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Article ; Online: Characterization of sleep habits of children with Sotos syndrome.

Stafford, Christine F / Ward, Carrie / Ward, Sally L D / Sanchez-Lara, Pedro A

American journal of medical genetics. Part A

2021 Volume 185, Issue 9, Page(s) 2815–2820

Abstract: Sotos syndrome (SS) is a genetic disorder characterized by accelerated growth in childhood, developmental deficits, and characteristic craniofacial features. While clinicians and parents have reported unusual sleep habits, only one study by Rutter and ... ...

Abstract	Sotos syndrome (SS) is a genetic disorder characterized by accelerated growth in childhood, developmental deficits, and characteristic craniofacial features. While clinicians and parents have reported unusual sleep habits, only one study by Rutter and Cole in 1991 mentioned sleep complaints (Rutter and Cole, Developmental Medicine and Child Neurology, 1991, 33, 898-902). This study aimed to characterize the sleep habits of individuals with SS. We performed a cross-sectional study of individuals with a definite, probable, or possible diagnosis of Sotos syndrome. Participants were asked to complete the Children's Sleep Habits Questionnaire (CHSQ). We compared our data to historical data available from the literature. Subjects with SS showed more sleep disturbance than typically developing individuals (TD), although their sleep onset was less likely to be delayed and their sleep duration was longer. Participants with SS also showed different sleep patterns compared to children with other forms of intellectual and developmental disabilities (IDD). Individuals with SS exhibited early bed and rise times, frequently used transitional objects, displayed repetitive motion at sleep onset, and did not show a decrease in sleep duration with age. The majority of participants fell asleep at the same time each night, in their own bed, and within 20 min, and rarely showed signs of sleepwalking or night terrors. These results improve our understanding of sleep habits of individuals with SS and may be used to guide treatment and provide normalization for children with SS.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Male ; Sleep ; Sleep Wake Disorders/etiology ; Sleep Wake Disorders/pathology ; Sotos Syndrome/complications ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2021-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2108614-X
ISSN	1552-4833 ; 0148-7299 ; 1552-4825
ISSN (online)	1552-4833
ISSN	0148-7299 ; 1552-4825
DOI	10.1002/ajmg.a.62212
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Article ; Online: Assessing Knowledge, Usage, and Perceptions of the Frazier Free Water Protocol: A Pilot Study.

Kokush, Emily M / Patel, Radhika / Boardingham, Christine E / Rothman, Brooke F / Ward, Jan / McKay, Ondrea A / Yonclas, Peter / Glass, Nina E

The Journal of surgical research

2023 Volume 293, Page(s) 381–388

Abstract: Introduction: Dysphagia is very common among hospitalized patients and is associated with increased length of hospital stay, morbidity, and mortality. Diet restrictions for dysphagia cause dehydration and discontent. The Frazier Free Water Protocol ( ... ...

Abstract	Introduction: Dysphagia is very common among hospitalized patients and is associated with increased length of hospital stay, morbidity, and mortality. Diet restrictions for dysphagia cause dehydration and discontent. The Frazier Free Water Protocol (FFWP) was developed to improve hydration and quality of life in dysphagia patients by establishing the safety of allowing sips of water between meals. Despite these potential benefits, we hypothesized that the FFWP is not widely utilized. We sought to determine barriers to utilization by assessing the familiarity, usage, and perceptions of the FFWP among health-care providers at our institution. Methods: We distributed an anonymous questionnaire to a convenience sample of nurses in the hospital during daily huddles. The questionnaire was adapted from a validated framework to assess provider acceptability of health-care interventions. Results: Of the 66 surveys distributed, we had 58 completed (88%). Only 10 nurses (17%) had heard of the "FFWP" by name. For those that were familiar with the indications, benefits, and risks of giving free water to patients with dysphagia (n = 18), less than half (39%) reported doing so. No nurses that had less than 10 y of patient care experience gave water to dysphagia patients, even if they knew the indications, benefits, and risks. Similarly, less than a fifth (19%) of all nurses surveyed were comfortable giving water to dysphagia patients, but comfort increased for some if the protocol was recommended by a speech-language pathologist (33%) or physician (13%). Nursing experience of >10 y or in intensive care settings did not yield significant differences in knowledge, usage, or comfort level than those with less years or nonintensive care experience, respectively. Conclusions: Nurses are essential to the implementation of the FFWP, yet many are unfamiliar and uncomfortable with utilizing it. Education about the protocol is necessary to improve patient outcomes and quality of life. We plan to provide targeted education about the FFWP as well as assess other members of the health-care team, in an attempt to increase utilization of the protocol and improve dysphagia management.
MeSH term(s)	Humans ; Deglutition Disorders/etiology ; Deglutition Disorders/therapy ; Pilot Projects ; Quality of Life ; Delivery of Health Care ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2023.08.034
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Article ; Online: Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly.

Ward, Christine F / Figiel, Gary S / McDonald, William M

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

2020 Volume 28, Issue 8, Page(s) 808–811

Abstract: The coronavirus disease of 2019 or COVID-19 was first identified in Hubei Province in China in November of 2019 and quickly spread to become a global pandemic. The virus, SARS-Coronavirus-2, is particularly virulent in the elderly who can develop ... ...

Abstract	The coronavirus disease of 2019 or COVID-19 was first identified in Hubei Province in China in November of 2019 and quickly spread to become a global pandemic. The virus, SARS-Coronavirus-2, is particularly virulent in the elderly who can develop symptoms and become mortally ill within days of contracting the virus. The virus is easily transmitted by droplets (e.g., sneezing and coughing) and communal living settings such as personal care homes can be vulnerable to the spread of the virus. Identifying patients early in the disease process is important to providing appropriate medical interventions. To date, most of the medical literature, including Center for Disease Control guidelines, has relied on three necessary symptoms in making the diagnosis of COVID-19: fever, cough, and shortness of breath. We present four cases of elderly patients who developed altered mental status as their presenting symptom without associated fever or respiratory symptoms.
MeSH term(s)	Aged, 80 and over ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/psychology ; Early Diagnosis ; Female ; Humans ; Male ; Mental Disorders/complications ; Mental Disorders/diagnosis ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/psychology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1278145-9
ISSN	1545-7214 ; 1064-7481
ISSN (online)	1545-7214
ISSN	1064-7481
DOI	10.1016/j.jagp.2020.05.013
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Article ; Online: 30-day mortality among very old patients admitted to European intensive care units for major trauma.

Duncan, Chris F / Lonsdale, Dagan O / Farrah, Helen / Farnell-Ward, Sarah / Ryan, Christine / Watson, Ximena / Cecconi, Maurizio / Fjølner, Jesper / Szczeklik, Wojciech / Moreno, Rui / Artigas, Antonio / Joannidis, Michael / De Lange, Dylan W / Guidet, Bertrand / Flaatten, Hans / Jung, Christian / Leaver, Susannah

Gerontology

2024

Abstract: Introduction: Cases of major trauma in the very old (over 80 years) are increasingly common in the intensive care unit. Predicting outcome is challenging in this group of patients as chronological age is a poor marker of health and poor predictor of ... ...

Abstract	Introduction: Cases of major trauma in the very old (over 80 years) are increasingly common in the intensive care unit. Predicting outcome is challenging in this group of patients as chronological age is a poor marker of health and poor predictor of outcome. Increasingly, decisions are guided with the use of organ dysfunction scores of both the acute condition (e.g. Sequential Organ Failure Assessment (SOFA) score) and chronic health issues (e.g. clinical frailty scale, (CFS)). Recent work suggests that increased CFS is associated with a worse outcome in elderly major trauma patients. We aimed to test whether this association held true in the very old (over 80) or whether SOFA had a stronger association with 30-day outcome. Methods: Data from the VIP-1 and VIP-2 studies for patients over 80 years old with major trauma admissions were merged. These participants were recruited from 20 countries across Europe. Baseline characteristics, level of care provided and outcome (ICU and 30-day mortality) were summarised. Uni- and multi- variable regression analysis were undertaken to determine associations between CFS and SOFA score in the first 24-hours, type of major trauma and outcomes. Results: Of the 8062 acute patients recruited to the two VIP studies, 498 patients were admitted to intensive care because of major trauma. Median age was 84 years; median SOFA score was 6 (IQR 3,9) and median CFS was 3 (IQR 2,5). Survival to 30-days was 54%. Median and inter-quartile range of CFS was the same in survivors and non-survivors. In the logistic regression analysis, CFS was not associated with increased mortality. SOFA score (p<0.001) and trauma with head injury (p<0.01) were associated with increased mortality. Conclusions: Major trauma admissions in the very old are not uncommon and 30-day mortality is high. We found that CFS was not a helpful predictor of mortality. SOFA and trauma with head injury were associated with worse outcomes in this patient group.
Language	English
Publishing date	2024-02-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	193798-4
ISSN	1423-0003 ; 0304-324X
ISSN (online)	1423-0003
ISSN	0304-324X
DOI	10.1159/000537718
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Article ; Online: Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly

Ward, Christine F. / Figiel, Gary S. / McDonald, William M.

The American Journal of Geriatric Psychiatry

2020 Volume 28, Issue 8, Page(s) 808–811

Keywords	Geriatrics and Gerontology ; Psychiatry and Mental health ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	1278145-9
ISSN	1545-7214 ; 1064-7481
ISSN (online)	1545-7214
ISSN	1064-7481
DOI	10.1016/j.jagp.2020.05.013
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Article: Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly

Ward, Christine F / Figiel, Gary S / McDonald, William M

Am J Geriatr Psychiatry

Abstract	The coronavirus disease of 2019 or COVID-19 was first identified in Hubei Province in China in November of 2019 and quickly spread to become a global pandemic. The virus, SARS-Coronavirus-2, is particularly virulent in the elderly who can develop symptoms and become mortally ill within days of contracting the virus. The virus is easily transmitted by droplets (e.g., sneezing and coughing) and communal living settings such as personal care homes can be vulnerable to the spread of the virus. Identifying patients early in the disease process is important to providing appropriate medical interventions. To date, most of the medical literature, including Center for Disease Control guidelines, has relied on three necessary symptoms in making the diagnosis of COVID-19: fever, cough, and shortness of breath. We present four cases of elderly patients who developed altered mental status as their presenting symptom without associated fever or respiratory symptoms.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #276591
Database	COVID19

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Article ; Online: Managing post-sexual assault suicide risk.

Gilmore, Amanda K / Ward-Ciesielski, Erin F / Smalling, Anna / Limowski, Anne R / Hahn, Christine K / Jaffe, Anna E

Archives of women's mental health

2020 Volume 23, Issue 5, Page(s) 673–679

Abstract: Suicidal ideation and suicidal behavior are common after experiencing a sexual assault. Therefore, it is imperative to assess for and manage suicidal ideation using evidence-based techniques after a sexual assault medical forensic examination (SAMFE). We ...

Abstract	Suicidal ideation and suicidal behavior are common after experiencing a sexual assault. Therefore, it is imperative to assess for and manage suicidal ideation using evidence-based techniques after a sexual assault medical forensic examination (SAMFE). We assessed factors associated with higher suicidal ideation identified in a post-SAMFE mental health screening conducted over the phone and strategies to manage suicide risk. We also discuss three case examples and unique considerations when assessing post-SAMFE suicide risk. It was found that among individuals who completed a post-SAMFE screen, individuals who have been previously hospitalized for a mental health problem, who had higher acute stress symptoms, and who were homeless reported more suicidal ideation than those without those histories or symptom presentations. No matter the risk factors for suicidal ideation post-SAMFE, it is essential to screen all individuals post-SAMFE due to their high risk for suicidal ideation and death by suicide.
MeSH term(s)	Adolescent ; Adult ; Depression/psychology ; Female ; Humans ; Mental Health ; Middle Aged ; Risk Factors ; Sex Offenses/psychology ; Stress Disorders, Post-Traumatic/psychology ; Suicidal Ideation ; Suicide/psychology ; Suicide, Attempted/psychology ; United States ; Young Adult
Language	English
Publishing date	2020-07-05
Publishing country	Austria
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1463529-X
ISSN	1435-1102 ; 1434-1816
ISSN (online)	1435-1102
ISSN	1434-1816
DOI	10.1007/s00737-020-01047-7
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Article ; Online: The impact of COVID-19 on medication reviews in English primary care. An OpenSAFELY-TPP analysis of 20 million adult electronic health records.

Wood, Christopher / Speed, Victoria / Fisher, Louis / Curtis, Helen J / Schaffer, Andrea L / Walker, Alex J / Croker, Richard / Brown, Andrew D / Cunningham, Christine / Hulme, William J / Andrews, Colm D / Butler-Cole, Ben F C / Evans, David / Inglesby, Peter / Dillingham, Iain / Bacon, Sebastian C J / Davy, Simon / Ward, Tom / Hickman, George /

Bridges, Lucy / O'Dwyer, Thomas / Maude, Steven / Smith, Rebecca M / Mehrkar, Amir / Bates, Chris / Cockburn, Jonathan / Parry, John / Hester, Frank / Harper, Sam / Goldacre, Ben / MacKenna, Brian

British journal of clinical pharmacology

2024

Abstract: Aims: The COVID-19 pandemic caused significant disruption to routine activity in primary care. Medication reviews are an important primary care activity ensuring safety and appropriateness of prescribing. A disruption could have significant negative ... ...

Abstract	Aims: The COVID-19 pandemic caused significant disruption to routine activity in primary care. Medication reviews are an important primary care activity ensuring safety and appropriateness of prescribing. A disruption could have significant negative implications for patient care. Using routinely collected data, our aim was first to describe codes used to record medication review activity and then to report the impact of COVID-19 on the rates of medication reviews. Methods: With the approval of NHS England, we conducted a cohort study of 20 million adult patient records in general practice, in-situ using the OpenSAFELY platform. For each month, between April 2019 and March 2022, we report the percentage of patients with a medication review coded monthly and in the previous 12 months with breakdowns by regional, clinical and demographic subgroups and those prescribed high-risk medications. Results: In April 2019, 32.3% of patients had a medication review coded in the previous 12 months. During the first COVID-19 lockdown, monthly activity decreased (-21.1% April 2020), but the 12-month rate was not substantially impacted (-10.5% March 2021). The rate of structured medication review in the last 12 months reached 2.9% by March 2022, with higher percentages in high-risk groups (care home residents 34.1%, age 90+ years 13.1%, high-risk medications 10.2%). The most used medication review code was Medication review done 314530002 (59.5%). Conclusions: There was a substantial reduction in the monthly rate of medication reviews during the pandemic but rates recovered by the end of the study period. Structured medication reviews were prioritized for high-risk patients.
Language	English
Publishing date	2024-03-26
Publishing country	England
Document type	Journal Article
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.16030
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Article ; Online: Selected Endemic Zoonoses in Pigs Presenting for Slaughter in Kampala, Uganda.

Atherstone, Christine / Mgode, Georgies F / Dhand, Navneet K / Alonso, Silvia / Grace, Delia / Ward, Michael P / Mor, Siobhan M

The American journal of tropical medicine and hygiene

2020 Volume 103, Issue 6, Page(s) 2552–2560

Abstract: Leptospirosis, brucellosis, and Q fever (coxiellosis) are bacterial zoonoses that cause acute febrile illness in people as well as reproductive losses in pigs. Pig keeping is an increasingly important livelihood to millions of smallholder farmers in ... ...

Abstract	Leptospirosis, brucellosis, and Q fever (coxiellosis) are bacterial zoonoses that cause acute febrile illness in people as well as reproductive losses in pigs. Pig keeping is an increasingly important livelihood to millions of smallholder farmers in Uganda because of exponential increases in demand for pork. The prevalence of leptospirosis and Q fever in pigs is unknown, and the few studies of porcine brucellosis have estimated a range of seroprevalence. Therefore, we undertook a prevalence survey of leptospirosis, brucellosis, and Q fever in pigs using quantitative real-time PCR to determine the potential importance of these zoonoses to the growing pig sector in Uganda. Six hundred forty-nine pigs were sampled in 2015-2016 at an urban pork slaughterhouse. Ten percent of pigs (
MeSH term(s)	Animals ; Brucellosis/epidemiology ; Brucellosis/veterinary ; Cross-Sectional Studies ; Data Collection ; Endemic Diseases/veterinary ; Female ; Leptospira/classification ; Leptospirosis/epidemiology ; Leptospirosis/microbiology ; Leptospirosis/veterinary ; Male ; Q Fever/epidemiology ; Q Fever/veterinary ; Real-Time Polymerase Chain Reaction/veterinary ; Risk Factors ; Swine ; Swine Diseases/epidemiology ; Swine Diseases/microbiology ; Uganda/epidemiology ; Zoonoses
Language	English
Publishing date	2020-10-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.20-0033
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Article ; Online: Glyphosate and Polyoxyethyleneamine Ingestion Leading to Renal, Hepatic, and Pulmonary Failure.

Bigner, Jessica A / Fiester, Steven E / Fulcher, James W / Schammel, Christine M G / Ward, Michael E / Burney, Harmonie E / Wheeler, John F / Wheeler, Sandy K / Teuber, Julie M

The American journal of forensic medicine and pathology

2021 Volume 42, Issue 3, Page(s) 282–285

Abstract: Abstract: Glyphosate is an organophosphorus compound and the active ingredient in commonly used herbicides, whereas polyoxyethyleneamine (POEA) is a nonionic surfactant often coupled with glyphosate in these herbicides to increase their efficacy. Cases ... ...

Abstract	Abstract: Glyphosate is an organophosphorus compound and the active ingredient in commonly used herbicides, whereas polyoxyethyleneamine (POEA) is a nonionic surfactant often coupled with glyphosate in these herbicides to increase their efficacy. Cases of glyphosate-POEA ingestion have shown a variety of outcomes, ranging from skin and mucosal surface irritation to death. Here, we report mortality after ingestion of at least 237 mL of an herbicide confirmed to contain both glyphosate and POEA. The decedent's electronic medical record indicates presentation to the emergency department shortly after ingestion and rapid decompensation, with death occurring on the fourth day of admission. The autopsy report showed extensive pulmonary edema and congestion with no alimentary tract abnormalities. Microscopically, airway inflammation, edema, and hemorrhage were shown as well as pericentral necrosis and macrovascular hepatic steatosis. This case is unusual for several reasons including the fatal outcome in a young 30-year-old patient, the large volume of the herbicide consumed, the associated large volume aspirated, and the lung pathology associated with exposure to glyphosate-POEA since inhalation, and in this case, aspiration is an uncommon route of glyphosate-POEA exposure. This report therefore offers rare respiratory tract pathological findings and the clinical course after aspiration of a large volume of glyphosate-POEA.
MeSH term(s)	Acute Kidney Injury/chemically induced ; Adult ; Edema/pathology ; Glycine/analogs & derivatives ; Glycine/poisoning ; Hemorrhage/pathology ; Herbicides/poisoning ; Humans ; Liver/pathology ; Liver Failure, Acute/chemically induced ; Lung/pathology ; Male ; Necrosis ; Polyethylene Glycols/poisoning ; Pulmonary Edema/pathology ; Respiratory Insufficiency/chemically induced ; Suicide, Completed ; Surface-Active Agents/poisoning ; Glyphosate
Chemical Substances	Herbicides ; Surface-Active Agents ; polyoxyethyleneamine ; Polyethylene Glycols (3WJQ0SDW1A) ; Glycine (TE7660XO1C)
Language	English
Publishing date	2021-02-25
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	604537-6
ISSN	1533-404X ; 0195-7910
ISSN (online)	1533-404X
ISSN	0195-7910
DOI	10.1097/PAF.0000000000000660
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