Integrating renal and palliative care project : A nurse-led initiative
- Smith, Vicky, Potts, Carita, Wellard, Sally, Penney, Wendy
- Authors: Smith, Vicky , Potts, Carita , Wellard, Sally , Penney, Wendy
- Date: 2015
- Type: Text , Journal article
- Relation: Renal Society of Australasia Journal Vol. 11, no. 1 (2015), p. 35-40
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- Description: Renal nurses working in dialysis settings in Australian regional and rural locations face challenges in facilitating advance care planning (ACP) and providing quality physical and psychological symptom care at the end of life (EOL) for a growing population of older and sicker people with end-stage kidney disease (ESKD). Following concerns raised by patients, families, renal and palliative care nurses early in 2009 in one regional setting, gaps in service delivery were identified. These identified gaps were supported by an emerging literature that identified the need for integrated, palliative, supportive care earlier in the disease trajectory. This care, provided on a needs basis, incorporates ACP, and identifies and addresses complex symptom and psychological issues to improve quality of life (QOL) and planning EOL care for patients and their families/carers. This approach to care, now called renal supportive care, is in varying stages of implementation across Australia for all renal patients, predominantly in metropolitan centres. With limited financial resources, a successful multi-professional collaboration and coordinated approach was established in January 2009 in Ballarat, a large regional setting in Victoria. An implementation framework was developed, addressing the continuum of care from pre-dialysis to withdrawal/cessation from renal replacement therapy (RRT), with an integrated palliative supportive approach during active treatment or EOL care. This project has provided a step forward in improving confidence and responsibility for palliative care by renal nurses working in dialysis settings, helping them to address the challenges faced in evaluating symptom burden, facilitating ACP and delivery of quality EOL care for patients, their families and carers with ESKD.
- Authors: Smith, Vicky , Potts, Carita , Wellard, Sally , Penney, Wendy
- Date: 2015
- Type: Text , Journal article
- Relation: Renal Society of Australasia Journal Vol. 11, no. 1 (2015), p. 35-40
- Full Text:
- Reviewed:
- Description: Renal nurses working in dialysis settings in Australian regional and rural locations face challenges in facilitating advance care planning (ACP) and providing quality physical and psychological symptom care at the end of life (EOL) for a growing population of older and sicker people with end-stage kidney disease (ESKD). Following concerns raised by patients, families, renal and palliative care nurses early in 2009 in one regional setting, gaps in service delivery were identified. These identified gaps were supported by an emerging literature that identified the need for integrated, palliative, supportive care earlier in the disease trajectory. This care, provided on a needs basis, incorporates ACP, and identifies and addresses complex symptom and psychological issues to improve quality of life (QOL) and planning EOL care for patients and their families/carers. This approach to care, now called renal supportive care, is in varying stages of implementation across Australia for all renal patients, predominantly in metropolitan centres. With limited financial resources, a successful multi-professional collaboration and coordinated approach was established in January 2009 in Ballarat, a large regional setting in Victoria. An implementation framework was developed, addressing the continuum of care from pre-dialysis to withdrawal/cessation from renal replacement therapy (RRT), with an integrated palliative supportive approach during active treatment or EOL care. This project has provided a step forward in improving confidence and responsibility for palliative care by renal nurses working in dialysis settings, helping them to address the challenges faced in evaluating symptom burden, facilitating ACP and delivery of quality EOL care for patients, their families and carers with ESKD.
- Snow, Pamela, Bagley, Kerryn, White, Donna
- Authors: Snow, Pamela , Bagley, Kerryn , White, Donna
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Speech-Language Pathology Vol. 20, no. 4 (2018), p. 458-467
- Full Text: false
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- Description: Purpose: Young people in youth justice (YJ) settings face high-risk for unidentified language disorder, however, speech-language pathology (SLP) services are not routinely offered in such settings. The aim of this study was to explore and describe the perceptions and experiences of YJ staff in a custodial centre of the utility of having a speech-language pathologist working with young offenders. Method: Following a SLP intervention trial, two staff focus groups were conducted by an independent SLP. Interview probes were developed through review of the literature and consultation with the practitioner who conducted the clinical intervention. Focus groups were digitally recorded for thematic analysis, which was carried out by the three authors independently. Result: YJ staff expressed consistently positive views about the SLP intervention trial in their centre. Staff indicated that they learnt a great deal about the complexity of communication difficulties in this population, and that this information informed and guided their own practices. They expressed surprise at the engagement of young people in the SLP service, and supported its embedding in the YJ setting. Conclusion: YJ staff endorsed the value of a SLP service in a custodial setting. Further research should focus on refining measurement of this service and its impact. © 2017,
Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017
- Soriano, J., Kendrick, P., Paulson, K., Gupta, V., Abrams, E., Rahman, Muhammad Aziz
- Authors: Soriano, J. , Kendrick, P. , Paulson, K. , Gupta, V. , Abrams, E. , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Respiratory Medicine Vol. 8, no. 6 (2020), p. 585-596
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- Description: Background: Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings: In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), age-standardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation: Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Soriano, J. , Kendrick, P. , Paulson, K. , Gupta, V. , Abrams, E. , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Respiratory Medicine Vol. 8, no. 6 (2020), p. 585-596
- Full Text:
- Reviewed:
- Description: Background: Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings: In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), age-standardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation: Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
Proteus effect profiles : how do they relate with disordered gaming behaviours?
- Stavropoulos, Vasileios, Pontes, Halley, Gomez, Rapson, Schivinski, Bruno, Griffiths, Mark
- Authors: Stavropoulos, Vasileios , Pontes, Halley , Gomez, Rapson , Schivinski, Bruno , Griffiths, Mark
- Date: 2020
- Type: Text , Journal article
- Relation: Psychiatric Quarterly Vol. 91, no. 3 (2020), p. 615-628
- Full Text: false
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- Description: Gamers represent themselves in online gaming worlds through their avatars. The term “Proteus Effect” (PE) defines the potential influences of the gamers’ avatars on their demeanour, perception and conduct and has been linked with excessive gaming. There is a significant lack of knowledge regarding likely distinct PE profiles and whether these could be differentially implicated with disordered gaming. A normative group of 1022 World of Warcraft (WoW) gamers were assessed in the present study (Mean age = 28.60 years). The Proteus Effect Scale (PES) was used to evaluate the possible avatar effect on gamers’ conduct, and the Internet Gaming Disorder Scale–Short-Form was used to examine gaming disorder behaviors. Latent class profiling resulted in three distinct PE classes, ‘non-influenced-gamers’ (NIGs), ‘perception-cognition-influenced-gamers’ (PCIGs), and ‘emotion-behaviour-influenced-gamers’ (EBIGs). The NIGs reported low rates across all PES items. The PCIGs indicated higher avatar influence in their perception-experience but did not report being affected emotionally. The EBIGs indicated significantly higher avatar influence in their emotion and behaviour than the other two classes but reported stability in their perception of aspects independent of their avatar. Gaming disorder behaviours were reduced for the NIGs and progressively increased for the PCIGs and the EBIGs. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
In search of the optimum structural model for internet gaming disorder
- Stavropoulos, Vasileios, Gomez, Rapson, Griffiths, Mark
- Authors: Stavropoulos, Vasileios , Gomez, Rapson , Griffiths, Mark
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 21, no. 1 (2021), p.
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- Description: Background: Internet gaming Disorder (IGD) constitutes a recently proposed clinical disorder (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2013). The present study examined if IGD is best conceptualized as categorical (present/absent), or dimensional (severity ranging from low to high), or both (i.e., hybrid of categorical/dimensional). Methods: Ratings of the nine DSM-5 IGD symptoms, as presented in the Internet Gaming Disorder Scale 9-Short Form (Pontes & Griffiths, Comput Hum Behav 45:137-143, 2015), from 738 gamers, aged 17 to 72 years, were collected. Confirmatory factor analysis (CFA), latent class analysis (LCA), and factor mixture modelling analysis (FMMA) procedures were applied to determine the optimum IGD model. Results: Although the findings showed most support for a FFMA model with two classes and one factor, there was also good statistical and substantive support for the one-factor CFA model, and the LCA model with three classes. Conclusion: It was concluded that while the optimum structure of IGD is most likely to be a hybrid model (i.e., concurrently categorical and dimensional), a uni-dimensional model and/or a three-class categorical model are also plausible. © 2021, The Author(s).
- Authors: Stavropoulos, Vasileios , Gomez, Rapson , Griffiths, Mark
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Internet gaming Disorder (IGD) constitutes a recently proposed clinical disorder (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2013). The present study examined if IGD is best conceptualized as categorical (present/absent), or dimensional (severity ranging from low to high), or both (i.e., hybrid of categorical/dimensional). Methods: Ratings of the nine DSM-5 IGD symptoms, as presented in the Internet Gaming Disorder Scale 9-Short Form (Pontes & Griffiths, Comput Hum Behav 45:137-143, 2015), from 738 gamers, aged 17 to 72 years, were collected. Confirmatory factor analysis (CFA), latent class analysis (LCA), and factor mixture modelling analysis (FMMA) procedures were applied to determine the optimum IGD model. Results: Although the findings showed most support for a FFMA model with two classes and one factor, there was also good statistical and substantive support for the one-factor CFA model, and the LCA model with three classes. Conclusion: It was concluded that while the optimum structure of IGD is most likely to be a hybrid model (i.e., concurrently categorical and dimensional), a uni-dimensional model and/or a three-class categorical model are also plausible. © 2021, The Author(s).
Inattention and disordered gaming : does culture matter?
- Stavropoulos, Vasileios, Baynes, Kyi, O’Farrel, Dominic, Gomez, Rapson, Mueller, Astrid, Yucel, Murat, Griffiths, Mark
- Authors: Stavropoulos, Vasileios , Baynes, Kyi , O’Farrel, Dominic , Gomez, Rapson , Mueller, Astrid , Yucel, Murat , Griffiths, Mark
- Date: 2020
- Type: Text , Journal article
- Relation: Psychiatric Quarterly Vol. 91, no. 2 (2020), p. 333-348
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- Description: Problematic gaming has emerged as a contemporary concern, leading to the introduction of the diagnostic term ‘Internet Gaming Disorder’ (IGD; American Psychiatric Association). The present study aims to empirically assess the association between inattention and IGD, in the light of variable levels of vertical-individualism that reflects cultural inclinations towards independence, competitiveness, and hierarchy. The participants (N = 1032) comprised a normative cohort of Massively Multiplayer Online (MMO) gamers (Mage = 24 years; 48.7% male). IGD was measured with the nine-item short-form IGD Scale (IGD9-SF), inattention with the Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale, and vertical individualism with the Individualism-Collectivism Questionnaire. Complex hierarchical and moderated regressions were employed. Findings demonstrated an association between IGD and inattention, and additionally showed that this association was exacerbated by a more vertically-individualistic cultural orientation without significant gender differences. The need of differentially addressing IGD risk among inattentive gamers of diverse cultural orientation is highlighted. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
- Authors: Stavropoulos, Vasileios , Baynes, Kyi , O’Farrel, Dominic , Gomez, Rapson , Mueller, Astrid , Yucel, Murat , Griffiths, Mark
- Date: 2020
- Type: Text , Journal article
- Relation: Psychiatric Quarterly Vol. 91, no. 2 (2020), p. 333-348
- Full Text:
- Reviewed:
- Description: Problematic gaming has emerged as a contemporary concern, leading to the introduction of the diagnostic term ‘Internet Gaming Disorder’ (IGD; American Psychiatric Association). The present study aims to empirically assess the association between inattention and IGD, in the light of variable levels of vertical-individualism that reflects cultural inclinations towards independence, competitiveness, and hierarchy. The participants (N = 1032) comprised a normative cohort of Massively Multiplayer Online (MMO) gamers (Mage = 24 years; 48.7% male). IGD was measured with the nine-item short-form IGD Scale (IGD9-SF), inattention with the Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale, and vertical individualism with the Individualism-Collectivism Questionnaire. Complex hierarchical and moderated regressions were employed. Findings demonstrated an association between IGD and inattention, and additionally showed that this association was exacerbated by a more vertically-individualistic cultural orientation without significant gender differences. The need of differentially addressing IGD risk among inattentive gamers of diverse cultural orientation is highlighted. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Responsible gambling among older adults : a qualitative exploration
- Subramaniam, Mythily, Satghare, Pratika, Vaingankar, Janhavi, Picco, Louisa, Browning, Colette, Chong, Siow, Thomas, Shane
- Authors: Subramaniam, Mythily , Satghare, Pratika , Vaingankar, Janhavi , Picco, Louisa , Browning, Colette , Chong, Siow , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
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- Reviewed:
- Description: Background: Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods: Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results: This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions: The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. © 2017 The Author(s).
- Authors: Subramaniam, Mythily , Satghare, Pratika , Vaingankar, Janhavi , Picco, Louisa , Browning, Colette , Chong, Siow , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods: Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results: This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions: The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. © 2017 The Author(s).
Quantifying psychopathology in rapid readmissions
- Suhail, Sam, Sandhu, Harpinder, Mellacheruvu, Sandeep
- Authors: Suhail, Sam , Sandhu, Harpinder , Mellacheruvu, Sandeep
- Date: 2021
- Type: Text , Journal article
- Relation: CNS spectrums Vol. 26, no. 2 (2021), p. 165-166
- Full Text:
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- Description: Psychiatric readmissions contribute to a significant cost and healthcare burden to physicians, hospitals, and the healthcare system as an entity. Furthermore, as part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) began to reduce financial coverage to hospitals with overwhelming rehospitalization rates. The purpose of this study was to do a systematic analysis on inpatient psychiatric readmission data and identify co-morbidities and risk factors that lead to high readmission rates. The data collection includes 163 patients with a total of 348 readmissions over the span of 90 days at one inner-city hospital in the Chicagoland area. Study findings suggest that higher rates of readmission are linked to cocaine abuse in both male and female populations. Diagnosis of bipolar in females and schizoaffective disorder in male populations were the among the highest for readmission. Key social factors such as homelessness and low socioeconomic status were identified to contribute to a large proportion of psychiatric readmission burden. However, an overwhelming amount of information was missing due to unobtained labs and lack of current patient social history. By using this data as well as data from electronic medical records (EMRs) to further investigate and identify other features of at-risk patients, hospitals can potentially address these markers to lower readmission rates. Ultimately, a higher understanding of the patients' needs can be understood and can help develop standardized plans of care for prevalent psychiatric illnesses in these populations.
- Authors: Suhail, Sam , Sandhu, Harpinder , Mellacheruvu, Sandeep
- Date: 2021
- Type: Text , Journal article
- Relation: CNS spectrums Vol. 26, no. 2 (2021), p. 165-166
- Full Text:
- Reviewed:
- Description: Psychiatric readmissions contribute to a significant cost and healthcare burden to physicians, hospitals, and the healthcare system as an entity. Furthermore, as part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) began to reduce financial coverage to hospitals with overwhelming rehospitalization rates. The purpose of this study was to do a systematic analysis on inpatient psychiatric readmission data and identify co-morbidities and risk factors that lead to high readmission rates. The data collection includes 163 patients with a total of 348 readmissions over the span of 90 days at one inner-city hospital in the Chicagoland area. Study findings suggest that higher rates of readmission are linked to cocaine abuse in both male and female populations. Diagnosis of bipolar in females and schizoaffective disorder in male populations were the among the highest for readmission. Key social factors such as homelessness and low socioeconomic status were identified to contribute to a large proportion of psychiatric readmission burden. However, an overwhelming amount of information was missing due to unobtained labs and lack of current patient social history. By using this data as well as data from electronic medical records (EMRs) to further investigate and identify other features of at-risk patients, hospitals can potentially address these markers to lower readmission rates. Ultimately, a higher understanding of the patients' needs can be understood and can help develop standardized plans of care for prevalent psychiatric illnesses in these populations.
Detection of low pathogenicity influenza a(H7n3) virus during duck mortality event, Cambodia, 2017
- Suttie, Annika, Yann, Sokhoun, Phalla, Y., Tum, Sothyra, Deng, Yi-Mo, Hul, Vibol, Horm, Viseth, Barr, Ian, Greenhill, Andrew, Horwood, Paul, Osbjer, Kristina, Karlsson, Erik, Dussart, Philippe
- Authors: Suttie, Annika , Yann, Sokhoun , Phalla, Y. , Tum, Sothyra , Deng, Yi-Mo , Hul, Vibol , Horm, Viseth , Barr, Ian , Greenhill, Andrew , Horwood, Paul , Osbjer, Kristina , Karlsson, Erik , Dussart, Philippe
- Date: 2018
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 24, no. 6 (2018), p. 1103-1107
- Full Text: false
- Reviewed:
- Description: In January 2017, an estimated 3,700 (93%) of 4,000 Khaki Campbell ducks (Anas platyrhynchos domesticus) died in Kampong Thom Province, Cambodia. We detected low pathogenicity avian influenza A(H7N3) virus and anatid herpesvirus 1 (duck plague) in the affected flock; however, the exact cause of the mortality event remains unclear.
- Tan, Pamela, Chen, Hui-Chen, Taylor, Beverley, Hegney, Desley
- Authors: Tan, Pamela , Chen, Hui-Chen , Taylor, Beverley , Hegney, Desley
- Date: 2012
- Type: Text , Journal article
- Relation: Wiley-Blackwell Publishing Asia Vol. 10, no. 3 (2012), p. 169-180
- Full Text: false
- Reviewed:
- Description: Aim: To synthesise the evidence on how community‐dwelling adults with type 1 and type 2 diabetes mellitus experience hypoglycaemia and the strategies they use to control it. Methods: Using a three‐step search strategy, all published and unpublished qualitative studies in English from January 2000 to August 2010 were retrieved. Participants diagnosed with type 1 or type 2 diabetes mellitus, experienced in self‐managing their hypoglycaemia, and who lived independently in the community and attended primary care or outpatient clinics were included. An initial limited search was conducted in MEDLINE and CINAHL to identify keywords and index terms, which were then used in a second search across the CINAHL, PUBMED, SCOPUS, PsycINFO, PsycARTICLES, Web of Science, JSTOR, EMBASE and MEDNAR databases. Additionally, the reference lists of all retrieved papers were hand‐searched for additional studies. Retrieved studies were assessed for methodological validity using the standardised Joanna Briggs Institute‐Qualitative Assessment and Review Instrument (JBI‐QARI). Data, in terms of research findings, were extracted from included studies using the standardised JBI‐QARI data extraction tool. Five studies (six papers) were included in the review. Results: The 20 findings from the six papers were grouped into three categories, which were then synthesised into one overall finding – that is ‘People with diabetes mellitus can self‐manage their diabetes and thus prevent hypoglycaemic episodes more effectively when health professionals provide psychological, physiological and spiritual support, and an individually targeted education programme’. Conclusions: Within the constraints of this review, it appears that the patient‐identified priority is to maintain normality in blood glucose self‐management. There is also evidence that some people lack the knowledge to identify and self‐manage hypoglycaemia. Implications for practice: To enable community‐dwelling adults with diabetes mellitus to self‐manage hypoglycaemia, healthcare professionals should provide individualised information and emotional support and regularly discuss and assess the person's level of knowledge, awareness of hypoglycaemia and their ability to self‐manage.
- Taylor, Rachael, Zagami, Alessandro, Gibson, William, Black, Deborah, Watson, Shaun, Halmagyi, Michael G., Welgampola, Miriam
- Authors: Taylor, Rachael , Zagami, Alessandro , Gibson, William , Black, Deborah , Watson, Shaun , Halmagyi, Michael G. , Welgampola, Miriam
- Date: 2012
- Type: Text , Journal article
- Relation: Cephalalgia Vol. 32, no. 3 (2012), p. 213-225
- Full Text: false
- Reviewed:
- Description: OBJECTIVES: It can be difficult to distinguish vestibular migraine (VM) from Meniere's disease (MD) in its early stages. Using vestibular-evoked myogenic potentials (VEMPs), we sought to identify test parameters that would help discriminate between these two vestibular disorders. METHODS: We first recorded ocular and cervical VEMPs (oVEMP/cVEMP) to air-conducted clicks and bone-conducted vibration in 30 control participants, 30 participants with clinically definite VM and 30 participants with clinically probable VM. Results were compared with a group of 60 MD patients from a previous study. oVEMPs and cVEMPs were then recorded at octave frequencies of 250 Hz to 2000 Hz in 20 controls and 20 participants each with clinically definite VM and MD. Inter-aural amplitude asymmetry ratios and amplitude frequency ratios were compared between groups. RESULTS: For click, tendon-hammer-tap and minishaker-tap VEMPs, there were no significant differences in reflex amplitudes or symmetry between controls, definite VM and probable VM. Compared with MD patients, participants with VM had significantly fewer reflex abnormalities for click-cVEMP, click-oVEMPs and minitap-cVEMPs. The ratio of cVEMP amplitude generated by tone bursts at a frequency of 0.5 kHz to that generated by 1 kHz was significantly lower for MD affected ears than for VM or controls ears. cVEMP asymmetry ratios for 0.5 kHz tone bursts were significantly higher for MD than VM. CONCLUSIONS: The 0.5/1 kHz frequency ratio, 0.5 kHz asymmetry ratio and caloric test combined, separated MD from VM with a sensitivity of 90.0% and specificity of 70.0%.
Workplace health and safety issues among community nurses : a study regarding the impact on providing care to rural consumers
- Terry, Daniel, Lê, Quynh, Nguyen, Uyen, Hoang, Hoang
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
- Full Text:
- Reviewed:
- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
Glycaemic control among rural health consumers : a retrospective study of a diabetes center
- Terry, Daniel, Glenister, Kristen, Kilmartin, John, Kilmartin, Gloria, Sands, Rob, Fowler, Jeremy, Wright, Julian
- Authors: Terry, Daniel , Glenister, Kristen , Kilmartin, John , Kilmartin, Gloria , Sands, Rob , Fowler, Jeremy , Wright, Julian
- Date: 2015
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 3, no. 2 (2015), p. 11-15
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- Description: Aim: The aim of this paper is to highlight the successes of and challenges faced by a publically funded diabetes center in a regional area. Methods: Demographic and laboratory cross sectional data were collected from electronic patient records. Data from a patient’s very first test undertaken when attending the hospital and the latest test undertaken at the dabetes center were noted and included age, sex, residential postcode and glycated haemoglobin (HbA1c) levels. Results: A third of patients reached the therapeutic guideline of ‘very good control’ for HbA1c levels. Females had lower Hb1Ac levels, while males and those that lived further away from the diabetes center had higher levels of HbA1c. However, a significant improvement in glycaemic control among men and those who lived ‘out of town’ was noted, while the corresponding pattern for women was not evident. Conclusion: The study demonstrated that there was an overall improvement in diabetes control among health consumers who attend the regional diabetes center, however, female patients residing in town showed a negligible change over time. At risk’ patient groups may need further targeting for intensive intervention to achieve optimal diabetes control, even within the diabetes center.
- Authors: Terry, Daniel , Glenister, Kristen , Kilmartin, John , Kilmartin, Gloria , Sands, Rob , Fowler, Jeremy , Wright, Julian
- Date: 2015
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 3, no. 2 (2015), p. 11-15
- Full Text:
- Reviewed:
- Description: Aim: The aim of this paper is to highlight the successes of and challenges faced by a publically funded diabetes center in a regional area. Methods: Demographic and laboratory cross sectional data were collected from electronic patient records. Data from a patient’s very first test undertaken when attending the hospital and the latest test undertaken at the dabetes center were noted and included age, sex, residential postcode and glycated haemoglobin (HbA1c) levels. Results: A third of patients reached the therapeutic guideline of ‘very good control’ for HbA1c levels. Females had lower Hb1Ac levels, while males and those that lived further away from the diabetes center had higher levels of HbA1c. However, a significant improvement in glycaemic control among men and those who lived ‘out of town’ was noted, while the corresponding pattern for women was not evident. Conclusion: The study demonstrated that there was an overall improvement in diabetes control among health consumers who attend the regional diabetes center, however, female patients residing in town showed a negligible change over time. At risk’ patient groups may need further targeting for intensive intervention to achieve optimal diabetes control, even within the diabetes center.
Satisfaction amid professional challenges : international medical graduates in rural Tasmania
- Terry, Daniel, Lê, Quynh, Hoang, Hoang
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
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- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
- Full Text:
- Reviewed:
- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
Cardiovascular diseases and G-protein beta 3 subunit gene (GNB3) in the era of genomewide scans
- Tomaszewski, Maciej, Charchar, Fadi, Padmanabhan, Sandosh, Zukowska-Szczechowska, Ewa, Grzeszczak, Wladyslaw, Dominiczak, Anna
- Authors: Tomaszewski, Maciej , Charchar, Fadi , Padmanabhan, Sandosh , Zukowska-Szczechowska, Ewa , Grzeszczak, Wladyslaw , Dominiczak, Anna
- Date: 2003
- Type: Text , Journal article
- Relation: Journal of Human Hypertension Vol. 17, no. 6 (2003), p. 379-380
- Full Text: false
- Reviewed:
- Tomaszewski, Maciej, Charchar, Fadi, Barnes, Timothy, Gawron-Kiszka, Magdalena, Sedkowska, Agnieszka, Grzeszczak, Wladyslaw, Samani, Nilesh, Zukowska-Szczechowska, Ewa
- Authors: Tomaszewski, Maciej , Charchar, Fadi , Barnes, Timothy , Gawron-Kiszka, Magdalena , Sedkowska, Agnieszka , Grzeszczak, Wladyslaw , Samani, Nilesh , Zukowska-Szczechowska, Ewa
- Date: 2008
- Type: Text , Journal article
- Relation: Hypertension Vol. 52, no. 4 (Oct 2008), p. E129-E129
- Full Text: false
- Reviewed:
- Description: C1
- Tomaszewski, Maciej, Debiec, Radoslaw, Braund, Peter, Nelson, Christopher, Hardwick, Robert, Christofidou, Paraskevi, Denniff, Matthew, Codd, Veryan, Rafelt, Suzanne, van der Harst, Pim, Waterworth, Dawn, Song, Kijoung, Vollenweider, Peter, Waeber, Gerard, Zukowska-Szczechowska, Ewa, Burton, Paul, Mooser, Vincent, Charchar, Fadi, Thompson, John, Tobin, Martin, Samani, Nilesh
- Authors: Tomaszewski, Maciej , Debiec, Radoslaw , Braund, Peter , Nelson, Christopher , Hardwick, Robert , Christofidou, Paraskevi , Denniff, Matthew , Codd, Veryan , Rafelt, Suzanne , van der Harst, Pim , Waterworth, Dawn , Song, Kijoung , Vollenweider, Peter , Waeber, Gerard , Zukowska-Szczechowska, Ewa , Burton, Paul , Mooser, Vincent , Charchar, Fadi , Thompson, John , Tobin, Martin , Samani, Nilesh
- Date: 2010
- Type: Text , Journal article
- Relation: Hypertension Vol. 56, no. 6 (2010), p. 1069-U146
- Full Text: false
- Reviewed:
- Description: Genetic determinants of blood pressure are poorly defined. We undertook a large-scale, gene-centric analysis to identify loci and pathways associated with ambulatory systolic and diastolic blood pressure. We measured 24-hour ambulatory blood pressure in 2020 individuals from 520 white European nuclear families (the Genetic Regulation of Arterial Pressure of Humans in the Community Study) and genotyped their DNA using the Illumina HumanCVD BeadChip array, which contains approximate to 50 000 single nucleotide polymorphisms in >2000 cardiovascular candidate loci. We found a strong association between rs13306560 polymorphism in the promoter region of MTHFR and CLCN6 and mean 24-hour diastolic blood pressure; each minor allele copy of rs13306560 was associated with 2.6 mm Hg lower mean 24-hour diastolic blood pressure (P=1.2 x 10(-8)). rs13306560 was also associated with clinic diastolic blood pressure in a combined analysis of 8129 subjects from the Genetic Regulation of Arterial Pressure of Humans in the Community Study, the CoLaus Study, and the Silesian Cardiovascular Study (P=5.4 x 10(-6)). Additional analysis of associations between variants in gene ontology-defined pathways and mean 24-hour blood pressure in the Genetic Regulation of Arterial Pressure of Humans in the Community Study showed that cell survival control signaling cascades could play a role in blood pressure regulation. There was also a significant overrepresentation of rare variants (minor allele frequency: <0.05) among polymorphisms showing at least nominal association with mean 24-hour blood pressure indicating that a considerable proportion of its heritability may be explained by uncommon alleles. Through a large-scale gene-centric analysis of ambulatory blood pressure, we identified an association of a novel variant at the MTHFR/CLNC6 locus with diastolic blood pressure and provided new insights into the genetic architecture of blood pressure.
- Tomaszewski, Maciej, Charchar, Fadi, Przybycin, Malgorzata, Crawford, Lynne, Wallace, A. Michael., Gosek, Katarzyna, Lowe, Gordon. D., Zukowska-Szczechowska, Ewa, Grzeszczak, Wladyslaw, Sattar, Naveed, Dominiczak, Anna
- Authors: Tomaszewski, Maciej , Charchar, Fadi , Przybycin, Malgorzata , Crawford, Lynne , Wallace, A. Michael. , Gosek, Katarzyna , Lowe, Gordon. D. , Zukowska-Szczechowska, Ewa , Grzeszczak, Wladyslaw , Sattar, Naveed , Dominiczak, Anna
- Date: 2003
- Type: Text , Journal article
- Relation: Arteriosclerosis Thrombosis and Vascular Biology Vol. 23, no. 9 (2003), p. 1640-1644
- Full Text: false
- Reviewed:
- Description: Objective-This study was undertaken to evaluate to what extent C-reactive protein (CRP) can be reduced by exercise by examining its circulating concentrations in male ultramarathon runners and to determine if low leptin as a robust circulating marker of fat mass could account for low CRP in such men. Methods and Results-Sixty-seven male ultramarathon runners and 63 sedentary male controls of similar age and body mass index were recruited. CRP and leptin were measured by ELISA and radioimmunoassay, respectively. Median CRP concentration in lean (body mass index <25 kg/m(2)) marathon runners was less than half control median (0.4 [0.2 to 0.9] mg/L versus 0.9 [0.5 to 2.7] mg/L, P=0.0013) and, more strikingly, in nonlean runners was approximately 26% of control median (0.4 [0.3 to 0.8] mg/L versus 1.5 [0.9 to 2.5] mg/L, P=0.0002). Circulating leptin levels were also substantially lower in lean (45% less) and nonlean (63% less, both P=0.0001) ultramarathon runners. However, interleukin-6 levels were not different. Furthermore, leptin adjustment only minimally attenuated the case-control difference in CRP, suggesting that mechanisms other than fat mass reduction contribute to low concentrations of CRP in marathon runners. Conclusions-This study suggests that circulating CRP concentrations can be markedly suppressed, independently of total adiposity or indeed fat mass, by intense regular physical exercise.
Pathway analysis shows association between FGFBP1 and hypertension
- Tomaszewski, Maciej, Charchar, Fadi, Nelson, Christopher, Barnes, Timothy, Denniff, Matthew, Kaiser, Michael, Debiec, Radoslaw, Christofidou, Paraskevi, Rafelt, Suzanne, Van Harst, Pim Der, Wang, William, Maric, Christine, Zukowska-Szczechowska, Ewa, Samani, Nilesh
- Authors: Tomaszewski, Maciej , Charchar, Fadi , Nelson, Christopher , Barnes, Timothy , Denniff, Matthew , Kaiser, Michael , Debiec, Radoslaw , Christofidou, Paraskevi , Rafelt, Suzanne , Van Harst, Pim Der , Wang, William , Maric, Christine , Zukowska-Szczechowska, Ewa , Samani, Nilesh
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of the American Society of Nephrology Vol. 22, no. 5 (2011), p. 947-955
- Full Text: false
- Reviewed:
- Description: Variants in the gene encoding fibroblast growth factor 1 (FGF1) co-segregate with familial susceptibility to hypertension, and glomerular upregulation of FGF1 associates with hypertension. To investigate whether variants in other members of the FGF signaling pathway may also associate with hypertension, we genotyped 629 subjects from 207 Polish families with hypertension for 79 single nucleotide polymorphisms in eight genes of this network. Family-based analysis showed that parents transmitted the major allele of the rs16892645 polymorphism in the gene encoding FGF binding protein 1 (FGFBP1) to hypertensive offspring more frequently than expected by chance (P = 0.005). An independent cohort of 807 unrelated Polish subjects validated this association. Furthermore, compared with normotensive subjects, hypertensive subjects had approximately 1.5- and 1.4-fold higher expression of renal FGFBP1 mRNA and protein (P = 0.04 and P = 0.001), respectively. By immunohistochemistry, hypertensionrelated upregulation of FGFBP1 was most apparent in the glomerulus and juxtaglomerular space. Taken together, these data suggest that FGFBP1 associates with hypertension and that systematic analysis of signaling pathways can identify previously undescribed genetic associations. Copyright © 2011 by the American Society of Nephrology.
Renal Mechanisms of Association between Fibroblast Growth Factor 1 and Blood Pressure
- Tomaszewski, Maciej, Eales, James, Denniff, Matthew, Myers, Stephen, Chew, Guatsiew, Nelson, Christopher, Christofidou, Paraskevi, Desai, Aishwarya, Büsst, Cara, Wojnar, Lukasz, Musialik, Katarzyna, Jozwiak, Jacek, Debiec, Radoslaw, Dominiczak, Anna, Navis, Gerjan, van Gilst, Wiek, van der Harst, Pim, Samani, Nilesh, Harrap, Stephen, Bogdanski, Pawel, Zukowska-Szczechowska, Ewa, Charchar, Fadi
- Authors: Tomaszewski, Maciej , Eales, James , Denniff, Matthew , Myers, Stephen , Chew, Guatsiew , Nelson, Christopher , Christofidou, Paraskevi , Desai, Aishwarya , Büsst, Cara , Wojnar, Lukasz , Musialik, Katarzyna , Jozwiak, Jacek , Debiec, Radoslaw , Dominiczak, Anna , Navis, Gerjan , van Gilst, Wiek , van der Harst, Pim , Samani, Nilesh , Harrap, Stephen , Bogdanski, Pawel , Zukowska-Szczechowska, Ewa , Charchar, Fadi
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of the American Society of Nephrology Vol. 26, no. 12 (2015), p. 3151-3160
- Relation: http://purl.org/au-research/grants/nhmrc/1009490
- Full Text:
- Reviewed:
- Description: The fibroblast growth factor 1 (FGF1) gene is expressed primarily in the kidney and may contribute to hypertension. However, the biologic mechanisms underlying the association between FGF1 and BP regulation remain unknown. We report that the major allele of FGF1 single nucleotide polymorphism rs152524 was associated in a dose-dependent manner with systolic BP (P=9.65 x10(-5)) and diastolic BP (P=7.61 x10(-3)) in a meta-analysis of 14,364 individuals and with renal expression of FGF1 mRNA in 126 human kidneys (P=9.0x10(-3)). Next-generation RNA sequencing revealed that upregulated renal expression of FGF1 or of each of the three FGF1 mRNA isoforms individually was associated with higher BP. FGF1-stratified coexpression analysis in two separate collections of human kidneys identified 126 FGF1 partner mRNAs, of which 71 and 63 showed at least nominal association with systolic and diastolic BP, respectively. Of those mRNAs, seven mRNAs in five genes (MME, PTPRO, REN, SLC12A3, and WNK1) had strong prior annotation to BP or hypertension. MME, which encodes an enzyme that degrades circulating natriuretic peptides, showed the strongest differential coexpression with FGF1 between hypertensive and normotensive kidneys. Furthermore, higher level of renal FGF1 expression was associated with lower circulating levels of atrial and brain natriuretic peptides. These findings indicate that FGF1 expression in the kidney is at least under partial genetic control and that renal expression of several FGF1 partner genes involved in the natriuretic peptide catabolism pathway, reninangiotensin cascade, and sodium handling network may explain the association between FGF1 and BP.
- Authors: Tomaszewski, Maciej , Eales, James , Denniff, Matthew , Myers, Stephen , Chew, Guatsiew , Nelson, Christopher , Christofidou, Paraskevi , Desai, Aishwarya , Büsst, Cara , Wojnar, Lukasz , Musialik, Katarzyna , Jozwiak, Jacek , Debiec, Radoslaw , Dominiczak, Anna , Navis, Gerjan , van Gilst, Wiek , van der Harst, Pim , Samani, Nilesh , Harrap, Stephen , Bogdanski, Pawel , Zukowska-Szczechowska, Ewa , Charchar, Fadi
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of the American Society of Nephrology Vol. 26, no. 12 (2015), p. 3151-3160
- Relation: http://purl.org/au-research/grants/nhmrc/1009490
- Full Text:
- Reviewed:
- Description: The fibroblast growth factor 1 (FGF1) gene is expressed primarily in the kidney and may contribute to hypertension. However, the biologic mechanisms underlying the association between FGF1 and BP regulation remain unknown. We report that the major allele of FGF1 single nucleotide polymorphism rs152524 was associated in a dose-dependent manner with systolic BP (P=9.65 x10(-5)) and diastolic BP (P=7.61 x10(-3)) in a meta-analysis of 14,364 individuals and with renal expression of FGF1 mRNA in 126 human kidneys (P=9.0x10(-3)). Next-generation RNA sequencing revealed that upregulated renal expression of FGF1 or of each of the three FGF1 mRNA isoforms individually was associated with higher BP. FGF1-stratified coexpression analysis in two separate collections of human kidneys identified 126 FGF1 partner mRNAs, of which 71 and 63 showed at least nominal association with systolic and diastolic BP, respectively. Of those mRNAs, seven mRNAs in five genes (MME, PTPRO, REN, SLC12A3, and WNK1) had strong prior annotation to BP or hypertension. MME, which encodes an enzyme that degrades circulating natriuretic peptides, showed the strongest differential coexpression with FGF1 between hypertensive and normotensive kidneys. Furthermore, higher level of renal FGF1 expression was associated with lower circulating levels of atrial and brain natriuretic peptides. These findings indicate that FGF1 expression in the kidney is at least under partial genetic control and that renal expression of several FGF1 partner genes involved in the natriuretic peptide catabolism pathway, reninangiotensin cascade, and sodium handling network may explain the association between FGF1 and BP.