bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of a Conjugate Vaccine Containing Polymannuronic Acid and Flagellin against Experimental Pseudomonas aeruginosa Lung Infection in Mice
Authors: Campodónico Victoria L. , Llosa Nicolas J. , Bentancor Leticia V. , Maira-Litran Tomas , Pier Gerald B. 
Published: June 2011

ABSTRACT

Vaccines that could effectively prevent
Pseudomonas aeruginosa
pulmonary infections in the settings of cystic fibrosis (CF) and nosocomial pneumonia could be exceedingly useful, but to date no effective immunotherapy targeting this pathogen has been successfully developed for routine use in humans. Evaluations using animals and limited human trials of vaccines and their associated immune effectors against different
P. aeruginosa
antigens have suggested that antibody to the conserved surface polysaccharide alginate, as well as the flagellar proteins, often give high levels of protection. However, alginate itself does not elicit protective antibody in humans, and flagellar vaccines containing the two predominant serotypes of this antigen may not provide sufficient coverage against variant flagellar types. To evaluate if combining these antigens in a conjugate vaccine would be potentially efficacious, we conjugated polymannuronic acid (PMA), containing the blocks of mannuronic acid conserved in all
P. aeruginosa
alginates, to type a flagellin (FLA) and evaluated immunogenicity, opsonic killing activity, and passive protective efficacy in mice. The PMA-FLA conjugate was highly immunogenic in mice and rabbits and elicited opsonic antibodies against mucoid but not nonmucoid
P. aeruginosa
, but nonetheless rabbit antibody to PMA-FLA showed evidence of protective efficacy against both types of this organism in a mouse lung infection model. Importantly, the PMA-FLA conjugate vaccine did not elicit antibodies that neutralized the Toll-like receptor 5 (TLR5)-activating activity of flagellin, an important part of innate immunity to flagellated microbial pathogens. Conjugation of PMA to FLA appears to be a promising path for developing a broadly protective vaccine against
P. aeruginosa
.
Antibodies in Action: Role of Human Opsonins in Killing Salmonella enterica Serovar Typhi
Authors: Lindow Janet C. , Fimlaid Kelly A. , Bunn Janice Y. , Kirkpatrick Beth D. 
Published: June 2011

ABSTRACTAlthough vaccines have been available for over a century, a correlate of protection for typhoid fever has yet to be identified. Antibodies are produced in response to typhoid infection and vaccination and are generally used as the gold standard for determining vaccine immunogenicity, even though their role in clearance ofSalmonella entericaserovar Typhi infections is poorly defined. Here, we describe the first functional characterization ofS.Typhi-specific antibodies following vaccination with a new vaccine, M01ZH09 (Ty2 ΔaroCΔssaV). We determined that postvaccination sera increased the uptake of wild-typeS.Typhi by human macrophages up to 2.3-fold relative to prevaccination (day 0) or placebo samples. These results were recapitulated using immunoglobulins purified from postvaccination serum, demonstrating that antibodies were largely responsible for increases in uptake. Imaging verified that macrophages internalized 2- to 9.5-fold moreS.Typhi when the bacteria were opsonized with postvaccination sera than when the bacteria were opsonized with day 0 or placebo sera. Once inside macrophages, the survival ofS.Typhi was reduced as much as 50% when opsonized with postvaccination sera relative to day 0 or placebo serum samples. Lastly, bactericidal assays indicated that antibodies generated postvaccination were recognized by complement factors and assisted in killingS.Typhi: mean postvaccination bactericidal antibody titers were higher at all time points than placebo and day 0 titers. These data clearly demonstrate that there are at least two mechanisms by which antibodies facilitate killing ofS.Typhi. Future work could lead to improved immunogenicity tests associated with vaccine efficacy and the identification of correlates of protection against typhoid fever.
The clinic embraces all aspects of SEM from ‘exercise on prescription’ and ‘functional rehabilitation programmes’ to specialist image guided spinal injections
Authors: Petrides Simon 
Published: June 2011

Simon is a Musculoskeletal and Sports physician and Director of the Blackberry Clinic in Milton Keynes. Simon has a special interest in prolotherapy injections as an adjunct to intense rehabilitation programmes for unremitting low back pain (LBP).This has culminated in successful treatment of many elite athletes and footballers.Most clinical trials on the treatment have shown significant benefits but no prominent trials have used patients with specific back pain diagnoses using selective block injections to determine which patients are most likely to benefit.Rowing has a LBP incidence of 100% and over 20 GB rowers have been successfully treated using this technique.The lecture will summarise his experience in the use of prolotherapy in these athlete.
Benefits and challenges of collaborative research: lessons from supportive and palliative care
Authors: Payne Sheila , Seymour Jane , Molassiotis Alex , Froggatt Katherine , Grande Gunn , Lloyd-Williams Mari , Foster Claire , Wilson Roger , Rolls Liz , Todd Chris , Addington-Hall Julia 
Published: May 2011

ObjectiveTo describe the processes of establishing and running the Cancer Experiences Collaborative (CECo), and reflect upon the benefits and challenges of undertaking collaborative research in supportive and palliative care.DesignA descriptive analysis of a 5-year research collaborative initiated in 2006.SettingResearch groups at the Universities of Lancaster, Liverpool, Manchester, Nottingham and Southampton, England.Participants26 UK organisations including the four largest hospices in England, hospital cancer centres, Help the Hospices (a national charity supporting independent hospices) and user representatives.FindingsThe aim of CECo was to enhance the value, quality and productivity of scientific research in supportive and palliative care, and to increase research capacity and improve the coordination of collaborative research. Three programmatic themes of research were established: (i) innovative approaches to complex symptoms, (ii) planning for the care of older adults towards the end of life and (iii) research methodology including narrative approaches. Four benefits and challenges are highlighted: strategic leadership and management structures for cross-institutional work, working in multidisciplinary groups and linking research with practice settings, capacity building, and user involvement.ConclusionsThe activities of CECo have resulted in significant benefits with an increase in good quality research studies that have led to the production of a significant number of peer-reviewed papers, and learning between academics, clinicians and users, which has contributed to raising the standards of supportive and palliative care research. However, the future of such research initiatives is fragile, with concerns about the sustainability of collaboration in the face of diminishing resources.
ACP: more than burial or cremation!
Authors: Loney J , Willoughby J , Miller H , Russell S , Loney J 
Published: May 2011

Three care home educators worked across nine care homes in East, North and West Hertfordshire to provide an End of Life Care Education Programme to care homes.496 staff took part in the education programme. (Isabel Hospice Project: 150 participants in 3 homes, Peace Hospice Project: 155 participants in 4 homes, Hospice of St Francis Project: 191 participants in 2 homes).Each education programme although designed differently contained the same education content and themes as well as measuring the education activity and impact of that education:▶Clarification of advance care planning terminology and documentation.▶Awareness of services and team working across organizations.▶Identification of residents at the end of life.▶Symptom control and assessment.▶Communication skills.▶Cultural care.▶Manager support for the end of life ethos.▶Support in policy writing.The education programme resulted in:▶An increase in the skills, confidence and competence of care home staff with the advance care planning process.▶Significant increase in the preferred place of care being achieved through the use of advance care planning with the residents.The three programmes focused on identifying, developing and sustaining the care home staff skills and confidence, thus enabling proactive advance care planning in the care home setting.This demonstrated that a flexible, learner centred and systematic approach to education can make a difference.
On Your Marks, Get Set, Go! Piloting Advance Care Planning Education
Authors: Russell S , Fowler C 
Published: May 2011

In 2009, Mount Vernon Cancer Network piloted four 1 day experiential advance care planning (ACP) workshops in four locations facilitated by two educators. The training the trainer model was considered early in order to increase the availability of ACP facilitators across MVCN. Participants to the 1 day workshops were invited to attend a ½ day ‘Teaching Advance Care Planning’.51 participants attended the workshops:▶45% Community Matrons, District, Respiratory Specialist Nurses, Care Home Staff▶18% palliative care education roles▶15% hospice care▶12% Clinical Nurse Specialists in Palliative Care▶6% hospice social workers▶4% associate specialist/GP assistant roles.The participants confidence increased significantly following attendance at the workshops: Pre PostConfidence in explaining ACP 54% 100%.What a statement of wishes and preferences is 33% 93%.What an advance decision to refuse treatment is 24% 91%.When lasting power of attorney (welfare) is used 15% 87%.A ‘Teaching Advance Care Planning’ ½ day interactive workshop discussed the rationale for the 1 day course, signposting to relevant resources and information about the wider evidence base for advance care planning. Participants brought to the sessions the type of sessions, target audience and timings that they planned to deliver training to. Draft lesson plans and resources were produced during the workshop for them to take away to practice. Delivery methods and interactive exercises were also discussed and offered. The education model was further developed and delivered in 2010.
Creating interest in ACP in a health group setting
Authors: Denson J , McKinnon A , Scammell S , Dickins C , Meehan L 
Published: May 2011

In 2009 Barwon Health's Chronic Heart Failure (CHF) team commenced promoting the opportunity of Advanced Care Planning (ACP) to clients in our 12 week group programs. Prior to 2009, ACP information was provided to clients individually when time permitted.The team was interested in exploring if this new approach led to a greater willingness to engage in discussion about ACP.Midway into a program the Cardiac Nurse provides a leaflet and information about ACP to all participants and partners. In the following weeks the Social Worker speaks to each client about his/her interest or questions. The discussions can then continue with Social Worker, client and family and any existing legal documents the client has are checked.There has been a marked increase both in information clients received about ACP and follow-up discussions. 51 of 99 clients and partners discussed ACP with the Social Worker and 37 plans completed with a high client satisfaction rate.This approach is innovative because the ACP information is initially offered with health related information when clients are relaxed within the group, familiar with the team and have an increased understanding of their heart condition. The process is connected with their weekly program attendance and moves at the client's pace. It is acceptable to clients, timely and leads to greater willingness to engage in the ACP process. We believe the approach can be used for many health group programs and has the potential to increase the participation in ACP within the community health population.
Advance Care Planning (ACP) within a palliative approach for residential aged care
Authors: Hudson R 
Published: May 2011

In a unique collaboration between palliative care and aged care the Australian government produced Guidelines for a palliative approach in residential aged care, endorsed by the National Health & Medical Research Council in 2006. Specific guidelines for Advance Care Planning (ACP) fit within the broader palliative approach with its emphasis on holistic assessment early in the course of life-threatening disease. Replacing ad hoc arrangements for offering end-of-life choices, the guidelines emphasise systematic implementation, regular education and ongoing assessment. The ACP component is clearly linked to many of the other 76 guidelines, demonstrating the role of ACP in the broader framework of goal setting and care planning.Two brief, contrasting case studies exemplify the successful application of the guidelines for (a) a very physically frail, mentally alert older person and (b) a person with advanced dementia and other co-morbidities. Noting the families' reports and the endorsement of professional colleagues, aged care workers enjoyed pride and satisfaction from seeing the guidelines at work. The challenge remains, however, to ensure consistency in the application of the guidelines over a sustained period of time.When advance care planning in care homes is based on endorsed guidelines drawn from the best available evidence, the end-of-life experience for older persons, families, and care staff can be transformed.
Communication skills for advance care planning at end-of-life
Authors: Campbell H , Lillyman S , Nicholson P , Fisher J 
Published: May 2011

A total of 44 one day advance care planning (ACP) communications workshops were developed and delivered across two counties to health and social care practitioners Band 5 and above. This collaborative project between two Hospices and a University aimed to develop knowledge, skills and confidence in ACP discussions underpinned by national and local initiatives and policy and the evidence base.Satisfaction with the programme was excellent with 98% of participants very satisfied/satisfied that the programme was clinically relevant. There were post programme increases in confidence in exploring patient cues, structuring an ACP discussion and identifying patient & relatives concerns.The workshops also highlighted areas for further development in more general communication skills including identifying and following through cues and use of questions and silence.The structure of these workshops has since been used for the development of other local programmes addressing ACP and dementia.However recommendations from this evaluation would suggest that further communication skills training prior to the application to ACP discussions would facilitate conversations taking place particularly in getting conversations started.
‘We were here – Three persons' journeys of life’
Authors: Laidlaw R 
Published: May 2011

Narrative interviewing can be traced in American history as far back as 1920. Its application to Advance Care Planning (ACP) as a research method has yet to be extensively researched but where explored, it is the meaning portrayed and the perspective of the value of the event that assists learning. The methodology being less structured and using conversational interaction provides ACP Facilitators' opportunity to reflect on elements such as culture diversity and aspects of life that have compelling interest.My curiosity in narrative interviewing began in the 80s when involved in death and dying education and was regenerated when implementing the Respecting Patient Choices Program (RPC) at Ipswich Hospital and the surrounding West Moreton Health Service District in 2009. Through the RPC processes including, training of Facilitators and leading the facilitation of ACP conversations in acute, residential and community settings it contributed to my desire to scribe the experiences and lives of three special people and follow their stories through to death with family members.Scribing these privileged moments in time has provided me with invaluable lessons in life and living, consolidated my reasons of the importance of sharing their lives and their personal meanings when training and preparing Facilitators. The lives explored in context confront positively the importance of ACP and become the infancy of a library of ‘real experiences' that can be intertwined in models of ACP learning.
Structured advance care planning and its impact on patients at end-of-life: a review
Authors: Renton J , Detering K , Silvester W 
Published: May 2011

IntroductionFollowing the trial conducted by Detering et al (2008), Respecting Patient Choices implemented a formal process for advance care planning (ACP) provided by dedicated ACP staff. The intention was to review the impact of ACP on end of life care 12 months after implementation.AimA systematic evaluation of deaths of patients who underwent ACP.MethodsWe reviewed the end of life care of patients over a 12 month period. The review included ACP documentation, patient acuity, demographics, legal capacity, location at death and medical interventions prior to death.ResultsOf 108 patients 68% had formal ACP while the other 32% were introduced to the concepts of ACP. Median age was 78, 47% Male with both genders comparable in ACP completion; 76% had 2–4 comorbidities, however less ACPs were completed in those with more comorbidities. 73% lived at home with others and were less likely to complete ACP (67%) than those living alone (83%). 70% had legal capacity on admission. Location of death showed that 40% of patients died in a palliative care unit, 32% died in an acute ward, while of patients who died at home 100% had completed ACP. Only 2/73 patients who completed ACP had ICU admissions versus 6/35 who only received a brief introduction to ACP.Conclusion(1) Using dedicated staff is an effective way of delivering ACP to patients. (2) A completed ACP process ensures that end of life wishes are known and respected.
Government inquiries: why bother?
Authors: Luxford Y 
Published: May 2011

Like many other nations, Australia is seeking to improve both the level of integration of delivery of health care, and better address the health needs of its people through significant health system reform. Invariably the reform process is dotted with consultations, discussion papers and numerous opportunities to respond to semi-developed concepts through the mechanism of written submissions.Preparing a written submission is a time consuming process for both individual practitioners who have an interest, and small NGOs with limited staff and diverse demands on their time.Despite competing priorities, Palliative Care Australia has found that the process of carefully preparing written submissions, accompanied by various mechanisms of advocacy, provides considerable opportunity to achieve systemic improvement of access to, and delivery of, end of life care.The primary example used in this presentation will address the current Productivity Commission inquiry into Caring for Older Australians, although other relevant inquiries, such as the National Health and Hospitals Reform Commission and the Advanced Care Directives inquiry will also be addressed.In each of these cases, explanation will be provided of successful techniques to ensure that messages supporting improved palliative care are conveyed to key decision makers such as politicians and governmental policy creators. Mechanisms discussed include collaboration with like-minded organisations to both pool resources and boost impact, ensuring that the needs of the membership base are met, the importance of robust and evidence based material and the value of direct lobbying.All reports from current significant inquiries in Australia are now addressing palliative care. Late 2010 saw the Senate strongly supporting a motion to improve funding and access.It is definitely worth responding to government inquiries – but just writing a letter is simply not enough.
ACP at Barwon health – a community program in a Victorian regional health service
Authors: Mann J 
Published: May 2011

Barwon Health's (BH) community sector has been the focus of the Respecting Patient Choices (RPC) program implementation as it was considered that treatment decisions were best made in the non-acute phase of a person's illness.The initial aim was to provide advance care planning (ACP) for patients with chronic illness participating in formal programs including the Hospital Admission Risk Program (CHF & COPD clients), Renal Services, Palliative Care Services and Aged Care. The acute site wards where these patients were likely to be admitted were also included in the initial phase of implementation.It became evident that as partners of patients and others in the community heard about the program, there were more individuals wanting to complete ACP's. This group of relatively well, ‘non-patients’ had a high completion rate of ACP documents (80%).As a result, strong links have been established with the local General Practice Association, General Practices, private hospitals and other health service providers. A public launch was held to raise awareness and the service was extended to provide access to ACP for all BH patients and the wider community.Process and systems are in place to provide follow up of patients post introduction, consultation, audit, electronic alerts and review. ACP documents are accessible to provide information to family and health care providers.Data collection and IT capabilities at BH have been useful for both reporting requirements and to identify potential patients and areas requiring ongoing focus.
It's my life: influences on advance care planning conversations
Authors: Russell S 
Published: May 2011

As part of a doctoral research study 20 hospice patients responded to an invitation to participate in a video interview to discuss their influences on discussing end of life wishes and preferences. 15 participants were interviewed.▶2 withdrew after reading the information sheet.▶1 retrospectively withdrew consent.▶1 died before participation.▶1 did not meet the sample criteria.The findings indicate participants:(a)Can feel processed through an end of life check list to make decisions where they are given the decisions and then asked to think rather than think and decide.(b)Do not always discuss issues with those closest to them because of a desire to protect them.(c)Are not always willing to make advance care planning decisions not because they are unaware of their illness but because they do not feel resilient to face the emotional impact of their choices as well as being within the advance care planning process of; (1) consideration of wishes and preferences, (2) discussion, (3) discussion and decision making, (4) decision making and documentation, (5) communication and implementation.(d)Are willing to discuss end of life wishes and preferences when conversations are empathetic, at their pace and as part of an ongoing process.ConclusionHealth care professionals should value the consideration and discussion part of advance care planning as the vehicle and support mechanism for decision making outcomes. A reductionist, tick box approach to advance care planning can enable participants to feel processed through rather than participating in advance care planning discussions.