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Trends in Clostridioides difficile infection rates in Canadian hospitals during the coronavirus disease 2019 (COVID-19) pandemic
Kelly B. Choi, Tim Du, Anada Silva, George R. Golding, Linda Pelude, Robyn Mitchell, Wallis Rudnick, Romeo Hizon, Ghada N Al-Rawahi, Blanda Chow, Ian Davis, Gerald A. Evans, Charles Frenette, Jennie Johnstone, Pamela Kibsey, Kevin C. Katz, Joanne M. Langley, Bonita E. Lee, Yves Longtin, Dominik Mertz, Jessica Minion, Michelle Science, Jocelyn A. Srigley, Paula Stagg, Kathryn N. Suh, Nisha Thampi, Alice Wong, Jeannette L. Comeau, Susy S. Hota, for the Canadian Nosocomial Infection Surveillance Program (CNISP)
Journal: Infection Control & Hospital Epidemiology , First View
Published online by Cambridge University Press: 18 August 2022, pp. 1-4
The coronavirus disease 2019 (COVID-19) pandemic has placed significant burden on healthcare systems. We compared Clostridioides difficile infection (CDI) epidemiology before and during the pandemic across 71 hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Using an interrupted time series analysis, we showed that CDI rates significantly increased during the COVID-19 pandemic.
Cerebrospinal fluid shunt–associated surgical site infection with three-month versus twelve-month surveillance periods in Canadian hospitals
Kelly B. Choi, Vivienne Steele, John Conly, Blanda Chow, Jeannette L. Comeau, Joanne Embree, Bonita E. Lee, Marie-Astrid Lefebvre, Robyn Mitchell, Linda Pelude, Allyson L. Shephard, Joanne M. Langley, for the Canadian Nosocomial Infection Surveillance Program (CNISP)
Published online by Cambridge University Press: 16 June 2022, pp. 1-4
Cerebrospinal fluid shunt–associated surgical site infection surveillance for 3 months compared to 12 months after surgery captures 83% of cases with no significant differences in patient characteristics, surgery types, or pathogens. A shorter 3-month follow-up can reduce resource use and allow for more timely reporting of healthcare-associated infection rates for hospitals.
Dementia-related continuing education for rural interprofessional primary health care in Saskatchewan, Canada: perceptions and needs of webinar participants
Julie Kosteniuk, Debra Morgan, Megan E. O'Connell, Dallas Seitz, Valerie Elliot, Melanie Bayly, Chelsie Cameron, Amanda Froehlich Chow
Journal: Primary Health Care Research & Development / Volume 23 / 2022
Published online by Cambridge University Press: 23 May 2022, e32
Dementia-related continuing education opportunities are important for rural primary health care (PHC) professionals given scarce specialized resources. This report explores the initial perceptions and continuing education needs of rural interprofessional memory clinic team members and other PHC professionals related to a short series of dementia-related education webinars. Three webinars on separate topics were delivered over an 8-month period in 2020 in Saskatchewan, Canada. The research design involved analysis of webinar comments and post-webinar survey data. Sixty-eight individuals participated in at least one webinar, and 46 surveys were completed. Rural memory clinic team members accounted for a minority of webinar participants and a majority of survey respondents. Initial perceptions were positive, with webinar topics and interactivity identified as the most effective aspects. Continuing education needs were mainly aligned with professional roles; however, some overlap of interests occurred. Future webinars will further explore learning needs within an interprofessional environment.
The Acknowledge–Normalize–Partner (ANP) Framework: A novel empathic communication tool for oncology nurses
Dana Kramer, Kimberly Chow, Mary Elizabeth Davis, Judith E. Nelson, Kelley Anderson, Molly Okpako, Camila Bernal, Catherine E. Malisse, Jessica I. Goldberg
Journal: Palliative & Supportive Care , First View
Published online by Cambridge University Press: 03 March 2022, pp. 1-8
To describe the development and implementation of a novel tool designed to enhance nurse–patient communication in a major academic cancer center, which nurses can learn quickly, incorporate into their primary palliative care practice, and broadly disseminate in order to improve the patient experience.
An evidence-based empathic communication tool and educational program were designed to provide essential skills to oncology nurses in having discussions with patients about their personal values. Evaluation included nurse focus groups, pre- and post-course evaluations and interviews, and patient questionnaires.
Nurses were satisfied with the educational program and found the communication tool effective in a variety of clinical situations including discussions about personal values. Patients reported increased occurrences of these discussions when nurses utilized the framework (97% vs. 58%, p < 0.0001) and a higher quality of clinician communication (mean [SD] from 0 = very worst to 10 = very best: 7.18 [2.3] vs. 5.04 [2.9], p = 0.001).
Significance of results
Skilled, empathic communication is an essential component of high-quality primary palliative care. Oncology nurses are well suited to lead communication and provide this care as part of an interprofessional team. The training and tool described here are targeted and efficient, and prepare nurses to respond skillfully to emotion while facilitating important discussions about patient values.
P.161 Management of recurrent glioblastoma multiforme: An inter-observer variability study
M Patel, K Au, V Mehta, R Broad, MM Chow, A Hockley, Z Kaderali, E Magro, A Nataraj, F Scholtes, M Chagnon, G Gevry, J Raymond, TE Darsaut
Journal: Canadian Journal of Neurological Sciences / Volume 48 / Issue s3 / November 2021
Published online by Cambridge University Press: 05 January 2022, p. S66
Background: A significant proportion of glioblastoma multiforme (GBM) patients are considered for repeat resection, but evidence regarding best management remains elusive. Methods: An electronic portfolio of MR images of 37 cases of pathologically confirmed recurrent GBM with an accompanying clinical vignette was constructed. Surgical responders from various countries, training backgrounds, and years' experience were asked for each case to select: their chosen management (repeat surgery, chemotherapy, radiation, or conservative), confidence in recommended management, and whether they would include the patient in a randomized trial that gave a 50% chance of re-operation. Responses were evaluated with kappa statistics and values interpreted according to Landis and Koch (0–0.2, slight; 0.21–0.4, fair; 0.41–0.6, moderate; 0.61–0.8, substantial; 0.81-1.0 perfect agreement). Results: 26 surgeons responded to the survey. Agreement regarding best management of recurrent GBM was slight, even when management options were dichotomized (repeat surgery vs. all others) (k=0.198 (95%CI 0.133-0.276). Country of practice, years' experience, and training background did not improve agreement. Responders were willing to include more than 70% of patients in a randomized trial. Conclusions: Only slight agreement exists regarding the question of re-operation for patients with recurrent GBM. This supports the need for a randomized controlled trial.
A Scoping Review of Care Trajectories across Multiple Settings for Persons with Dementia
Julie G. Kosteniuk, Debra G. Morgan, Valerie Elliot, Amanda Froehlich Chow, Melanie Bayly, Erin Watson, Meric Osman, Beliz Acan Osman, Megan E. O'Connell, Andrew Kirk, Norma Stewart, Allison Cammer, Anthea Innes
Journal: Canadian Journal on Aging / La Revue canadienne du vieillissement / Volume 41 / Issue 1 / March 2022
Multiple transitions across care settings can be disruptive for older adults with dementia and their care partners, and can lead to fragmented care with adverse outcomes. This scoping review was conducted to identify and classify care trajectories across multiple settings for people with dementia, and to understand the prevalence of multiple transitions and associated factors at the individual and organizational levels. Searches of three databases, limited to peer-reviewed studies published between 2007 and 2017, provided 33 articles for inclusion. We identified 26 distinct care trajectories. Common trajectories involved hospital readmission or discharge from hospital to long-term care. Factors associated with transitions were identified mainly at the level of demographic and medical characteristics. Findings suggest a need for investing in stronger community-based systems of care that may reduce transitions. Further research is recommended to address knowledge gaps about complex and longitudinal care trajectories and trajectories experienced by sub-populations of people living with dementia.
Australian square kilometre array pathfinder: I. system description
Australian SKA Pathfinder
A. W. Hotan, J. D. Bunton, A. P. Chippendale, M. Whiting, J. Tuthill, V. A. Moss, D. McConnell, S. W. Amy, M. T. Huynh, J. R. Allison, C. S. Anderson, K. W. Bannister, E. Bastholm, R. Beresford, D. C.-J. Bock, R. Bolton, J. M. Chapman, K. Chow, J. D. Collier, F. R. Cooray, T. J. Cornwell, P. J. Diamond, P. G. Edwards, I. J. Feain, T. M. O. Franzen, D. George, N. Gupta, G. A. Hampson, L. Harvey-Smith, D. B. Hayman, I. Heywood, C. Jacka, C. A. Jackson, S. Jackson, K. Jeganathan, S. Johnston, M. Kesteven, D. Kleiner, B. S. Koribalski, K. Lee-Waddell, E. Lenc, E. S. Lensson, S. Mackay, E. K. Mahony, N. M. McClure-Griffiths, R. McConigley, P. Mirtschin, A. K. Ng, R. P. Norris, S. E. Pearce, C. Phillips, M. A. Pilawa, W. Raja, J. E. Reynolds, P. Roberts, D. N. Roxby, E. M. Sadler, M. Shields, A. E. T. Schinckel, P. Serra, R. D. Shaw, T. Sweetnam, E. R. Troup, A. Tzioumis, M. A. Voronkov, T. Westmeier
Published online by Cambridge University Press: 05 March 2021, e009
In this paper, we describe the system design and capabilities of the Australian Square Kilometre Array Pathfinder (ASKAP) radio telescope at the conclusion of its construction project and commencement of science operations. ASKAP is one of the first radio telescopes to deploy phased array feed (PAF) technology on a large scale, giving it an instantaneous field of view that covers $31\,\textrm{deg}^{2}$ at $800\,\textrm{MHz}$. As a two-dimensional array of 36 $\times$12 m antennas, with baselines ranging from 22 m to 6 km, ASKAP also has excellent snapshot imaging capability and 10 arcsec resolution. This, combined with 288 MHz of instantaneous bandwidth and a unique third axis of rotation on each antenna, gives ASKAP the capability to create high dynamic range images of large sky areas very quickly. It is an excellent telescope for surveys between 700 and $1800\,\textrm{MHz}$ and is expected to facilitate great advances in our understanding of galaxy formation, cosmology, and radio transients while opening new parameter space for discovery of the unknown.
Neutron Star Extreme Matter Observatory: A kilohertz-band gravitational-wave detector in the global network
K. Ackley, V. B. Adya, P. Agrawal, P. Altin, G. Ashton, M. Bailes, E. Baltinas, A. Barbuio, D. Beniwal, C. Blair, D. Blair, G. N. Bolingbroke, V. Bossilkov, S. Shachar Boublil, D. D. Brown, B. J. Burridge, J. Calderon Bustillo, J. Cameron, H. Tuong Cao, J. B. Carlin, S. Chang, P. Charlton, C. Chatterjee, D. Chattopadhyay, X. Chen, J. Chi, J. Chow, Q. Chu, A. Ciobanu, T. Clarke, P. Clearwater, J. Cooke, D. Coward, H. Crisp, R. J. Dattatri, A. T. Deller, D. A. Dobie, L. Dunn, P. J. Easter, J. Eichholz, R. Evans, C. Flynn, G. Foran, P. Forsyth, Y. Gai, S. Galaudage, D. K. Galloway, B. Gendre, B. Goncharov, S. Goode, D. Gozzard, B. Grace, A. W. Graham, A. Heger, F. Hernandez Vivanco, R. Hirai, N. A. Holland, Z. J. Holmes, E. Howard, E. Howell, G. Howitt, M. T. Hübner, J. Hurley, C. Ingram, V. Jaberian Hamedan, K. Jenner, L. Ju, D. P. Kapasi, T. Kaur, N. Kijbunchoo, M. Kovalam, R. Kumar Choudhary, P. D. Lasky, M. Y. M. Lau, J. Leung, J. Liu, K. Loh, A. Mailvagan, I. Mandel, J. J. McCann, D. E. McClelland, K. McKenzie, D. McManus, T. McRae, A. Melatos, P. Meyers, H. Middleton, M. T. Miles, M. Millhouse, Y. Lun Mong, B. Mueller, J. Munch, J. Musiov, S. Muusse, R. S. Nathan, Y. Naveh, C. Neijssel, B. Neil, S. W. S. Ng, V. Oloworaran, D. J. Ottaway, M. Page, J. Pan, M. Pathak, E. Payne, J. Powell, J. Pritchard, E. Puckridge, A. Raidani, V. Rallabhandi, D. Reardon, J. A. Riley, L. Roberts, I. M. Romero-Shaw, T. J. Roocke, G. Rowell, N. Sahu, N. Sarin, L. Sarre, H. Sattari, M. Schiworski, S. M. Scott, R. Sengar, D. Shaddock, R. Shannon, J. SHI, P. Sibley, B. J. J. Slagmolen, T. Slaven-Blair, R. J. E. Smith, J. Spollard, L. Steed, L. Strang, H. Sun, A. Sunderland, S. Suvorova, C. Talbot, E. Thrane, D. Töyrä, P. Trahanas, A. Vajpeyi, J. V. van Heijningen, A. F. Vargas, P. J. Veitch, A. Vigna-Gomez, A. Wade, K. Walker, Z. Wang, R. L. Ward, K. Ward, S. Webb, L. Wen, K. Wette, R. Wilcox, J. Winterflood, C. Wolf, B. Wu, M. Jet Yap, Z. You, H. Yu, J. Zhang, J. Zhang, C. Zhao, X. Zhu
Published online by Cambridge University Press: 05 November 2020, e047
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
Magnetic resonance imaging in dogs with neuroangiostrongyliasis (rat lungworm disease)
Matthew K. Wun, Richard Malik, Jane Yu, Kathleen E. Chow, Michelle Lau, Juan M. Podadera, Natalie Webster, Rogan Lee, Jan Šlapeta, Sarah Davies
Journal: Parasitology / Volume 148 / Issue 2 / February 2021
The magnetic resonance imaging (MRI) appearance of the brain and spinal cord in humans with neuroangiostrongyliasis (NA) due to Angiostrongylus cantonensis infection has been well reported. Equivalent studies in animals are lacking. This case series describes clinical and MRI findings in 11 dogs with presumptively or definitively diagnosed NA. MRI of the brain and/or spinal cord was performed using high-field (1.5 T) or low-field (0.25 T) scanners using various combinations of transverse, sagittal, dorsal and three-dimensional (3D) T1-weighted (T1W), transverse, sagittal and dorsal T2-weighted (T2W), T2W fluid-attenuated inversion recovery (FLAIR) and T2*-weighted (T2*W) gradient echo (GRE), dorsal T2W short tau inversion recovery (STIR) and post-gadolinium transverse, sagittal, dorsal and 3D T1W and transverse T2W FLAIR sequences. In 4/6 cases where the brain was imaged, changes consistent with diffuse meningoencephalitis were observed. Evidence of meningeal involvement was evident even when not clinically apparent. The spinal cord was imaged in 9 dogs, with evidence of meningitis and myelitis detected in regions consistent with the observed neuroanatomical localization. Pathognomonic changes of neural larva migrans, as described in some human patients with NA, were not detected. NA should be considered in the differential diagnosis of dogs with MRI evidence of focal or diffuse meningitis, myelitis and/or encephalitis, especially in areas where A. cantonensis is endemic. If not precluded by imaging findings suggestive of brain herniation, cerebrospinal fluid (CSF) collection for cytology, fluid analysis, real-time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA) testing should be considered mandatory in such cases after the MRI studies.
PKS 2250–351: A giant radio galaxy in Abell 3936
GAMA Legacy ATCA Southern Survey
N. Seymour, M. Huynh, S. S. Shabala, J. Rogers, L. J. M. Davies, R. J. Turner, A. O'Brien, C. H. Ishwara-Chandra, J. E. Thorne, T. J. Galvin, T. Jarrett, H. Andernach, C. Anderson, J. Bunton, K. Chow, J. D. Collier, S. Driver, M. D. Filipovic, G. Gürkan, A. M. Hopkins, A. D. Kapińska, D. A. Leahy, J. Marvil, P. Manojlovic, R. P. Norris, C. Phillips, A. Robotham, L. Rudnick, V. Singh, S. V. White
We present a detailed analysis of the radio galaxy PKS $2250{-}351$ , a giant of 1.2 Mpc projected size, its host galaxy, and its environment. We use radio data from the Murchison Widefield Array, the upgraded Giant Metre-wavelength Radio Telescope, the Australian Square Kilometre Array Pathfinder, and the Australia Telescope Compact Array to model the jet power and age. Optical and IR data come from the Galaxy And Mass Assembly (GAMA) survey and provide information on the host galaxy and environment. GAMA spectroscopy confirms that PKS $2250{-}351$ lies at $z=0.2115$ in the irregular, and likely unrelaxed, cluster Abell 3936. We find its host is a massive, 'red and dead' elliptical galaxy with negligible star formation but with a highly obscured active galactic nucleus dominating the mid-IR emission. Assuming it lies on the local M– $\sigma$ relation, it has an Eddington accretion rate of $\lambda_{\rm EDD}\sim 0.014$ . We find that the lobe-derived jet power (a time-averaged measure) is an order of magnitude greater than the hotspot-derived jet power (an instantaneous measure). We propose that over the lifetime of the observed radio emission ( ${\sim} 300\,$ Myr), the accretion has switched from an inefficient advection-dominated mode to a thin disc efficient mode, consistent with the decrease in jet power. We also suggest that the asymmetric radio morphology is due to its environment, with the host of PKS $2250{-}351$ lying to the west of the densest concentration of galaxies in Abell 3936.
A MUSE study of NGC 7469: Spatially resolved star-formation and AGN-driven outflows
A. C. Robleto-Orús, J. P. Torres-Papaqui, A. L. Longinotti, R. A. Ortega-Minakata, S. F. Sánchez, Y. Ascasibar, E. Bellocchi, L. Galbany, M. Chow-Martínez, J. J. Trejo-Alonso, A. Morales-Vargas, F. J. Romero-Cruz, K. A. Cutiva-Alvarez, R. Coziol
Journal: Proceedings of the International Astronomical Union / Volume 15 / Issue S359 / March 2020
NGC 7469 is a well-known type 1 AGN with a cirumnuclear star formation ring. It has previous detections of X-rays warm absorbers and an infrared biconical outflow. We analysed archival MUSE/VLT observations of this galaxy in order to look for an optical counterpart of these outflows. We report spatially resolved winds in the [O III] λ5007 emission line in two regimes: a high velocity regime possibly associated with the AGN and a slower one associated with the massive star formation of the ring. This slower regime is also detected with Hβ.
Neurocognition and adaptive functioning in a genetic high risk model of schizophrenia
A. M. Fiksinski, E. J. Breetvelt, Y. J. Lee, E. Boot, N. Butcher, L. Palmer, E. W. C. Chow, R. S. Kahn, J. A. S. Vorstman, A. S. Bassett
Journal: Psychological Medicine / Volume 49 / Issue 6 / April 2019
Print publication: April 2019
Identifying factors that influence the functional outcome is an important goal in schizophrenia research. The 22q11.2 deletion syndrome (22q11DS) is a unique genetic model with high risk (20–25%) for schizophrenia. This study aimed to identify potentially targetable domains of neurocognitive functioning associated with functional outcome in adults with 22q11DS.
We used comprehensive neurocognitive test data available for 99 adults with 22q11DS (n = 43 with schizophrenia) and principal component analysis to derive four domains of neurocognition (Verbal Memory, Visual and Logical Memory, Motor Performance, and Executive Performance). We then investigated the association of these neurocognitive domains with adaptive functioning using Vineland Adaptive Behavior Scales data and a linear regression model that accounted for the effects of schizophrenia status and overall intellectual level.
The regression model explained 46.8% of the variance in functional outcome (p < 0.0001). Executive Performance was significantly associated with functional outcome (p = 0.048). Age and schizophrenia were also significant factors. The effects of Executive Performance on functioning did not significantly differ between those with and without psychotic illness.
The findings provide the impetus for further studies to examine the potential of directed (early) interventions targeting Executive Performance to improve long-term adaptive functional outcome in individuals with, or at high risk for, schizophrenia. Moreover, the neurocognitive test profiles may benefit caregivers and clinicians by providing insight into the relative strengths and weaknesses of individuals with 22q11DS, with and without psychotic illness.
31 Intracranial growing teratoma syndrome (IGTS): An international retrospective study
George Michaiel, Douglas Strother, Nicholas Gottardo, Ute Bartels, Hallie Coltin, David D. Eisenstat, Juliette Hukin, Donna L. Johnston, Beverly Wilson, Shayna Zelcer, Jordan R. Hansford, Olivia Wells, Mohamed S. AbdelBaki, Mohammad H. Abu-Arja, Kristina A. Cole, Girish Dhall, Paul G. Fisher, Lindsey Hoffman, Sarah E.S. Leary, Emily E. Owens Pickle, Natasha P. Smiley, Amy Smith, Anna Vinitsky, Nicholas A. Vitanza, Avery Wright, Kee K. Yeo, Lionel M.L. Chow, Maria Kirby, Santosh Valvi, Magimairajan I. Vanan, Grace Wong, David Ziegler, Eric Bouffet, Lucie Lafay-Cousi
Journal: Canadian Journal of Neurological Sciences / Volume 45 / Issue S3 / June 2018
Published online by Cambridge University Press: 27 July 2018, p. S13
BACKGROUND: IGTS is a rare phenomenon of paradoxical germ cell tumor (GCT) growth during or following treatment despite normalization of tumor markers. We sought to evaluate the frequency, clinical characteristics and outcome of IGTS in patients in 21 North-American and Australian institutions. METHODS: Patients with IGTS diagnosed from 2000-2017 were retrospectively evaluated. RESULTS: Out of 739 GCT diagnoses, IGTS was identified in 33 patients (4.5%). IGTS occurred in 9/191 (4.7%) mixed-malignant GCTs, 4/22 (18.2%) immature teratomas (ITs), 3/472 (0.6%) germinomas/germinomas with mature teratoma, and in 17 secreting non-biopsied tumours. Median age at GCT diagnosis was 10.9 years (range 1.8-19.4). Male gender (84%) and pineal location (88%) predominated. Of 27 patients with elevated markers, median serum AFP and Beta-HCG were 70 ng/mL (range 9.2-932) and 44 IU/L (range 4.2-493), respectively. IGTS occurred at a median time of 2 months (range 0.5-32) from diagnosis, during chemotherapy in 85%, radiation in 3%, and after treatment completion in 12%. Surgical resection was attempted in all, leading to gross total resection in 76%. Most patients (79%) resumed GCT chemotherapy/radiation after surgery. At a median follow-up of 5.3 years (range 0.3-12), all but 2 patients are alive (1 succumbed to progressive disease, 1 to malignant transformation of GCT). CONCLUSION: IGTS occurred in less than 5% of patients with GCT and most commonly after initiation of chemotherapy. IGTS was more common in patients with IT-only on biopsy than with mixed-malignant GCT. Surgical resection is a principal treatment modality. Survival outcomes for patients who developed IGTS are favourable.
Anorectal swabs as a marker of male-to-male sexual exposure in STI surveillance systems
F. H. AMPT, C. EL HAYEK, P. A. AGIUS, A. L. BOWRING, N. BARTNIK, C. VAN GEMERT, C. K. FAIRLEY, E. P. F. CHOW, C. S. BRADSHAW, N. STEPHENS, M. S. C. LIM, M. E. HELLARD
Journal: Epidemiology & Infection / Volume 145 / Issue 12 / September 2017
Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007–2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.
PS1 - 160 A Telephone Based Cognitive Assessment Tool for Brain Metastases Patients
M.N. Tsao, K. Edelstein, L.J. Bernstein, J. Wong, N. Laperriere, J.R. Perry, A. Sahgal, C. Menard, H. Soliman, E. Chow, T. Barnes, C. Danjoux, B.A. Millar, R. Wong, W. Wells, R.S. McIntyre, W. Mason, C. Chung
Journal: Canadian Journal of Neurological Sciences / Volume 43 / Issue S4 / October 2016
Published online by Cambridge University Press: 18 October 2016, p. S9
Improving neurocognitive outcomes following treatment for brain metastases have become increasingly important. We propose that a brief telephone-based neurocognitive assessment may improve follow-up cognitive assessments in this palliative population. Aim: To prospectively assess the feasibility and reliability of a telephone based brief neurocognitive assessment compared to the same tests delivered face-to-face. Methods: Brain metastases patients to be treated with whole brain radiotherapy (WBRT) were assessed using a brief validated neurocognitive battery at baseline, at 1 month and 3 months following WBRT (in person and over the phone). The primary outcome was feasibility and inter-procedural (in person versus telephone) reliability. The secondary objective was to evaluate the change in neurocognitive function before and after WBRT. Results: Out of 39 patients enrolled, 82% of patients completed the baseline in-person and telephone neurocognitive assessments. However, at 1 month, only 41% of enrolled patients completed the in-person and telephone cognitive assessments and at 3 months, only 10% of patients completed them. Results pertaining to reliability and change in neurocognitive function will be updated. Conclusion: The pre-defined definition of feasibility (at least 80% completion for face to face and telephone neurocognitive assessments) was met at baseline. However, a large proportion of participants did not complete either telephone or in person neurocognitive follow-up at 1 month and at 3 months post-WBRT. Attrition remained a challenge for neurocognitive testing in this population even when a telephone-based brief assessment was used.
The ASKAP/EMU Source Finding Data Challenge
Data Analysis Pipelines and Software
A. M. Hopkins, M. T. Whiting, N. Seymour, K. E. Chow, R. P. Norris, L. Bonavera, R. Breton, D. Carbone, C. Ferrari, T. M. O. Franzen, H. Garsden, J. González-Nuevo, C. A. Hales, P. J. Hancock, G. Heald, D. Herranz, M. Huynh, R. J. Jurek, M. López-Caniego, M. Massardi, N. Mohan, S. Molinari, E. Orrù, R. Paladino, M. Pestalozzi, R. Pizzo, D. Rafferty, H. J. A. Röttgering, L. Rudnick, E. Schisano, A. Shulevski, J. Swinbank, R. Taylor, A. J. van der Horst
The Evolutionary Map of the Universe (EMU) is a proposed radio continuum survey of the Southern Hemisphere up to declination + 30°, with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU will use an automated source identification and measurement approach that is demonstrably optimal, to maximise the reliability and robustness of the resulting radio source catalogues. As a step toward this goal we conducted a "Data Challenge" to test a variety of source finders on simulated images. The aim is to quantify the accuracy and limitations of existing automated source finding and measurement approaches. The Challenge initiators also tested the current ASKAPsoft source-finding tool to establish how it could benefit from incorporating successful features of the other tools. As expected, most finders show completeness around 100% at ≈ 10σ dropping to about 10% by ≈ 5σ. Reliability is typically close to 100% at ≈ 10σ, with performance to lower sensitivities varying between finders. All finders show the expected trade-off, where a high completeness at low signal-to-noise gives a corresponding reduction in reliability, and vice versa. We conclude with a series of recommendations for improving the performance of the ASKAPsoft source-finding tool.
Duration of syphilis symptoms at presentations in men who have sex with men in Australia: are current public health campaigns effective?
E. P. F. CHOW, K. DUTT, G. FEHLER, I. DENHAM, M. Y. CHEN, C. BATROUNEY, J. PEEL, T. R. H. READ, C. S. BRADSHAW, C. K. FAIRLEY
Journal: Epidemiology & Infection / Volume 144 / Issue 1 / January 2016
Published online by Cambridge University Press: 01 June 2015, pp. 113-122
The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007–2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6–14] days and 14 (IQR 7–30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64–256) was higher than in primary syphilis (median 4, IQR 1–32) and in early latent syphilis (median 32, IQR 4–64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.
Response to clozapine in a clinically identifiable subtype of schizophrenia
Nancy J. Butcher, Wai Lun Alan Fung, Laura Fitzpatrick, Alina Guna, Danielle M. Andrade, Anthony E. Lang, Eva W. C. Chow, Anne S. Bassett
Journal: The British Journal of Psychiatry / Volume 206 / Issue 6 / June 2015
Genetic testing in psychiatry promises to improve patient care through advances in personalised medicine. However, there are few clinically relevant examples.
To determine whether patients with a well-established genetic subtype of schizophrenia show a different response profile to the antipsychotic clozapine than those with idiopathic schizophrenia.
We retrospectively studied the long-term safety and efficacy of clozapine in 40 adults with schizophrenia, half with a 22q11.2 deletion (22q11.2DS group) and half matched for age and clinical severity but molecularly confirmed to have no pathogenic copy number variant (idiopathic group).
Both groups showed similar clinical improvement and significant reductions in hospitalisations, achieved at a lower median dose for those in the 22q11.2DS group. Most common side-effects were similarly prevalent between the two groups, however, half of the 22q11.2DS group experienced at least one rare serious adverse event compared with none of the idiopathic group. Many were successfully retried on clozapine.
Individuals with 22q11.2DS-schizophrenia respond as well to clozapine treatment as those with other forms of schizophrenia, but may represent a disproportionate number of those with serious adverse events, primarily seizures. Lower doses and prophylactic (for example anticonvulsant) management strategies can help ameliorate side-effect risks. This first systematic evaluation of antipsychotic response in a genetic subtype of schizophrenia provides a proof-of-principle for personalised medicine and supports the utility of clinical genetic testing in schizophrenia.
Adolescents' awareness and use of menu labels in eating establishments: results from a focus group study
Alexandra E Evans, Samantha R Weiss, Kerry J Meath, Sherman Chow, Elizabeth A Vandewater, Roberta B Ness
Journal: Public Health Nutrition / Volume 19 / Issue 5 / April 2016
Menu labelling has been identified as a potential strategy to help individuals make healthier choices when eating out. Although adolescents eat out often, little research involving menu labelling has been conducted with this population. The objectives of the present study were to: (i) gather qualitative information from adolescents regarding use of menu labels when eating out; (ii) gather adolescents' suggestions for optimal ways to design menu labels; and (iii) examine differences between adolescents living in communities of different socio-economic status.
Qualitative. Five focus groups of five to ten participants.
Austin, TX, USA, 2012.
Forty-one adolescents living in diverse communities recruited using a snowballing technique at public and private recreation centres (twenty-four females; twenty-two African American).
Participants reported that menu labelling, in general, does not influence food selections when eating out. Among participants living in low-income communities, food purchases were based on price, taste and familiarity. Among participants living in high-income areas, food purchases were based on quality and ability to satiate (among boys). According to participants, effective ways to present menu labels are by matching calorie levels with physical activity equivalents or through simple graphics.
For adolescents, providing menu labels in their current format may not be an effective strategy to increase healthy food selection. Given that the current menu label format has been set by federal policy in the USA cannot be easily changed, research to determine how this format can be best presented or enhanced so that it can have an impact on all US sub-populations is warranted.
Endovascular Management of an Embedded Intracranial Knife
T E Darsaut, R A Ashforth, M M Chow, J M Findlay
Journal: Canadian Journal of Neurological Sciences / Volume 34 / Issue 4 / November 2007
Published online by Cambridge University Press: 02 December 2014, pp. 460-463
Endovascular therapy (ET) is infrequently used in the setting of acute penetrating intracranial trauma.
We report a case where ET was used immediately prior to and following removal of an embedded intracranial knife, which was found to be disrupting the anterior cerebral artery.
The proximal vessel was coiled and angiographically occluded and then the knife was removed with the microcatheter in place. Immediate angiography allowed us to see and quickly treat the contrast extravasation with further coiling. Despite full medical management, the patient died of elevated intracranial pressure.
In this severely injured patient, endovascular therapy represented the most suitable means to attempt safe removal of the knife.