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Tinkler L, Robertson S, Tod A. Multi-professional perceptions of clinical research delivery and the Clinical Research Nurse role: a realist review. J Res Nurs 2022; 27:9-29. [PMID: 35392190 PMCID: PMC8980584 DOI: 10.1177/17449871211068017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction & Background The delivery of clinical research and the Clinical Research Nurse (CRN) role is fundamental to the wider health agenda, yet both remain misunderstood outwith research teams. Methods A realist review was conducted to identify factors that influence how clinical research is perceived by healthcare professionals operating outside NHS clinical research teams. Keyword searches were undertaken across four healthcare databases including grey literature, with iterative snowball searching. Data were extracted from 42/387 sources. Coding generated 3664 extracts of text across 160 themes. Theories generated were presented as ‘If-Then’ statements. Results Thirteen theory statements described factors that may influence how clinical research is perceived by healthcare professionals operating outside clinical research teams across three contextual levels: • Micro: Individual characteristics/behaviours/CRN perceptions • Meso: Interpersonal relationships at the interface between CRN roles and healthcare delivery • Macro: Systemwide/infrastructural/cultural issues impacting clinical research delivery. Conclusion Factors at micro, meso and macro level contexts may influence how clinical research is perceived by healthcare professionals operating outside clinical research teams. This has the potential to affect the success of clinical research delivery. Meso level theories regarding the perceptions of healthcare professionals outwith research teams may provide insight. Empirical testing of one such theory is underway.
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Robertson S, Olanloye E, Hon Y, England A, McNair H, Cruickshank S. Are radiographers suffering from symptoms of compassion fatigue due to occupational stress: A systematic review. Radiography (Lond) 2022; 28:857-864. [DOI: 10.1016/j.radi.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/04/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
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Mortimer K, Lesosky M, García-Marcos L, Innes Asher M, Pearce N, Ellwood E, Bissell K, El Sony A, Ellwood P, Marks GB, Martínez-Torres A, Morales E, Perez-Fernandez V, Robertson S, Rutter CE, Silverwood RJ, Strachan DP, Chiang CY. The burden of asthma, hay fever and eczema in adults in 17 countries: GAN Phase I study. Eur Respir J 2022; 60:13993003.02865-2021. [PMID: 35210319 PMCID: PMC9474894 DOI: 10.1183/13993003.02865-2021] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/03/2022] [Indexed: 11/05/2022]
Abstract
Asthma, hay fever and eczema are three common chronic conditions. There are no recent multi-country data on the burden of these three conditions in adults; the aims of this study are to fill this evidence gap.The Global Asthma Network (GAN) Phase I is a multi-country cross-sectional population-based study using the same core methodology as the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III. It provides data on the burden of asthma, hay fever, and eczema not only in children and adolescents but also for the first time in their parents/guardians.Data were available from 193 912 adults (104 061 female; mean age 38 (sd 7.5)) in 43 centres in 17 countries. The overall prevalences (range) of symptoms of current wheeze, asthma ever, hay fever ever and eczema ever were 6.6% (0.9%-32.7%), 4.4%(0.9%-29.0%), 14.4%(2.8%-45.7%), and 9.9%(1.6%-29.5%), respectively. Centre prevalence varied considerably both between countries and within countries. There was a moderate correlation between hay fever ever and asthma ever, and between eczema ever and hay fever ever at the centre level. There were moderate to strong correlations between indicators of the burden of disease reported in adults and the two younger age groups.We found evidence for a substantial burden of asthma, hay fever ever and eczema ever in countries examined highlighting the major public health importance of these diseases. Prevention strategies and equitable access to effective and affordable treatments for these three conditions would help mitigate the avoidable morbidity they cause.
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García-Marcos L, Innes Asher M, Pearce N, Ellwood E, Bissell K, Chiang CY, El Sony A, Ellwood P, Marks GB, Mortimer K, Elena Martínez-Torres A, Morales E, Perez-Fernandez V, Robertson S, Rutter CE, Silverwood RJ, Strachan DP. The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study. Eur Respir J 2022; 60:13993003.02866-2021. [PMID: 35144987 PMCID: PMC9474895 DOI: 10.1183/13993003.02866-2021] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/19/2022] [Indexed: 11/16/2022]
Abstract
Aims There have been no worldwide standardised surveys of prevalence and severity of asthma, rhinoconjunctivitis and eczema in school children for 15 years. The present study aims to provide this information. Methods Following the exact International Study of Asthma and Allergies in Childhood (ISAAC) methodology (cross-sectional questionnaire-based survey), Global Asthma Network (GAN) Phase I was carried out between 2015 and 2020 in many centres worldwide. Results The study included 157 784 adolescents (13–14 years of age) in 63 centres in 25 countries and 101 777 children (6–7 years of age) in 44 centres in 16 countries. The current prevalence of symptoms, respectively, was 11.0% and 9.1% for asthma, 13.3% and 7.7% for rhinoconjunctivitis and 6.4% and 5.9% for eczema. The prevalence of asthma ever was 10.5% and 7.6%, hay fever ever was 15.2% and 11.1% and eczema ever was 10.6% and 13.4%, respectively. Centres in low or lower middle gross national income countries (LICs or LMICs) had significantly lower prevalence of the three disease symptoms and diagnoses (except for hay fever). In children, the prevalence of asthma and rhinoconjunctivitis symptoms was higher in boys, while the reverse occurred among adolescents. For eczema, while the prevalence among female adolescents was double that of males, there was no sex difference among children. Centre accounted for non-negligible variability in all disease symptoms (10–20%). Conclusion The burdens of asthma, rhinoconjunctivitis and eczema vary widely among the limited number of countries studied. Although symptom prevalence is lower in LICs and LMICs, it represents a considerable burden everywhere studied. There is a substantial global burden of asthma, hay fever and eczema in adolescents and children, representing a major global public health problem. Accessible, affordable, equitable and effective strategies are needed to reduce this burden.https://bit.ly/3nXKkzd
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Abbasi R, Ackermann M, Adams J, Aguilar JA, Ahlers M, Ahrens M, Alispach C, Alves AA, Amin NM, An R, Andeen K, Anderson T, Anton G, Argüelles C, Ashida Y, Axani S, Bai X, Balagopal V A, Barbano A, Barwick SW, Bastian B, Basu V, Baur S, Bay R, Beatty JJ, Becker KH, Becker Tjus J, Bellenghi C, BenZvi S, Berley D, Bernardini E, Besson DZ, Binder G, Bindig D, Blaufuss E, Blot S, Boddenberg M, Bontempo F, Borowka J, Böser S, Botner O, Böttcher J, Bourbeau E, Bradascio F, Braun J, Bron S, Brostean-Kaiser J, Browne S, Burgman A, Burley RT, Busse RS, Campana MA, Carnie-Bronca EG, Chen C, Chen Z, Chirkin D, Choi K, Clark BA, Clark K, Classen L, Coleman A, Collin GH, Conrad JM, Coppin P, Correa P, Cowen DF, Cross R, Dappen C, Dave P, De Clercq C, DeLaunay JJ, Dembinski H, Deoskar K, Desai A, Desiati P, de Vries KD, de Wasseige G, de With M, DeYoung T, Dharani S, Diaz A, Díaz-Vélez JC, Dittmer M, Dujmovic H, Dunkman M, DuVernois MA, Dvorak E, Ehrhardt T, Eller P, Engel R, Erpenbeck H, Evans J, Evenson PA, Fan KL, Fazely AR, Feigl N, Fiedlschuster S, Fienberg AT, Filimonov K, Finley C, Fischer L, Fox D, Franckowiak A, Friedman E, Fritz A, Fürst P, Gaisser TK, Gallagher J, Ganster E, Garcia A, Garrappa S, Gerhardt L, Ghadimi A, Glaser C, Glauch T, Glüsenkamp T, Gonzalez JG, Goswami S, Grant D, Grégoire T, Griswold S, Gündüz M, Günther C, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Ha Minh M, Hanson K, Hardin J, Harnisch AA, Haungs A, Hauser S, Hebecker D, Helbing K, Henningsen F, Hettinger EC, Hickford S, Hignight J, Hill C, Hill GC, Hoffman KD, Hoffmann R, Hoinka T, Hokanson-Fasig B, Hoshina K, Huang F, Huber M, Huber T, Hultqvist K, Hünnefeld M, Hussain R, In S, Iovine N, Ishihara A, Jansson M, Japaridze GS, Jeong M, Jones BJP, Kang D, Kang W, Kang X, Kappes A, Kappesser D, Karg T, Karl M, Karle A, Katz U, Kauer M, Kellermann M, Kelley JL, Kheirandish A, Kin K, Kintscher T, Kiryluk J, Klein SR, Koirala R, Kolanoski H, Kontrimas T, Köpke L, Kopper C, Kopper S, Koskinen DJ, Koundal P, Kovacevich M, Kowalski M, Kozynets T, Kun E, Kurahashi N, Lad N, Lagunas Gualda C, Lanfranchi JL, Larson MJ, Lauber F, Lazar JP, Lee JW, Leonard K, Leszczyńska A, Li Y, Lincetto M, Liu QR, Liubarska M, Lohfink E, Lozano Mariscal CJ, Lu L, Lucarelli F, Ludwig A, Luszczak W, Lyu Y, Ma WY, Madsen J, Mahn KBM, Makino Y, Mancina S, Mariş IC, Maruyama R, Mase K, McElroy T, McNally F, Mead JV, Meagher K, Mechbal S, Medina A, Meier M, Meighen-Berger S, Micallef J, Mockler D, Montaruli T, Moore RW, Morse R, Moulai M, Naab R, Nagai R, Naumann U, Necker J, Nguyễn LV, Niederhausen H, Nisa MU, Nowicki SC, Obertacke Pollmann A, Oehler M, Oeyen B, Olivas A, O'Sullivan E, Pandya H, Pankova DV, Park N, Parker GK, Paudel EN, Paul L, Pérez de Los Heros C, Peters L, Peterson J, Philippen S, Pieloth D, Pieper S, Pittermann M, Pizzuto A, Plum M, Popovych Y, Porcelli A, Prado Rodriguez M, Price PB, Pries B, Przybylski GT, Raab C, Raissi A, Rameez M, Rawlins K, Rea IC, Rehman A, Reichherzer P, Reimann R, Renzi G, Resconi E, Reusch S, Rhode W, Richman M, Riedel B, Roberts EJ, Robertson S, Roellinghoff G, Rongen M, Rott C, Ruhe T, Ryckbosch D, Rysewyk Cantu D, Safa I, Saffer J, Sanchez Herrera SE, Sandrock A, Sandroos J, Santander M, Sarkar S, Sarkar S, Satalecka K, Scharf M, Schaufel M, Schieler H, Schindler S, Schlunder P, Schmidt T, Schneider A, Schneider J, Schröder FG, Schumacher L, Schwefer G, Sclafani S, Seckel D, Seunarine S, Sharma A, Shefali S, Silva M, Skrzypek B, Smithers B, Snihur R, Soedingrekso J, Soldin D, Spannfellner C, Spiczak GM, Spiering C, Stachurska J, Stamatikos M, Stanev T, Stein R, Stettner J, Steuer A, Stezelberger T, Stürwald T, Stuttard T, Sullivan GW, Taboada I, Tenholt F, Ter-Antonyan S, Tilav S, Tischbein F, Tollefson K, Tomankova L, Tönnis C, Toscano S, Tosi D, Trettin A, Tselengidou M, Tung CF, Turcati A, Turcotte R, Turley CF, Twagirayezu JP, Ty B, Unland Elorrieta MA, Valtonen-Mattila N, Vandenbroucke J, van Eijndhoven N, Vannerom D, van Santen J, Verpoest S, Walck C, Watson TB, Weaver C, Weigel P, Weindl A, Weiss MJ, Weldert J, Wendt C, Werthebach J, Weyrauch M, Whitehorn N, Wiebusch CH, Williams DR, Wolf M, Woschnagg K, Wrede G, Wulff J, Xu XW, Yanez JP, Yoshida S, Yu S, Yuan T, Zhang Z. Search for Relativistic Magnetic Monopoles with Eight Years of IceCube Data. PHYSICAL REVIEW LETTERS 2022; 128:051101. [PMID: 35179913 DOI: 10.1103/physrevlett.128.051101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/09/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
We present an all-sky 90% confidence level upper limit on the cosmic flux of relativistic magnetic monopoles using 2886 days of IceCube data. The analysis was optimized for monopole speeds between 0.750c and 0.995c, without any explicit restriction on the monopole mass. We constrain the flux of relativistic cosmic magnetic monopoles to a level below 2.0×10^{-19} cm^{-2} s^{-1} sr^{-1} over the majority of the targeted speed range. This result constitutes the most strict upper limit to date for magnetic monopoles with β≳0.8 and up to β∼0.995 and fills the gap between existing limits on the cosmic flux of nonrelativistic and ultrarelativistic magnetic monopoles.
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Ryan T, Talpur AA, Robertson S. Nurses’ contribution during pandemic conditions: A synthesis of qualitative literature. J Clin Nurs 2022; 32:1738-1747. [PMID: 35639958 DOI: 10.1111/jocn.16203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/17/2021] [Accepted: 12/09/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To synthesise the evidence relating to the contribution nurses make during respiratory infectious disease pandemics. BACKGROUND Pandemics are known for their abrupt and contagious nature, as well as their impact on individuals and society. Nurses are more likely to work closely with patients experiencing illness and disease during pandemics, and studies on the role of the profession have mainly focused on the challenges, barriers and shortfalls in nursing care provision. The nursing role in service delivery and their contribution in improving patient well-being has received far less attention. METHODS In May 2020, three review registers, grey literature and the following databases were searched: Medline via Ovid, Web of Science, CINAHL via EBSCO and Cochrane Library. The specific focus was on qualitative literature that considered the experiences and perceptions of nurses providing care during several respiratory pandemics. Selected papers were appraised using CASP checklist. ENTREQ checklist was used to inform stages associated with the synthesis of selected papers. RESULTS From 5553 retrieved citations, the analysis of 24 eligible papers resulted in three key themes: the implications of working during pandemics on nurses' personal and family life, nursing contribution in challenging conditions, and working above and beyond. Considering nurses' role in healthcare system, research on their contribution found to have received little appreciation in peer-reviewed journals. CONCLUSIONS This review pertains to nurses' work in global context and highlights the huge contribution made by the profession in the context of respiratory pandemics. It confirms that nurses' experiences outweighed economic, social and psychological implications of providing care during the pandemic crisis. Acknowledging nurses' resilience and professional motivations, we also argue that the nurse contribution during pandemics can be enhanced when resources, support and training are provided. Further research on contexts and conditions which mitigate nurses the potential for sustained contribution is needed.
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Strachan DP, Rutter CE, Asher MI, Bissell K, Chiang CY, El Sony A, Ellwood E, Ellwood P, García-Marcos L, Marks GB, Morales E, Mortimer K, Pearce N, Pérez-Fernández V, Robertson S, Silverwood RJ. Worldwide time trends in prevalence of symptoms of rhinoconjunctivitis in children: Global Asthma Network Phase I. Pediatr Allergy Immunol 2022; 33:e13656. [PMID: 34453861 PMCID: PMC9012331 DOI: 10.1111/pai.13656] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/28/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Global Asthma Network (GAN), by using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology, has updated trends in prevalence of symptoms of childhood allergic diseases, including non-infective rhinitis and conjunctivitis ('rhinoconjunctivitis'), which is reported here. METHODS Prevalence and severity of rhinoconjunctivitis were assessed by questionnaire among schoolchildren in GAN Phase I and ISAAC Phase I and III surveys 15-23 years apart. Absolute rates of change in prevalence were estimated for each centre and modelled by multi-level linear regression to compare trends by age group, time period and per capita national income. RESULTS Twenty-seven GAN centres in 14 countries surveyed 74,361 13- to 14-year-olds ('adolescents') and 45,434 6- to 7-year-olds ('children'), with average response proportions of 90% and 79%, respectively. Many centres showed highly significant (p < .001) changes in prevalence of rhinoconjunctivitis in the past year ('current rhinoconjunctivitis') compared with ISAAC. The direction and magnitude of centre-level trends varied significantly (p < .001) both within and between countries. Overall, current rhinoconjunctivitis prevalence decreased slightly from ISAAC Phase III to GAN: -1.32% per 10 years, 95% CI [-2.93%, +0.30%] among adolescents; and -0.44% [-1.29%, +0.42%] among children. Together, these differed significantly (p < .001) from the upward trend within ISAAC. Among adolescents, centre-level trends in current rhinoconjunctivitis were highly correlated with those for eczema symptoms (rho = 0.72, p < .0001) but not with centre-level trends in asthma symptoms (rho = 0.15, p = .48). Among children, these correlations were positive but not significant. CONCLUSION Symptoms of non-infective rhinoconjunctivitis among schoolchildren may no longer be on the increase globally, although trends vary substantially within and between countries.
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Beltran-Bless A, Murshed M, Zakikhani M, Kuchuk I, Bouganim N, Robertson S, Kekre N, Vandermeer L, Li J, Addison C, Rauch F, Clemons M, Kremer R. Histomorphometric and microarchitectural analysis of bone in metastatic breast cancer patients. Bone Rep 2021; 15:101145. [PMID: 34841014 PMCID: PMC8605385 DOI: 10.1016/j.bonr.2021.101145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/09/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Despite widespread use of repeated doses of potent bone-targeting agents (BTA) in oncology patients, relatively little is known about their in vivo effects on bone homeostasis, bone quality, and bone architecture. Traditionally bone quality has been assessed using a trans-iliac bone biopsy with a 7 mm "Bordier" core needle. We examined the feasibility of using a 2 mm "Jamshidi™" core needle as a more practical and less invasive technique. METHODS Patients with metastatic breast cancer on BTAs were divided according to the extent of bone metastases. They were given 2 courses of tetracycline labeling and then underwent a posterior trans-iliac trephine biopsy and bone marrow aspirate. Samples were analyzed for the extent of tumor invasion and parameters of bone turnover and bone formation by histomorphometry. RESULTS Twelve patients were accrued, 1 had no bone metastases, 3 had limited bone metastases (LSM) (<3 lesions) and 7 had extensive bone metastases (ESM) (>3 lesions). Most of the primary tumors were estrogen receptor (ER)/progesterone receptor (PR) positive. The procedure was well tolerated. The sample quality was sufficient to analyze bone trabecular structure and bone turnover by histomorphometry in 11 out of 12 patients. There was a good correlation between imaging data and morphometric analysis of tumor invasion. Patients with no evidence or minimal bone metastases had no evidence of tumor invasion. Most had suppressed bone turnover and no detectable bone formation when treated with BTA. In contrast, 6 out of 7 patients with extensive bone invasion by imaging and evidence of tumor cells in the marrow had intense osteoclastic activity as measured by the number of osteoclasts. Of these 7 patients with ESM, 6 were treated with BTA with 5 showing resistance to BTA as demonstrated by the high number of osteoclasts present. 3 of these 6 patients had active bone formation. Based on osteoblast activity and bone formation, 3 out of 6 patients with ESM responded to BTA compared to all 3 with LSM. Compared to untreated patients, all patients treated with BTA showed a trend towards suppression of bone formation, as measured by tetracycline labelling. There was also a trend towards a significant difference between ESM and LSM treated with BTA, highly suggestive of resistance although limited by the small sample size. DISCUSSION Our results indicate that trans-iliac bone biopsy using a 2 mm trephine shows excellent correlation between imaging assessment of tumor invasion and tumor burden by morphometric analysis of bone tissues. In addition, our approach provides additional mechanistic information on therapeutic response to BTA supporting the current clinical understanding that the majority of patients with extensive bone involvement eventually fail to suppress bone turnover (Petrut B, et al. 2008). This suggests that antiresorptive therapies become less effective as disease progresses.
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Key Words
- BM, Bone met
- BPs, Bisphosphonates
- BTAs, Bone targeting agents
- Bone biopsy
- Bone microarchitecture
- Bone turnover
- Bone-targeted agents
- Breast cancer
- CK, Cytokeratin staining
- CM, Collagen material
- DEXA, Dual-energy X-ray absorptiometry
- ER, Estrogen receptor
- ESM, Extensive skeletal metastases
- HE, Haematoxylin and Eosin
- HER2, Human Epidermal growth factor Receptor 2
- Histomorphometry
- IDC, Invasive ductal carcinoma
- IHC, Immunohistochemistry staining
- LSM, Limited skeletal metastases
- MB, Mineralized bone
- OB, Osteoblasts
- OC, Osteoclasts
- OS, Osteoid surface
- PAM, Pamidronate
- PFA/PBS, Paraformaldehyde/phosphate buffer solution
- PR, Progesterone receptor
- QCT, Quantitative CT
- SREs, Skeletal related events
- TRAP, Tartrate-resistant acid phosphatase staining
- VKVG, von Kossa and van Gieson
- Zol, Zoledronic acid
- astasis AI, Aromatase inhibitors
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Asher MI, Rutter CE, Bissell K, Chiang CY, El Sony A, Ellwood E, Ellwood P, García-Marcos L, Marks GB, Morales E, Mortimer K, Pérez-Fernández V, Robertson S, Silverwood RJ, Strachan DP, Pearce N. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study. Lancet 2021; 398:1569-1580. [PMID: 34755626 PMCID: PMC8573635 DOI: 10.1016/s0140-6736(21)01450-1] [Citation(s) in RCA: 152] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/16/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing. METHODS This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993-95), ISAAC Phase III (2001-03), or both. We included individuals from two age groups (children aged 6-7 years and adolescents aged 13-14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders. FINDINGS Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993-2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (-0·37, 95% CI -0·69 to -0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (-1·37, -2·47 to -0·27], in children and -1·67, -2·70 to -0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries. INTERPRETATION Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma. FUNDING International Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim New Zealand, AstraZeneca Educational Grant, National Institute for Health Research, UK Medical Research Council, European Research Council, and Instituto de Salud Carlos III.
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Robertson S, Lazaraviciute G, Kerr L, Hendry D. 798 A Rare Complication and Unexpected Pathology Following an Anterior Exenteration – A Case Report. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
We present a case report of an unexpected pathology in addition to a rare complication in a 62-year-old female following an anterior exenteration and an abdominal wall reconstruction. Initial biopsies characterised the malignancy as a potential urachal adenocarcinoma, but the final pathology revealed a solitary endometrial adenocarcinoma metastasis from endometrial cancer 6 years previously.
Due to the nature of the tumour, an abdominal wall resection was required, and reconstruction involved a pedicled thigh flap. Post-operatively the small bowel herniated under the flap and this resulted in true mechanical small bowel obstruction. The loop of herniated bowel is visible on CT imaging in the area of the proximal thigh. The patient returned to theatre for an emergency laparotomy and the abdominal wall defect was closed instead with a surgical implant derived from animal tissue. The patient made an excellent recovery, was discharged home, and continues to do well. This patient is an example of excelling in adversity.
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Gough B, Robertson S, Luck H. Engendered Expressions of Anxiety: Men's Emotional Communications With Women and Other Men. FRONTIERS IN SOCIOLOGY 2021; 6:697356. [PMID: 34268351 PMCID: PMC8275859 DOI: 10.3389/fsoc.2021.697356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
While the contemporary therapeutic discourse inveigles us to talk about our personal problems, a countervailing neo-liberal healthist discourse, aligning with conventional masculinity norms, presumes that we will manage any issues independently. This discursive tension can be difficult to navigate, especially for men confronted with still powerful traditional expectations around masculinity (e.g., self-reliance; personal control; restricted emotionality). Although qualitative research has examined how men negotiate masculinities with respect to depression, to date there has been scant attention focused on men experiencing anxiety. This article reports on an interview study with men, some with anxiety diagnoses and some without (N = 17). Thematic analysis highlights that participants can and do talk about their anxieties, most readily with significant women in their lives (e.g., partners; mothers)-although this is not always straightforward. Talking to other men was more fraught, and while participants were wary of sharing problems with male friends, or signaled issues indirectly, they also highlighted situations where they would open up e.g., workspaces where they felt safe; with best friends. Those who had gone through a therapeutic process over many years tended to me more comfortable talking to others, male or female, about their mental health-and were also keen to other support to others where they could. Our analysis suggests that despite stereotypical notions of silent, self-contained men, there are many contexts where men may feel comfortable sharing their stories of pain and suffering. This chimes with wider cultural changes and the reported experiences of some mental health initiatives.
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Aktuerk D, Ali J, Badran A, Balmforth D, Bleetman D, Brown C, Suelo-Calanao R, Cartwright J, Casey L, Chiwera L, Fudulu D, Garner M, Gradinariu G, Harky A, Hussain A, Hutton S, Kew E, Loubani M, Mani K, Martin J, Rochon M, Moawad N, Mohamed S, Muretti M, Murphy G, Olivieri G, Paglinawan I, Quijano-Campos J, Rizzo V, Robertson S, Rogers L, Roman M, Salmon K, Sanders J, Talukder S, Tanner J, Vaja R, Zientara A, Green S, Miles R, Lamagni T, Harrington P. National survey of variations in practice in the prevention of surgical site infections in adult cardiac surgery, United Kingdom and Republic of Ireland. J Hosp Infect 2020; 106:812-819. [DOI: 10.1016/j.jhin.2020.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/11/2020] [Indexed: 11/25/2022]
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Brady M, Refshauge G, Robertson S, Atkinson T, Allworth B, Hernandez-Jover M. An exploratory study to investigate animal health and reproductive wastage among Australian meat goat producers. Aust Vet J 2020; 98:602-609. [PMID: 33063857 DOI: 10.1111/avj.13033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
The Australian goat meat industry has grown significantly in the last decade, with the value of exports nearly tripling. However, because carcase weight has remained constant over this time, the drivers of industry growth are price and supply. Animal health and reproduction are key factors contributing to supply and productivity, yet limitations to production management are poorly understood, hampering advice for effective intervention. This exploratory study aims to provide insights into the animal health and reproductive management practices and perceptions among meat goat producers in Australia. To achieve this aim, 20 producers, located in New South Wales, Queensland, Western Australia and Victoria, operating under different production systems were interviewed. The results of this study suggest that animal health management could be improved and that producers perceive a lack of relevant and species-specific information available to help them make informed decisions. Reproductive management and records varied greatly across producers interviewed. Kid loss was identified as an issue, with a 28% estimated average (6%-47% range) of losses from kidding until weaning. Producers identified predation, doe nutrition and mismothering as the biggest contributors to kid loss, with the majority of losses occurring within a week of birth. All producers believed management could minimise kid loss. This study highlights the importance of improving reproductive rates among goat enterprises and provides new information on the current practices within the Australian meat goat industry. This may assist the development of appropriate strategies for improving health and reproductive management and delivery of advice to producers.
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Aartsen MG, Abbasi R, Ackermann M, Adams J, Aguilar JA, Ahlers M, Ahrens M, Alispach C, Amin NM, Andeen K, Anderson T, Ansseau I, Anton G, Argüelles C, Auffenberg J, Axani S, Bagherpour H, Bai X, Balagopal A, Barbano A, Barwick SW, Bastian B, Basu V, Baum V, Baur S, Bay R, Beatty JJ, Becker KH, Becker Tjus J, BenZvi S, Berley D, Bernardini E, Besson DZ, Binder G, Bindig D, Blaufuss E, Blot S, Bohm C, Böser S, Botner O, Böttcher J, Bourbeau E, Bourbeau J, Bradascio F, Braun J, Bron S, Brostean-Kaiser J, Burgman A, Buscher J, Busse RS, Carver T, Chen C, Cheung E, Chirkin D, Choi S, Clark BA, Clark K, Classen L, Coleman A, Collin GH, Conrad JM, Coppin P, Correa P, Cowen DF, Cross R, Dave P, De Clercq C, DeLaunay JJ, Dembinski H, Deoskar K, De Ridder S, Desai A, Desiati P, de Vries KD, de Wasseige G, de With M, DeYoung T, Dharani S, Diaz A, Díaz-Vélez JC, Dujmovic H, Dunkman M, DuVernois MA, Dvorak E, Ehrhardt T, Eller P, Engel R, Evenson PA, Fahey S, Fazely AR, Fedynitch A, Felde J, Fienberg AT, Filimonov K, Finley C, Fox D, Franckowiak A, Friedman E, Fritz A, Gaisser TK, Gallagher J, Ganster E, Garrappa S, Gerhardt L, Glauch T, Glüsenkamp T, Goldschmidt A, Gonzalez JG, Grant D, Grégoire T, Griffith Z, Griswold S, Günder M, Gündüz M, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Hanson K, Hardin J, Haungs A, Hauser S, Hebecker D, Heereman D, Heix P, Helbing K, Hellauer R, Henningsen F, Hickford S, Hignight J, Hill GC, Hoffman KD, Hoffmann R, Hoinka T, Hokanson-Fasig B, Hoshina K, Huang F, Huber M, Huber T, Hultqvist K, Hünnefeld M, Hussain R, In S, Iovine N, Ishihara A, Jansson M, Japaridze GS, Jeong M, Jones BJP, Jonske F, Joppe R, Kang D, Kang W, Kappes A, Kappesser D, Karg T, Karl M, Karle A, Katz U, Kauer M, Kellermann M, Kelley JL, Kheirandish A, Kim J, Kintscher T, Kiryluk J, Kittler T, Klein SR, Koirala R, Kolanoski H, Köpke L, Kopper C, Kopper S, Koskinen DJ, Koundal P, Kowalski M, Krings K, Krückl G, Kulacz N, Kurahashi N, Kyriacou A, Lanfranchi JL, Larson MJ, Lauber F, Lazar JP, Leonard K, Leszczyńska A, Li Y, Liu QR, Lohfink E, Lozano Mariscal CJ, Lu L, Lucarelli F, Ludwig A, Lünemann J, Luszczak W, Lyu Y, Ma WY, Madsen J, Maggi G, Mahn KBM, Makino Y, Mallik P, Mancina S, Mariş IC, Maruyama R, Mase K, Maunu R, McNally F, Meagher K, Medici M, Medina A, Meier M, Meighen-Berger S, Merz J, Meures T, Micallef J, Mockler D, Momenté G, Montaruli T, Moore RW, Morse R, Moulai M, Muth P, Nagai R, Naumann U, Neer G, Nguyen LV, Niederhausen H, Nisa MU, Nowicki SC, Nygren DR, Obertacke Pollmann A, Oehler M, Olivas A, O'Murchadha A, O'Sullivan E, Palczewski T, Pandya H, Pankova DV, Park N, Parker GK, Paudel EN, Peiffer P, Pérez de Los Heros C, Philippen S, Pieloth D, Pieper S, Pinat E, Pizzuto A, Plum M, Popovych Y, Porcelli A, Prado Rodriguez M, Price PB, Przybylski GT, Raab C, Raissi A, Rameez M, Rauch L, Rawlins K, Rea IC, Rehman A, Reimann R, Relethford B, Renschler M, Renzi G, Resconi E, Rhode W, Richman M, Riedel B, Robertson S, Rongen M, Rott C, Ruhe T, Ryckbosch D, Rysewyk Cantu D, Safa I, Sanchez Herrera SE, Sandrock A, Sandroos J, Santander M, Sarkar S, Sarkar S, Satalecka K, Scharf M, Schaufel M, Schieler H, Schlunder P, Schmidt T, Schneider A, Schneider J, Schröder FG, Schumacher L, Sclafani S, Seckel D, Seunarine S, Shefali S, Silva M, Smithers B, Snihur R, Soedingrekso J, Soldin D, Song M, Spiczak GM, Spiering C, Stachurska J, Stamatikos M, Stanev T, Stein R, Stettner J, Steuer A, Stezelberger T, Stokstad RG, Stößl A, Strotjohann NL, Stürwald T, Stuttard T, Sullivan GW, Taboada I, Tenholt F, Ter-Antonyan S, Terliuk A, Tilav S, Tollefson K, Tomankova L, Tönnis C, Toscano S, Tosi D, Trettin A, Tselengidou M, Tung CF, Turcati A, Turcotte R, Turley CF, Ty B, Unger E, Unland Elorrieta MA, Usner M, Vandenbroucke J, Van Driessche W, van Eijk D, van Eijndhoven N, Vannerom D, van Santen J, Verpoest S, Vraeghe M, Walck C, Wallace A, Wallraff M, Watson TB, Weaver C, Weindl A, Weiss MJ, Weldert J, Wendt C, Werthebach J, Whelan BJ, Whitehorn N, Wiebe K, Wiebusch CH, Williams DR, Wills L, Wolf M, Wood TR, Woschnagg K, Wrede G, Wulff J, Xu XW, Xu Y, Yanez JP, Yodh G, Yoshida S, Yuan T, Zhang Z, Zöcklein M. eV-Scale Sterile Neutrino Search Using Eight Years of Atmospheric Muon Neutrino Data from the IceCube Neutrino Observatory. PHYSICAL REVIEW LETTERS 2020; 125:141801. [PMID: 33064514 DOI: 10.1103/physrevlett.125.141801] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/31/2020] [Indexed: 06/11/2023]
Abstract
The results of a 3+1 sterile neutrino search using eight years of data from the IceCube Neutrino Observatory are presented. A total of 305 735 muon neutrino events are analyzed in reconstructed energy-zenith space to test for signatures of a matter-enhanced oscillation that would occur given a sterile neutrino state with a mass-squared differences between 0.01 and 100 eV^{2}. The best-fit point is found to be at sin^{2}(2θ_{24})=0.10 and Δm_{41}^{2}=4.5 eV^{2}, which is consistent with the no sterile neutrino hypothesis with a p value of 8.0%.
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Aartsen M, Abbasi R, Ackermann M, Adams J, Aguilar J, Ahlers M, Ahrens M, Alispach C, Amin N, Andeen K, Anderson T, Ansseau I, Anton G, Argüelles C, Auffenberg J, Axani S, Bagherpour H, Bai X, Balagopal V. A, Barbano A, Barwick S, Bastian B, Basu V, Baum V, Baur S, Bay R, Beatty J, Becker KH, Becker Tjus J, BenZvi S, Berley D, Bernardini E, Besson D, Binder G, Bindig D, Blaufuss E, Blot S, Bohm C, Böser S, Botner O, Böttcher J, Bourbeau E, Bourbeau J, Bradascio F, Braun J, Bron S, Brostean-Kaiser J, Burgman A, Buscher J, Busse R, Carver T, Chen C, Cheung E, Chirkin D, Choi S, Clark B, Clark K, Classen L, Coleman A, Collin G, Conrad J, Coppin P, Correa P, Cowen D, Cross R, Dave P, De Clercq C, DeLaunay J, Dembinski H, Deoskar K, De Ridder S, Desai A, Desiati P, de Vries K, de Wasseige G, de With M, DeYoung T, Dharani S, Diaz A, Díaz-Vélez J, Dujmovic H, Dunkman M, DuVernois M, Dvorak E, Ehrhardt T, Eller P, Engel R, Evenson P, Fahey S, Fazely A, Fedynitch A, Felde J, Fienberg A, Filimonov K, Finley C, Fox D, Franckowiak A, Friedman E, Fritz A, Gaisser T, Gallagher J, Ganster E, Garrappa S, Gerhardt L, Glauch T, Glüsenkamp T, Goldschmidt A, Gonzalez J, Grant D, Grégoire T, Griffith Z, Griswold S, Günder M, Gündüz M, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Hanson K, Hardin J, Haungs A, Hauser S, Hebecker D, Heereman D, Heix P, Helbing K, Hellauer R, Henningsen F, Hickford S, Hignight J, Hill G, Hoffman K, Hoffmann R, Hoinka T, Hokanson-Fasig B, Hoshina K, Huang F, Huber M, Huber T, Hultqvist K, Hünnefeld M, Hussain R, In S, Iovine N, Ishihara A, Jansson M, Japaridze G, Jeong M, Jones B, Jonske F, Joppe R, Kang D, Kang W, Kappes A, Kappesser D, Karg T, Karl M, Karle A, Katz U, Kauer M, Kellermann M, Kelley J, Kheirandish A, Kim J, Kintscher T, Kiryluk J, Kittler T, Klein S, Koirala R, Kolanoski H, Köpke L, Kopper C, Kopper S, Koskinen D, Koundal P, Kowalski M, Krings K, Krückl G, Kulacz N, Kurahashi N, Kyriacou A, Lanfranchi J, Larson M, Lauber F, Lazar J, Leonard K, Leszczyńska A, Li Y, Liu Q, Lohfink E, Lozano Mariscal C, Lu L, Lucarelli F, Ludwig A, Lünemann J, Luszczak W, Lyu Y, Ma W, Madsen J, Maggi G, Mahn K, Makino Y, Mallik P, Mancina S, Mariş I, Maruyama R, Mase K, Maunu R, McNally F, Meagher K, Medici M, Medina A, Meier M, Meighen-Berger S, Merz J, Meures T, Micallef J, Mockler D, Momenté G, Montaruli T, Moore R, Morse R, Moulai M, Muth P, Nagai R, Naumann U, Neer G, Nguyen L, Niederhausen H, Nisa M, Nowicki S, Nygren D, Obertacke Pollmann A, Oehler M, Olivas A, O’Murchadha A, O’Sullivan E, Palczewski T, Pandya H, Pankova D, Park N, Parker G, Paudel E, Peiffer P, Pérez de los Heros C, Philippen S, Pieloth D, Pieper S, Pinat E, Pizzuto A, Plum M, Popovych Y, Porcelli A, Prado Rodriguez M, Price P, Przybylski G, Raab C, Raissi A, Rameez M, Rauch L, Rawlins K, Rea I, Rehman A, Reimann R, Relethford B, Renschler M, Renzi G, Resconi E, Rhode W, Richman M, Riedel B, Robertson S, Rongen M, Rott C, Ruhe T, Ryckbosch D, Rysewyk Cantu D, Safa I, Sanchez Herrera S, Sandrock A, Sandroos J, Santander M, Sarkar S, Sarkar S, Satalecka K, Scharf M, Schaufel M, Schieler H, Schlunder P, Schmidt T, Schneider A, Schneider J, Schröder F, Schumacher L, Sclafani S, Seckel D, Seunarine S, Shefali S, Silva M, Smithers B, Snihur R, Soedingrekso J, Soldin D, Song M, Spiczak G, Spiering C, Stachurska J, Stamatikos M, Stanev T, Stein R, Stettner J, Steuer A, Stezelberger T, Stokstad R, Stößl A, Strotjohann N, Stürwald T, Stuttard T, Sullivan G, Taboada I, Tenholt F, Ter-Antonyan S, Terliuk A, Tilav S, Tollefson K, Tomankova L, Tönnis C, Toscano S, Tosi D, Trettin A, Tselengidou M, Tung C, Turcati A, Turcotte R, Turley C, Ty B, Unger E, Unland Elorrieta M, Usner M, Vandenbroucke J, Van Driessche W, van Eijk D, van Eijndhoven N, Vannerom D, van Santen J, Verpoest S, Vraeghe M, Walck C, Wallace A, Wallraff M, Watson T, Weaver C, Weindl A, Weiss M, Weldert J, Wendt C, Werthebach J, Whelan B, Whitehorn N, Wiebe K, Wiebusch C, Williams D, Wills L, Wolf M, Wood T, Woschnagg K, Wrede G, Wulff J, Xu X, Xu Y, Yanez J, Yodh G, Yoshida S, Yuan T, Zhang Z, Zöcklein M. Searching for eV-scale sterile neutrinos with eight years of atmospheric neutrinos at the IceCube Neutrino Telescope. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.102.052009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Aartsen MG, Ackermann M, Adams J, Aguilar JA, Ahlers M, Ahrens M, Alispach C, Andeen K, Anderson T, Ansseau I, Anton G, Argüelles C, Auffenberg J, Axani S, Backes P, Bagherpour H, Bai X, Balagopal V A, Barbano A, Barwick SW, Bastian B, Baum V, Baur S, Bay R, Beatty JJ, Becker KH, Becker Tjus J, BenZvi S, Berley D, Bernardini E, Besson DZ, Binder G, Bindig D, Blaufuss E, Blot S, Bohm C, Böser S, Botner O, Böttcher J, Bourbeau E, Bourbeau J, Bradascio F, Braun J, Bron S, Brostean-Kaiser J, Burgman A, Buscher J, Busse RS, Carver T, Chen C, Cheung E, Chirkin D, Choi S, Clark K, Classen L, Coleman A, Collin GH, Conrad JM, Coppin P, Correa P, Cowen DF, Cross R, Dave P, De Clercq C, DeLaunay JJ, Dembinski H, Deoskar K, De Ridder S, Desiati P, de Vries KD, de Wasseige G, de With M, DeYoung T, Diaz A, Díaz-Vélez JC, Dujmovic H, Dunkman M, Dvorak E, Eberhardt B, Ehrhardt T, Eller P, Engel R, Evenson PA, Fahey S, Fazely AR, Felde J, Filimonov K, Finley C, Fox D, Franckowiak A, Friedman E, Fritz A, Gaisser TK, Gallagher J, Ganster E, Garrappa S, Gerhardt L, Ghorbani K, Glauch T, Glüsenkamp T, Goldschmidt A, Gonzalez JG, Grant D, Grégoire T, Griffith Z, Griswold S, Günder M, Gündüz M, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Hanson K, Haungs A, Hebecker D, Heereman D, Heix P, Helbing K, Hellauer R, Henningsen F, Hickford S, Hignight J, Hill GC, Hoffman KD, Hoffmann R, Hoinka T, Hokanson-Fasig B, Hoshina K, Huang F, Huber M, Huber T, Hultqvist K, Hünnefeld M, Hussain R, In S, Iovine N, Ishihara A, Jansson M, Japaridze GS, Jeong M, Jero K, Jones BJP, Jonske F, Joppe R, Kang D, Kang W, Kappes A, Kappesser D, Karg T, Karl M, Karle A, Katz U, Kauer M, Kelley JL, Kheirandish A, Kim J, Kintscher T, Kiryluk J, Kittler T, Klein SR, Koirala R, Kolanoski H, Köpke L, Kopper C, Kopper S, Koskinen DJ, Kowalski M, Krings K, Krückl G, Kulacz N, Kurahashi N, Kyriacou A, Lanfranchi JL, Larson MJ, Lauber F, Lazar JP, Leonard K, Lesiak-Bzdak M, Leszczyńska A, Leuermann M, Liu QR, Lohfink E, Lozano Mariscal CJ, Lu L, Lucarelli F, Lünemann J, Luszczak W, Lyu Y, Ma WY, Madsen J, Maggi G, Mahn KBM, Makino Y, Mallik P, Mallot K, Mancina S, Mariş IC, Maruyama R, Mase K, Maunu R, McNally F, Meagher K, Medici M, Medina A, Meier M, Meighen-Berger S, Merino G, Meures T, Micallef J, Mockler D, Momenté G, Montaruli T, Moore RW, Morse R, Moulai M, Muth P, Nagai R, Naumann U, Neer G, Niederhausen H, Nisa MU, Nowicki SC, Nygren DR, Obertacke Pollmann A, Oehler M, Olivas A, O'Murchadha A, O'Sullivan E, Palczewski T, Pandya H, Pankova DV, Park N, Peiffer P, Pérez de Los Heros C, Philippen S, Pieloth D, Pieper S, Pinat E, Pizzuto A, Plum M, Porcelli A, Price PB, Przybylski GT, Raab C, Raissi A, Rameez M, Rauch L, Rawlins K, Rea IC, Rehman A, Reimann R, Relethford B, Renschler M, Renzi G, Resconi E, Rhode W, Richman M, Robertson S, Rongen M, Rott C, Ruhe T, Ryckbosch D, Rysewyk D, Safa I, Sanchez Herrera SE, Sandrock A, Sandroos J, Santander M, Sarkar S, Sarkar S, Satalecka K, Schaufel M, Schieler H, Schlunder P, Schmidt T, Schneider A, Schneider J, Schröder FG, Schumacher L, Sclafani S, Seckel D, Seunarine S, Shefali S, Silva M, Snihur R, Soedingrekso J, Soldin D, Song M, Spiczak GM, Spiering C, Stachurska J, Stamatikos M, Stanev T, Stein R, Stettner J, Steuer A, Stezelberger T, Stokstad RG, Stößl A, Strotjohann NL, Stürwald T, Stuttard T, Sullivan GW, Taboada I, Tenholt F, Ter-Antonyan S, Terliuk A, Tilav S, Tollefson K, Tomankova L, Tönnis C, Toscano S, Tosi D, Trettin A, Tselengidou M, Tung CF, Turcati A, Turcotte R, Turley CF, Ty B, Unger E, Unland Elorrieta MA, Usner M, Vandenbroucke J, Van Driessche W, van Eijk D, van Eijndhoven N, van Santen J, Verpoest S, Vraeghe M, Walck C, Wallace A, Wallraff M, Wandkowsky N, Watson TB, Weaver C, Weindl A, Weiss MJ, Weldert J, Wendt C, Werthebach J, Whelan BJ, Whitehorn N, Wiebe K, Wiebusch CH, Wille L, Williams DR, Wills L, Wolf M, Wood J, Wood TR, Woschnagg K, Wrede G, Xu DL, Xu XW, Xu Y, Yanez JP, Yodh G, Yoshida S, Yuan T, Zöcklein M. Characteristics of the Diffuse Astrophysical Electron and Tau Neutrino Flux with Six Years of IceCube High Energy Cascade Data. PHYSICAL REVIEW LETTERS 2020; 125:121104. [PMID: 33016752 DOI: 10.1103/physrevlett.125.121104] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/02/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
We report on the first measurement of the astrophysical neutrino flux using particle showers (cascades) in IceCube data from 2010-2015. Assuming standard oscillations, the astrophysical neutrinos in this dedicated cascade sample are dominated (∼90%) by electron and tau flavors. The flux, observed in the sensitive energy range from 16 TeV to 2.6 PeV, is consistent with a single power-law model as expected from Fermi-type acceleration of high energy particles at astrophysical sources. We find the flux spectral index to be γ=2.53±0.07 and a flux normalization for each neutrino flavor of ϕ_{astro}=1.66_{-0.27}^{+0.25} at E_{0}=100 TeV, in agreement with IceCube's complementary muon neutrino results and with all-neutrino flavor fit results. In the measured energy range we reject spectral indices γ≤2.28 at ≥3σ significance level. Because of high neutrino energy resolution and low atmospheric neutrino backgrounds, this analysis provides the most detailed characterization of the neutrino flux at energies below ∼100 TeV compared to previous IceCube results. Results from fits assuming more complex neutrino flux models suggest a flux softening at high energies and a flux hardening at low energies (p value ≥0.06). The sizable and smooth flux measured below ∼100 TeV remains a puzzle. In order to not violate the isotropic diffuse gamma-ray background as measured by the Fermi Large Area Telescope, it suggests the existence of astrophysical neutrino sources characterized by dense environments which are opaque to gamma rays.
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Senek M, Robertson S, Ryan T, King R, Wood E, Taylor B, Tod A. Determinants of nurse job dissatisfaction - findings from a cross-sectional survey analysis in the UK. BMC Nurs 2020; 19:88. [PMID: 32963498 PMCID: PMC7499408 DOI: 10.1186/s12912-020-00481-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background A lower recruitment and high turnover rate of registered nurses have resulted in a global shortage of nurses. In the UK, prior to the COVID-19 epidemic, nurses’ intention to leave rates were between 30 and 50% suggesting a high level of job dissatisfaction. Methods In this study, we analysed data from a cross-sectional mixed-methods survey developed by the Royal College of Nursing and administered to the nursing workforce across all four UK nations, to explore the levels of dissatisfaction and demoralisation- one of the predictors of nurses’ intention to leave. We carried out logistic regression analysis on available data in order to determine what impacts job dissatisfaction. Results In total, 1742 nurses responded to questions about working conditions on their last shift. We found that nearly two-thirds of respondents were demoralised. Nurses were five times more likely (OR 5.08, 95% CI: 3.82–6.60) to feel demoralised if they reported missed care. A perceived lack of support had nearly the same impact on the level of demoralisation (OR 4.8, 95% CI: 3.67–6.38). These findings were reflected in the qualitative findings where RNs reported how staffing issues and failures in leadership, left them feeling disempowered and demoralised. Conclusion A large proportion of nurses reported feeling dissatisfied and demoralised. In order to reduce the negative impact of dissatisfaction and improve retention, more research needs to investigate the relationship dynamics within healthcare teams and how the burden experienced by RNs when unsupported by managers impacts on their ability to provide safe, good-quality care. These findings predate the current Covid-19 pandemic outbreak which may have had a further detrimental effect on job satisfaction in the UK and other nation’s nursing workforce.
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Senek M, Tod A, Robertson S. The gendered Experience of mesothelioma study (GEMS): findings from a survey data analysis. Lung Cancer 2020. [DOI: 10.1183/13993003.congress-2020.1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Dahabreh I, Robertson S, Steingrimsson J, Gravenstein S, Joyce N. Extending Inferences from a Cluster‐Randomized Trial to a Target Population. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13486] [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] Open
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Zhao SS, Robertson S, Reich T, Harrison NL, Moots RJ, Goodson N. FRI0326 PREVALENCE AND IMPACT OF COMORBIDITIES IN AXIAL SPONDYLOARTHRITIS: SYSTEMATIC REVIEW AND META-ANALYSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Comorbidities are common among patients with axial spondyloarthritis (axSpA). The majority of axSpA patients have at least one comorbid medical condition in addition to any extra-articular manifestations [1]. Comorbidity ‘burden’ is associate with poorer function, quality of life and work-related outcomes [2]. They also influence treatment decisions and are key drivers of mortality.Objectives:We performed a systematic review and meta-analysis to 1) describe the prevalence of commonly reported comorbidities, 2) compare the prevalence of comorbidities between axSpA and control populations.Methods:A systematic review was performed in September 2019 using Medline, PubMed, Scopus and Web of Science, in accordance with PRISMA guidelines. Studies were included if they reported the prevalence of comorbidities on disease outcomes, and excluded if they focused on a single comorbidity or closely related diseases in one organ system. Two independent reviewers screened titles and abstracts, assessed full-texts for eligibility and extracted data from qualifying studies. Where possible, we performed meta-analyses for comorbidities reported by at least 3 studies using random-effects models. Pooled prevalence estimates were reported as percentages (95% confidence interval, I2statistic for heterogeneity).Results:36 studies reported prevalence of of individual comorbidities, amounting to a combined sample size of 119,427 patients. The most prevalent individual comorbidities were hypertension (pooled prevalence 22%), hyperlipidaemia (17%) and obesity (14%) (Figure 1). Eleven studies consistently showed higher prevalence of comorbidities in axSpA than controls (Table 1); odds ratios (OR) were particularly large for depression (pooled OR 1.80) and congestive cardiac failure (OR 1.84). There was significant heterogeneity for the majority of meta-analysis estimates.Table 1.Meta-analysis estimates for odds ratios (OR) of comorbidities compared between axSpA and control groups.Number of studiesPooled OR95% confidence intervalI2, %Hypertension91.581.29 to 1.9298Any cardiovascular disease31.420.999 to 2.0399Any ischaemic heart disease71.511.21 to 1.8787Congestive cardiac failure41.841.25 to 2.7389Stroke61.301.04 to 1.6281Peripheral vascular disease51.471.10 to 1.9683Diabetes81.141.001 to 1.3083Hyperlipidaemia51.181.01 to 1.3994Cancer51.221.01 to 1.4793Depression41.801.45 to 2.2392Figure 1.Pooled prevalence of individual comorbidities.Conclusion:Comorbidities are common in axSpA. Almost all comorbidities examined were more prevalent in axSpA patients than age and sex matched controls, with ≥80% higher odds for congestive cardiac failure and depression. Systematic and repeated assessments should therefore be integrated into routine clinical practice to ensure holistic patient-centred management. Additional studies are needed to validate comorbidities indices for axSpA research.References:[1]Zhao SS, Radner H, Siebert S, et al. Comorbidity burden in axial spondyloarthritis: a cluster analysis. Rheumatology. 2019 Oct 1;58(10):1746–54.[2]Nikiphorou E, Ramiro S, van der Heijde D, et al. Association of Comorbidities in Spondyloarthritis With Poor Function, Work Disability, and Quality of Life: Results From the Assessment of SpondyloArthritis International Society Comorbidities in Spondyloarthritis Study. Arthritis Care Res. 2018 Aug;70(8):1257–62.Disclosure of Interests:None declared
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Vuillier L, Robertson S, Greville-Harris M. Orthorexic tendencies are linked with difficulties with emotion identification and regulation. J Eat Disord 2020; 8:15. [PMID: 32337044 PMCID: PMC7178625 DOI: 10.1186/s40337-020-00291-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/30/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Orthorexia nervosa (ON) is characterised by an unhealthy obsession with healthy eating and while it is not recognised as an eating disorder (or any disorder), current research is exploring similarities and differences with such disorders. The literature has shown that individuals with eating disorders have difficulties identifying and describing emotions (known as alexithymia) as well as regulating them. However no research to date has looked at whether people with orthorexic tendencies also suffer from difficulties with emotions. In this paper, we refer to people with orthorexic tendencies but do not assume that their healthy eating is at a pathological level needing clinical attention. METHODS The current study examined this by asking 196 healthy adults with an interest in healthy eating to complete four questionnaires to measure ON (ORTO-15 - reduced to ORTO-7CS), eating psychopathology (EAT-26), alexithymia (TAS-20) and emotion dysregulation (DERS-16). RESULTS We found that difficulties identifying and regulating emotions was associated with symptoms of ON, similar to what is found in other eating disorders. We suggest that ON behaviours may be used as a coping strategy in order to feel in control in these participants who have poor emotion regulation abilities. CONCLUSIONS Our results show that individuals with ON tendencies may share similar difficulties with emotions compared to other eating disorders. While important, our results are limited by the way we measured ON behaviours and we recommend that further research replicate our findings once a better and more specific tool is developed and validated to screen for ON characteristics more accurately.
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Wright B, Kronen PW, Lascelles D, Monteiro B, Murrell JC, Robertson S, Steagall PVM, Yamashita K. Ice therapy: cool, current and complicated. J Small Anim Pract 2020; 61:267-271. [PMID: 32201945 DOI: 10.1111/jsap.13130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 12/01/2022]
Abstract
This is the fourth Capsule review article provided by the WSAVA Global Pain Council and which discusses the use of ice or cold therapy as a non-pharmacologic modality for pain control in small animal practice. The physiological effects of cold therapy on tissues, receptors and ion channels are discussed; as well as indications, recommendations for, and limitations of use.
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Dorney E, Botfield JR, Robertson S, McGeechan K, Bateson D. Acceptability of the copper intrauterine device as a form of emergency contraception in New South Wales, Australia. EUR J CONTRACEP REPR 2020; 25:114-119. [PMID: 32072848 DOI: 10.1080/13625187.2020.1726888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The copper-intrauterine device (Cu-IUD) is the most effective emergency contraception (EC), and the only method providing ongoing contraception; however, it is underutilised in Australia.Methods: An online cross-sectional survey of clients and clinicians at a family planning service was undertaken. Clients aged 16-55 and identifying as female or transgender male were eligible. The survey explored previous experience with and knowledge of the Cu-IUD as EC among clients, current EC practices among clinicians, and barriers and enablers among clients and clinicians.Results: Of 470 clients, 64.5% had previously used EC. Only 12.7% knew the Cu-IUD was a form of EC and 2% had used it. When given information on effectiveness, side-effects and costs, 46.8% reported they would consider the Cu-IUD for EC. However, 40% viewed cost and possible side-effects as barriers. Of the 58 clinicians surveyed, 55% reported discussing Cu-IUD as EC with clients versus 94% discussing oral EC, with time pressures reported as the main barrier.Conclusion: Low awareness among clients, and limited discussion by clinicians, highlights a need for increased education and promotion strategies for the Cu-IUD as EC. With greater knowledge, demand for this option may increase. This will require processes to ensure timely access to insertions.
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Aartsen MG, Ackermann M, Adams J, Aguilar JA, Ahlers M, Ahrens M, Alispach C, Andeen K, Anderson T, Ansseau I, Anton G, Argüelles C, Auffenberg J, Axani S, Backes P, Bagherpour H, Bai X, Balagopal A, Barbano A, Barwick SW, Bastian B, Baum V, Baur S, Bay R, Beatty JJ, Becker KH, Becker Tjus J, BenZvi S, Berley D, Bernardini E, Besson DZ, Binder G, Bindig D, Blaufuss E, Blot S, Bohm C, Börner M, Böser S, Botner O, Böttcher J, Bourbeau E, Bourbeau J, Bradascio F, Braun J, Bron S, Brostean-Kaiser J, Burgman A, Buscher J, Busse RS, Carver T, Chen C, Cheung E, Chirkin D, Choi S, Clark K, Classen L, Coleman A, Collin GH, Conrad JM, Coppin P, Correa P, Cowen DF, Cross R, Dave P, De Clercq C, DeLaunay JJ, Dembinski H, Deoskar K, De Ridder S, Desiati P, de Vries KD, de Wasseige G, de With M, DeYoung T, Diaz A, Díaz-Vélez JC, Dujmovic H, Dunkman M, Dvorak E, Eberhardt B, Ehrhardt T, Eller P, Engel R, Evenson PA, Fahey S, Fazely AR, Felde J, Filimonov K, Finley C, Fox D, Franckowiak A, Friedman E, Fritz A, Gaisser TK, Gallagher J, Ganster E, Garrappa S, Gerhardt L, Ghorbani K, Glauch T, Glüsenkamp T, Goldschmidt A, Gonzalez JG, Grant D, Griffith Z, Griswold S, Günder M, Gündüz M, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Hanson K, Haungs A, Hebecker D, Heereman D, Heix P, Helbing K, Hellauer R, Henningsen F, Hickford S, Hignight J, Hill GC, Hoffman KD, Hoffmann R, Hoinka T, Hokanson-Fasig B, Hoshina K, Huang F, Huber M, Huber T, Hultqvist K, Hünnefeld M, Hussain R, In S, Iovine N, Ishihara A, Japaridze GS, Jeong M, Jero K, Jones BJP, Jonske F, Joppe R, Kang D, Kang W, Kappes A, Kappesser D, Karg T, Karl M, Karle A, Katz U, Kauer M, Kelley JL, Kheirandish A, Kim J, Kintscher T, Kiryluk J, Kittler T, Klein SR, Koirala R, Kolanoski H, Köpke L, Kopper C, Kopper S, Koskinen DJ, Kowalski M, Krings K, Krückl G, Kulacz N, Kurahashi N, Kyriacou A, Labare M, Lanfranchi JL, Larson MJ, Lauber F, Lazar JP, Leonard K, Leszczyńska A, Leuermann M, Liu QR, Lohfink E, Lozano Mariscal CJ, Lu L, Lucarelli F, Lünemann J, Luszczak W, Lyu Y, Ma WY, Madsen J, Maggi G, Mahn KBM, Makino Y, Mallik P, Mallot K, Mancina S, Mariş IC, Maruyama R, Mase K, Matis HS, Maunu R, McNally F, Meagher K, Medici M, Medina A, Meier M, Meighen-Berger S, Menne T, Merino G, Meures T, Micallef J, Mockler D, Momenté G, Montaruli T, Moore RW, Morse R, Moulai M, Muth P, Nagai R, Naumann U, Neer G, Niederhausen H, Nisa MU, Nowicki SC, Nygren DR, Obertacke Pollmann A, Oehler M, Olivas A, O'Murchadha A, O'Sullivan E, Palczewski T, Pandya H, Pankova DV, Park N, Peiffer P, Pérez de Los Heros C, Philippen S, Pieloth D, Pinat E, Pizzuto A, Plum M, Porcelli A, Price PB, Przybylski GT, Raab C, Raissi A, Rameez M, Rauch L, Rawlins K, Rea IC, Reimann R, Relethford B, Renschler M, Renzi G, Resconi E, Rhode W, Richman M, Robertson S, Rongen M, Rott C, Ruhe T, Ryckbosch D, Rysewyk D, Safa I, Sanchez Herrera SE, Sandrock A, Sandroos J, Santander M, Sarkar S, Sarkar S, Satalecka K, Schaufel M, Schieler H, Schlunder P, Schmidt T, Schneider A, Schneider J, Schröder FG, Schumacher L, Sclafani S, Seckel D, Seunarine S, Shefali S, Silva M, Snihur R, Soedingrekso J, Soldin D, Song M, Spiczak GM, Spiering C, Stachurska J, Stamatikos M, Stanev T, Stein R, Steinmüller P, Stettner J, Steuer A, Stezelberger T, Stokstad RG, Stößl A, Strotjohann NL, Stürwald T, Stuttard T, Sullivan GW, Taboada I, Tenholt F, Ter-Antonyan S, Terliuk A, Tilav S, Tollefson K, Tomankova L, Tönnis C, Toscano S, Tosi D, Trettin A, Tselengidou M, Tung CF, Turcati A, Turcotte R, Turley CF, Ty B, Unger E, Unland Elorrieta MA, Usner M, Vandenbroucke J, Van Driessche W, van Eijk D, van Eijndhoven N, Vanheule S, van Santen J, Vraeghe M, Walck C, Wallace A, Wallraff M, Wandkowsky N, Watson TB, Weaver C, Weindl A, Weiss MJ, Weldert J, Wendt C, Werthebach J, Whelan BJ, Whitehorn N, Wiebe K, Wiebusch CH, Wille L, Williams DR, Wills L, Wolf M, Wood J, Wood TR, Woschnagg K, Wrede G, Xu DL, Xu XW, Xu Y, Yanez JP, Yodh G, Yoshida S, Yuan T, Zöcklein M. Time-Integrated Neutrino Source Searches with 10 Years of IceCube Data. PHYSICAL REVIEW LETTERS 2020; 124:051103. [PMID: 32083934 DOI: 10.1103/physrevlett.124.051103] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
This Letter presents the results from pointlike neutrino source searches using ten years of IceCube data collected between April 6, 2008 and July 10, 2018. We evaluate the significance of an astrophysical signal from a pointlike source looking for an excess of clustered neutrino events with energies typically above ∼1 TeV among the background of atmospheric muons and neutrinos. We perform a full-sky scan, a search within a selected source catalog, a catalog population study, and three stacked Galactic catalog searches. The most significant point in the northern hemisphere from scanning the sky is coincident with the Seyfert II galaxy NGC 1068, which was included in the source catalog search. The excess at the coordinates of NGC 1068 is inconsistent with background expectations at the level of 2.9σ after accounting for statistical trials from the entire catalog. The combination of this result along with excesses observed at the coordinates of three other sources, including TXS 0506+056, suggests that, collectively, correlations with sources in the northern catalog are inconsistent with background at 3.3σ significance. The southern catalog is consistent with background. These results, all based on searches for a cumulative neutrino signal integrated over the 10 years of available data, motivate further study of these and similar sources, including time-dependent analyses, multimessenger correlations, and the possibility of stronger evidence with coming upgrades to the detector.
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Robertson S, Cooper C, Hoe J, Lord K, Rapaport P, Marston L, Cousins S, Lyketsos CG, Livingston G. Comparing proxy rated quality of life of people living with dementia in care homes. Psychol Med 2020; 50:86-95. [PMID: 30691541 PMCID: PMC6945323 DOI: 10.1017/s0033291718003987] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 10/31/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes. METHODS We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews. RESULTS Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family's (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as 'Poor' (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents' QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia. CONCLUSION Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently.
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