caledonian UniversityGlasgow and Health Protection ScotlandGlasgowUK
| | - Avril Taylor
- School of Social Sciences, University of West of ScotlandPaisleyUK
| | - Julie Bruneau
- Department of Family and Emergency MedicineUniversity of MontrealMontrealCanada
| | - Matthew Hickman
- School of Social and Community MedicineUniversity of BristolBristolUK
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Morgul MH, Raschzok N, Schwartlander R, Vondran F, Michel R, Stelter L, Pinkernelle J, Jordan A, Teichgraber U, Sauer IM. Tracking of Primary Human Hepatocytes with Clinical MRI: Initial Results with Tat-Peptide Modified Superparamagnetic Iron Oxide Particles. Int J Artif Organs 2018; 31:252-7. [DOI: 10.1177/039139880803100309] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The transplantation of primary human hepatocytes is a promising approach in the treatment of specific liver diseases. However, little is known about the fate of the cells following application. Magnetic resonance imaging (MRI) could enable real-time tracking and long-term detection of transplanted hepatocytes. The use of superparamagnetic iron oxide particles as cellular contrast agents should allow for the non-invasive detection of labelled cells on high-resolution magnetic resonance images. Experiments were performed on primary human hepatocytes to transfer the method of detecting labelled cells via clinical MRI into human hepatocyte transplantation. For labelling, Tat-peptide modified nano-sized superparamagnetic MagForce particles were used. Cells were investigated via a clinical MR scanner at 3.0 Tesla and the particle uptake within single hepatocytes was estimated using microscopic examinations. The labelled primary human hepatocytes were clearly detectable by MRI, proving the feasibility of this new concept. Therefore, this method is a useful tool to investigate the effects of human hepatocyte transplantation and to improve safety aspects of this method.
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Affiliation(s)
- M. H. Morgul
- Department of General, Visceral, and Transplantation Surgery, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
- Istanbul Faculty of Medicine, Istanbul University, Istanbul - Turkey
| | - N. Raschzok
- Department of General, Visceral, and Transplantation Surgery, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - R. Schwartlander
- Department of General, Visceral, and Transplantation Surgery, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - F.W. Vondran
- Department of General, Visceral, and Transplantation Surgery, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - R. Michel
- Department of Radiology, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - L. Stelter
- Department of Radiology, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - J. Pinkernelle
- Department of Radiology, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - A. Jordan
- Department of Radiology, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - U. Teichgraber
- Department of Radiology, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
| | - I. M. Sauer
- Department of General, Visceral, and Transplantation Surgery, Chiarité - Campus Virchow, Universitätsmedizin Berlin - Germany
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Fry MM, Yao B, Ríos C, Wong C, Mann S, McArt JAA, Nydam DV, Leal Yepes FA, Viesselmann L, Geick A, Goldin K, Jordan A, Behling-Kelly E. Diagnostic performance of cytology for assessment of hepatic lipid content in dairy cattle. J Dairy Sci 2017; 101:1379-1387. [PMID: 29248218 DOI: 10.3168/jds.2017-12897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 03/20/2017] [Accepted: 10/10/2017] [Indexed: 12/26/2022]
Abstract
The objective of our study was to characterize the diagnostic performance of cytology for assessing hepatic lipid content (HLC) in dairy cows by comparing microscopic evaluation of lipid vacuolation in touch imprint slide preparations of liver biopsies with quantitative measurement of triglyceride concentration ([TG]; mg/mg of wet weight) in paired biopsy samples. Our study also sought to compare the diagnostic performance of liver cytology, plasma nonesterified fatty acid concentration ([NEFA]), and plasma β-hydroxybutyrate concentration ([BHB]) derived from a measurement performed on whole blood, for assessing HLC. Chemical extraction of TG from liver tissue remains the gold standard for quantifying HLC, largely because available blood tests, although useful for detecting some types of pathology, such as increased lipid mobilization, ketosis, or hepatocellular injury, are nonspecific as to etiology. Veterinary practitioners can sample bovine liver for cytological evaluation in a fast, minimally invasive, and inexpensive manner. Thus, if highly predictive of HLC, cytology would be a practical diagnostic tool for dairy veterinarians. In our study, liver biopsy samples from Holstein cows (219 samples from 105 cows: 52 from cows 2 to 20 d prepartum, 105 from cows 0 to 10 d in milk, 62 from cows 18 to 25 d in milk) were used to prepare cytology slides and to quantify [TG] using the Folch extraction method followed by the Hantzch condensation reaction and spectrophotometric measurement. An ordinal scale (0-4) based on amount of hepatocellular cytoplasm occupied by discrete clear vacuoles was used by 3 blinded, independent observers to rank HLC in Wright-Giemsa-stained slides. Interobserver agreement in cytology scoring was good. Corresponding plasma [NEFA] and [BHB] measurements were available for 187 and 195 of the 219 samples, respectively. Liver [TG] correlated more strongly with cytology score than with NEFA or BHB, and receiver operating characteristic curve analysis showed that cytology had better diagnostic performance than either NEFA or BHB for correctly categorizing [TG] at thresholds of 5, 10, and 15%. Hepatic lipidosis in high-producing dairy cows is of major clinical and economic importance, and this study demonstrates that cytology is an accurate means of assessing HLC. Additional work is indicated to evaluate the diagnostic utility of liver cytology.
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Affiliation(s)
- M M Fry
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville 37996
| | - B Yao
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853
| | - C Ríos
- Dirección Académica, Universidad Santo Tomás, Mendoza 120, Los Ángeles, Chile
| | - C Wong
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853
| | - S Mann
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853
| | - J A A McArt
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853
| | - D V Nydam
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853
| | - F A Leal Yepes
- Department of Animal Science, Cornell University, Ithaca NY 14853
| | - L Viesselmann
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville 37996
| | - A Geick
- College of Veterinary Medicine, University of Tennessee, Knoxville 37996
| | - K Goldin
- College of Veterinary Medicine, University of Tennessee, Knoxville 37996
| | - A Jordan
- College of Veterinary Medicine, University of Tennessee, Knoxville 37996
| | - E Behling-Kelly
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853.
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Cori J, Rochford P, O'Donoghue F, Trinder J, Jordan A. Hypocapnia has minimal influence on genioglossus muscle afterdischarge elicited by arousal from sleep in healthy individuals. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.196] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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O'Connell A, Tummon A, Coleman K, Jordan A, McCormack J, Kelly ME. Antenatal Pertussis Vaccination: Why are General Practitioners Reluctant? A Mixed Methods StudySetting. Ir Med J 2017; 110:634. [PMID: 29372949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pertussis has a disproportionately higher morbidity and mortality in infants less than 3 months of age. International and national guidelines recommend pertussis vaccination during pregnancy, as a safe and effective way to protect these infants. Antenatal pertussis vaccination uptake rates remain suboptimal, with many health care professionals (HCPs) still not recommending it. The reasons underlying this reluctance on behalf of HCPs have not been fully established. This study aims to evaluate the current practice and attitudes of General Practitioners (GPs) with regard to antenatal pertussis vaccination. An embedded mixed method design was used. The response rate was 41% (n=109). 54% of GPs who responded (n=59) routinely recommend antenatal pertussis vaccination. Safety concerns and a sense of isolation emerged as the major qualitative themes. More safety data, adequate funding from the Health Service Executive (HSE) and support from secondary care may help to increase the GP recommendation rate and enhance vaccination uptake in pregnancy.
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Affiliation(s)
- A O'Connell
- GP Registrar, Western Training Programme in General Practice, Galway University Hospital, Galway, Ireland
| | - A Tummon
- GP Registrar, Western Training Programme in General Practice, Galway University Hospital, Galway, Ireland
| | - K Coleman
- GP Registrar, Western Training Programme in General Practice, Galway University Hospital, Galway, Ireland
| | - A Jordan
- GP Registrar, Western Training Programme in General Practice, Galway University Hospital, Galway, Ireland
| | - J McCormack
- Assistant Programme Director, Western Training Programme in General Practice, Galway University Hospital, Galway, Ireland
| | - M E Kelly
- Assistant Programme Director, Western Training Programme in General Practice, Galway University Hospital, Galway, Ireland
- Lecturer in the Discipline of General Practice, Medical School, National University of Ireland, Galway
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Platt L, Minozzi S, Reed J, Vickerman P, Hagan H, French C, Jordan A, Degenhardt L, Hope V, Hutchinson S, Maher L, Palmateer N, Taylor A, Bruneau J, Hickman M. Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs. Cochrane Database Syst Rev 2017; 9:CD012021. [PMID: 28922449 PMCID: PMC5621373 DOI: 10.1002/14651858.cd012021.pub2] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugsNeedle syringe programmes (NSP) and opioid substitution therapy (OST) are the primary interventions to reduce hepatitis C (HCV) transmission in people who inject drugs. There is good evidence for the effectiveness of NSP and OST in reducing injecting risk behaviour and increasing evidence for the effectiveness of OST and NSP in reducing HIV acquisition risk, but the evidence on the effectiveness of NSP and OST for preventing HCV acquisition is weak. OBJECTIVES To assess the effects of needle syringe programmes and opioid substitution therapy, alone or in combination, for preventing acquisition of HCV in people who inject drugs. SEARCH METHODS We searched the Cochrane Drug and Alcohol Register, CENTRAL, the Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment Database (HTA), the NHS Economic Evaluation Database (NHSEED), MEDLINE, Embase, PsycINFO, Global Health, CINAHL, and the Web of Science up to 16 November 2015. We updated this search in March 2017, but we have not incorporated these results into the review yet. Where observational studies did not report any outcome measure, we asked authors to provide unpublished data. We searched publications of key international agencies and conference abstracts. We reviewed reference lists of all included articles and topic-related systematic reviews for eligible papers. SELECTION CRITERIA We included prospective and retrospective cohort studies, cross-sectional surveys, case-control studies and randomised controlled trials that measured exposure to NSP and/or OST against no intervention or a reduced exposure and reported HCV incidence as an outcome in people who inject drugs. We defined interventions as current OST (within previous 6 months), lifetime use of OST and high NSP coverage (regular attendance at an NSP or all injections covered by a new needle/syringe) or low NSP coverage (irregular attendance at an NSP or less than 100% of injections covered by a new needle/syringe) compared with no intervention or reduced exposure. DATA COLLECTION AND ANALYSIS We followed the standard Cochrane methodological procedures incorporating new methods for classifying risk of bias for observational studies. We described study methods against the following 'Risk of bias' domains: confounding, selection bias, measurement of interventions, departures from intervention, missing data, measurement of outcomes, selection of reported results; and we assigned a judgment (low, moderate, serious, critical, unclear) for each criterion. MAIN RESULTS We identified 28 studies (21 published, 7 unpublished): 13 from North America, 5 from the UK, 4 from continental Europe, 5 from Australia and 1 from China, comprising 1817 incident HCV infections and 8806.95 person-years of follow-up. HCV incidence ranged from 0.09 cases to 42 cases per 100 person-years across the studies. We judged only two studies to be at moderate overall risk of bias, while 17 were at serious risk and 7 were at critical risk; for two unpublished datasets there was insufficient information to assess bias. As none of the intervention effects were generated from RCT evidence, we typically categorised quality as low. We found evidence that current OST reduces the risk of HCV acquisition by 50% (risk ratio (RR) 0.50, 95% confidence interval (CI) 0.40 to 0.63, I2 = 0%, 12 studies across all regions, N = 6361), but the quality of the evidence was low. The intervention effect remained significant in sensitivity analyses that excluded unpublished datasets and papers judged to be at critical risk of bias. We found evidence of differential impact by proportion of female participants in the sample, but not geographical region of study, the main drug used, or history of homelessness or imprisonment among study samples.Overall, we found very low-quality evidence that high NSP coverage did not reduce risk of HCV acquisition (RR 0.79, 95% CI 0.39 to 1.61) with high heterogeneity (I2 = 77%) based on five studies from North America and Europe involving 3530 participants. After stratification by region, high NSP coverage in Europe was associated with a 76% reduction in HCV acquisition risk (RR 0.24, 95% CI 0.09 to 0.62) with less heterogeneity (I2 =0%). We found low-quality evidence of the impact of combined high coverage of NSP and OST, from three studies involving 3241 participants, resulting in a 74% reduction in the risk of HCV acquisition (RR 0.26 95% CI 0.07 to 0.89). AUTHORS' CONCLUSIONS OST is associated with a reduction in the risk of HCV acquisition, which is strengthened in studies that assess the combination of OST and NSP. There was greater heterogeneity between studies and weaker evidence for the impact of NSP on HCV acquisition. High NSP coverage was associated with a reduction in the risk of HCV acquisition in studies in Europe.
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Affiliation(s)
- Lucy Platt
- London School of Hygiene and Tropical MedicineDepartment of Social and Environmental Health Research15 ‐ 17 Tavistock PlaceLondonUKWC1H 9SH
| | - Silvia Minozzi
- Lazio Regional Health ServiceDepartment of EpidemiologyVia Cristoforo Colombo, 112RomeItaly00154
| | | | - Peter Vickerman
- University of BristolSchool of Social and Community MedicineBristolUK
| | - Holly Hagan
- New York University College of NursingNew YorkNYUSA
| | - Clare French
- University of BristolSchool of Social and Community MedicineBristolUK
| | - Ashly Jordan
- New York University College of NursingNew YorkNYUSA
| | - Louisa Degenhardt
- UNSWNational Drug and Alcohol Research CentreBuilding R322‐32 King StreetRandwickNSWAustralia2031
| | - Vivian Hope
- Liverpool John Moores UniversityPublic Health InstituteLiverpoolUKL3 2ET
| | | | - Lisa Maher
- Kirby Institute, University of New South WalesSydneyAustralia
| | | | | | - Julie Bruneau
- University of MontrealDepartment of Family and Emergency MedicineMontrealCanada
| | - Matthew Hickman
- University of BristolSchool of Social and Community MedicineBristolUK
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Sachdev N, Maxwell S, Jordan A, Prates R, Konstantinidis M, Licciardi F. Determining the odds of pregnancy in brca positive women undergoing combined pre-implantation genetic diagnosis (PGD) and screening. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gay J, Armenti E, Cabey R, Goldberg-Strassler D, Jordan A, Escudero T, Munne S. Identification of patients presenting for preimplantation genetic diagnosis: trends in risk ascertainment for single gene testing and impact of expanded carrier screening. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.194] [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: 10/18/2022]
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Gupta A, Ayub M, Miller C, Rothwell D, Wallace A, Jordan A, Cook N, Thistlethwaite F, Carter L, O’Brien C, Aruketty S, Dean E, Hudson A, Frese K, Dransfield J, Hughes A, Marais R, Dive C, Brady G, Krebs M. Development of the Manchester Cancer Research Centre Molecular Tumour Board for matching patients to clinical trials based on tumour and ctDNA genetic profiling. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jordan A, Alexanderson-Rosas E, Meave-Gonzalez A, Berrios E, Cetina L. P1457Cardiac toxicity evaluated with magnetic resonance in mexican oncologic population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1457] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cartagena LJ, Kang A, Munnangi S, Jordan A, Nweze IC, Sasthakonar V, Boutin A, George Angus LD. Risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall. Aging Clin Exp Res 2017; 29:427-433. [PMID: 27142683 DOI: 10.1007/s40520-016-0579-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Falls are a significant cause of mortality in the elderly patients. Despite this, the literature on in-hospital mortality related to elderly falls remains sparse. Our study aims to determine the risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall. METHODS All elderly case records with fall-related injuries between 2003 and 2013 were retrospectively analyzed for demographic characteristics, injury severities, comorbidity factors and clinical outcomes. Logistic regression analysis was used to examine the risk factors associated with in-hospital mortality. RESULTS In total, 1026 elderly patients with fall-related injuries were included in the study. The average age of patients was 80.94 ± 8.16 years. Seventy seven percent of the patients had at least one comorbid condition. Majority of the falls occurred at home. More than half of the patients fell from ground level. Overall, the in-hospital mortality rate was 16 %. Head injury constituted the most common injury sustained in patients who died (77 %). In addition to age, ISS, GCS, ICU admission and anemia were significantly (P < 0.05) associated with in-hospital deaths in elderly fall patients. CONCLUSION Ground-level falls in the elderly can be devastating and carry a significant mortality rate. Elderly patients with anemia were two times more likely to die in the hospital after sustaining a fall in our study population. Increased focus on anemia which is often underappreciated in elderly fall patients can be beneficial in improving outcomes and reducing in-hospital mortality.
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Affiliation(s)
- L J Cartagena
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA
| | - A Kang
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA
| | - S Munnangi
- Department of Emergency Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY, 11554, USA.
| | - A Jordan
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA
| | - I C Nweze
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA
| | - V Sasthakonar
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA
| | - A Boutin
- Department of Emergency Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY, 11554, USA
| | - L D George Angus
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA
- Department of Surgery, Kings County Hospital Center, Brooklyn, NY, USA
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Goldberg-Strassler D, Cabey R, Jordan A, Prates R, Mounts E, e. barbieri, Hershlag A, Guarnaccia M, Surrey M, Munne S. Diagnostic and clinical outcomes of 694 cycles using karyomapping for preimplantation genetic diagnosis (PGD) of single gene disorders. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.472] [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: 10/21/2022]
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Jordan A, Nisson H, Colls P, Danzer H, Barritt J, Mounts E, Zhang J, Becker A, Wagner Coughlin C, Werlin L, Munne S. Outcomes from 9822 array comparative genomic hybridization (aCGH) cycles for preimplantation genetic screening (PGS). Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.442] [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: 10/21/2022]
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Goldberg-Strassler D, Cabey R, Armenti E, Jordan A. Preimplantation genetic diagnosis (PGD) genetic counseling; but why? the patient experience. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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James D, Fairweather E, Griffiths L, Hopkins G, Jordan A, McGonagle A, Smith K, Stowell A, Waddell I, Ogilvie D. Novel cell-permeable PARG inhibitors are selective and sensitize cells to alkylating DNA damage. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61448-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Watson M, James D, Begum H, Durant S, Goodwin L, Griffiths L, Jordan A, Small H, Waddell I, Ogilvie D. Identifying novel DDR targets; the Cancer Research UK Manchester Institute approach. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61650-7] [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: 10/21/2022]
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Hurley M, Carter A, Rosam A, Jordan A, Wilson N. THU0648-HPR Increasing Access To Community-Based Rehabilitation for Osteoarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2953] [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: 11/04/2022]
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Jordan A, Chen D, Yi QL, Kanias T, Gladwin MT, Acker JP. Assessing the influence of component processing and donor characteristics on quality of red cell concentrates using quality control data. Vox Sang 2016; 111:8-15. [PMID: 26991891 DOI: 10.1111/vox.12378] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 11/15/2015] [Accepted: 12/10/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Quality control (QC) data collected by blood services are used to monitor production and to ensure compliance with regulatory standards. We demonstrate how analysis of quality control data can be used to highlight the sources of variability within red cell concentrates (RCCs). MATERIALS AND METHODS We merged Canadian Blood Services QC data with manufacturing and donor records for 28 227 RCC between June 2011 and October 2014. Units were categorized based on processing method, bag manufacturer, donor age and donor sex, then assessed based on product characteristics: haemolysis and haemoglobin levels, unit volume, leucocyte count and haematocrit. RESULTS Buffy-coat method (top/bottom)-processed units exhibited lower haemolysis than units processed using the whole-blood filtration method (top/top). Units from female donors exhibited lower haemolysis than male donations. Processing method influenced unit volume and the ratio of additive solution to residual plasma. CONCLUSIONS Stored red blood cell characteristics are influenced by prestorage processing and donor factors. Understanding the relationship between processing, donors and RCC quality will help blood services to ensure the safety of transfused products.
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Affiliation(s)
- A Jordan
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.,Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
| | - D Chen
- Canadian Blood Services, Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology, University of British Columbia, Vancouver, BC, Canada
| | - Q-L Yi
- Canadian Blood Services, Ottawa, ON, Canada
| | - T Kanias
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - M T Gladwin
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - J P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.,Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
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Armenti E, Munne S, Mullen C, Singer T, Jordan A, Hershlag A. The frequency of X-linked disorders in preimplantation genetic diagnosis (PGD): a call for wider screening. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2015.12.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Platt L, Reed J, Minozzi S, Vickerman P, Hagan H, French C, Jordan A, Degenhardt L, Hope V, Hutchinson S, Maher L, Palmateer N, Taylor A, Hickman M. Effectiveness of needle/syringe programmes and opiate substitution therapy in preventing HCV transmission among people who inject drugs. Cochrane Database Syst Rev 2016; 2016:CD012021. [PMID: 27127417 PMCID: PMC4843520 DOI: 10.1002/14651858.cd012021] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the impact of needle/syringe programmes with and without opiate substitution therapy (OST) on the incidence of HCV infection among people who inject drugs (PWID).To assess the effect of OST alone on the incidence of HCV infection among PWID. RESEARCH QUESTIONS How effective are needle/syringe programmes (NSP) with and without the use of OST for reducing HCV incidence among PWID?How effective is OST alone for reducing HCV incidence among PWID?How does the effect of NSP and OST vary according to duration of treatment (i.e. for NSPs weekly attendance versus monthly)?How does the effect of NSP vary according to the type of service (fixed site versus mobile; high coverage versus low coverage)?How does the effect of OST vary according to the dosage of OST, type of substitution used and adherence to treatment?
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Affiliation(s)
- Lucy Platt
- Centre for Research on Drugs and Health Behaviour, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Jennifer Reed
- New York University College of Nursing, New York, NY, USA
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Peter Vickerman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Holly Hagan
- New York University College of Nursing, New York, NY, USA
| | - Clare French
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ashly Jordan
- New York University College of Nursing, New York, NY, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW, Randwick, Australia
| | | | | | - Lisa Maher
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | | | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Toomath R, Szecket N, Nahill A, Denison T, Spriggs D, Lay C, Wilkinson L, Poole P, Jordan A, Lees J, Millner S, Snow B. Medical service redesign shares the load saving 6000 bed days and improving morale. Intern Med J 2015; 44:785-90. [PMID: 24863137 DOI: 10.1111/imj.12477] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/20/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS In 2010, demand on the Auckland City Hospital general medical service exceeded capacity. A review by the Royal Australasian College of Physicians was critical of training offered to registered medical officers, and low morale was a problem across the service. Management offered support for an improved model that would solve these problems. METHODS A project to redesign the general medical service was undertaken. Baseline analysis found uneven workload and insufficient capacity at peak times for patient presentations. Workshops involving the entire service led to a new model that splits workload and teams into patients likely to have a short stay from those requiring longer, ward-based care. Admissions are now distributed over 12 teams on weekdays and 4 on the weekends. There was an increase of approximately 2.5 in consultant full time equivalents but no change in registrar or house officer staffing. RESULTS Since the introduction of the new model, the average length of stay has fallen from 3.7 to 3.2 days (14%) and the median length of stay by 28%, resulting in a saving of 6000 bed days per year. Readmission, inpatient and 30-day mortality rates are unchanged. These results have been sustained over 18 months with signs of continuing improvement. CONCLUSION This project owes its success to the following factors - management support; iterative engagement of a range of staff; provision of timely data analysis; increases in senior medical officer staffing and reorganisation leading to more predictable and fair work practices. One challenge is discontinuity, whether between doctors and patients or within the medical team.
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Affiliation(s)
- R Toomath
- Department of General Medicine, Auckland City Hospital, Auckland, New Zealand
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Armenti E, Jordan A, Goldberg-Strassler D, Cabey R, Barrionuevo M, Kiltz R, Racowsky C, Stelling J, Kenigsberg D, Vitiello D, Munne S. PGD via ACGH for translocations: a review of cycle outcomes. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Prates R, Jaroudi S, Jordan A, Goodall N, Chu B, Tecson V, Hershlag A, Garrisi M, Licciardi F, Witt B, Konstantinidis M. Advantages of triplet repeat expansion detection in blastocyst biopsy for preimplantation genetic diagnosis of fragile X syndrome. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jordan A, El Haloui O, Breaud J, Chevalier D, Antomarchi J, Bongain A, Boucoiran I, Delotte J. Formation des internes de gynécologie obstétrique : évaluation d’un programme pédagogique intégrant cours théoriques et sessions pratiques sur simulateurs. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.gyobfe.2015.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Coleman MA, Bates AE, Stuart-Smith RD, Malcolm HA, Harasti D, Jordan A, Knott NA, Edgar GJ, Kelaher BP. Functional traits reveal early responses in marine reserves following protection from fishing. DIVERS DISTRIB 2015. [DOI: 10.1111/ddi.12309] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- M. A. Coleman
- Marine Ecosystem Research; Department of Primary Industries; New South Wales Fisheries; PO Box 4321 Coffs Harbour NSW 2450 Australia
- National Marine Science Centre; Southern Cross University; 2 Bay Drive Coffs Harbour NSW 2450 Australia
| | - A. E. Bates
- Ocean and Earth Science; National Oceanography Centre Southampton; University of Southampton; Southampton SO14 3ZH UK
| | - R. D. Stuart-Smith
- Institute for Marine and Antarctic Studies; University of Tasmania; Hobart Tas. 7001 Australia
| | - H. A. Malcolm
- Department of Primary Industries; Marine Ecosystem Research; 32 Marina Drive Coffs Harbour NSW 2450 Australia
| | - D. Harasti
- Department of Primary Industries; Marine Ecosystem Research; Locked Bag 800 Nelson Bay NSW 2315 Australia
| | - A. Jordan
- Department of Primary Industries; Marine Ecosystem Research; Locked Bag 800 Nelson Bay NSW 2315 Australia
| | - N. A. Knott
- Department of Primary Industries; Marine Ecosystem Research; PO Box 89 Huskisson NSW 2540 Australia
| | - G. J. Edgar
- Institute for Marine and Antarctic Studies; University of Tasmania; Hobart Tas. 7001 Australia
| | - B. P. Kelaher
- National Marine Science Centre; Southern Cross University; 2 Bay Drive Coffs Harbour NSW 2450 Australia
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Jordan A, Acton B, Fairweather E, Hamilton N, Holt S, Hitchin J, Hutton C, James D, Jones S, McGonagle A, Small H, Smith K, Stowell A, Waddell I, Waszkowycz B, Ogilvie D. 284 Poly(ADP-ribose) glycohydrolase (PARG) inhibitors increase nuclear poly(ADP-ribose) after methylating DNA damage. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70410-1] [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: 10/24/2022]
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41
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Prates R, Jordan A, Rosen G, DiMattina M, Chen S, Tan SL, Hoffman D, Jaroudi S, Konstantinidis M. Usage of karyomapping for preimplantation genetic diagnosis (PGD) of complex single gene disorders (sgds). Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mateu-Gelabert P, Gwadz MV, Guarino H, Sandoval M, Cleland CM, Jordan A, Hagan H, Lune H, Friedman SR. The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection. AIDS Educ Prev 2014; 26:144-157. [PMID: 24694328 PMCID: PMC4039031 DOI: 10.1521/aeap.2014.26.2.144] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks.
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Tanskanen V, Jordan A, Puustinen M, Kyrki-Rajamäki R. CFD simulation and pattern recognition analysis of the chugging condensation regime. ANN NUCL ENERGY 2014. [DOI: 10.1016/j.anucene.2013.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Prates R, Jordan A, Goodall NN, Tortoriello D, Kiltz R, Jaroudi S. Multiple advantages of blastocyst versus cleavage stage biopsy for preimplantation genetic diagnosis (PGD) of single gene disorders. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Koopmans W, Woon ST, Zeng ISL, Jordan A, Brothers S, Browett P, Ameratunga R. Variability of memory B cell markers in a cohort of common variable immune deficiency patients over 6 months. Scand J Immunol 2013; 77:470-5. [PMID: 23360162 DOI: 10.1111/sji.12028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 01/10/2013] [Indexed: 11/30/2022]
Abstract
Common Variable Immunodeficiency Disorder (CVID) is a complex disorder that predisposes patients to recurrent and severe infections. Immunophenotypic classification schemes were developed to categorize patients with CVID into phenotypic and prognostic groups based on different memory B cell subsets. Whether the B cell subset analysis is stable over time has not been investigated. B cell phenotyping in patients with CVID (n = 15) and sex- and age-matched controls (n = 26) were carried out according to the three B cell classifications. Patients with CVID were evaluated monthly over 6 months. Controls were assessed once during the study. We scored how often each patient was assigned to the same group within each classification. The Freiburg classification assigned patients to the same group at a rate of 73% and the Paris classification at 88%. The EUROclass classification of smB- versus smB+ was at 90%. The two subclassifications [(smB-21low or smB-21norm) and transitional B] were at 87% and 97%, respectively. The level of naïve B cells measured in all patients with CVID during the 6-month evaluation was the most stable B cell subset. We conclude that all classifications systems show considerable variability, but the EUROclass classification was the most reliable scheme for our 15 CVID and 26 healthy cohorts. Our results indicate that phenotypic classifications within CVID will be difficult while there is variability of commonly used assays.
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Affiliation(s)
- W Koopmans
- Departments of Virology and Immunology, Auckland City Hospital, Auckland, New Zealand
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Cs.Nagy G, Wunsch M, Jordan A, Lange K. Antegrade Eversion Endarterectomy of the External Iliac Artery. Eur J Vasc Endovasc Surg 2013; 46:103-9. [DOI: 10.1016/j.ejvs.2013.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 03/14/2013] [Indexed: 10/26/2022]
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Dehmel M, Demirakca S, Jordan A, Dahlheim M, Diehm T, Schroten H, Tenenbaum T. Pneumomediastinum and subcutaneus emphysema - an uncommon presentation of respiratory-syncytial virus infection in an infant. Klin Padiatr 2013; 225:230-1. [PMID: 23519751 DOI: 10.1055/s-0032-1329948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M Dehmel
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
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Meyerholz M, Mense K, Steufmehl M, Duevel A, Hanstedt A, Jordan A, Baumgarten M, Hoedemaker M, Piechotta M. IGF-I is not a useful predictive marker for competence of embryo transfer recipients but it clearly is influenced by cycle stage and pregnancy status. Reprod Biol 2013. [DOI: 10.1016/j.repbio.2013.01.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cvitanovic C, Wilson SK, Fulton CJ, Almany GR, Anderson P, Babcock RC, Ban NC, Beeden RJ, Beger M, Cinner J, Dobbs K, Evans LS, Farnham A, Friedman KJ, Gale K, Gladstone W, Grafton Q, Graham NAJ, Gudge S, Harrison PL, Holmes TH, Johnstone N, Jones GP, Jordan A, Kendrick AJ, Klein CJ, Little LR, Malcolm HA, Morris D, Possingham HP, Prescott J, Pressey RL, Skilleter GA, Simpson C, Waples K, Wilson D, Williamson DH. Critical research needs for managing coral reef marine protected areas: perspectives of academics and managers. J Environ Manage 2013; 114:84-91. [PMID: 23220604 DOI: 10.1016/j.jenvman.2012.10.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 03/22/2012] [Accepted: 10/09/2012] [Indexed: 06/01/2023]
Abstract
Marine protected areas (MPAs) are a primary policy instrument for managing and protecting coral reefs. Successful MPAs ultimately depend on knowledge-based decision making, where scientific research is integrated into management actions. Fourteen coral reef MPA managers and sixteen academics from eleven research, state and federal government institutions each outlined at least five pertinent research needs for improving the management of MPAs situated in Australian coral reefs. From this list of 173 key questions, we asked members of each group to rank questions in order of urgency, redundancy and importance, which allowed us to explore the extent of perceptional mismatch and overlap among the two groups. Our results suggest the mismatch among MPA managers and academics is small, with no significant difference among the groups in terms of their respective research interests, or the type of questions they pose. However, managers prioritised spatial management and monitoring as research themes, whilst academics identified climate change, resilience, spatial management, fishing and connectivity as the most important topics. Ranking of the posed questions by the two groups was also similar, although managers were less confident about the achievability of the posed research questions and whether questions represented a knowledge gap. We conclude that improved collaboration and knowledge transfer among management and academic groups can be used to achieve similar objectives and enhance the knowledge-based management of MPAs.
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Affiliation(s)
- C Cvitanovic
- ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville, QLD 4811, Australia.
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