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Article ; Online: A Virtual Children's Hospice in Response to COVID-19: The Scottish Experience.

Ellis, Kirsteen / Lindley, Lisa C

2020 Volume 60, Issue 2, Page(s) e40–e43

Abstract: This case report describes a pediatric hospice provider in Scotland and their experience implementing a telehospice program in response to COVID-19. Children's Hospices Across Scotland (CHAS) is the only provider of pediatric hospice care in the entire ... ...

Abstract	This case report describes a pediatric hospice provider in Scotland and their experience implementing a telehospice program in response to COVID-19. Children's Hospices Across Scotland (CHAS) is the only provider of pediatric hospice care in the entire of Scotland, and we describe their experience offering pediatric telehospice. CHAS had strategically planned to implement a telehospice program, but COVID-19 accelerated the process. The organization evaluated its pediatric clinical and wrap-around hospice services and rapidly migrated them to a virtual environment. They creatively added new services to meet the unique needs of the entire family, who were caring for a child at end of life during COVID-19. CHAS's experience highlights the planning and implementing processes of telehospice with key lessons learned, while acknowledging the challenges inherent in using technology to deliver hospice care.
MeSH term(s)	COVID-19 ; Child ; Coronavirus Infections/therapy ; Hospice Care/methods ; Hospices ; Humans ; Pandemics ; Pneumonia, Viral/therapy ; Scotland ; Telemedicine/methods
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	639142-4
ISSN	1873-6513 ; 0885-3924
ISSN (online)	1873-6513
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2020.05.011
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Article ; Online: A Virtual Children's Hospice in Response to COVID-19

Ellis, Kirsteen / Lindley, Lisa C.

Journal of Pain and Symptom Management

The Scottish Experience

2020 Volume 60, Issue 2, Page(s) e40–e43

Keywords	Anesthesiology and Pain Medicine ; General Nursing ; Clinical Neurology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	639142-4
ISSN	0885-3924
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2020.05.011
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: A Virtual Children's Hospice in Response to COVID-19: The Scottish Experience

Ellis, Kirsteen / Lindley, Lisa C

J. pain symptom manage

Abstract	This case report describes a pediatric hospice provider in Scotland and their experience implementing a telehospice program in response to COVID-19. Children's Hospices Across Scotland (CHAS) is the only provider of pediatric hospice care in the entire of Scotland, and we describe their experience offering pediatric telehospice. CHAS had strategically planned to implement a telehospice program, but COVID-19 accelerated the process. The organization evaluated its pediatric clinical and wrap-around hospice services and rapidly migrated them to a virtual environment. They creatively added new services to meet the unique needs of the entire family, who were caring for a child at end of life during COVID-19. CHAS's experience highlights the planning and implementing processes of telehospice with key lessons learned, while acknowledging the challenges inherent in using technology to deliver hospice care.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32416232
Database	COVID19

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Article: A review of amputation, phantom pain and nursing responsibilities.

Ellis, Kirsteen

British journal of nursing (Mark Allen Publishing)

2002 Volume 11, Issue 3, Page(s) 155–7, 160–3

Abstract: Phantom pain is a common phenomenon among amputee patients. It is usually reported during the immediate postoperative period but can persist for up to 2 years. Sixty per cent of patients can still experience phantom pain 7 years postamputation and it has ...

Abstract	Phantom pain is a common phenomenon among amputee patients. It is usually reported during the immediate postoperative period but can persist for up to 2 years. Sixty per cent of patients can still experience phantom pain 7 years postamputation and it has even been reported 30 years postamputation. Pain of any type, which persists for more than 7 months, is difficult to treat and is often unresponsive to analgesia, including opioids. A large percentage of patients undergoing amputation have experienced chronic pain before their operation. Chronic pain is known to affect adversely patients' quality of life, and ability to function and achieve quality sleep. Nurses, therefore, need to address not only the physical aspects of amputation and phantom pain but also the psychological aspects.
MeSH term(s)	Amputation/nursing ; Chronic Disease ; Humans ; Pain, Postoperative/nursing ; Phantom Limb/nursing ; Postoperative Care/methods ; Preoperative Care/methods ; Quality of Life
Language	English
Publishing date	2002-02
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1119191-0
ISSN	0966-0461
ISSN	0966-0461
DOI	10.12968/bjon.2002.11.3.10063
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Article: Details behind the dots: How different intensive care units used common and contrasting methods to prevent ventilator associated pneumonia.

Daniel, Malcolm / Booth, Malcolm / Ellis, Kirsteen / Maher, Shaun / Longmate, Andrew

BMJ quality improvement reports

2015 Volume 4, Issue 1

Abstract: Care bundles promote delivery of effective care and improve patient outcomes. The understanding of how to improve delivery of care bundles is incomplete. The Scottish Patient Safety Programme is a national collaborative with the aim of improving the ... ...

Abstract	Care bundles promote delivery of effective care and improve patient outcomes. The understanding of how to improve delivery of care bundles is incomplete. The Scottish Patient Safety Programme is a national collaborative with the aim of improving the delivery of care to patients in acute hospitals in Scotland. Critical care is one of five workstreams in the programme. A programme goal is to reduce incidence of ventilator-associated pneumonia (VAP) to zero or 300 calendar days between events through use of a VAP Prevention bundle. We studied two ICUs participating in this programme. Each ICU had established infection surveillance system prior to the programme starting. Both units had an appreciable incidence of VAP. Initial VAP prevention bundle adherence was low in each ICU (35% and 41%). Comparing time periods before and after 80% bundle VAP prevention bundle adherence was achieved showed a similar reduction in VAP incidence (from 6.9 to 1.0, and from 7.8 to 1.4/1000 ventilation days). When compared each ICU used common and contrasting approaches to accomplish this improvement. We describe the five improvement knowledge systems used to improve bundle adherence to bundle elements in each hospital. The insights gained from these front-line clinical teams can be used as a template for improvement efforts in a variety of other healthcare settings.
Language	English
Publishing date	2015-03-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2677829-4
ISSN	2050-1315
ISSN	2050-1315
DOI	10.1136/bmjquality.u207660.w3069
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Reduction of ventilator-associated pneumonia: active versus passive guideline implementation.

Hawe, Caroline S / Ellis, Kirsteen S / Cairns, Chris J S / Longmate, Andrew

Intensive care medicine

2009 Volume 35, Issue 7, Page(s) 1180–1186

Abstract: Purpose: Ventilator-associated pneumonia (VAP) is associated with increased morbidity, mortality and costs. We describe an active, multifaceted implementation of a VAP prevention bundle designed to improve staff compliance with evidence-based actions ... ...

Abstract	Purpose: Ventilator-associated pneumonia (VAP) is associated with increased morbidity, mortality and costs. We describe an active, multifaceted implementation of a VAP prevention bundle designed to improve staff compliance with evidence-based actions and reduce the incidence of VAP. Method: A 'VAP prevention bundle' was designed then implemented, first passively, then actively, as defined by a multimodal programme incorporating staff education, process measurement and outcome measurement and feedback to staff and organisational change. Results: Compliance with the VAP prevention bundle increased after active implementation. VAP incidence fell significantly from 19.2 to 7.5 per 1,000 ventilator days. Rate difference (99% CI) = 11.6 (2.3-21.0) per 1,000 ventilator days; rate ratio (99% CI) = 0.39 (0.16, 0.96). Conclusions: An active implementation programme increased staff compliance with evidence-based interventions and was associated with a significant reduction in VAP acquisition.
MeSH term(s)	Clinical Protocols ; Evidence-Based Medicine ; Female ; Guideline Adherence ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Pneumonia, Ventilator-Associated/epidemiology ; Pneumonia, Ventilator-Associated/prevention & control ; Severity of Illness Index ; United Kingdom/epidemiology
Language	English
Publishing date	2009-03-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-009-1461-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Elimination of central-venous-catheter-related bloodstream infections from the intensive care unit.

Longmate, Andrew G / Ellis, Kirsteen S / Boyle, Louise / Maher, Shaun / Cairns, Chris J S / Lloyd, Suzanne M / Lang, Colin

BMJ quality & safety

2011 Volume 20, Issue 2, Page(s) 174–180

Abstract: Introduction: Central-venous-catheter (CVC)-related bloodstream infection (CRBSI) is a complication of intensive care stay which can have important adverse consequences for both patient and institution. There are a number of evidence-based interventions ...

Abstract	Introduction: Central-venous-catheter (CVC)-related bloodstream infection (CRBSI) is a complication of intensive care stay which can have important adverse consequences for both patient and institution. There are a number of evidence-based interventions that reduce CRBSI, but it is recognised that consistently applying the best evidence every time is a challenge. Methods: The authors set out to reduce CRBSI and introduced interventions in our intensive care unit (ICU) over a 4-year period using a quality improvement approach. In a setting supportive to change and improvement, the authors established infection surveillance and introduced bundles of care processes relating to insertion and maintenance of CVCs. The changes were supported by educational interventions. The authors measured care processes and outcomes, and used statistical process control charts to illustrate changes. The final 18 months of the work was performed in the context of a national safety improvement programme (The Scottish Patient Safety Programme). Results: Following interventions, the annual CRBSI rate fell from 3.4 to 0/1000 patient days with zero episodes during the final 19 months of the study. Conclusions: The authors describe a significant reduction in CRBSI for the first time in a UK ICU. The authors summarised and simplified what to do, measured and provided feedback on outcomes, and improved expectations of performance standards for care processes. The authors believe that these approaches are worthy of serious consideration elsewhere.
MeSH term(s)	Catheter-Related Infections/prevention & control ; Cross Infection/prevention & control ; Female ; Humans ; Intensive Care Units ; Male ; Outcome Assessment (Health Care) ; Quality Assurance, Health Care/methods ; Safety Management/organization & administration ; Scotland
Language	English
Publishing date	2011-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2592912-4
ISSN	2044-5423 ; 2044-5415
ISSN (online)	2044-5423
ISSN	2044-5415
DOI	10.1136/bmjqs.2009.037200
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: 2-Mercapto-Quinazolinones as Inhibitors of Type II NADH Dehydrogenase and Mycobacterium tuberculosis: Structure-Activity Relationships, Mechanism of Action and Absorption, Distribution, Metabolism, and Excretion Characterization.

Murugesan, Dinakaran / Ray, Peter C / Bayliss, Tracy / Prosser, Gareth A / Harrison, Justin R / Green, Kirsteen / Soares de Melo, Candice / Feng, Tzu-Shean / Street, Leslie J / Chibale, Kelly / Warner, Digby F / Mizrahi, Valerie / Epemolu, Ola / Scullion, Paul / Ellis, Lucy / Riley, Jennifer / Shishikura, Yoko / Ferguson, Liam / Osuna-Cabello, Maria /

Read, Kevin D / Green, Simon R / Lamprecht, Dirk A / Finin, Peter M / Steyn, Adrie J C / Ioerger, Thomas R / Sacchettini, Jim / Rhee, Kyu Y / Arora, Kriti / Barry, Clifton E / Wyatt, Paul G / Boshoff, Helena I M

ACS infectious diseases

2018 Volume 4, Issue 6, Page(s) 954–969

Abstract: Mycobacterium tuberculosis ( MTb) possesses two nonproton pumping type II NADH dehydrogenase (NDH-2) enzymes which are predicted to be jointly essential for respiratory metabolism. Furthermore, the structure of a closely related bacterial NDH-2 has been ... ...

Abstract	Mycobacterium tuberculosis ( MTb) possesses two nonproton pumping type II NADH dehydrogenase (NDH-2) enzymes which are predicted to be jointly essential for respiratory metabolism. Furthermore, the structure of a closely related bacterial NDH-2 has been reported recently, allowing for the structure-based design of small-molecule inhibitors. Herein, we disclose MTb whole-cell structure-activity relationships (SARs) for a series of 2-mercapto-quinazolinones which target the ndh encoded NDH-2 with nanomolar potencies. The compounds were inactivated by glutathione-dependent adduct formation as well as quinazolinone oxidation in microsomes. Pharmacokinetic studies demonstrated modest bioavailability and compound exposures. Resistance to the compounds in MTb was conferred by promoter mutations in the alternative nonessential NDH-2 encoded by ndhA in MTb. Bioenergetic analyses revealed a decrease in oxygen consumption rates in response to inhibitor in cells in which membrane potential was uncoupled from ATP production, while inverted membrane vesicles showed mercapto-quinazolinone-dependent inhibition of ATP production when NADH was the electron donor to the respiratory chain. Enzyme kinetic studies further demonstrated noncompetitive inhibition, suggesting binding of this scaffold to an allosteric site. In summary, while the initial MTb SAR showed limited improvement in potency, these results, combined with structural information on the bacterial protein, will aid in the future discovery of new and improved NDH-2 inhibitors.
MeSH term(s)	Molecular Structure ; Mycobacterium tuberculosis/enzymology ; NADH Dehydrogenase/antagonists & inhibitors ; NADH Dehydrogenase/chemistry ; Quinazolinones/chemical synthesis ; Quinazolinones/chemistry ; Quinazolinones/pharmacology ; Structure-Activity Relationship
Chemical Substances	Quinazolinones ; NADH dehydrogenase II (EC 1.6.99.-) ; NADH Dehydrogenase (EC 1.6.99.3)
Language	English
Publishing date	2018-03-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2373-8227
ISSN (online)	2373-8227
DOI	10.1021/acsinfecdis.7b00275
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Essential but Not Vulnerable: Indazole Sulfonamides Targeting Inosine Monophosphate Dehydrogenase as Potential Leads against Mycobacterium tuberculosis.

Park, Yumi / Pacitto, Angela / Bayliss, Tracy / Cleghorn, Laura A T / Wang, Zhe / Hartman, Travis / Arora, Kriti / Ioerger, Thomas R / Sacchettini, Jim / Rizzi, Menico / Donini, Stefano / Blundell, Tom L / Ascher, David B / Rhee, Kyu / Breda, Ardala / Zhou, Nian / Dartois, Veronique / Jonnala, Surendranadha Reddy / Via, Laura E /

Mizrahi, Valerie / Epemolu, Ola / Stojanovski, Laste / Simeons, Fred / Osuna-Cabello, Maria / Ellis, Lucy / MacKenzie, Claire J / Smith, Alasdair R C / Davis, Susan H / Murugesan, Dinakaran / Buchanan, Kirsteen I / Turner, Penelope A / Huggett, Margaret / Zuccotto, Fabio / Rebollo-Lopez, Maria Jose / Lafuente-Monasterio, Maria Jose / Sanz, Olalla / Diaz, Gracia Santos / Lelièvre, Joël / Ballell, Lluis / Selenski, Carolyn / Axtman, Matthew / Ghidelli-Disse, Sonja / Pflaumer, Hannah / Bösche, Markus / Drewes, Gerard / Freiberg, Gail M / Kurnick, Matthew D / Srikumaran, Myron / Kempf, Dale J / Green, Simon R / Ray, Peter C / Read, Kevin / Wyatt, Paul / Barry, Clifton E / Boshoff, Helena I

ACS infectious diseases

2016 Volume 3, Issue 1, Page(s) 18–33

Abstract: A potent, noncytotoxic indazole sulfonamide was identified by high-throughput screening of >100,000 synthetic compounds for activity against Mycobacterium tuberculosis (Mtb). This noncytotoxic compound did not directly inhibit cell wall biogenesis but ... ...

Abstract	A potent, noncytotoxic indazole sulfonamide was identified by high-throughput screening of >100,000 synthetic compounds for activity against Mycobacterium tuberculosis (Mtb). This noncytotoxic compound did not directly inhibit cell wall biogenesis but triggered a slow lysis of Mtb cells as measured by release of intracellular green fluorescent protein (GFP). Isolation of resistant mutants followed by whole-genome sequencing showed an unusual gene amplification of a 40 gene region spanning from Rv3371 to Rv3411c and in one case a potential promoter mutation upstream of guaB2 (Rv3411c) encoding inosine monophosphate dehydrogenase (IMPDH). Subsequent biochemical validation confirmed direct inhibition of IMPDH by an uncompetitive mode of inhibition, and growth inhibition could be rescued by supplementation with guanine, a bypass mechanism for the IMPDH pathway. Beads containing immobilized indazole sulfonamides specifically interacted with IMPDH in cell lysates. X-ray crystallography of the IMPDH-IMP-inhibitor complex revealed that the primary interactions of these compounds with IMPDH were direct pi-pi interactions with the IMP substrate. Advanced lead compounds in this series with acceptable pharmacokinetic properties failed to show efficacy in acute or chronic murine models of tuberculosis (TB). Time-kill experiments in vitro suggest that sustained exposure to drug concentrations above the minimum inhibitory concentration (MIC) for 24 h were required for a cidal effect, levels that have been difficult to achieve in vivo. Direct measurement of guanine levels in resected lung tissue from tuberculosis-infected animals and patients revealed 0.5-2 mM concentrations in caseum and normal lung tissue. The high lesional levels of guanine and the slow lytic, growth-rate-dependent effect of IMPDH inhibition pose challenges to developing drugs against this target for use in treating TB.
MeSH term(s)	Animals ; Antitubercular Agents/pharmacology ; Drug Design ; Drug Discovery ; Drug Resistance, Bacterial ; Gene Expression Regulation, Bacterial/drug effects ; Gene Expression Regulation, Enzymologic/drug effects ; Humans ; IMP Dehydrogenase/antagonists & inhibitors ; Mice ; Mice, Inbred C57BL ; Molecular Structure ; Mutation ; Mycobacterium tuberculosis/drug effects ; Mycobacterium tuberculosis/enzymology ; Protein Conformation ; Rabbits ; Structure-Activity Relationship ; Sulfonamides/chemistry ; Sulfonamides/pharmacokinetics ; Sulfonamides/pharmacology ; Tuberculosis/drug therapy
Chemical Substances	Antitubercular Agents ; Sulfonamides ; IMP Dehydrogenase (EC 1.1.1.205)
Language	English
Publishing date	2016-10-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ISSN	2373-8227
ISSN (online)	2373-8227
DOI	10.1021/acsinfecdis.6b00103
Database	MEDical Literature Analysis and Retrieval System OnLINE

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