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Saunders P. The evolutionary paradigm is changing. THEORETICAL BIOLOGY FORUM 2018; 111:105-106. [PMID: 31089676 DOI: 10.19272/201811402012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Abstract
This paper analyzes the characteristics of male and female participants attending pioneering entrepreneurship development programs, which form part of an economic strategy directed at increasing the quality and quantity of new firms. The participants did not need to have a business plan, finance available or formal education, but must have had a “reasonably feasible idea”. The results show significant differences between the characteristics of the male and female entrepreneurs, and the businesses which they form.
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Saunders P, Maher TM. Cough in fibrotic lung disease: An unresolved challenge. Respirology 2017; 22:1491-1492. [PMID: 28677213 DOI: 10.1111/resp.13116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 06/07/2017] [Indexed: 11/29/2022]
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Saunders P, Tsipouri V, Keir GJ, Ashby D, Flather MD, Parfrey H, Babalis D, Renzoni EA, Denton CP, Wells AU, Maher TM. Rituximab versus cyclophosphamide for the treatment of connective tissue disease-associated interstitial lung disease (RECITAL): study protocol for a randomised controlled trial. Trials 2017; 18:275. [PMID: 28619061 PMCID: PMC5471887 DOI: 10.1186/s13063-017-2016-2] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 05/25/2017] [Indexed: 11/24/2022] Open
Abstract
Background Interstitial lung disease (ILD) frequently complicates systemic autoimmune disorders resulting in considerable morbidity and mortality. The connective tissue diseases (CTDs) most frequently resulting in ILD include: systemic sclerosis, idiopathic inflammatory myositis (including dermatomyositis, polymyositis and anti-synthetase syndrome) and mixed connective tissue disease. Despite the development, over the last two decades, of a range of biological therapies which have resulted in significant improvements in the treatment of the systemic manifestations of CTD, the management of CTD-associated ILD has changed little. At present there are no approved therapies for CTD-ILD. Following trials in scleroderma-ILD, cyclophosphamide is the accepted standard of care for individuals with severe or progressive CTD-related ILD. Observational studies have suggested that the anti-CD20 monoclonal antibody, rituximab, is an effective rescue therapy in the treatment of refractory CTD-ILD. However, before now, there have been no randomised controlled trials assessing the efficacy of rituximab in this treatment population. Methods/design RECITAL is a UK, multicentre, prospective, randomised, double-blind, double-dummy, controlled trial funded by the Efficacy and Mechanism Evaluation Programme of the Medical Research Council and National Institute for Health Research. The trial will compare rituximab 1 g given intravenously, twice at an interval of 2 weeks, with intravenously administered cyclophosphamide given monthly at a dose of 600 mg/m2 body surface area in individuals with ILD due to systemic sclerosis, idiopathic inflammatory myositis (including anti-synthetase syndrome) or mixed connective tissue disease. A total of 116 individuals will be randomised 1:1 to each of the two treatment arms, with stratification based on underlying CTD, and will be followed for a total of 48 weeks from first dose. The primary endpoint for the study will be change in forced vital capacity (FVC) at 24 weeks. Key secondary endpoints include: safety, change in FVC at 48 weeks as well as survival, change in oxygen requirements, total 48-week corticosteroid exposure and utilisation of health care resources. Discussion This is the first randomised control trial to study the efficacy of rituximab as first-line treatment in CTD-associated ILD. The results generated should provide important information on the treatment of a life-threatening complication affecting a rare group of CTDs. Trial registration ClinicalTrials.gov, NCT01862926. Registered on 22 May 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2016-2) contains supplementary material, which is available to authorized users.
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Yurteri-Kaplan L, Andriani L, Kumar A, Saunders P, Mete M, Sokol A. 6: Operative team members’ perceptions of requirements for successful minimally invasive surgery (MIS). Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Saunders P. The Forgotten Dimension of Central-Local Relations: Theorising the ‘Regional State’. ACTA ACUST UNITED AC 2016. [DOI: 10.1068/c030149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
It is argued that the regional level of the state in Britain has been neglected in recent work on intrastate relations. The aim in this paper is to develop, through the application, development, and amendment of a ‘dual politics’ thesis, a middle-range theory of the political processes which characterise the regional state level. On the basis of a review and discussion of primary and secondary research materials relating to English Regional Water Authorities and Regional Health Authorities, it is suggested that the ‘politics of production’ at regional level are characterised by class domination organised through corporatist forms, whereas the ‘politics of consumption’ at this level tend towards a pattern of bureaucratic and professional closure. Explanations for such a divergence are put forward and the implications for democracy of a growth of state functions at a regional level are briefly explored.
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Saunders P, Katam K, Young S. Five year review of an enhanced recovery program following knee arthroplasty at a UK general district hospital. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Saunders P, Stock CJ, Molyneaux PL, Kokosi M, Kingston S, Belvisi MG, Wells AU, Renzoni EA, Maher TM. S45 MUC5B Genotype does not influence cough severity in IPF. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kokosi M, Saunders P, Karagiannis K, Chua F, Maher TM, Renzoni EA, Wells AU. P33 Rituximab as rescue therapy in advanced progressive systemic sclerosis associated interstitial lung disease. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Woodhall SC, Soldan K, Sonnenberg P, Mercer CH, Clifton S, Saunders P, da Silva FC, Alexander S, Tanton C, Field N, Copas A, Ison CA, Johnson AM. P08.13 What can probability surveys tell us about changes in chlamydia prevalence in britain? evidence from the national surveys of sexual attitudes and lifestyles (natsal). Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Saunders P, Goodman AL, Smith CJ, Marshall N, O'Connor JL, Lampe FC, Johnson MA. Does gender or mode of HIV acquisition affect virological response to modern antiretroviral therapy (ART)? HIV Med 2015; 17:18-27. [PMID: 26140659 DOI: 10.1111/hiv.12272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Previous UK studies have reported disparities in HIV treatment outcomes for women. We investigated whether these differences persist in the modern antiretroviral treatment (ART) era. METHODS A single-centre cohort analysis was carried out. We included in the study all previously ART-naïve individuals at our clinic starting triple ART from 1 January 2006 onwards with at least one follow-up viral load (VL). Time to viral suppression (VS; first viral load < 50 HIV-1 RNA copies/mL), virological failure (VF; first of two consecutive VLs > 200 copies/mL more than 6 months post-ART) and treatment modification were estimated using standard survival methods. RESULTS Of 1086 individuals, 563 (52%) were men whose risk for HIV acquisition was sex with other men (MSM), 207 (19%) were men whose risk for HIV acquisition was sex with women (MSW) and 316 (29%) were women. Median pre-ART CD4 count and time since HIV diagnosis in these groups were 298, 215 and 219 cells/μL, and 2.3, 0.3 and 0.3 years, respectively. Time to VS was comparable between groups, but women [adjusted hazard ratio (aHR) 2.32; 95% confidence interval (CI) 1.28-4.22] and MSW (aHR 3.28; 95% CI 1.91-5.64) were at considerably higher risk of VF than MSM. Treatment switches and complete discontinuation were also more common among MSW [aHR 1.38 (95% CI 1.04-1.81) and aHR 1.73 (95% CI 0.97-3.16), respectively] and women [aHR 1.87 (95% CI 1.43-2.46) and aHR 3.20 (95% CI 2.03-5.03), respectively] than MSM. CONCLUSIONS Although response rates were good in all groups, poorer virological outcomes for women and MSW have persisted into the modern ART era. Factors that might influence the differences include socioeconomic status and mental health disorders. Further interventions to ensure excellent response rates in women and MSW are required.
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Nathan B, Appiah J, Saunders P, Heron D, Nichols T, Brum R, Alexander S, Baraitser P, Ison C. Microscopy outperformed in a comparison of five methods for detecting Trichomonas vaginalis in symptomatic women. Int J STD AIDS 2014; 26:251-6. [PMID: 24855131 DOI: 10.1177/0956462414534833] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the UK, despite its low sensitivity, wet mount microscopy is often the only method of detecting Trichomonas vaginalis infection. A study was conducted in symptomatic women to compare the performance of five methods for detecting T. vaginalis: an in-house polymerase chain reaction (PCR); Aptima T. vaginalis kit; OSOM ®Trichomonas Rapid Test; culture and microscopy. Symptomatic women underwent routine testing; microscopy and further swabs were taken for molecular testing, OSOM and culture. A true positive was defined as a sample that was positive for T. vaginalis by two or more different methods. Two hundred and forty-six women were recruited: 24 patients were positive for T. vaginalis by two or more different methods. Of these 24 patients, 21 patients were detected by real-time PCR (sensitivity 88%); 22 patients were detected by the Aptima T. vaginalis kit (sensitivity 92%); 22 patients were detected by OSOM (sensitivity 92%); nine were detected by wet mount microscopy (sensitivity 38%); and 21 were detected by culture (sensitivity 88%). Two patients were positive by just one method and were not considered true positives. All the other detection methods had a sensitivity to detect T. vaginalis that was significantly greater than wet mount microscopy, highlighting the number of cases that are routinely missed even in symptomatic women if microscopy is the only diagnostic method available.
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Kong ML, Saunders P. Lessons that cross the surgical drapes. Arab J Urol 2014; 12:37-41. [PMID: 26019921 PMCID: PMC4434498 DOI: 10.1016/j.aju.2013.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 12/31/2013] [Indexed: 11/14/2022] Open
Abstract
Background Modern medicine has created a need for innovative methods of training that create safe, proficient specialists with adequate experience, and who are fit for purpose in this new system. Patient safety and patient-focused care are central to current practice and promoted by the use of simulation, human factors, team-based, multidisciplinary and interspecialty training. An acknowledgement that postgraduate training occurs within the work environment underlies the need to create systems that support learning within the workplace. Supervision, protected time for adequate induction and the opportunity to be involved in workplace learning are the key. It is also important that robust mechanisms to assure the quality of postgraduate education are in place. Methods Available reports were researched, and the particularities of anaesthetic training were outlined and summarised. Then, in a translational approach, we examined how to apply the lessons learned from anaesthesiological training to surgical training. Results The trend towards reducing the working hours of junior doctors, whilst still providing excellent training, creates a need for innovative, efficient, concentrated training programmes, where trainers and trainees are engaged in a seamless, constant educational endeavour. Conclusion Within this review we offer the system of anaesthetic training in the UK, and some of its recent changes, as a template to highlight themes in postgraduate education that exemplify this innovation and are transferable not only to surgery but across different specialties.
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Saunders P, Giudice S, Swart J. Identifying measurement knowledge and its relationship to engineering design. INTERNATIONAL JOURNAL OF METROLOGY AND QUALITY ENGINEERING 2014. [DOI: 10.1051/ijmqe/2014006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Saunders P, Reading J, Harvey J, Murthy S, Capocci S, Hopkins S, Seneviratne S, Cropley I, Lipman M. P32 When a test is neither positive nor negative: the impact of equivocal and indeterminate quantiferon TB IGRA in a UK population: Abstract P32 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rudge GM, Suglani N, Saunders P, Middleton J. OP24 Are Fast Food Outlets Concentrated in more Deprived Areas? A Geo-Statistical Analysis of an Urban Area in Central England. J Epidemiol Community Health 2013. [DOI: 10.1136/jech-2013-203126.24] [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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Toby M, Ison C, Saunders P. P2.056 Prevalence of Neisseria GonorrhoeaeSpecimens Containing Por APseudogene Deletion Among Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP)Specimens at the Health Protection Agency. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Nathan B, Appiah J, Heron D, Saunders P, Brum R, Alexander S, Baraitser P, Ison C. O06.1 Evaluation of 5 Different Tests For Trichomonas Vaginalis (TV) Infection and Cost Effective Planning For Clinical Implementation. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0113] [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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Motz K, Graves K, Gross C, Saunders P, Amri H, Harazduk N, Haramati A. OA05.03. Impact of a mind-body medicine skills course on medical students’ perceived stress, mindfulness and elements of emotional intelligence. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012. [PMCID: PMC3373346 DOI: 10.1186/1472-6882-12-s1-o19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Appiah J, Saunders P, Yapa M, Tong CYW, White J, Ison C, Alexander S. P71 Validation of an in house nucleic acid amplification (NAATs) PCR test for Trichomonas vaginalis: Abstract P71 Table 1. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nathan B, Heron D, Appiah J, Saunders P, Brum R, Nichols T, Alexander S, Baraister P, Ison C. P55 Evaluation of NAAT and POCT for detectingTrichomonas vaginalisinfection in women at a London sexual health clinic. Sex Transm Infect 2012. [DOI: 10.1136/sextrans-2012-050601c.55] [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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Bonacci J, Blanch P, Saunders P, Green D, Vicenzino B. The relationship between measures of cycle intensity and running economy. J Sci Med Sport 2011. [DOI: 10.1016/j.jsams.2011.11.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hunningher A, Saunders P. Algorithm for management of vomiting after induction. Br J Anaesth 2011; 107:472; author reply 472-3. [DOI: 10.1093/bja/aer246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Saunders P. Christian Medical Fellowship's chief executive responds to Lobby Watch article. BMJ (CLINICAL RESEARCH ED.) 2011; 343:d5214. [PMID: 21846704 DOI: 10.1136/bmj.d5214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Painter G, Hothi G, Saunders P, Durie J, Ghani G, Wardle M, Wardle T. Mass action. Br Dent J 2010; 209:543; discussion 543-4. [DOI: 10.1038/sj.bdj.2010.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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