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"Oliver, Susan"
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Dear Oliver : an unexpected friendship with Oliver Sacks
When Susan Barry first wrote to Oliver Sacks, she never expected a response, let alone the deep friendship that blossomed over ten years of letters. A funny, fascinating, and intimate glimpse of the great Oliver Sacks, 'Dear Oliver' is also a love letter to scientific inquiry, and a testimony to the power of friendship at any time in life.
BOOK
EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis
The objective was to develop evidence -based recommendations and a research and educational agenda for the non-pharmacological management of hip and knee osteoarthritis (OA). The multidisciplinary task force comprised 21 experts: nurses, occupational therapists, physiotherapists, rheumatologists, orthopaedic surgeons, general practitioner, psychologist, dietician, clinical epidemiologist and patient representatives. After a preliminary literature review, a first task force meeting and five Delphi rounds, provisional recommendations were formulated in order to perform a systematic review. A literature search of Medline and eight other databases was performed up to February 2012. Evidence was graded in categories I–IV and agreement with the recommendations was determined through scores from 0 (total disagreement) to 10 (total agreement). Eleven evidence-based recommendations for the non-pharmacological core management of hip and knee OA were developed, concerning the following nine topics: assessment, general approach, patient information and education, lifestyle changes, exercise, weight loss, assistive technology and adaptations, footwear and work. The average level of agreement ranged between 8.0 and 9.1. The proposed research agenda included an overall need for more research into non-pharmacological interventions for hip OA, moderators to optimise individualised treatment, healthy lifestyle with economic evaluation and long-term follow-up, and the prevention and reduction of work disability. Proposed educational activities included the required skills to teach, initiate and establish lifestyle changes. The 11 recommendations provide guidance on the delivery of non-pharmacological interventions to people with hip or knee OA. More research and educational activities are needed, particularly in the area of lifestyle changes.
Journal Article
The untold history of the United States : young readers edition. Volume 1, 1898-1945
A people's history of the American Empire, adapted for the next generation of young history buffs.
Book
Optimisation of Additives to Maximise Performance of Expandable Graphite-Based Intumescent-Flame-Retardant Polyurethane Composites
The effect of varying the weight percentage composition (wt.%) of low-cost expandable graphite (EG), ammonium polyphosphate (APP), fibreglass (FG), and vermiculite (VMT) in polyurethane (PU) polymer was studied using a traditional intumescent flame retardant (IFR) system. The synergistic effect between EG, APP, FG, and VMT on the flame retardant properties of the PU composites was investigated using SEM, TGA, tensile strength tests, and cone calorimetry. The IFR that contained PU composites with 40 wt.% EG displayed superior flame retardant performance compared with the composites containing only 20 w.t.% or 10 w.t.% EG. The peak heat release rate, total smoke release, and carbon dioxide production from the 40 wt.% EG sample along with APP, FG, and VMT in the PU composite were 88%, 93%, and 92% less than the PU control sample, respectively. As a result, the synergistic effect was greatly influenced by the compactness of the united protective layer. The PU composite suppressed smoke emission and inhibited air penetrating the composite, thus reducing reactions with the gas volatiles of the material. SEM images and TGA results provided positive evidence for the combustion tests. Further, the mechanical properties of PU composites were also investigated. As expected, compared with control PU, the addition of flame-retardant additives decreased the tensile strength, but this was ameliorated with the addition of FG. These new PU composite materials provide a promising strategy for producing polymer composites with flame retardation and smoke suppression for construction materials.
Journal Article
2017 EULAR recommendations for a core data set to support observational research and clinical care in rheumatoid arthritis
Personalised medicine, new discoveries and studies on rare exposures or outcomes require large samples that are increasingly difficult for any single investigator to obtain. Collaborative work is limited by heterogeneities, both what is being collected and how it is defined. To develop a core set for data collection in rheumatoid arthritis (RA) research which (1) allows harmonisation of data collection in future observational studies, (2) acts as a common data model against which existing databases can be mapped and (3) serves as a template for standardised data collection in routine clinical practice to support generation of research-quality data. A multistep, international multistakeholder consensus process was carried out involving voting via online surveys and two face-to-face meetings. A core set of 21 items (‘what to collect’) and their instruments (‘how to collect’) was agreed: age, gender, disease duration, diagnosis of RA, body mass index, smoking, swollen/tender joints, patient/evaluator global, pain, quality of life, function, composite scores, acute phase reactants, serology, structural damage, treatment and comorbidities. The core set should facilitate collaborative research, allow for comparisons across studies and harmonise future data from clinical practice via electronic medical record systems.
Journal Article
Reflections of executive staff using the SaferCare Victoria COVID-19 clinical screening tool in a residential aged care service during the pandemic in Victoria, Australia
Screening tools are useful for identifying disease during an early and pre-symptomatic stage. Older people dwelling in residential aged care services are particularly susceptible to COVID-19 and if infected have a high mortality rate. This article describes the lived experiences and reflections of some of the executive staff of an aged care service following the use of a COVID-19 clinical screening tool developed by SaferCare Victoria. The reflections were based on experiences of the contributors to this article during the second wave of the pandemic during 2020 in Victoria, Australia.
Open learning sessions were held via teleconference for staff to be trained in use of the tool. The tool was used in a variety of different circumstances for monitoring all residents. At times residents would decline to have certain observations taken and clinical staff were initially concerned about the potential extra work.
The regular use of the tool to track a residents' clinical observations over a 14-day period allowed opportunities to identify early subtle changes from the individual’s baseline. There was a perceived improvement in detection of residents with dehydration, delirium, urinary tract infections and those approaching the need for end-of-life care.
Using the tool appears to assist in shifting the aged care service to a more systematic approach to responding to the pandemic. This appears to benefit the organisation, facility, staff, residents and their families however, more empirical research is required to test and validate these perceptions.
Journal Article
Fabrication of a Low-Cost Microfluidic Device for High-Throughput Drug Testing on Static and Dynamic Cancer Spheroid Culture Models
Drug development is a complex and expensive process from new drug discovery to product approval. Most drug screening and testing rely on in vitro 2D cell culture models; however, they generally lack in vivo tissue microarchitecture and physiological functionality. Therefore, many researchers have used engineering methods, such as microfluidic devices, to culture 3D cells in dynamic conditions. In this study, a simple and low-cost microfluidic device was fabricated using Poly Methyl Methacrylate (PMMA), a widely available material, and the total cost of the completed device was USD 17.75. Dynamic and static cell culture examinations were applied to monitor the growth of 3D cells. α-MG-loaded GA liposomes were used as the drug to test cell viability in 3D cancer spheroids. Two cell culture conditions (i.e., static and dynamic) were also used in drug testing to simulate the effect of flow on drug cytotoxicity. Results from all assays showed that with the velocity of 0.005 mL/min, cell viability was significantly impaired to nearly 30% after 72 h in a dynamic culture. This device is expected to improve in vitro testing models, reduce and eliminate unsuitable compounds, and select more accurate combinations for in vivo testing.
Journal Article
Assessment of the practicability of implementing the EULAR recommendations for the role of nurses in the management of chronic inflammatory arthritis in China
Chronic inflammatory arthritis (CIA) severely impacts quality of life in over 100 million people in China. In 2011, the European League Against Rheumatism (EULAR) developed recommendations for the role of nurses in the management of CIA. However, it remains unknown whether these recommendations could be fully implemented in China. Therefore, we aimed to solve the problem in this study. We conducted a nationwide cross-sectional study among 485 nurses in rheumatology and immunology departments based on an online questionnaire. The agreement of the recommendations by the subjects and the feasibility of the recommendations they believe were assessed by visual analogue scale (VAS). Our results showed that over 80% of the subjects agreed with each recommendation (VAS 5–10), and over 80% of the subjects considered the recommendations feasible (VAS 5–10). This study indicates that the EULAR recommendations can also be well implemented in China.
Journal Article
Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force
BackgroundReaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards this therapeutic goal in routine clinical practice, but these recommendations need to be re-evaluated for appropriateness and practicability in the light of new insights.ObjectiveTo update the 2010 treat-to-target recommendations based on systematic literature reviews (SLR) and expert opinion.MethodsA task force of rheumatologists, patients and a nurse specialist assessed the SLR results and evaluated the individual items of the 2010 recommendations accordingly, reformulating many of the items. These were subsequently discussed, amended and voted upon by >40 experts, including 5 patients, from various regions of the world. Levels of evidence, strengths of recommendations and levels of agreement were derived.ResultsThe update resulted in 4 overarching principles and 10 recommendations. The previous recommendations were partly adapted and their order changed as deemed appropriate in terms of importance in the view of the experts. The SLR had now provided also data for the effectiveness of targeting low-disease activity or remission in established rather than only early disease. The role of comorbidities, including their potential to preclude treatment intensification, was highlighted more strongly than before. The treatment aim was again defined as remission with low-disease activity being an alternative goal especially in patients with long-standing disease. Regular follow-up (every 1–3 months during active disease) with according therapeutic adaptations to reach the desired state was recommended. Follow-up examinations ought to employ composite measures of disease activity that include joint counts. Additional items provide further details for particular aspects of the disease, especially comorbidity and shared decision-making with the patient. Levels of evidence had increased for many items compared with the 2010 recommendations, and levels of agreement were very high for most of the individual recommendations (≥9/10).ConclusionsThe 4 overarching principles and 10 recommendations are based on stronger evidence than before and are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA.
Journal Article