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Rosqvist HB, Nygren A, O'Donoghue S. Moving Through a Textual Space Autistically. J Med Humanit 2024; 45:17-34. [PMID: 37131117 PMCID: PMC10890973 DOI: 10.1007/s10912-023-09797-y] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/04/2023]
Abstract
This article is an investigation of neurodivergent reading practices. It is a collectively written paper where the focus is as much on an autoethnographic exploration of our autistic readings of autism/autistic fiction as it is on the read texts themselves. The reading experiences described come primarily from Yoon Ha Lee's Dragon Pearl (2019) and Dahlia Donovan's The Grasmere Cottage Mystery (2018), which we experience as opposite each other in how they depict their neurodivergent characters and speak to us as autistic readers. Through the article, we describe a formation of neurodivergent (critical) collective readings of autism/autistic fiction. The article contributes to an academic and activistic discourse around neurodivergent reader responses and power relations between neurodivergent and neurotypical readers and authors.
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Affiliation(s)
| | - Anna Nygren
- HDK-Valand-Academy of Art and Design, University of Gothenburg, Gothenburg, Sweden
| | - Sarinah O'Donoghue
- Department of English, School of Language, Literature, Music, and Visual Culture, University of Aberdeen, Aberdeen, Scotland, AB24 3FX
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Ray Chaudhuri K, Podlewska A, Hui Lau Y, Gonde C, McIntosh A, Qamar M, O'Donoghue S, Larcombe K, Adeeko M, Gupta A, Bajwah S, Lafond S, Awogbemila O, van Coller R, Murtagh A, Ocloo J. Addressing the gap for racially diverse research involvement: The King's Model for minority ethnic research participant recruitment. Public Health Pract (Oxf) 2023; 6:100426. [PMID: 37744301 PMCID: PMC10511795 DOI: 10.1016/j.puhip.2023.100426] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/30/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives Ethnic minorities (EM) are still underrepresented in research recruitment. Despite wide literature outlining the barriers, enablers and recommendations for driving inclusion and diversity in research, there is still little evidence for successful diversity in research participation, which has a direct impact on the quality of care provided to ethnically diverse individuals. A new, comprehensive approach to recruitment strategies is therefore necessary. Study design service improvement initiative. Methods In the light of the Covid-19 pandemic and the key public health need to address the disparity in care provided to non-white populations, we used a novel, comprehensive approach (The King's Model) comprising of local and community actions to promote inclusive research recruitment. We then compared rates of diverse recruitment in studies where the novel approach, was applied to studies which had been closed to recruitment at the time of analysis and where ethnicity data was available. Results Our results demonstrate that following the introduction of the King's Model for diverse recruitment, commercial interventional study diverse recruitment increased from 6.4% to 16.1%, and for non-commercial studies, from 30.2% to 41.0% and 59.2% in the selected studies. Conclusions King's Model is potentially a useful tool in enhancing non-Caucasian recruitment to clinical research. Enriched by additional recommendations based on our experiences during the Covid-19 research recruitment drive, we propose the King's Model is used to support ethnically diverse research recruitment. Further evidence is needed to replicate our findings, although this preliminary evidence provides granular details necessary to address the key unmet need of validating clinical research outcomes in non-white populations.
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Affiliation(s)
- K. Ray Chaudhuri
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Podlewska
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Yue Hui Lau
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - C. Gonde
- Institute of Liver Studies, King's College Hospital, NHS Trust Foundation, London, United Kingdom
| | - A. McIntosh
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - M.A. Qamar
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - S. O'Donoghue
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's Health Partners, London, SE1 9RT, United Kingdom
| | - K. Larcombe
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - M. Adeeko
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - A. Gupta
- Paediatric Respiratory Medicine, King's College Hospital, London, United Kingdom
| | - S. Bajwah
- Cicely Saunders Institute, King's College London, London, United Kingdom
| | - S. Lafond
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - O. Awogbemila
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - R. van Coller
- Department of Neurology, Faculty of Health Sciences, University of Pretoria, South Africa
| | - A.M. Murtagh
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - J.E. Ocloo
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
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Rosqvist HB, Botha M, Hens K, O'Donoghue S, Pearson A, Stenning A. Being, Knowing, and Doing: Importing Theoretical Toolboxes for Autism Studies. Autism Adulthood 2023; 5:15-23. [PMID: 36941858 PMCID: PMC10024257 DOI: 10.1089/aut.2022.0021] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
The aim of this article was to think with and elaborate on theories developed outside of autism research and the autistic community, and through this support the production of new autistic-led theories: theories and concepts based on autistic people's own embodied experiences and the social worlds we inhabit. The article consists of three different sections all of part of the overall umbrella, Being, knowing, and doing: Importing theoretical toolboxes for autism studies. In each section, we import useful concepts from elsewhere and tailor them to autism studies. Throughout, we mingle our own autoethnographic accounts and shared discourse in relation to research accounts and theories. Illustrating being, we explore and discuss the possibilities of critical realism in autism studies. Illustrating knowing, we explore and discuss the possibilities of standpoint theory in autism studies. Finally, illustrating doing, we explore and discuss the possibilities of neurocosmopolitics including epistemic (in)justice in autism studies. Our proposal here is for an epistemic shift toward neurodiverse collaboration. We are inviting nonautistic people to work with, not on, us, aiming at to make autism research more ethical, breaking down bureaucratic structures, and questioning poor theory and shoddy methodology. Acknowledging intersecting axes of oppression in which an individual seeks to renegotiate and reimagine what it means to belong also means to understand what needs changing in society, as it is and how we might do things differently.
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Affiliation(s)
| | - Monique Botha
- Division of Psychology, University of Stirling, Stirling, Scotland
| | - Kristien Hens
- Department of Philosophy, University of Antwerp, Antwerp, Belgium
| | - Sarinah O'Donoghue
- Department of English, School of Language, Literature, Music, and Visual Culture, University of Aberdeen, Aberdeen, Scotland
| | - Amy Pearson
- School of Psychology, Faculty of Health and Wellbeing, University of Sunderland, Sunderland, United Kingdom
| | - Anna Stenning
- Faculty of Arts, Humanities and Cultures, University of Leeds, Leeds, United Kingdom
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Bertilsdotter Rosqvist H, Botha M, Hens K, O'Donoghue S, Pearson A, Stenning A. Cutting our own keys: New possibilities of neurodivergent storying in research. Autism 2022:13623613221132107. [PMID: 36259512 DOI: 10.1177/13623613221132107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT A lot of people who do research are also neurodivergent (such as being autistic or attention deficit hyperactivity disorder), but neurodivergent people do not always feel welcome in research spaces which are often shaped around neurotypical people. Some neurotypical researchers lack confidence in talking to neurodivergent people, and others feel like neurodivergent people might not be able to do good research about other people who are like them without being biased. We think it is important that all researchers are able to work well together, regardless of whether they are neurotypical, autistic, or attention deficit hyperactivity disorder (or any other neurotype) - in truly 'neurodiverse' teams. In this article we talk about how to create better spaces for all researchers, where we feel valued for who we are and take each others' needs into account. We do this using some approaches from other areas of research and talking about how they relate to our personal experiences of being neurodivergent researchers with our own personal stories. This article adds to a growing work on how we can work with people who are different from us, in more respectful and kind ways.
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Mcgloughlin SA, Udy A, O'Donoghue S, Bandeshe H, Gowardman JR. Therapeutic Hypothermia following Out-Of-Hospital Cardiac Arrest (Ohca): An Audit of Compliance at a Large Australian Hospital. Anaesth Intensive Care 2019; 40:844-9. [DOI: 10.1177/0310057x1204000512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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)
- S. A. Mcgloughlin
- Department of Intensive Care, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - A. Udy
- Department of Intensive Care, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - S. O'Donoghue
- Department of Intensive Care, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - H. Bandeshe
- Department of Intensive Care, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - J. R. Gowardman
- Department of Intensive Care, Royal Brisbane Hospital, Herston, Queensland, Australia
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O'Donoghue S, Kilmartin L, O'Hora D, Emsell L, Langan C, McInerney S, Forde NJ, Leemans A, Jeurissen B, Barker GJ, McCarthy P, Cannon DM, McDonald C. Anatomical integration and rich-club connectivity in euthymic bipolar disorder. Psychol Med 2017; 47:1609-1623. [PMID: 28573962 DOI: 10.1017/s0033291717000058] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although repeatedly associated with white matter microstructural alterations, bipolar disorder (BD) has been relatively unexplored using complex network analysis. This method combines structural and diffusion magnetic resonance imaging (MRI) to model the brain as a network and evaluate its topological properties. A group of highly interconnected high-density structures, termed the 'rich-club', represents an important network for integration of brain functioning. This study aimed to assess structural and rich-club connectivity properties in BD through graph theory analyses. METHOD We obtained structural and diffusion MRI scans from 42 euthymic patients with BD type I and 43 age- and gender-matched healthy volunteers. Weighted fractional anisotropy connections mapped between cortical and subcortical structures defined the neuroanatomical networks. Next, we examined between-group differences in features of graph properties and sub-networks. RESULTS Patients exhibited significantly reduced clustering coefficient and global efficiency, compared with controls globally and regionally in frontal and occipital regions. Additionally, patients displayed weaker sub-network connectivity in distributed regions. Rich-club analysis revealed subtly reduced density in patients, which did not withstand multiple comparison correction. However, hub identification in most participants indicated differentially affected rich-club membership in the BD group, with two hubs absent when compared with controls, namely the superior frontal gyrus and thalamus. CONCLUSIONS This graph theory analysis presents a thorough investigation of topological features of connectivity in euthymic BD. Abnormalities of global and local measures and network components provide further neuroanatomically specific evidence for distributed dysconnectivity as a trait feature of BD.
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Affiliation(s)
- S O'Donoghue
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
| | - L Kilmartin
- College of Engineering and Informatics, National University of Ireland Galway,Galway,Republic of Ireland
| | - D O'Hora
- School of Psychology, National University of Ireland Galway,Galway,Republic of Ireland
| | - L Emsell
- Translational MRI, Department of Imaging & Pathology,KU Leuven & Radiology, University Hospitals Leuven,Leuven,Belgium
| | - C Langan
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
| | - S McInerney
- Department of Psychiatry,St Michael's Hospital,Toronto,Ontario,Canada
| | - N J Forde
- Department of Psychiatry,University Medical Centre Groningen,Groningen,The Netherlands
| | - A Leemans
- Image Sciences Institute, University Medical Center Utrecht,Utrecht,The Netherlands
| | - B Jeurissen
- Vision Lab,University of Antwerp,Antwerp,Belgium
| | - G J Barker
- Institute of Psychiatry, Psychology and Neuroscience,London,UK
| | - P McCarthy
- Radiology, University Hospital Galway,Galway,Republic of Ireland
| | - D M Cannon
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
| | - C McDonald
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
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Agarwal S, O'Donoghue S, Gowardman J, Kennedy G, Bandeshe H, Boots R. Intensive care unit experience of haemopoietic stem cell transplant patients. Intern Med J 2013; 42:748-54. [PMID: 21627739 DOI: 10.1111/j.1445-5994.2011.02533.x] [Citation(s) in RCA: 25] [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: 01/14/2023]
Abstract
BACKGROUND Previous research at our institution (1988-1998) established an intensive care unit (ICU) and hospital mortality between 70% and 80% in haemopoietic stem cell transplant (HSCT) patients requiring ICU admission. AIMS This study explored mortality in a more contemporary cohort while comparing outcomes to published literature and our previous experience. METHODS Retrospective chart review of HSCT patients admitted to ICU between December 1998 and June 2008. RESULTS Of 146 admissions, 53% were male, with a mean age of 44 years, an Acute Physiologic and Chronic Health Evaluation II score of 28 and Sepsis Organ Failure Assessment score of 11. Fifty-six per cent had graft versus host disease (GVHD), with respiratory failure (67%) being the most common admission diagnosis. All but one received mechanical ventilation. The ICU and hospital mortality were 42% (72% 1988-1998 cohort) and 64% (82% 1998-1998 cohort) respectively. The 6- and 12-month survivals were 29% and 24% respectively for the 1998-2008 cohort. Dying in ICU was independently predicted by fungal infection (P= 0.02) and early onset of organ failure (P < 0.001), while GVHD (P= 0.04) predicted survival. Mortality at 12 months was independently predicted by the acute physiology score (P= 0.002), increasing number of organ failures (P= 0.001), and cytomegalovirus positive serology (P= 0.005), while blood stream infection (P= 0.003), an antibiotic change on admission to the ICU (P= 0.007) and a diagnosis of non-Hodgkin lymphoma (P= 0.02) predicted survival. CONCLUSION Our study found that acute admission of HSCT patients to the ICU is associated with improved survival compared to our previous experience, with organ failure progression a strong predictor of ICU outcome, and specific disease characteristics contributing to long-term survival.
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Affiliation(s)
- S Agarwal
- Department of Intensive Care Medicine, Haematology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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8
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Lennon P, O'Donovan JP, O'Donoghue S, Fenton JE. The otolaryngology, head and neck training appraisal questionnaire: a national general practice perspective. Ir J Med Sci 2013; 182:609-14. [PMID: 23526234 DOI: 10.1007/s11845-013-0937-7] [Citation(s) in RCA: 5] [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: 09/28/2012] [Accepted: 03/04/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diseases of the Ear, Nose and Throat (ENT) make up a considerable proportion of the everyday workload of general practitioners (GPs). It is recognized that ENT makes up a very small part of the undergraduate curriculum, but some post-graduate training schemes are now offering placements in Otolaryngology. AIM The aim of the study was to examine a perceived knowledge 'gap' of GPs in the area of Otolaryngology. METHOD A postal questionnaire was sent to 1,000 GPs distributed evenly throughout the country. RESULTS There was a 47.3 % response rate; 72 % of GPs felt that they would see at least three or more children with a relevant ENT problem each day. Almost 70 % of GPs had less than a month exposure to ENT in medical school and 84 % of GPs felt that further emphasis was required at the undergraduate level. Twenty-one per cent of GPs surveyed had spent some time in Postgraduate ENT training. Ninety-one per cent of GPs agreed that further emphasis on ENT training was required at the Postgraduate level. CONCLUSION General Practitioners feel that increased importance should be placed on the study of Otolaryngology at both undergraduate and Postgraduate level.
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Affiliation(s)
- P Lennon
- Department of Otolaryngology, Head and Neck Surgery, University Hospital, Limerick, Dooradoyle, Limerick, Ireland,
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Habruseva T, O'Donoghue S, Rebrova N, Kéfélian F, Hegarty SP, Huyet G. Optical linewidth of a passively mode-locked semiconductor laser. Opt Lett 2009; 34:3307-3309. [PMID: 19881576 DOI: 10.1364/ol.34.003307] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We measured the optical linewidths of a passively mode-locked quantum dot laser and show that, in agreement with theoretical predictions, the modal linewidth exhibits a parabolic dependence with the mode optical frequency. The minimum linewidth follows a Schawlow-Townes behavior with a rebroadening at high power. In addition, the slope of the parabola is proportional to the RF linewidth of the laser and can therefore provide a direct measurement of the timing jitter. Such a measurement could be easily applied to mode-locked semiconductor lasers with a fast repetition rate where the RF linewidth cannot be directly measured.
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Affiliation(s)
- T Habruseva
- Tyndall National Institute, Lee Maltings, Cork, Ireland.
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Udy A, O'Donoghue S, D'Intini V, Healy H, Lipman J. Point of care measurement of plasma creatinine in critically ill patients with acute kidney injury. Anaesthesia 2009; 64:403-7. [PMID: 19317706 DOI: 10.1111/j.1365-2044.2008.05818.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We report the utility of an enzymatic point of care system for estimation of plasma creatinine concentration in critically ill patients with acute kidney injury. Multiple measurements were obtained from a heterogenous population admitted to a multi-disciplinary intensive care unit. The acute kidney injury network guidelines were used to identify and stratify patients based on the creatinine concentration. Central laboratory values were used as comparators to assess the precision and bias of the system. Overall, point of care measurements correlated well with central pathology results (R(2) = 0.991, p < 0.001), although there tended to be a small negative bias in patients with acute kidney injury (3 micromol x l(-1)). The accuracy of point of care measurement is within clinically acceptable limits and given the much shorter turn around time can be used to identify and monitor patients with acute kidney injury in the critical care environment.
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Affiliation(s)
- A Udy
- Department of Intensive Care medicine, Royal Brisbane and Womens Hospital, Brisbane, Qld, Australia.
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Abstract
Polymorphic ventricular tachycardia (PVT) is a form of ventricular tachycardia characterized by QRS complexes that seem to change direction during the tachycardia. If associated with a prolonged QT interval, it is called torsades de pointes. In the absence of a congenital long QT syndrome, torsades is seen with certain drugs such as antiarrhythmic agents (Class IA, IC, III), psychotropic medications, antidepressants, antihistamines, and electrolyte disturbances. We report the first case of polymorphic ventricular tachycardia with normal QT interval associated with the oral use of levofloxacin in the absence of other etiologies known to cause these arrhythmias.
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Affiliation(s)
- B Paltoo
- Section of Cardiology, Washington Hospital Center, 110 Irving St. NW, Washington, DC 20010, USA
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O'Donoghue S, Bagnall A. Videofluoroscopic evaluation in the assessment of swallowing disorders in paediatric and adult populations. Folia Phoniatr Logop 1999; 51:158-71. [PMID: 10450023 DOI: 10.1159/000021494] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Videofluoroscopic swallow studies (VFSS) are often considered the 'gold standard' technique to assess dysphagia. Despite this status, unanimous agreement has not been reached regarding the protocol for this procedure. Review of the literature reveals two main schools of thought. The first advocates a uniform, standardised protocol used with all patients. The second argues for functional, tailor-made studies, which aim to elicit a sample of swallowing representative of typical feeding patterns. This paper reviews the literature on VFSS methodology and evaluates the applicability of protocols to the paediatric population. Broadly speaking, adult protocols tend towards uniform procedures, whereas paediatric studies aim to be more individualised and tailor-made. Clinical recommendations based upon VFSS are examined in the light of validity and reliability issues. The need for standardisation of the VFSS procedure is highlighted. The question is raised whether it is possible to achieve uniformity and consistency between clinicians and still perform patient-centered, tailor-made VFSSs, which are truly representative of a patient's swallow function. It is revealed that dysphagia specialists should achieve greater consistency in the VFSS procedure before claiming to be implementing a 'gold standard' technique.
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Affiliation(s)
- S O'Donoghue
- Department of Speech and Language Therapy, Charing Cross Hospital, London, UK.
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13
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Brosseau L, Tousignant M, Budd J, Chartier N, Duciaume L, Plamondon S, O'Sullivan JP, O'Donoghue S, Balmer S. Intratester and intertester reliability and criterion validity of the parallelogram and universal goniometers for active knee flexion in healthy subjects. Physiother Res Int 1998; 2:150-66. [PMID: 9421820 DOI: 10.1002/pri.97] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE A new parallelogram goniometer was designed by the Rehabilitation Centre of the Royal Ottawa Health Care Group in 1983. The advantage of using such a goniometer is that the clinician is not required to estimate the joint axis of rotation when taking a measurement. The parallelogram goniometer has obtained a good intratester and intertester reliability when measuring active range of motion of hip abduction on eight individuals with hip pathologies. However, the validity of the parallelogram goniometer has not been examined. The purposes of this study were to examine the intratester and intertester reliability and the criterion validity of the parallelogram and universal goniometers for active knee flexion on healthy individuals. SUBJECTS Sixty healthy university students (44 females and 16 males; mean age of 20.6 yrs.) participated to this study. METHODS Measurements with the universal and parallelogram goniometers were taken in two different positions, the smaller and larger angles of active knee flexion. All measurements were taken by two trained testers. A radiograph was taken in both positions to serve as the 'gold standard'. The sequence of the measurements and radiographs were randomly selected. The intra and intertester reliability of both goniometers were established by calculating the intraclass correlation coefficients (ICCs) using the repeated-measures ANOVA. The criterion validity was examined by calculating Pearson product-moment correlation coefficients (tau) between each goniometric and radiologic measurements. A 0.05 level of significance was chosen for each statistical test. RESULTS Intratester reliability ranged from good to excellent for the small angles (ICC = 0.85 and 0.87) and the large angles (ICC = 0.91 and 0.96) when using the parallelogram goniometer. Intertester reliability was fair for the small angles of flexion (ICC = 0.43 to 0.52) and good to excellent for the large angles of flexion (ICC = 0.82 to 0.88). The parallelogram goniometer was found to have greater validity when measuring the large angles of knee flexion (r = 0.73 and 0.77) compared to the small angles of knee flexion (r = 0.33 and 0.41). Similar results of reliability and validity were obtained with the universal goniometer. CONCLUSION The results of this study have clinical importance. The use of the parallelogram goniometer was found to be as reliable and valid as the universal goniometer when measuring active knee flexion. However, the parallelogram goniometer offered clinicians the advantages of obtaining precise angular measurements with fewer adjustments, and a faster application technique. Further studies on the parallelogram goniometer are necessary among individuals presenting with altered range of motion at different joints.
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Affiliation(s)
- L Brosseau
- School of Rehabilitation Sciences, University of Ottawa, Ontario, Canada.
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Abstract
The problem of predicting protein structure from the sequence remains fundamentally unsolved despite more than three decades of intensive research effort. However, new and promising methods in three-dimensional (3D), 2D and 1D prediction have reopened the field. Mean-force-potentials derived from the protein databases can distinguish between correct and incorrect models (3D). Inter-residue contacts (2D) can be detected by analysis of correlated mutations, albeit with low accuracy. Secondary structure, solvent accessibility and transmembrane helices (1D) can be predicted with significantly improved accuracy using multiple sequence alignments. Some of these new prediction methods have proven accurate and reliable enough to be useful in genome analysis, and in experimental structure determination. Moreover, the new generation of theoretical methods is increasingly influencing experiments in molecular biology.
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Affiliation(s)
- B Rost
- European Molecular Biology Laboratory, Protein Design Group, Heidelberg, Germany.
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Abstract
A 26-year-old man who had sustained a traumatic head injury aspirated when fed in the upright position. By contrast, when fed in the side-lying position swallowing improved and there was no aspiration. Implications for management are discussed.
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Affiliation(s)
- W Drake
- Regional Neurological Rehabilitation Unit, London, UK
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Affiliation(s)
- N K Williams
- Department of Biochemistry, University of Sydney, NSW, Australia
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Barradas MA, Jagroop A, O'Donoghue S, Jeremy JY, Mikhailidis DP. Effect of milrinone in human platelet shape change, aggregation and thromboxane A2 synthesis: an in vitro study. Thromb Res 1993; 71:227-36. [PMID: 8267765 DOI: 10.1016/0049-3848(93)90097-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Milrinone (MIL; a cAMP-specific phosphodiesterase type-III inhibitor), added in vitro to achieve concentrations below the therapeutic levels, inhibited agonist-induced platelet shape change (PSC). Arachidonic acid (AA)-induced PSC was significantly more inhibited by a combination of MIL and indomethacin (INDO; a cyclooxygenase inhibitor) than by either alone. PSC induced by 5-hydroxytryptamine was inhibited by MIL but not by INDO; and this effect of MIL was not augmented by INDO. Whole blood-platelet aggregation (WB-PA) and platelet-rich plasma aggregation induced by potent stimulators of thromboxane A2 (TXA2) synthesis such as AA and calcium ionophore and by less potent agonists (e.g. ADP and U46619) were inhibited by MIL at or near therapeutic concentrations. WB-PA induced by collagen was significantly more inhibited by the MIL and INDO combination than by either of these agents alone whereas with ADP-induced WB-PA no additional effect could be shown when both MIL and INDO were co-incubated. MIL and similar types of drugs may be of benefit in conditions associated with platelet hyperactivity and some of these effects may be enhanced by cyclooxygenase inhibitors.
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Affiliation(s)
- M A Barradas
- Department of Chemical Pathology & Human Metabolism, Royal Free Hospital School of Medicine (University of London), U.K
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Barradas MA, O'Donoghue S, Mikhailidis DP. Measurement of platelet volume using a channelyzer: assessment of the effect of agonists and antagonists. In Vivo 1992; 6:629-34. [PMID: 1296813] [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: 12/26/2022]
Abstract
Platelets undergo morphological changes prior to aggregating. This phenomenon is known as the platelet shape change (PSC) and is usually accompanied by at increase in median platelet volume (MePV). We evaluated MePV changes in human platelet rich plasma (PRP) using a high resolution pulse-height analyser ("channelyzer"). Increases in MePV were induced by the addition of low concentrations of known aggregating agents. These agonists showed different patterns in terms of potency, duration and reversibility.
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Affiliation(s)
- M A Barradas
- Department of Chemical Pathology & Human Metabolism, Royal Free Hospital School of Medicine (University of London), United Kingdom
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Abstract
The use of MAP recording techniques has been said to have bridged the gap between basic in vitro investigation of the transmembrane action potential and observations made in situ from the beating heart. With regard to antiarrhythmic agents, MAP recordings are particularly useful in evaluating drugs which prolong repolarization. The simultaneous measurement of MAP and ERP at the same site permits the comparison of drug effects on repolarization and refractoriness. The ability to safely and reliably record the MAP contributes importantly to the evaluation and classification of antiarrhythmic drug effects in vivo and may ultimately lead to more rational selection of drug therapy for individual patients. Antiarrhythmic drug effects demonstrated with MAP recordings have generally shown good agreement with the Vaughan Williams classification of electrophysiological actions. An important key to drug efficacy may be that some drugs prolong refractoriness beyond their effect on repolarization. Conversely, a potential explanation for proarrhythmia may lie in slowing of conduction without the concomitant protective effect of postrepolarization refractoriness. The phenomenon of use dependence, which has been demonstrated for many drugs, suggests why an agent that prevents induction of arrhythmia during programmed stimulation in the electrophysiology laboratory may not prevent spontaneous arrhythmia initiation at slower heart rates. The paramount task of clinical electrophysiology is the successful treatment of rhythm disturbances. The more detailed and quantitative evaluation of drug effects afforded by MAP recordings may ultimately result in the more effective use of antiarrhythmic drugs in general and to more precise tailoring of therapy for individual patients.
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Affiliation(s)
- S O'Donoghue
- Cardiac Arrhythmia Center, Washington Hospital Center, Washington, DC 20010
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Abstract
The evaluation of survivors of sudden cardiac death with serial electrophysiologic studies involves a lengthy and expensive hospitalization, especially when an automatic implantable cardioverter-defibrillator is ultimately necessary. The cost efficacy of this conventional approach was therefore compared with direct implantation of a cardioverter-defibrillator after the first electrophysiologic study. Thirty-two survivors of sudden death who had inducible ventricular tachycardia during their initial electrophysiologic study underwent serial drug trials. At discharge 12 (37%) were taking an antiarrhythmic drug found to prevent induction of ventricular tachycardia and 20 underwent cardioverter-defibrillator implantation after serial drug trials proved ineffective. The average length of hospitalization for this group that had undergone serial drug testing was 20.2 +/- 9.3 days at an average cost of $48,900 +/- $31,600. Seven survivors of sudden death had no inducible ventricular tachycardia during their initial electrophysiologic study and underwent direct cardioverter-defibrillator implantation. Their average length of hospitalization was 12.6 +/- 6.2 days at an average cost of $40,400 +/- $8,300. It is concluded that automatic implantable cardioverter-defibrillator implantation as an early intervention is not more costly and indeed may be cost-effective compared with therapy guided by serial electrophysiologic testing. As antitachycardia devices become more versatile, long lived and easier to implant, earlier implantation is likely to compare even more favorably with drug therapy.
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Affiliation(s)
- S O'Donoghue
- Cardiac Arrhythmia Center, Washington Hospital Center, Washington, D.C
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Affiliation(s)
- H P Liebert
- Washington Heart, Washington Hospital Center, Washington, DC 20010
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Affiliation(s)
- J Lindsay
- Section of Cardiology, Washington Hospital Center, Washington, DC 20010
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23
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Abstract
We surveyed 12 medical centers with regard to the reuse of pacing catheters during electrophysiologic studies. The prevalence of superficial skin infections or bacteremia related to EP studies was extremely low, and was not significantly different in the catheter reuse group compared to the single use group. We conclude that catheter resterilization and reuse is safe and cost-effective.
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Affiliation(s)
- S O'Donoghue
- Cardiology Division, Washington Hospital Center, Washington, DC 20010
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Falvey J, O'Donoghue S. The symbolic significance of Munchausen's syndrome. Br J Psychiatry 1987; 151:703-4. [PMID: 2451552 DOI: 10.1192/s0007125000284286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Hickey N, Mulcahy R, Daly L, Graham I, O'Donoghue S, Kennedy C. Cigar and pipe smoking related to four year survival of coronary patients. Br Heart J 1983; 49:423-6. [PMID: 6838730 PMCID: PMC481328 DOI: 10.1136/hrt.49.5.423] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Six hundred and thirty-four male patients under 60 years who survived a first attack of unstable angina or myocardial infarction were followed for a period of four years. Details of initial and follow-up smoking habits were examined. Patients who continued to smoke cigarettes or cigars had an excess mortality compared with non-smokers, with those who stopped smoking, and with cigarette smokers who changed to pipe smoking. Pipe smokers who continued smoking the pipe had an observed mortality which was greater than that of the non-smokers, but the numbers were small and the results were not statistically significant. The effect of smoking habit on mortality was not influenced by two other determinants of prognosis: age and severity of initial attack. These results confirm that the long-term prognosis of patients after unstable angina or myocardial infarction may be significantly influenced by smoking habits. They are consistent with the hypothesis that cigar and pipe smoking may have an adverse effect after myocardial infarction but further studies are needed to corroborate the association between cigar and pipe smoking and prognosis of coronary heart disease.
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Abstract
A 35-year-old man with chronic granulocytic leukemia had disseminated herpes simplex virus type II. Cerebrospinal fluid pleocytosis, aphasia, and an abnormal electroencephalogram suggested the diagnosis of meningoencephalitis. He was treated with adenosine arabinoside and recovered without clinically evident sequelae.
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Hickey N, O'Donoghue S, Guiry U, Graham I, Mulcahy R, Belton P, Carmody M, Sheridan J, Quigley P, Jackson M. Metolazone and pindolol in the treatment of hypertension: a double blind multicentre trial. Ir Med J 1982; 75:194-6. [PMID: 7050009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
One hundred one patients with unstable angina were treated conservatively without the routine use of beta receptor blocking agents, calcium antagonist drugs, anticoagulant agents or nitrates. Only two patients underwent arteriography and coronary arterial bypass surgery during hospitalization and one patient during the 1st year of follow-up study. The 28 day mortality rate was 4 percent and the total 1 year cardiac mortality rate 10 percent. Two patients died from carcinoma. The incidence rate of nonfatal myocardial infarction was 9 percent during the first 28 days and a further 3 percent for the 1st year. These results compare favorably with the immediate and 1 year prognosis reported from other studies using different treatment procedures, including modern intensive drug treatment and coronary arterial bypass surgery. Various factors studied during the acute stage of unstable angina were assessed in an effort to predict the immediate and long-term outcome. Only persistence of pain after admission to the hospital was found a significant indicator of an adverse prognosis. Modern medical treatment of unstable angina with beta receptor blocking agents, calcium antagonist drugs, anticoagulant agents, nitrates and antiarrhythmic agents is critically examined. The paucity of proper randomized controlled studies confirming the value of medication is underlined. There is little evidence to show that aggressive or intensive medical or surgical treatment is superior to a conservative approach to management in the coronary care unit. This approach includes bed rest until the pain has resolved, symptomatic drug treatment only, the minimal use of invasive investigations and careful risk factor intervention.
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Abstract
A new anti-inflammatory assay is described, utilizing a subcutaneously implanted elongated section of cotton twine to induce granuloma in rats. The cotton twine irritant is easily introduced under the abdominal skin and after seven days a well formed granuloma is established. The procedure works effectively for both steroidal and non-steroidal anti-inflammatory drug evaluation. Consistency of the cotton twine eliminates individual weighing of each section and uniformity in compactness affords reproducible results.
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Fennelly JJ, McBride A, O'Donoghue S, Kavanagh TM, Cahalane S. Management of childhood acute leukaemia. Ir Med J 1974; 67:589-94. [PMID: 4533268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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