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Botten J, Beard J, Zorzi A, Thompson A. A simple intervention to improve antibiotic treatment times for neutropenic sepsis. Acute Med 2016; 15:3-6. [PMID: 27116580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Patients with suspected Neutropenic sepsis require rapid antibiotic administration, but despite extensive education, only 67% of patients received antibiotics within 60 minutes . METHODS A Neutropenic Sepsis Alert Card was created, as a Patient Specific Directive - this allows nurses to administer antibiotics to specific patients without prior medical review. RESULTS Since the intervention, 301 patients presented with suspected neutropenic sepsis. 277 patients (92%) received their first dose of intravenous antibiotics within 1 hour of arrival into hospital, compared to 95 out of 143 patients (67%) presenting between January and June of 2014 (p=0.036). CONCLUSION The Neutropenic Sepsis Alert Card can significantly improve door to antibiotic needle time for chemotherapy patients with suspected neutropenic sepsis. This intervention is inexpensive and easily replicable in other health care organisations.
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Onyango MA, Adu-Sarkodie Y, Adjei R, Poku TA, Green K, Wambugu S, Falconer A, Kopelman CH, Beard J. O12.2 Understanding the relationship dynamics between female sex workers and their intimate partners in kumasi, ghana. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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King C, Beard J, Crampin AC, Costello A, Mwansambo C, Cunliffe NA, Heyderman RS, French N, Bar-Zeev N. Methodological challenges in measuring vaccine effectiveness using population cohorts in low resource settings. Vaccine 2015; 33:4748-55. [PMID: 26235370 PMCID: PMC4570930 DOI: 10.1016/j.vaccine.2015.07.062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/07/2015] [Accepted: 07/21/2015] [Indexed: 11/20/2022]
Abstract
We discuss methodological challenges for evaluating vaccine effectiveness using cohorts. No single set of definitions or analytical approach can address all possible biases. Careful consideration of denominator, exposure and outcome definitions is needed. Sensitivity analyses are crucial to examine assumptions and explore subtle relationships.
Post-licensure real world evaluation of vaccine implementation is important for establishing evidence of vaccine effectiveness (VE) and programme impact, including indirect effects. Large cohort studies offer an important epidemiological approach for evaluating VE, but have inherent methodological challenges. Since March 2012, we have conducted an open prospective cohort study in two sites in rural Malawi to evaluate the post-introduction effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against all-cause post-neonatal infant mortality and monovalent rotavirus vaccine (RV1) against diarrhoea-related post-neonatal infant mortality. Our study sites cover a population of 500,000, with a baseline post-neonatal infant mortality of 25 per 1000 live births. We conducted a methodological review of cohort studies for vaccine effectiveness in a developing country setting, applied to our study context. Based on published literature, we outline key considerations when defining the denominator (study population), exposure (vaccination status) and outcome ascertainment (mortality and cause of death) of such studies. We assess various definitions in these three domains, in terms of their impact on power, effect size and potential biases and their direction, using our cohort study for illustration. Based on this iterative process, we discuss the pros and cons of our final per-protocol analysis plan. Since no single set of definitions or analytical approach accounts for all possible biases, we propose sensitivity analyses to interrogate our assumptions and methodological decisions. In the poorest regions of the world where routine vital birth and death surveillance are frequently unavailable and the burden of disease and death is greatest We conclude that provided the balance between definitions and their overall assumed impact on estimated VE are acknowledged, such large scale real-world cohort studies can provide crucial information to policymakers by providing robust and compelling evidence of total benefits of newly introduced vaccines on reducing child mortality.
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Calvet D, Mas JL, Algra A, Becquemin JP, Bonati LH, Dobson J, Fraedrich G, Jansen O, Mali WP, Ringleb PA, Chatellier G, Brown MM, Calvet D, Mas JL, Algra A, Becquemin JP, Bonati L, Dobson J, Fraedrich G, Jansen O, Mali W, Ringleb P, Chatellier G, Brown M, Algra A, Becquemin J, Chatellier G, Mas JL, Fraedrich G, Ringleb P, Jansen O, Bonati LH, Brown MM, Mali WP, Mas JL, Chatellier G, Becquemin JP, Bonneville JF, Branchereau A, Crochet D, Gaux JC, Larrue V, Leys D, Watelet J, Hacke W, Hennerici M, Allenberg J, Maurer P, Eckstein HH, Zeumer H, Jansen O, Algra A, Bamford J, Beard J, Bland M, Bradbury A, Brown M, Clifton A, Gaines P, Hacke W, Halliday A, Malik I, Mas JL, McGuire A, Sidhu P, Venables G. Carotid Stenting. Stroke 2014; 45:527-32. [DOI: 10.1161/strokeaha.113.003526] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sabin L, Agyarko-Poku T, Rahman YAA, Wambugu S, DeSilva MB, Esang M, Green K, Ashigbie PG, Beard J, Adu-Sarkodie Y. P3.427 Exploring the Beliefs, Attitudes, and Behaviours of MSM Engaged in Substance Use and Transactional Sex in Ghana. Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.0878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Baba-Djara M, Agyarko-Poku T, Opoku KB, Ashigbie PG, Breman A, Corneliess C, Akuoko K, Beard J, Adu-Sarkodie Y. P4.051 Vulnerability to HIV and Prevention Needs of Female Post-Secondary Students Engaged in Transactional Sex in Kumasi, Ghana - A Qualitative Study. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Spafford C, Oakley C, Beard J. Commentary on 'Availability of supervised exercise programs and the role of structured home-based exercise in peripheral arterial disease'. Eur J Vasc Endovasc Surg 2012; 44:576. [PMID: 23040295 DOI: 10.1016/j.ejvs.2012.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/11/2012] [Indexed: 11/18/2022]
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Abbott A, Adelman M, Alexandrov A, Barnett H, Beard J, Bell P, Björck M, Blacker D, Buckley C, Cambria R, Comerota A, Connolly E, Davies A, Eckstein H, Faruqi R, Fraedrich G, Gloviczki P, Hankey G, Harbaugh R, Heldenberg E, Kittner S, Kleinig T, Mikhailidis D, Moore W, Naylor R, Nicolaides A, Paraskevas K, Pelz D, Prichard J, Purdie G, Ricco J, Riles T, Rothwell P, Sandercock P, Sillesen H, Spence J, Spinelli F, Tan A, Thapar A, Veith F, Zhou W. Why the United States Center for Medicare and Medicaid Services (CMS) Should not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting. Eur J Vasc Endovasc Surg 2012; 43:247-51. [DOI: 10.1016/j.ejvs.2011.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 12/05/2011] [Indexed: 11/30/2022]
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Abbott AL, Adelman MA, Alexandrov AB, Barnett HJM, Beard J, Bell P, Björck M, Blacker D, Buckley CJ, Cambria RP, Comerota AJ, Sander E, Davies AH, Eckstein HH, Fraedrich G, Gloviczki P, Hankey GJ, Harbaugh RE, Heldenberg E, Kittner SJ, Kleinig TJ, Mikhailidis DP, Moore WS, Naylor R, Nicolaides A, Paraskevas KI, Pelz DM, Prichard JW, Purdie G, Ricco JB, Riles T, Rothwell P, Sandercock P, Sillesen H, Spence JD, Spinelli F, Tan A, Thapar A, Veith FJ, Zhou W. Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting. INT ANGIOL 2012; 31:85-89. [PMID: 22330629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Andrieu S, Aboderin I, Baeyens JP, Beard J, Benetos A, Berrut G, Brainin M, Cha HB, Chen LK, Du P, Forette B, Forette F, Franco A, Fratiglioni L, Gillette-Guyonnet S, Gold G, Gomez F, Guimaraes R, Gustafson D, Khachaturian A, Luchsinger J, Mangialasche F, Mathiex-Fortunet H, Michel JP, Richard E, Schneider LS, Solomon A, Vellas B. IAGG workshop: health promotion program on prevention of late onset dementia. J Nutr Health Aging 2011; 15:562-75. [PMID: 21808935 DOI: 10.1007/s12603-011-0142-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
IAGG, WHO, and SFGG organized a international workshop on Health promotion programs on prevention of late on-set dementia. Thirty world specialists coming from Europe, North America, Asia, South America, Africa and Australia, shared their experience on methods and results of large epidemiological interventions to reduce incidents of dementia or delay its on-set. Chaired by Laura FRATIGLIONI, an expert in Epidemiological studies on dementia issues, the workshop gave opportunity for discussions and controversies about the state-of-the-art. Based on different national and international trials (ADAPT, MAPT, FINGER, GUDIAGE, GEM etc) the questions remained opened for different aspects of methodology, the choice of domain or multi domain intervention, the choice and the definition of the target populations, the best age of candidates, the issues related to the discrepancy between late effects, and interventions' duration. We are please to publish in the Journal, the presentations presented to this workshop. These publications will complete previously task force published in the journal in the last two years on methodological issues for Alzheimer's trials including end point, biomarkers, and the experience of past therapeutic trials.
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Beard J. Comments regarding ‘Outcome Following Carotid Endarterectomy: Lessons Learned From a Large International Vascular Registry’. Eur J Vasc Endovasc Surg 2011; 41:741. [DOI: 10.1016/j.ejvs.2011.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/09/2011] [Indexed: 10/18/2022]
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Beard J. Comments regarding 'Venous angioplasty is safe to perform and may have benefits forin patients with multiple sclerosis. Results of a pilotcase control pilot study'. Eur J Vasc Endovasc Surg 2011; 43:123. [PMID: 21555227 DOI: 10.1016/j.ejvs.2011.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/31/2011] [Indexed: 10/18/2022]
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Rolland Y, Aquino JP, Andrieu S, Beard J, Benetos A, Berrut G, Coll-Planas L, Dartigues JF, Dong B, Forette F, Franco A, Franzoni S, Hornez T, Metais P, Ruault G, Stephan E, Swagerty D, Tolson D, Volicer L, Vellas B, Morley J. Identification of the main domains for quality of care and clinical research in nursing homes. J Nutr Health Aging 2011; 15:410-24. [PMID: 21528170 DOI: 10.1007/s12603-011-0091-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Beard J. THE ACTION OF TRYPSIN UPON THE LIVING CELLS OF JENSEN'S MOUSE-TUMOUR: A Preliminary Note upon a Research made (with a Grant from the Carnegie Trust). BRITISH MEDICAL JOURNAL 2011; 1:140-1. [PMID: 20762488 DOI: 10.1136/bmj.1.2351.140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Al-Jundi W, Durham-Hall A, Oakley E, Beard J. Intraoperative Buttock Ischemia with Postoperative Necrosis following Infrainguinal Bypass Surgery. Eur J Vasc Endovasc Surg 2010. [DOI: 10.1016/j.ejvs.2009.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yang T, Wu J, Rockett I, Abdullah A, Beard J, Ye J. Smoking patterns among Chinese rural–urban migrant workers. Public Health 2009; 123:743-9. [DOI: 10.1016/j.puhe.2009.09.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 09/16/2009] [Accepted: 09/24/2009] [Indexed: 11/26/2022]
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Oakley C, Zwierska I, Tew G, Beard J, Saxton J. Nordic poles immediately improve walking distance in claudicants. Br J Surg 2009. [DOI: 10.1002/bjs.6541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Khan MA, Beard J. Peripheral Vascular Disease in an Individual with Pseudoxanthoma Elasticum. Eur J Vasc Endovasc Surg 2007; 34:590-1. [PMID: 17543555 DOI: 10.1016/j.ejvs.2007.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Accepted: 04/03/2007] [Indexed: 10/23/2022]
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Khan MA, Beard J, Delbridge M. Ischaemic rest pain of the head: a case report. Eur J Vasc Endovasc Surg 2007; 35:11-2. [PMID: 17714963 DOI: 10.1016/j.ejvs.2007.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Accepted: 06/19/2007] [Indexed: 10/22/2022]
Abstract
A 54-year-old man presented with a 3-year history of rest pain of an ischaemic scalp ulcer. Angiography demonstrated that the only blood supply to his head was the left internal carotid artery. Stenting the left subclavian artery and subsequently allowing flow into his left vertebral artery alleviated his symptoms.
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Roback P, Beard J, Baumann D, Gille C, Henry K, Krohn S, Wiste H, Voskuil M, Rainville C, Rutherford R. A predicted operon map for Mycobacterium tuberculosis. Nucleic Acids Res 2007; 35:5085-95. [PMID: 17652327 PMCID: PMC1976454 DOI: 10.1093/nar/gkm518] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The prediction of operons in Mycobacterium tuberculosis (MTB) is a first step toward understanding the regulatory network of this pathogen. Here we apply a statistical model using logistic regression to predict operons in MTB. As predictors, our model incorporates intergenic distance and the correlation of gene expression calculated for adjacent gene pairs from over 474 microarray experiments with MTB RNA. We validate our findings with known examples from the literature and experimentation. From this model, we rank each potential operon pair by the strength of evidence for cotranscription, choose a classification threshold with a true positive rate of over 90% at a false positive rate of 9.1%, and use it to construct an operon map for the MTB genome.
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Beard J, Morgan G, Earnest A, Summerhayes R, Houlder P, Dunn T. Spatio-temporal Analysis of the Impact of Socioeconomic Status on Admissions for Acute Myocardial Infarction and Related Procedures, in New South Wales, Australia. Epidemiology 2006. [DOI: 10.1097/00001648-200611001-01021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rock G, Berger R, Bormanis J, Giulivi A, ElSaadany S, Afzal M, Beard J, Neurath D, Jones TG. A review of nearly two decades in an autologous blood programme: the rise and fall of activity. Transfus Med 2006; 16:307-11. [PMID: 16999752 DOI: 10.1111/j.1365-3148.2006.00696.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Autologous blood donation (ABD) has been widely recommended. Data from one of the oldest hospital-based programmes in Canada describe both activities and drawbacks. Data were compared over the nearly two decades of activity that peaked in 1996. A 5-year review of recent activity showed that of the 2410 patients referred for consideration, 1823 (75.64%) were accepted into the programme. Surgical services requested 5825 units of autologous blood. Of these, 3147 units were donated by 1536 patients, 803 units were transfused in the operating room and 558 units were given postoperatively. In total, only 1361 units (43.25%) were transfused. The mean age of the patients was 58 years (median 61 years and mode 69 years). The haemoglobin concentrations before donation were significantly higher, averaging 145.2 g L(-1) before donation and 114.9 g L(-1) immediately before surgery, whereas at the time of discharge, the haemoglobin concentration averaged 126.2 g L(-1) (P = 0.0001) in transfused patients. Data from this well-established ABD programme indicate less than 50% overall utilization. The activity in the programme increased until 1996 following which it dropped progressively. The low haemoglobin concentration after surgery is of concern and should foster a transfusion algorithm for these patients.
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Choksy SA, Lee Chong P, Smith C, Ireland M, Beard J. A randomised controlled trial of the use of a tourniquet to reduce blood loss during transtibial amputation for peripheral arterial disease. Eur J Vasc Endovasc Surg 2006; 31:646-50. [PMID: 16750790 DOI: 10.1016/j.ejvs.2006.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Accepted: 03/08/2006] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the effects of an exsanguination tourniquet on blood loss during transtibial amputation in patients with peripheral arterial disease (PAD). DESIGN Prospective randomised blinded controlled trial. MATERIALS AND METHODS Sixty-four patients undergoing transtibial amputation for non-reconstructible PAD were randomised to either tourniquet or no tourniquet (control). Blood loss (primary outcome), fall in haemoglobin, transfusion requirements, wound healing, breakdown and revision (secondary outcomes) were also recorded. RESULTS Twenty-five patients in the tourniquet and 29 in the control group conformed to the trial protocol and completed the follow up. Intra-operative blood loss (median and IQR) was significantly greater in the control group compared to the tourniquet group (550 ml (255-1050) vs 255 ml (150-572.5), respectively, p=0.014, Mann-Whitney). There was a significantly greater drop in haemoglobin concentration (median and IQR) in the control compared to the tourniquet group (1.8 g/dl (0-1.2) vs 1.0 g/dl (0.6-2.4), p=0.035, t-test). Transfusion requirements were lower in the tourniquet group (p=0.05, Mann-Whitney). The rate of wound healing, breakdown and revision were similar in the tourniquet and control groups, respectively (59 vs 57%, 0 vs 9%, 14 vs 9%, p=NS). CONCLUSIONS The use of a tourniquet during transtibial amputation for severe PAD reduces blood loss and need for blood transfusion.
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Lincoln D, Morgan G, Sheppeard V, Jalaludin B, Corbett S, Beard J. Childhood asthma and return to school in Sydney, Australia. Public Health 2006; 120:854-62. [PMID: 16904142 DOI: 10.1016/j.puhe.2006.05.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2005] [Accepted: 05/17/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To describe the seasonal pattern of hospital admissions for childhood asthma in Sydney, Australia and investigate the relationship between these admissions and time of return to school. STUDY DESIGN Time-series analysis of daily hospital admissions for childhood asthma in Sydney from 1994 to 2000. METHODS We defined the time series of all asthma-related hospital admissions in Sydney between 1994 and 2000 for age groups 1-4 and 5-14 years. We analysed the time series for each age group using a generalized additive model with a log-link function, an offset term and quasi-likelihood estimation. Daily admissions were modelled using penalised regression splines adjusting for long term trends, school terms and holidays, weekday and influenza epidemics. RESULTS After adjusting for potential confounding, the risk of asthma admission increased to a peak between 2 and 4 weeks after the first day of school in each term and varied between 1.5 and 3 times the risk prior to return to school for both age groups. The largest increase in asthma risk occurring in term one after the long summer holiday. The increase in admission risk began soon after the first day of school of each term for school age children 5-14 years, but not in pre-school age children 1-4 years. CONCLUSIONS Returning to school after term holidays is strongly associated with increased risk of hospital admissions for asthma in children, especially following the long summer holiday. Preventive measures focused on return to school have the potential to substantially decrease admissions for asthma in children.
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