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Bilton D, Aitken M, Flume P, Geller D, Lapey A, Zuckerman J, De Boeck K, Bellon G, Hebestreit H, Haarman E, Robinson P, Cooper P, Kolbe J, Gallagher C, Fox H, Charlton B. 78 Combined data from two phase III studies of Bronchitol (inhaled dry powder mannitol) in adult cystic fibrosis (CF) patients. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60096-9] [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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Aitken M, Bilton D, Piñero R, Fox H, Charlton B. 76 Mannitol inhaler device culture: no evidence of an increased microbiological contamination. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bilton D, Aitken M, Fox H, Charlton B. 79 Inhaled dry powder mannitol in cystic fibrosis (CF): the microbiology demographics and results from the phase III studies (CF301 and CF302). J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60097-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Armstrong J, Laing D, Wilkes F, Carroll A, Aitken M, Jaffe A. Taste and smell function in children with cystic fibrosis. J Cyst Fibros 2008. [DOI: 10.1016/s1569-1993(08)60368-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Aitken M. Redefining quality of care. J R Soc Med 2007. [DOI: 10.1258/jrsm.100.7.304-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kay D, Aitken M, Crowther J, Dickson I, Edwards AC, Francis C, Hopkins M, Jeffrey W, Kay C, McDonald AT, McDonald D, Stapleton CM, Watkins J, Wilkinson J, Wyer MD. Reducing fluxes of faecal indicator compliance parameters to bathing waters from diffuse agricultural sources: the Brighouse Bay study, Scotland. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2007; 147:138-49. [PMID: 17055631 DOI: 10.1016/j.envpol.2006.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Accepted: 08/10/2006] [Indexed: 05/09/2023]
Abstract
The European Water Framework Directive requires the integrated management of point and diffuse pollution to achieve 'good' water quality in 'protected areas'. These include bathing waters, which are regulated using faecal indicator organisms as compliance parameters. Thus, for the first time, European regulators are faced with the control of faecal indicator fluxes from agricultural sources where these impact on bathing water compliance locations. Concurrently, reforms to the European Union (EU) Common Agricultural Policy offer scope for supporting on-farm measures producing environmental benefits through the new 'single farm payments' and the concept of 'cross-compliance'. This paper reports the first UK study involving remedial measures, principally stream bank fencing, designed to reduce faecal indicator fluxes at the catchment scale. Considerable reduction in faecal indicator flux was observed, but this was insufficient to ensure bathing water compliance with either Directive 76/160/EEC standards or new health-evidence-based criteria proposed by WHO and the European Commission.
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Aitken M. Nursing downgraded by surreptitious political change. J R Soc Med 2007. [DOI: 10.1258/jrsm.100.5.208-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Aitken M. Inconvenient truths. J R Soc Med 2007. [DOI: 10.1258/jrsm.100.2.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Aitken M, Roberts DW, Shultz LM. MODELING DISTRIBUTIONS OF RARE PLANTS IN THE GREAT BASIN, WESTERN NORTH AMERICA. WEST N AM NATURALIST 2007. [DOI: 10.3398/1527-0904(2007)67[26:mdorpi]2.0.co;2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vinten AJA, Lewis DR, McGechan M, Duncan A, Aitken M, Hill C, Crawford C. Predicting the effect of livestock inputs of E. coli on microbiological compliance of bathing waters. WATER RESEARCH 2004; 38:3215-3224. [PMID: 15276737 DOI: 10.1016/j.watres.2004.04.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2003] [Revised: 04/20/2004] [Accepted: 04/29/2004] [Indexed: 05/24/2023]
Abstract
Three alternative approaches to predicting delivery of faecal indicators from livestock sources to surface water in the catchment of the River Irvine, Ayrshire, Scotland, are described. These are a soil transport model which assumes all E. coli are transported through the soil, a regression model using observed E. coli concentrations in surface waters, and a distributed catchment model (PAMIMO). Each of these is linked to a simple group of equations describing inputs of E. coli from livestock to land, transport and inactivation in the river Irvine and mixing and inactivation in the sea. The models predict E. coli content of bathing water for Irvine beach. The regression model gives the best predictions of bathing water quality. The low values predicted by the soil transport model suggests that preventing surface runoff of faecal indicators from livestock would provide an adequate solution to the problem of bathing water contamination.
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Khan F, Everard J, Ahmed S, Coleman RE, Aitken M, Hancock BW. Low-risk persistent gestational trophoblastic disease treated with low-dose methotrexate: efficacy, acute and long-term effects. Br J Cancer 2004; 89:2197-201. [PMID: 14676794 PMCID: PMC2395266 DOI: 10.1038/sj.bjc.6601422] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the efficacy and toxicity of low-dose methotrexate with folinic acid rescue in a large series of consecutively treated patients with low-risk persistent gestational trophoblastic disease. Between January 1987 and December 2000, 250 patients were treated with intramuscular methotrexate (50 mg on alternate days 1, 3, 5, 7) with folinic acid (7.5 mg orally on alternate days 2, 4, 6, 8) rescue. The overall complete response rate without recurrence was 72% for first-line treatment and 95% for those who required second-line chemotherapy. Eight women (3.2%) had recurrence following remission and two (0.8%) had new moles. Two women (0.8%) died of their disease giving an overall cure of 99%. Only 10 women (4%) experienced grade III/IV toxicity during the first course of treatment and 13 women (5.2%) subsequently. Toxicity included mucositis and stomatitis, pleuritic chest pain, thrombocytopenia, uterine bleeding, abdominal pain, liver function changes, rash and pericardial effusion. A total of 59 women (23.6%) required second-line chemotherapy; 48 women had methotrexate resistance, eight had methotrexate toxicity and an empirical decision to change therapy was made in three. In all, 11 women (4.4%) had a hysterectomy before, during or after treatment; 141 women (56.4%) became pregnant following treatment: in 128 (90.7%), the outcome was successful. Methotrexate with folinic acid rescue is an effective treatment for low-risk persistent trophoblastic disease. It has minimal severe toxicity, excellent cure rates and does not appear to affect fertility.
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Aitken M. Trainees' attitudes to shift work depend on grade and specialty. BMJ : BRITISH MEDICAL JOURNAL 2003. [DOI: 10.1136/bmj.326.7379.48] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Campbell WB, Aitken M, Tooke JE. Expectations for the skills of final year medical students in examining lower limb arteries and veins. Eur J Vasc Endovasc Surg 2002; 23:270-1. [PMID: 11914016 DOI: 10.1053/ejvs.2002.1596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Heard SR, Schiller G, Aitken M, Fergie C, McCready Hall L. Continuous quality improvement: educating towards a culture of clinical governance. Qual Health Care 2002. [PMID: 11700383 DOI: 10.1136/qhc.0100070..] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The National Health Service in England and Wales has recently adopted a policy aimed at embedding continuous quality improvement (CQI) at all levels and across all services. The key goal is to achieve changes in practice which improve patient outcomes. This paper describes the use of a training course for multiprofessional groups of participants tailored to offer them relevant knowledge, management and team working skills, and approaches to personal and career development. These were intended to assist them in changing their practice for the benefit of patients. The participants rated the course highly in fulfilling its objectives. One cohort followed up for 6 months named changes in practice which related specifically to learning from the course. This paper shows the important contribution of multiprofessional learning to CQI and presents a useful method of evaluating links between learning and performance.
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Aitken M, Wheeler JG, Rowlands LA. Pediatric advocacy: more lessons. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 2001; 155:1390. [PMID: 11732963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Heard SR, Schiller G, Aitken M, Fergie C, McCready Hall L. Continuous quality improvement: educating towards a culture of clinical governance. Qual Health Care 2001; 10 Suppl 2:ii70-8. [PMID: 11700383 PMCID: PMC1765755 DOI: 10.1136/qhc.0100070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The National Health Service in England and Wales has recently adopted a policy aimed at embedding continuous quality improvement (CQI) at all levels and across all services. The key goal is to achieve changes in practice which improve patient outcomes. This paper describes the use of a training course for multiprofessional groups of participants tailored to offer them relevant knowledge, management and team working skills, and approaches to personal and career development. These were intended to assist them in changing their practice for the benefit of patients. The participants rated the course highly in fulfilling its objectives. One cohort followed up for 6 months named changes in practice which related specifically to learning from the course. This paper shows the important contribution of multiprofessional learning to CQI and presents a useful method of evaluating links between learning and performance.
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Paice E, Aitken M, Moss F. Informed consent and the preregistration house officer. HOSPITAL MEDICINE (LONDON, ENGLAND : 1998) 2001; 62:699-701. [PMID: 11762103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
A survey of preregistration house officers demonstrated that less than a third had never felt compelled to obtain consent from patients for procedures they themselves did not understand. This had occurred frequently for over a fifth of respondents. Learning how to obtain informed consent is an important part of the education and training of a doctor. The wrong lessons will be learned if they feel compelled to do this when ill-equipped with relevant information about risks and alternatives.
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Bercher DL, Staley K, Turner LW, Aitken M. Pediatric injuries resulting from use of all-terrain vehicles. THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY 2001; 97:351-3. [PMID: 11269970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Annually, 20,000 children are injured while operating all-terrain vehicles (ATVs). The purpose of this paper was to review child-ATV injuries in Arkansas and identify any areas in need of further investigation. An analysis of emergency-medical-service transports was done for children 0-19 years who had ATV-related injuries in Arkansas from 1998 to 1999. Prehospital-reported child-ATV emergencies were identified, separated by county, and emergency encounter rates were calculated. Our results indicate that emergency medical services (EMS) transported 319 children in Arkansas from 1998 to 1999. ATV injury information is limited in Arkansas, but available data indicate high injury rates existed for many rural counties.
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Aitken M. The potential role of IT in supporting the work of junior doctors. JOURNAL OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON 2000; 34:502. [PMID: 11077672 PMCID: PMC9665513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Paice E, Aitken M, Cowan G, Heard S. Trainee satisfaction before and after the Calman reforms of specialist training: questionnaire survey. BMJ (CLINICAL RESEARCH ED.) 2000; 320:832-6. [PMID: 10731174 PMCID: PMC27320 DOI: 10.1136/bmj.320.7238.832] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the impact of the Calman reforms of higher specialist training on trainee satisfaction. DESIGN Questionnaire surveys using portable electronic survey units, two years apart. SETTING Postgraduate, teaching, district general, and community NHS trusts in North Thames. North Thames deanery includes London north of the Thames, Essex, and Hertfordshire. PARTICIPANTS Trainees in all grades and all specialties: 3078 took part in the first survey and 3517 in the second survey. MAIN OUTCOME MEASURES Trainees' satisfaction with training in their current post, including educational objectives, training agreements, induction, consultant feedback, hands on experience acquired, use of log books, consultant supervision, and overall satisfaction with the post. RESULTS In the second survey respondents were more likely to have discussed educational objectives with their consultant, used a log book, and had useful feedback from their consultant. They were more likely to give high ratings to induction, consultant supervision, and hands on experience acquired in the post. Each of these elements was associated with increased satisfaction with the post overall. Improvements were most noticeable at the level of specialist registrar, but changes in the same direction were also seen in more junior grades. CONCLUSIONS After the reforms of specialist training, trainees in all grades reported greater satisfaction with their current posts. The changes required extra training time and effort from consultants.
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Whang K, Tsai DC, Nam EK, Aitken M, Sprague SM, Patel PK, Healy KE. Ectopic bone formation via rhBMP-2 delivery from porous bioabsorbable polymer scaffolds. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 1998; 42:491-9. [PMID: 9827671 DOI: 10.1002/(sici)1097-4636(19981215)42:4<491::aid-jbm3>3.0.co;2-f] [Citation(s) in RCA: 164] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Drug delivery devices have received considerable interest in the field of tissue engineering due to the advent of proteins that can induce proliferation and differentiation of various cells to form specific tissues and organs, for example, bone morphogenetic protein (BMP-2) for osteogenesis. In this work the delivery of a clinically relevant bioactive factor, recombinant human rhBMP-2, was tested in vivo in a rat ectopic bone induction assay. Contact radiography and radiomorphometry showed significantly more radiopacity (1798+/-183 mm2 versus. 784+/-570 mm2 radiopaque area/g scaffold) in the BMP scaffolds than controls (p < 0.002). De novo woven bone and abundant osteoid formation were confirmed from histological sections while controls contained minimal amounts of tissue. Histomorphometry revealed significantly more bone (124+/-93 mm2 versus 7+/-12 mm2) and osteoid (72+/-43 mm2 versus 20+/-21 mm2) in the BMP implants (p < 0.001). These scaffolds demonstrated the ability to deliver viable rhBMP-2 and to induce bone formation in an ectopic site.
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Aitken M, Taylor JA. Prevalence of clinical sinusitis in young children followed up by primary care pediatricians. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 1998; 152:244-8. [PMID: 9529461 DOI: 10.1001/archpedi.152.3.244] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine the proportion of young children seen in primary care pediatric practices who meet clinical criteria for the diagnosis of sinusitis, and variations in the management of these patients' conditions. DESIGN Observational cohort study. SETTINGS Pediatric practices in the Seattle, Wash, area participating in the Puget Sound Pediatric Research Network, a regional practice-based research organization. PATIENTS Children, 1 to 5 years old, presenting for any reason to participating practices. METHODS Parents of all 1307 eligible children completed a survey specifically detailing the presence of nasal congestion or discharge and daytime cough, the duration of these symptoms, and whether the symptoms were improving. For patients meeting clinical criteria for sinusitis (nasal congestion and daytime cough persisting for > 9 days without improvement), the pediatrician recorded the presence/severity of other signs and symptoms, and the treatment prescribed. Severity of symptoms was reassessed using telephone interviews with parents at 48 to 72 hours, and again at 10 to 14 days, after the office visit. Study data were collected during 1-week to 3-week blocks at each office site during the winter months. RESULTS Data were collected on 1307 children; 121 had persistent respiratory symptoms meeting criteria for a diagnosis of sinusitis (9.3%, 95% confidence interval, 7.7%-10.9%). Patients who presented with cold/cough symptoms were significantly more likely to meet criteria for sinusitis than those who came for any other reason (17.3% vs 4.2%, respectively, P < .001). A physician study form was completed on 87 children with persistent symptoms; antibiotics were prescribed for 68 (78%) of these patients. Antibiotic-treated patients were more likely to have symptoms lasting longer than 29 days (P = .004) and to have purulent nasal discharge (P = .03), and were judged to be sicker at enrollment (P = .001) than untreated children. A concurrent otitis media was diagnosed in 40 (46%) of 87 patients; if the proportion of children with otitis media is excluded, 5% of children 1 to 5 years old who are seen in primary care pediatrics might be expected to receive antibiotics exclusively for a diagnosis of sinusitis. At 24 to 48 hours and at 10 to 14 days after the clinic visit, a trend was noted toward more rapid improvement among those children who were treated with antibiotics. CONCLUSION When the criteria are strictly adhered to, only a small proportion of young children seen during the winter months in primary care pediatric practices will be diagnosed with sinusitis.
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Wood ND, Aitken M, Durston S, Harris S, McClelland GR, Sharp S. Cartilage protective agent (CPA) Ro 32-3555, a new matrix metalloproteinase inhibitor for the treatment of rheumatoid arthritis. AGENTS AND ACTIONS. SUPPLEMENTS 1998; 49:49-55. [PMID: 9426828 DOI: 10.1007/978-3-0348-8857-8_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CPA was well tolerated at all dose levels (10-150 mg) following single oral dose administration to healthy male volunteers. There was no relationship between the intensity, duration and number of adverse events reported and the dose of CPA. There was a dose-related increase in exposure as measured by AUC0-infinity and Cmax. Administration of 10 mg CPA following food resulted in a delayed tmax, and a significant decrease in Cmax but not AUC0-infinity.
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Rivara FP, Aitken M. Prevention of injuries to children and adolescents. Adv Pediatr 1998; 45:37-72. [PMID: 9742297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Injury prevention is one of the most important preventive health challenges for pediatricians worldwide. A science of injury control has developed. Matching a child's skill and development age is needed for anticipatory guidance. Poor children living in rural areas are at greatest risk and require continuous reinforcement. Family function relates closely to injuries and recovery from injury. Prevention involves education, legislation, environmental modification, and engineering techniques.
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