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Bennett HE, Duke S, Richardson A. Parent experience of advance care planning: reconstructing meaning - grounded theory. BMJ Support Palliat Care 2023:spcare-2023-004348. [PMID: 37699663 DOI: 10.1136/spcare-2023-004348] [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: 04/24/2023] [Accepted: 08/09/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES Parents have unique experience of caring for their child with a life-limiting illness and significant insight into the experience of advance care planning. However, little is known about how they experience and manage this process. Our objective was to understand parents' experience of advance care planning for their child. METHODS Data collected through semistructured interviews and documents using a constructivist and situational grounded theory approach. Parents with experience of end-of-life decisions or advance care planning for a child (age 0-17 years) with a life-limiting condition or life-threatening condition. RESULTS 13 parents participated; 11 interviews were undertaken with analysis of 9 advance care plans. Parents were interviewed separately (n=9) or together (n=2).Overarching and inter-related categories, realisation, reconciling multiple tensions and building confidence and asserting control explained the actions and processes of parents' experience of advance care planning. The arising theory, reconstructing meaning through advance care planning, describes how the process of advance care planning, enables parents to make 'good' decisions in complex medical situations and despite the emotional distress, has therapeutic value. CONCLUSION This study confirms parents want to engage in advance care planning, use the process to continuously reorientate their values alongside treatment decisions and that offers a therapeutic value not previously recognised. This requires healthcare professionals to reframe their approach to advance care planning conversations valuing parents' voices and desire for a sense of control and empowering them to make future decisions that offer hope and build resilience to face the future death of their child.
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Affiliation(s)
| | - Sue Duke
- School of Health Sciences, University of Southampton Faculty of Medicine Health and Life Sciences, Southampton, UK
| | - Alison Richardson
- Cancer Nursing and End of Life Care, University of Southampton Faculty of Medicine Health and Life Sciences, Southampton, UK
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Lin D, Wahid K, Nelms B, He R, Naser M, Duke S, Sherer M, Cislo M, Murphy J, Gillespie E, Fuller C. Interobserver agreement among multiple generalists or specialists are comparable to that of recognized experts: Prospective acceptability benchmarks for H&N from the C3RO crowdsourced initiative. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.06.019] [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: 10/15/2022]
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Bennett HE, Duke S, Richardson A. Paediatric advance care planning in life-limiting conditions: scoping review of parent experiences. BMJ Support Palliat Care 2022; 13:161-173. [DOI: 10.1136/bmjspcare-2022-003544] [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] [Received: 01/18/2022] [Accepted: 05/16/2022] [Indexed: 11/04/2022]
Abstract
BackgroundAdvance care planning is considered best practice for children and young people with life-limiting conditions but there is limited evidence how parents’ perceive, understand and engage with the process.AimTo understand parents’ experience of advance care planning for a child or young person with a life-limiting condition.DesignScoping review, theoretically informed by Family Sense of Coherence. Parents’ experience was conceptualised in terms of meaningfulness, comprehensibility and manageability.Data sourcesElectronic databases Medline, CINAHL and PyschINFO were searched for studies published between 1990 and 2021, using MeSH and broad-base terms.Results150 citations were identified and screened; 15 studies were included: qualitative (n=10), survey (n=3) and participatory research (n=2). Parents’ experience of advance care planning was contextualised by their family values and beliefs, needs and goals and the day-to-day impact of caring for their child and family. They valued conversations, which helped them to maximise their child’s quality of life and minimise their suffering. They preferred flexible, rather than definitive decisions about end-of-life care and treatment.ConclusionsAdvance care planning which solely focuses on treatment decisions is at odds with parents’ concerns about the current and future impact of illness on their child and family. Parents want advance care planning for their child to reflect what matters to them as a family. Future longitudinal and comparative studies are needed to understand the influence of advance care planning on parental decision-making over time and how social, cultural and contextual nuances influence parental experience.
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Wan Mamat WH, Lund S, Jarrett N, Mohd Taib NA, Duke S. Understanding How Malaysian Women Appraise their Breast Cancer Symptoms: A Narrative Approach. imjm 2022. [DOI: 10.31436/imjm.v21i2.1712] [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: 11/07/2022]
Abstract
INTRODUCTION: Awareness of breast cancer symptoms has made a positive impact on recognition and screening, however there is little research describing how women interpret their bodily changes. This study was conducted to explore how Malaysian women with breast cancer appraise their symptoms and how their interpretation of the symptoms had been shaped by the social norms, knowledge and previous experiences. Materials and Methods: 14 women with breast cancer were recruited using purposeful sampling. The participants took part in in-depth, one-time, face-to-face, and audio-recorded interviews. All the interviews were subsequently transcribed verbatim and analysed using structure and content of a narrative approach. Results: Women interpreted their symptoms based on the physical presentation of the symptoms, previous experiences, and societal norms and beliefs. Some women immediately understood the potential meaning of their breast changes and sought medical opinion, while others waited from one week up to until one year to observe symptoms or normalised them in terms of previous and current experiences. The use of narrative enabled these women to recapitulate particular experiences that had special meaning in order to make sense of their action. Conclusions: The way women interpreted their symptoms reflected their understanding on the significant meaning of the symptoms. Acknowledging this symptom appraisal information may assist healthcare professionals in providing appropriate information that can challenge misconceptions, myths, and negative beliefs about breast cancer to improve breast cancer awareness and early detection among the community.
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Duke S, Richardson A, May C, Lund S, Lunt N, Campling N. Evaluation of the usability, accessibility and acceptability for a family support intervention (Family-Focused Support Conversation) for end of life care discharge planning from hospital: A participatory learning and action research study. International Journal of Nursing Studies Advances 2021. [DOI: 10.1016/j.ijnsa.2021.100022] [Citation(s) in RCA: 1] [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: 10/22/2022] Open
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Perkin LC, Oppert B, Duke S, Suh CPC. Assessment of DNA Integrity From Trap-Captured Boll Weevil (Coleoptera: Curculionidae) for Use in a New PCR-Based Diagnostic Tool. J Econ Entomol 2021; 114:1321-1328. [PMID: 33885764 DOI: 10.1093/jee/toab073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 06/12/2023]
Abstract
The boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), is a major pest of commercial cotton (Gossypium hirsutum) in the southern United States and throughout Central and South America. Efforts are underway to develop a PCR-based diagnostic tool that can be used to rapidly and accurately differentiate boll weevils from other weevil species that are commonly captured in pheromone traps. However, the quantity and integrity of weevil DNA must be sufficient for a successful PCR assay. Currently, active eradication programs service traps weekly, but post-eradication programs service traps at 2- or 3-wk intervals. Consequently, captured weevils may be dead, dismembered, and exposed to environmental conditions for prolonged periods which may adversely affect the quantity and quality of weevil DNA. We documented DNA quantity and integrity in boll weevils and weevil body parts aged in traps over a 3-wk period under field conditions. The quantity of DNA extracted from whole weevils, heads, abdomens, and legs generally remained sufficient (> 1 ng/μl) for successful PCR amplification throughout the 21-d period. The integrity (fragment length) of extracted DNA declined over time but generally was sufficient (> 700 bp) for successful amplification. PCR amplification of three marker genes validated that the quality and integrity of DNA extracted from dead weevils and individual weevil body parts aged in traps up to 21 d remained at sufficient levels for the PCR-based assay. However, our data also suggested that rain events may accelerate degradation of weevil DNA.
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Affiliation(s)
- L C Perkin
- USDA, ARS, SPARC, Insect Control and Cotton Disease Research Unit, College Station, TX, USA
| | - B Oppert
- USDA, ARS, CGAHR, Stored Product Insect and Engineering Research Unit, Manhattan, KS, USA
| | - S Duke
- USDA, ARS, SPARC, Insect Control and Cotton Disease Research Unit, College Station, TX, USA
| | - C P-C Suh
- USDA, ARS, SPARC, Insect Control and Cotton Disease Research Unit, College Station, TX, USA
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Duke S, Campling N, May CR, Lund S, Lunt N, Richardson A. Co-construction of the family-focused support conversation: a participatory learning and action research study to implement support for family members whose relatives are being discharged for end-of-life care at home or in a nursing home. BMC Palliat Care 2020; 19:146. [PMID: 32957952 PMCID: PMC7507823 DOI: 10.1186/s12904-020-00647-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Many people move in and out of hospital in the last few weeks of life. These care transitions can be distressing for family members because they signify the deterioration and impending death of their ill relative and forthcoming family bereavement. Whilst there is evidence about psychosocial support for family members providing end-of-life care at home, there is limited evidence about how this can be provided in acute hospitals during care transitions. Consequently, family members report a lack of support from hospital-based healthcare professionals. METHODS The aim of the study was to implement research evidence for family support at the end-of-life in acute hospital care. Informed by Participatory Learning and Action Research and Normalization Process Theory (NPT) we co-designed a context-specific intervention, the Family-Focused Support Conversation, from a detailed review of research evidence. We undertook a pilot implementation in three acute hospital Trusts in England to assess the potential for the intervention to be used in clinical practice. Pilot implementation was undertaken during a three-month period by seven clinical co-researchers - nurses and occupational therapists in hospital specialist palliative care services. Implementation was evaluated through data comprised of reflective records of intervention delivery (n = 22), in-depth records of telephone implementation support meetings between research team members and co-researchers (n = 3), and in-depth evaluation meetings (n = 2). Data were qualitatively analysed using an NPT framework designed for intervention evaluation. RESULTS Clinical co-researchers readily incorporated the Family-Focused Support Conversation into their everyday work. The intervention changed family support from being solely patient-focused, providing information about patient needs, to family-focused, identifying family concerns about the significance and implications of discharge and facilitating family-focused care. Co-researchers reported an increase in family members' involvement in discharge decisions and end-of-life care planning. CONCLUSION The Family-Focused Support Conversation is a novel, evidenced-based and context specific intervention. Pilot implementation demonstrated the potential for the intervention to be used in acute hospitals to support family members during end-of-life care transitions. This subsequently informed a larger scale implementation study. TRIAL REGISTRATION n/a.
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Affiliation(s)
- Sue Duke
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England.
| | - Natasha Campling
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
| | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England
| | - Susi Lund
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
| | - Neil Lunt
- Department of Social Policy and Social Work, University of York, Heslington, York, YO10 5DD, England
| | - Alison Richardson
- University Hospitals Southampton and School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
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Ziser K, Dutkiewicz C, Byun M, Robertson G, Duke S, Sindone A, Shaw E, Tofler G. 169 Sodium-glucose Co-transporter-2 (SGLT2) Inhibitor Usage in Heart Failure Patients With Type Two Diabetes. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.176] [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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Duke S, Pötter R, Sturdza A, Schmid M, Rumpold T, Mahantshetty U, Nesvacil N, De Leeuw A, Kirisits C, Tanderup K, Nout R, Lindegaard J, Jurgenliemk-Schulz I, Tan L. OC-0176 A systematic analysis of delineation performance seen in EMBRACE-II brachytherapy quality assurance. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30596-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Petersen M, Muscha J, Roberts A, Duke S. 261 Responses by heifers to development strategies using confinement or supplemented native range herbivory in Northern Great Plains. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - J Muscha
- USDA-ARS,Miles City, MT, United States
| | - A Roberts
- USDA Agricultural Research Service, Fort Keogh Livestock and Range Research Laboratory,Miles City, MT, United States
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Duke S, Jensen N, Rumpold T, De Leeuw A, Lindegaard J, Tanderup K, Pötter R, Nout R, Jurgenliemk-Schultz I, Tan L. PO-0809: Implementing a novel online education programme to support RTQA – the EMBRACE-II experience. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31119-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Latter S, Hopkinson JB, Lowson E, Hughes JA, Hughes J, Duke S, Anstey S, Bennett MI, May C, Smith P, Richardson A. Supporting carers to manage pain medication in cancer patients at the end of life: A feasibility trial. Palliat Med 2018; 32:246-256. [PMID: 28679073 DOI: 10.1177/0269216317715197] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Carers of people with advanced cancer play a significant role in managing pain medication, yet they report insufficient information and support to do so confidently and competently. There is limited research evidence on the best ways for clinicians to help carers with medication management. AIMS To develop a pain medicines management intervention (Cancer Carers Medicines Management) for cancer patients' carers near the end of life and evaluate feasibility and acceptability to nurses and carers. To test the feasibility of trial research procedures and to inform decisions concerning a full-scale randomised controlled trial. DESIGN Phase I-II clinical trial. A systematic, evidence-informed participatory method was used to develop CCMM: a nurse-delivered structured conversational process. A two-arm, cluster randomised controlled feasibility trial of Cancer Carers Medicines Management was conducted, with an embedded qualitative study to evaluate participants' experiences of Cancer Carers Medicines Management and trial procedures. SETTING Community settings in two study sites. PARTICIPANTS Phase I comprises 57 carers, patients and healthcare professionals and Phase II comprises 12 nurses and 15 carers. RESULTS A novel intervention was developed. Nurses were recruited and randomised. Carer recruitment to the trial was problematic with fewer than predicted eligible participants, and nurses judged a high proportion unsuitable to recruit into the study. Attrition rates following recruitment were typical for the study population. Cancer Carers Medicines Management was acceptable to carers and nurses who took part, and some benefits were identified. CONCLUSION Cancer Carers Medicines Management is a robustly developed medicines management intervention which merits further research to test its effectiveness to improve carers' management of pain medicines with patients at the end of life. The study highlighted aspects of trial design that need to be considered in future research.
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Affiliation(s)
- Sue Latter
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jane B Hopkinson
- 2 School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Elizabeth Lowson
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jane A Hughes
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jacki Hughes
- 2 School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Sue Duke
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Sally Anstey
- 2 School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Michael I Bennett
- 3 Academic Unit of Palliative Care, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Carl May
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Peter Smith
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Alison Richardson
- 1 Faculty of Health Sciences, University of Southampton, Southampton, UK.,4 Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Campling N, Duke S, Firth P, Lund S, Lunt N, May C, Richardson A. Supporting family caregivers in the transition between hospital and their relative’s preferred place for end of life care. BMJ Support Palliat Care 2016. [DOI: 10.1136/bmjspcare-2016-001204.53] [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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Jarrett N, Porter K, Davis C, Lathlean J, Duke S, Corner J, Addington-Hall J. Palliative care patients' perceptions of the work involved in understanding and managing the network of care provision surrounding them. BMJ Support Palliat Care 2015; 7:133-139. [PMID: 25829381 DOI: 10.1136/bmjspcare-2014-000781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 02/17/2015] [Accepted: 03/11/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore the work carried out for cancer palliative care patients in understanding and dealing with the often large network of care provision surrounding them. METHOD Qualitative thematic analysis of interviews with 24 patients (aged 48-85 years) with 15 different types/sites of cancer and palliative care needs. RESULTS The main theme of 'patient work-their strategies and project management' is presented. Subthemes included: being organised and keeping records; planning ahead and coordinating care; information gathering; understanding the hierarchy and knowing who the key people are; strategies to remember names and roles; understanding and 'working the system'. Insights are given into the work carried out on patients' behalf by family, although it was unclear who would do this work if no family was available. Some of the challenges faced by patients and families are identified. These included limited information; uncertainty when care is transferred between different teams or locations; deciding who to contact and how; and negotiating through gatekeepers. CONCLUSIONS The number and variety of people contributing to the care of a cancer palliative care patient can be difficult for patients and family to comprehend. Work is required by patients or family on their behalf to achieve the level of understanding required to become accomplished at navigating the system and project managing their care organisation, and is probably influenced by role expectations and previous experience. Much of this additional, often hidden, workload for patients and family could probably be reduced with clear, timely information provision by health professionals.
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Affiliation(s)
- N Jarrett
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - K Porter
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - C Davis
- Countess Mountbatten House, Moorgreen Hospital and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Lathlean
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - S Duke
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - J Corner
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - J Addington-Hall
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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Jarrett N, Porter K, Davis C, Addington-Hall J, Duke S, Corner J, Lathlean J. The networks of care surrounding cancer palliative care patients. BMJ Support Palliat Care 2015; 5:435-42. [PMID: 25812576 DOI: 10.1136/bmjspcare-2014-000782] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 03/11/2015] [Indexed: 11/04/2022]
Affiliation(s)
- N Jarrett
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, Hants, UK
| | - K Porter
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, Hants, UK
| | - C Davis
- Countess Mountbatten House, Moorgreen Hospital and University Hospital Southampton NHS Foundation Trust, Southampton, Hants, UK
| | - J Addington-Hall
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, Hants, UK
| | - S Duke
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, Hants, UK
| | - J Corner
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, Hants, UK
| | - J Lathlean
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, Hants, UK
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Latter S, Hopkinson J, Lowson E, Richardson A, Hughes J, Duke S, Anstey S, Bennett M, May C, Smith P, Hughes J. CANCER CARERS MEDICINES MANAGEMENT: A FEASIBILITY TRIAL OF AN EDUCATIONAL INTERVENTION FOR MANAGING END OF LIFE PAIN MEDICATION. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2014-000838.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Latter S, Lowson E, Hopkinson J, Hughes J, Richardson A, Duke S, Anstey S, Bennett M, May C, Smith P. CANCER CARERS MEDICINES MANAGEMENT: A FEASIBILITY TRIAL OF AN EDUCATIONAL INTERVENTION FOR MANAGING END OF LIFE PAIN MEDICATION. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.11] [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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Hopkinson J, Hughes J, Lowson E, Richardson A, Duke S, Anstey S, Bennett M, Smith P, May C, Latter S. CANCER CARERS MEDICINES MANAGEMENT: A FEASIBILITY TRIAL OF AN EDUCATIONAL INTERVENTION FOR MANAGING END OF LIFE PAIN MEDICATION. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000654.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wilson C, Duke S, Mukesh M, Parashar D, Hughes-Davies L, Wishart G, Coles C. PD-0322: The Cambridge post-mastectomy radiotherapy (C-PMRT) index: a practical tool for patient selection. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32628-1] [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: 10/23/2022]
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Latter S, Hopkinson J, Richardson A, Lowson E, Duke S, Anstey S, Bennett M, Smith P, May C. A PHASE I-II FEASIBILITY TRIAL OF CANCER CARER MEDICINES MANAGEMENT: AN OVERVIEW. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000453b.18] [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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Jarrett N, Porter K, Addington-Hall J, Corner J, Davis C, Duke S, Lathlean J. How do people with cancer and palliative care needs understand and contribute to the management of communication surrounding their care? BMJ Support Palliat Care 2012. [DOI: 10.1136/bmjspcare-2012-000196.130] [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: 11/03/2022]
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Porter K, Jarrett N, Addington-Hall J, Corner J, Davis C, Duke S, Lathlean J. ‘Many hands make light work’ or ‘too many cooks spoil the broth’? Achieving the tricky balance of appropriate involvement in palliative care for cancer. BMJ Support Palliat Care 2012. [DOI: 10.1136/bmjspcare-2012-000196.134] [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: 11/03/2022]
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Bailey C, Seymour KC, Duke S, Moore M. Experiences and support needs of older care givers caring for family members (or friends) with cancer. BMJ Support Palliat Care 2012. [DOI: 10.1136/bmjspcare-2012-000196.41] [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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Oldford D, Duke S. N043 Cardiogeriatric syndromes: Timely recognition and management of cognitive impairment. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.08.044] [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] Open
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Prior L, Purtell L, Duke S, Campbell L, Sainsbury A, Herzog H. Mouse model of Prader–Willi syndrome: The role of SNORD116 in the regulation of energy homeostasis. Obes Res Clin Pract 2010. [DOI: 10.1016/j.orcp.2010.09.012] [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: 10/18/2022]
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Duke S, Bennett H. Review: a narrative review of the published ethical debates in palliative care research and an assessment of their adequacy to inform research governance. Palliat Med 2010; 24:111-26. [PMID: 19965950 DOI: 10.1177/0269216309352714] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The quality of research, and the resulting quality of evidence available to guide palliative care, is dependent on the ethical decisions underpinning its design, conduct and report. Whilst much has been published debating the ethics of palliative care research, an assessment of the quality and synthesis of the central debates is not available. Such a review is timely to inform research governance. The methodology of this study is based on the principles of systematic reviews. Fifty-seven papers were reviewed following a thorough search, and were critically appraised for their literary quality, the knowledge on which they drew and the research standards they addressed. The debates identified address vulnerability, moral appropriateness, consent, gate-keeping and inclusion and research culture. The quality of debate and the sources of knowledge varied. The debate was rich in quality and knowledge with respect to the protection of the dignity, rights and safety of research participants, but less developed in relation to those of researchers and other staff. There is also little debate about the ethics of reporting of research and the ethics underpinning research leadership. A framework is offered that reconciles the ethical issues raised with potential methodological strategies identified from the review.
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Affiliation(s)
- Sue Duke
- University of Southampton, Southampton, UK.
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McReynolds J, Waneck C, Byrd J, Genovese K, Duke S, Nisbet D. Efficacy of multistrain direct-fed microbial and phytogenetic products in reducing necrotic enteritis in commercial broilers. Poult Sci 2009; 88:2075-80. [DOI: 10.3382/ps.2009-00106] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Suh CPC, Armstrong JS, Spurgeon DW, Duke S. Comparisons of boll weevil (Coleoptera: Curculionidae) pheromone traps with and without kill strips. J Econ Entomol 2009; 102:183-186. [PMID: 19253635 DOI: 10.1603/029.102.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), eradication programs typically equip pheromone traps with an insecticide-impregnated kill strip. These strips are intended to kill captured insects, thereby simplifying trap servicing and reducing the loss of weevils from predation and escape. However, the effectiveness of kill strips has not been extensively evaluated. We examined the influences of kill strips on weevil captures, trap servicing, and the incidences of weevil predation and trap obstruction (e.g., by spider webs). Evaluations were conducted weekly during three different production periods (pre- to early-, late-, and postseason) of cotton, Gossypium hirsutum L., to represent different environmental conditions and weevil population levels. Within each period, mean weekly captures of weevils in traps with and without kill strips were statistically similar. On average, traps with kill strips took 9 s longer to service than traps without kill strips, but statistical differences were only detected during the late-season period. Overall, the mean weekly proportion of traps with evidence of weevil predation or trap obstruction was significantly lower for traps with kill strips (0.25) than for traps without kill strips (0.37). However, this reduction in the frequency of weevil predation or trap obstruction was too small to produce a corresponding increase in the numbers of weevils captured. In light of these findings, the use of kill strips is likely unnecessary in eradication programs, but may be a consideration in situations when the numbers of deployed traps are reduced and chronic problems with weevil predation or trap obstruction exist.
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Affiliation(s)
- C P C Suh
- Areawide Pest Management Research Unit, USDA-ARS, 2771 F&B Rd., College Station, TX 77845, USA.
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Duke S, Appleton J. The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year. J Adv Nurs 2000; 32:1557-68. [PMID: 11136426 DOI: 10.1046/j.1365-2648.2000.01604.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year Reflection has gained a reputation for encouraging the integration between theory and practice within professional education. However, this reputation is based on an evidence base that mostly consists of theoretical debate. The aim of this study was to test our experience that the ability to reflect is developmental and that some reflective skills are harder to achieve than others. The research was undertaken by assessing the degree to which registered nurses achieved reflective criteria within assignments submitted for a variety of palliative care undergraduate modules. A total of 160 assignments were analysed using a marking grid constructed from a literature review and the results were compared between students and across academic terms. The results suggest that students are able to describe their practice but find it harder to analyse knowledge, the context of care and to action plan. Nevertheless, reflective abilities developed over time with significant developments made between each term. However, the development of skills indicative of critical reflection was less evident and confined to the ability to raise implications for future learning. The lack of multivariate analysis limits the study. However, the findings build on previous research and prompt questions for future work, particularly with respect to the process of reflection and how this can be supported in order to encourage the development of critical reflective skills.
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Affiliation(s)
- S Duke
- Nurse Consultant in Palliative Care, Royal Berkshire and Battle Hospitals NHS Trust and Senior Lecturer, School of Health Care, Oxford Brookes University, Oxford, England.
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LaForce CF, Pearlman DS, Ruff ME, Silvers WS, Weinstein SW, Clements DS, Brown A, Duke S, Harding SM, House KW. Efficacy and safety of dry powder fluticasone propionate in children with persistent asthma. Ann Allergy Asthma Immunol 2000; 85:407-15. [PMID: 11101186 DOI: 10.1016/s1081-1206(10)62556-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [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: 12/01/2022]
Abstract
BACKGROUND Flovent Diskus is a powder formulation of the inhaled corticosteroid fluticasone propionate (FP) delivered via a breath-actuated, multidose inhaler. OBJECTIVE To determine the efficacy and safety of dry powder FP administered once or twice daily (200 microg per day) to children with persistent asthma. METHODS Twelve-week, randomized, double-blind, placebo-controlled, multicenter trial with a 52-week, open-label extension. Children aged 4 to 11 were required to have pulmonary function 50% to 85% of predicted values. The population was stratified for baseline therapy (inhaled corticosteroid/cromolyn or bronchodilators only). After a 2-week placebo run-in, 242 patients received dry powder FP 200 microg each morning, dry powder FP 100 microg BID, or placebo for 12 weeks; 192 were rerandomized to the QD or BID regimen for an additional 52 weeks of open-label treatment. Primary endpoints were mean changes in FEV1 and morning PEF recorded at clinic visits. RESULTS Both dry powder FP regimens significantly improved FEV1, evening PEF, and asthma symptoms at the double-blind phase endpoint (P < or = .017 compared with placebo). The BID regimen also significantly improved morning PEF and nighttime awakenings due to asthma (P < or = .005). Among patients previously treated with inhaled corticosteroids/cromolyn, improvements observed with the QD and BID regimens were similar. Patients switched from BID to open-label QD treatment showed additional improvements at week 52 generally comparable to patients who received the BID regimen during both phases. Fluticasone propionate was well tolerated for up to 64 weeks with few reports of drug-related adverse events or morning plasma cortisol abnormalities. CONCLUSIONS Once daily dosing of dry powder FP 200 microg is an effective and convenient alternative for children whose asthma is controlled with a more frequent dosing regimen of inhaled corticosteroids.
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Affiliation(s)
- C F LaForce
- North Carolina Clinical Research, Raleigh 27607, USA.
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Wolfe J, Rooklin A, Grady J, Munk ZM, Stevens A, Prillaman B, Duke S, Harding S. Comparison of once- and twice-daily dosing of fluticasone propionate 200 micrograms per day administered by diskus device in patients with asthma treated with or without inhaled corticosteroids. J Allergy Clin Immunol 2000; 105:1153-61. [PMID: 10856150 DOI: 10.1067/mai.2000.107037] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are limited published data regarding the efficacy of once- versus twice-daily administration of flutica-sone propionate. OBJECTIVE Our purpose was to evaluate the effectiveness of fluticasone propionate powder 200 microg/d administered as a once- or twice-daily dosage regimen in patients who were currently being treated with bronchodilators only (BD patients) and in patients who required inhaled corticosteroids for maintenance treatment of asthma (ICS patients). METHODS Five hundred seventy patients were randomly assigned to receive one of the following inhaled treatments through the Diskus device (Glaxo Wellcome, Research Triangle Park, NC) for 12 weeks: fluticasone propionate 100 microg twice daily (FP100BID) or 200 microg once daily (FP200QD) or placebo. RESULTS BD patients treated with FP100BID, FP200QD, and placebo had mean increases in FEV(1) from baseline to end point of 0. 49 L, 0.37 L, and 0.21 L, respectively (P <.001, FP100BID vs placebo; P =.05, FP200QD vs placebo). ICS patients treated with FP100BID and FP200QD had mean increases in FEV(1) of 0.27 L and 0.11 L, respectively, compared with a decrease in FEV(1) of -0.08 L with placebo (P <.001, FP100BID vs placebo; P =.023, FP200QD vs placebo). BD patients treated with FP100BID and FP200QD had mean increases in morning peak expiratory flow from baseline to end point of 31 L/min and 27 L/min, respectively, compared with a 1 L/min increase in patients treated with placebo. ICS patients treated with FP100BID had a mean increase in morning peak expiratory flow (from baseline to end point) of 18 L/min compared with mean decreases of -3 L/min and -12 L/min in the FP200QD and placebo groups, respectively. More patients were withdrawn from placebo (26% and 48%, in BD and ICS patients, respectively) than from fluticasone propionate (7%-9% [BID-QD] and 18%-32% [BID-QD], in BD and ICS patients, respectively) because of failure to meet predetermined asthma stability criteria. CONCLUSION The efficacies of FP100BID and FP200QD were comparable with regard to improvement in pulmonary function and asthma stability in BD patients. In ICS patients, asthma control was maintained with FP200QD, whereas FP100BID provided greater improvements in pulmonary function and asthma stability.
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Affiliation(s)
- J Wolfe
- Allergy and Asthma Associates Research Center of Santa Clara Valley, San Jose, CA 95117, USA
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Duke S. HMNo: the name of this practice says it all. Med Econ 2000; 77:78, 81-2, 84 passim. [PMID: 10848414] [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: 02/16/2023]
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Abstract
Anticipatory grief has been the subject of much debate since Lindemann first coined the term to describe premature mourning. Much of the research in this area takes a positivist approach focusing on the effect of anticipatory grief on bereavement. In contrast, this study, explores anticipatory grief through a Heideggerian phenomenological approach to elicit the experience of anticipatory grief. Unstructured interviews were conducted with four participants. The resulting data were interpreted using hermeneutics and evaluated using the criteria identified by Madison. The themes arising from this interpretation identify the change the participants experienced. Although these findings are limited to four participants, they are offered to raise awareness of the impact of multiple role loss and the impact of diagnosis on supporting partners. The findings also raise ways in which nurses might support people experiencing loss.
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Affiliation(s)
- S Duke
- Palliative Care, Oxford Radcliffe Trust and School of Health Care, Oxford Brookes University, England
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Abstract
This study explores the changing characteristics of patients admitted to Sir Michael Sobell House, Oxford, between 1978-89. These dates represent the period between the first available records and the first computerized records. Analysis is between these dates and has been undertaken to enable future comparison between the early life of the unit with more recent developments. Using secondary sources the following areas were compared statistically: information related to general characteristics such as sex and age; information related to referral such as the number of referrals; diagnosis on referral and reasons for referral; information related to problems presented and place of death. Significant findings included an increase in referrals and patient survival; an increase in patients dying at home; a decrease in symptoms presented on referral and fewer referrals for terminal care; and an increase in referral for rehabilitation, assessment and support. Reasons for these changes are suggested.
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Affiliation(s)
- S Duke
- Oxford Radcliffe NHS Trust, UK
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Duke S. Financial advisers. What to expect--and what not to. Med Econ 1995; 72:81-4, 86, 89. [PMID: 10153696] [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: 02/11/2023]
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Duke S. 94 years old--and still practicing. Med Econ 1995; 72:155-6, 158-9. [PMID: 10161219] [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: 04/12/2023]
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Duke S. Do you really know the person you're hiring? Med Econ 1994; 71:51-3, 56, 58-60. [PMID: 10136135] [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: 02/11/2023]
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Gadacz TR, Chase JA, Duke S. Technology of Prosthetic Material. Surg Innov 1994. [DOI: 10.1177/155335069400100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Duke S. When your parents need help managing their money. Med Econ 1994; 71:167-8, 170, 172. [PMID: 10131901] [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: 02/11/2023]
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Duke S. Turn your computer into a medical library. Med Econ 1993; 70:231-2, 235. [PMID: 10124700] [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: 02/11/2023]
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Duke S. Nursing narratives. Space to speak. Nurs Times 1992; 88:50. [PMID: 1608784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Duke S, Copp G. Hidden nursing. Nurs Times 1992; 88:40-2. [PMID: 1598253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
Susan Duke looks at research into the effects of bereavement and examines the interventions necessary for establishing the most helpful support service. Current research is limited, she says, and suggests that bereavement programmes should see research as an important component of their function. With the right preparation, existing staff can provide support without the need for bereavement specialists.
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Abstract
The degree of conversion and physical properties of two contemporary resin veneers based on light-cured microfilled composite formulations and employing proprietary curing systems were evaluated. Visio-gem (V) and Dentacolor (D) were polymerized using the appropriate curing systems. Polymer structure and degree of conversion were determined by Fourier transform infra-red (FTIR) techniques. Physical properties, including depth of cure, compressive and diametral tensile strengths, hardness, thermal expansion and colour stability were determined by standard test modalities. Both materials appear to have the properties of typical microfilled resins including low compressive yield strengths and high thermal expansion coefficients. The curing system for V produced an increased depth of cure compared to conventional light curing techniques and the D system, but no clinically significant increase in the physical properties.
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Affiliation(s)
- E Greener
- Department of Biological Materials, Northwestern University Dental School, Chicago, Illinois 60611
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Waldroup PW, Hellwig HM, Johnson ZB, Krueger WF, Moore RW, Charles OW, Duke S, Primo RA, Trammell JH, Fell RV. Response of broiler chickens to dietary supplementation with roxarsone and bacitracin methylene disalicylate in diets containing narasin. Poult Sci 1988; 67:103-7. [PMID: 3375164 DOI: 10.3382/ps.0670103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 01/05/2023] Open
Abstract
Six trials were conducted at different locations to examine the response of broiler chickens to roxarsone and bacitracin in the form of bacitracin methylene disalicylate (BMD) in the presence of the anticoccidal narasin. All diets contained narasin (80 mg/kg) and were fortified with a factorial arrangement of roxarsone (0 to 50 mg/kg) and BMD (0 or 55 mg/kg). Broilers were grown to market weights with narasin and roxarsone removed from the diets for the final 5 days. Addition of both roxarsone and BMD resulted in significant (P less than .05) improvements in body weight and feed utilization. Response to roxarsone for feed utilization was influenced to some extent by the presence or absence of BMD. Although the response to roxarsone was always positive, the degree of response was lessened by the presence of BMD. This resulted in a significant (P less than .10) interaction between roxarsone and BMD for feed utilization but not for body weight.
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Affiliation(s)
- P W Waldroup
- Department of Animal Sciences, University of Arkansas, Fayetteville 72701
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Morahan PS, Bradley SG, Munson AE, Duke S, Fromtling RA, Marciano-Cabral F. Immunotoxic effects of diethylstilbestrol on host resistance: comparison with cyclophosphamide. J Leukoc Biol 1984; 35:329-41. [PMID: 6323603 DOI: 10.1002/jlb.35.3.329] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
To evaluate the usefulness of host resistance assays for measurement of immunotoxicologic effects of chemicals, the immunosuppressive effects of exposure to diethylstilbestrol (DES) were compared with the effects of treatment with the known immunosuppressive drug cyclophosphamide (CPS). A panel of six host resistance models was evaluated, including infection with the bacterium Listeria monocytogenes, herpes simplex virus type 2 (HSV-2), and encephalomyocarditis virus (EMC), the yeast Cryptococcus neoformans, the parasite Naegleria fowleri, and transplantation of the B16F10 melanoma tumor. The results demonstrate a general correlation between the effects of CPS and DES on host resistance. Acute treatment with CPS (200 mg/kg) markedly depressed resistance to the microbial infections with L. monocytogenes and HSV, and exposure to DES usually also decreased resistance in a dose dependent manner. Moreover, CPS had no marked effect on resistance to N. fowleri and EMC virus, and exposure to DES also had a neglible or slight effect. There were, however, two model systems in which the effects of CPS and DES diverged. Whereas treatment with DES produced no significant effect on resistance to C. neoformans, acute treatment with CPS prior to the fungal infection produced a marked increase in resistance. Also, while treatment with CPS markedly increased B16F10 lung metastases, treatment with DES significantly decreased the incidence and number of lung metastases. The data support the general validity of host resistance assays, particularly with models of short disease course, for measuring immunosuppression. However, the results also emphasize the complexity of interpreting effects of environmental chemicals on host resistance, because of the interplay of such factors as relative times of exposure to the chemical in relation to pathogenesis of infection, the length of the disease course, the nature of the operative host defense mechanisms, and the compensatory recovery of these mechanisms.
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Duke S, Alsedek A. Buy your supplies in bulk and increase your savings. Hosp Purch Manage 1981; 6:13-4. [PMID: 10252712] [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: 02/12/2023]
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Duke S, Forward GC. Calcium fluoride and fluoridated hydroxyapatite formation in relation to the acid dissolution rate of enamel mineral. Caries Res 1978; 12:12-20. [PMID: 271520 DOI: 10.1159/000260310] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Brook AH, Duke S, Winter GB. Effect on plaque calcium and phosphorus concentration of short exposure to deionised water. Caries Res 1977; 11:243-4. [PMID: 266425 DOI: 10.1159/000260275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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