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Search Results: 1 - 10 of 1743 matches for " Janet Darbyshire "
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The Development of Vaginal Microbicides for the Prevention of HIV Transmission
Jonathan Weber ,Kamal Desai,Janet Darbyshire,on behalf of the Microbicides Development Programme
PLOS Medicine , 2005, DOI: 10.1371/journal.pmed.0020142
Antenatal screening for Group B Streptococcus: A diagnostic cohort study
Janet E Hiller, Helen M McDonald, Philip Darbyshire, Caroline A Crowther
BMC Pregnancy and Childbirth , 2005, DOI: 10.1186/1471-2393-5-12
Abstract: Consented women received vaginal and perianal swabs at 31–33 weeks gestation, 35–38 weeks gestation and during labour. Swabs were cultured on layered horse blood agar and inoculated into selective broth prior to analysis. Test characteristics were calculated with exact confidence intervals for a high risk strategy and for antenatal screening at 31–33 and 35–37 weeks gestation for vaginal cultures alone, perianal cultures alone and combined low vaginal and perianal cultures.The high risk strategy was not informative in predicting GBS status during labour. There is an unequivocal benefit for the identification of women colonised with GBS during labour associated with delaying screening until 36 weeks however the results for method of screening were less definitive with no clear advantage in using a combined low vaginal and perianal swabbing regimen over the use of a low vaginal swab alone.This study can contribute to the development of prevention strategies in that it provides clear evidence for optimal timing of swabs. The addition of a perianal swab does not confer clear benefit. The quantification of advantages and disadvantages provided in this study will facilitate communication with clinicians and pregnant women alike.Group B Streptococcus (GBS) infection in infants as a consequence of vertically acquired infection, is an important cause of neonatal mortality and morbidity, presenting as sepsis or pneumonia [1]. The incidence of early onset group B streptococcus sepsis (EOGBS) occurring within the first week of life has fallen in Australia from 2.0 per 1000 live births in 1991–1993 to 0.5 per 1000 live births in 1995–1997 [2]. This figure is similar to the recently reported annual incidence of 0.48 per 1000 from the United Kingdom and Ireland [3].Vaginal colonisation occurs in 11–30% of all pregnant women [4-6] and 50–75% of their infants become colonised usually during labour or birth. There is clear evidence that intrapartum colonisation is strongly associated
Nursing heroism in the 21st Century'
Philip Darbyshire
BMC Nursing , 2011, DOI: 10.1186/1472-6955-10-4
Abstract: Is heroism a legitimate part of nursing, or are nurses simply 'just doing their job' even when facing extreme personal danger? In this paper I explore the place and relevance of heroism in contemporary nursing. I propose that nursing heroism deserves a broader appreciation and that within the term lie many hidden, 'unsung' or 'unrecorded' heroisms. I also challenge the critiques of heroism that would condemn it as part of a 'militarisation' of nursing. Finally, I argue that nursing needs to be more open in celebrating our heroes and the transformative power of nursing achievements.The language of heroism may sound quaint by 21st Century standards but nursing heroism is alive and well in the best of our contemporary nursing ethos and practice.Any author addressing the topic of "Nursing Heroics: what it means in the 21st Century" faces a challenge and even more so when they take this on as the Vivian Bullwinkel Memorial Lecture.They are perhaps doomed before they begin, for what modern day nursing heroism outside of a war zone is ever going to be able to withstand comparison with the experiences of Sister Bullwinkel and her colleagues - during the fall of Singapore, the sinking of the Vyner Brooke, the murderous machine gunning of Vivian and her 21 fellow nurses on Radji Beach and her years of internment in the death camps of Sumatra.[1-3]Somehow, to mention any other forms of heroism in the same breath seems almost disrespectful, a feat of linguistic relativism designed to dilute or trivialize the power of the term. But please, bear with me as I explore the idea and the practices of nursing heroism in our current age.First, the more traditional concept of heroism as courage and providing service to others in the face of extreme personal danger is undoubtedly alive and well in nursing and in other human services. Firemen still enter burning buildings to save their occupants and nurses still join their health care colleagues in providing care to the hungry, the fearful
Modeling Agent Communication in a Complex System as a Neural Net
Paul Darbyshire
Lecture Notes in Engineering and Computer Science , 2011,
Re-description of Dysponetus joeli Olivier et al., 2012 (Polychaeta, Chrysopetalidae), with a new key to species of the genus
Teresa Darbyshire
European Journal of Taxonomy , 2012, DOI: 10.5852/ejt.2012.27
Abstract: Dysponetus is a genus of the family Chrysopetalidae with twelve currently described species. Specimens are fragile and easily damaged or broken during sampling making identification difficult. The most recently described species, Dysponetus joeli Olivier et al., 2012, from the Bay of Biscay and English Channel, was described from a few small, damaged and poorly preserved specimens. New specimens from the Isles of Scilly, in much better condition, resembled D. joeli except for the absence of ventral cirri on segment 3. Examination of the type material of D. joeli showed it to be identical to these new specimens and highlighted errors in the original description of the species. This paper corrects the errors and a revised key to species is produced. The differences between D. joeli and the two most similar species, D. bipapillatus Dahlgren, 1996 and D. macroculatus Dahlgren, 1996 are also detailed.
Death by acid rain: VAP or EXIT?
Kentigern Thorburn, Andrew Darbyshire
Critical Care , 2009, DOI: 10.1186/cc8169
Abstract: Ventilator-associated pneumonia (VAP) is defined as a new (nosocomial) lower respiratory tract infection diagnosed in mechanically ventilated patients ≥48 hours ('early-onset' VAP) or ≥4 days ('late-onset' VAP) after intubation [1-5]. Management of early-onset and late-onset VAP may differ as the causative factors and likely pathogens will influence treatment strategies, such as antimicrobial therapy [2,3,5]. VAP is associated with increased mortality and morbidity, prolonged duration of ventilation and hospital stay, and escalated costs of hospitalisation [2,3,5-9]. In resource-rich countries VAP is reported to be the second most common nosocomial/hospital-acquired infection in pediatric and neonatal intensive care units, with incidences ranging from 3 to 30% and VAP-attributable mortality rates up to 20% [5,7,9]. The potential devastating impact of VAP is emphasized by the study of Abdel Gawad and colleagues [1] where a 50% incidence of VAP and 70% mortality with VAP means that more than 80% of all the deaths in their unit were due to hospital-acquired infection/VAP.Defining VAP is the easy aspect, making the correct diagnosis (let alone confirmation) becomes more challenging, and establishing universally accepted criteria is a distant goal. There is no gold standard. The Clinical Pulmonary Infection Score (CPIS), utilized in the study by Abdel Gawad and colleagues, is based on five clinical parameters - fever, leucocytosis, purulence of secretions, oxygenation, extent of radiographic infiltrates - and strengthened by cultures from the lower respiratory tract (most often broncho-alveolar lavage (BAL)) [10]. It suffers from poor inter-rater agreement and retrograde influence from positive BAL results [11]. The current reference standard (read 'gold standard') comprises the clinical criteria for the diagnosis of VAP established by the National Nosocomial Infection Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC), which incorporate a
Results of Antiretroviral Treatment Interruption and Intensification in Advanced Multi-Drug Resistant HIV Infection from the OPTIMA Trial
Mark Holodniy,Sheldon T. Brown,D. William Cameron,Tassos C. Kyriakides,Brian Angus,Abdel Babiker,Joel Singer,Douglas K. Owens,Aslam Anis,Ruth Goodall,Fleur Hudson,Mirek Piaseczny,John Russo,Martin Schechter,Lawrence Deyton,Janet Darbyshire
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0014764
Abstract: Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR) and limited retreatment options. We assessed two novel antiretroviral (ARV) treatment approaches in this setting.
Parental Engagement in Children’s Learning: Moving on from Mass Superstition  [PDF]
Janet Goodall
Creative Education (CE) , 2018, DOI: 10.4236/ce.2018.911116
Abstract: In this article, I build on Goodman’s concept of mass superstition, which he applied to the schooling system. Goodman holds that we continue to believe in the value of this system, without clear evidence that it is working. I use this concept to apply the argument to the way the current system deals with parents. In spite of clear indications in the research that parental engagement with children’s learning is one of the best means to support educational achievement, particularly for children at risk of failure in the current system, parents are still routinely held at a distance from the learning processes fostered by the school system. I argue for a change to the foundational beliefs of the system, so that schools and families will work in partnership as co-constructors of children’s learning.
Cost Effectiveness Analysis of Clinically Driven versus Routine Laboratory Monitoring of Antiretroviral Therapy in Uganda and Zimbabwe
Antonieta Medina Lara, Jesse Kigozi, Jovita Amurwon, Lazarus Muchabaiwa, Barbara Nyanzi Wakaholi, Ruben E. Mujica Mota, A. Sarah Walker, Ronnie Kasirye, Francis Ssali, Andrew Reid, Heiner Grosskurth, Abdel G. Babiker, Cissy Kityo, Elly Katabira, Paula Munderi, Peter Mugyenyi, James Hakim, Janet Darbyshire, Diana M. Gibb, Charles F. Gilks, on behalf of the DART Trial Team
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0033672
Abstract: Background Despite funding constraints for treatment programmes in Africa, the costs and economic consequences of routine laboratory monitoring for efficacy and toxicity of antiretroviral therapy (ART) have rarely been evaluated. Methods Cost-effectiveness analysis was conducted in the DART trial (ISRCTN13968779). Adults in Uganda/Zimbabwe starting ART were randomised to clinically-driven monitoring (CDM) or laboratory and clinical monitoring (LCM); individual patient data on healthcare resource utilisation and outcomes were valued with primary economic costs and utilities. Total costs of first/second-line ART, routine 12-weekly CD4 and biochemistry/haematology tests, additional diagnostic investigations, clinic visits, concomitant medications and hospitalisations were considered from the public healthcare sector perspective. A Markov model was used to extrapolate costs and benefits 20 years beyond the trial. Results 3316 (1660LCM;1656CDM) symptomatic, immunosuppressed ART-naive adults (median (IQR) age 37 (32,42); CD4 86 (31,139) cells/mm3) were followed for median 4.9 years. LCM had a mean 0.112 year (41 days) survival benefit at an additional mean cost of $765 [95%CI:685,845], translating into an adjusted incremental cost of $7386 [3277,dominated] per life-year gained and $7793 [4442,39179] per quality-adjusted life year gained. Routine toxicity tests were prominent cost-drivers and had no benefit. With 12-weekly CD4 monitoring from year 2 on ART, low-cost second-line ART, but without toxicity monitoring, CD4 test costs need to fall below $3.78 to become cost-effective (<3xper-capita GDP, following WHO benchmarks). CD4 monitoring at current costs as undertaken in DART was not cost-effective in the long-term. Conclusions There is no rationale for routine toxicity monitoring, which did not affect outcomes and was costly. Even though beneficial, there is little justification for routine 12-weekly CD4 monitoring of ART at current test costs in low-income African countries. CD4 monitoring, restricted to the second year on ART onwards, could be cost-effective with lower cost second-line therapy and development of a cheaper, ideally point-of-care, CD4 test.
A case of an ectopic cervical thymic cyst  [PDF]
Simon Davey, Janet McNally
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.22041

Ectopic cervical thymic cysts are uncommon lesions and definitive preoperative diagnosis is not always possible. Surgical excision is recommended due to the small but possible chance of malignant degeneration in adulthood. We present a case of a nine year old boy with an asymptomatic lesion in his neck, discuss the differential diagnoses of such lesions and treatment considerations.

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