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Mauffrey C, Giannoudis P, Civil I, Gray AC, Roberts C, Pape HC, Evans C, Kool B, Mauffrey OJ, Stengel D. Pearls and pitfalls of open access: The immortal life of Henrietta Lacks. Injury 2017; 48:1-2. [PMID: 28017190 DOI: 10.1016/j.injury.2016.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Hughes M, Moore T, Manning J, Wilkinson J, Dinsdale G, Roberts C, Murray A, Herrick AL. Reduced perfusion in systemic sclerosis digital ulcers (both fingertip and extensor) can be increased by topical application of glyceryl trinitrate. Microvasc Res 2016; 111:32-36. [PMID: 28027937 PMCID: PMC5351498 DOI: 10.1016/j.mvr.2016.12.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 12/02/2022]
Abstract
Objectives In patients with systemic sclerosis (SSc), fingertip digital ulcers (DUs) are believed to be ischaemic, and extensor surface DUs a result of mechanical factors/microtrauma. Our aim was to assess blood flow response to topical glyceryl trinitrate (GTN) compared to placebo in SSc DUs, looking for differences in pathophysiology between fingertip and extensor lesions. Method This was a double-blind, randomised, crossover, placebo-controlled study. Sixteen (6 fingertip, 10 extensor) DUs were each studied twice (one day apart): once with GTN and once with placebo ointment. Perfusion at the DU centre (‘DUCore’) and periphery (‘DUPeriphery’), as measured by laser Doppler imaging was performed before and immediately after ointment application, then every 10 min, up to 90 min post-application. We calculated the area under the response curve (AUC) and the ratio of peak perfusion to baseline, then compared these between GTN and placebo. Results Perfusion was lower in the DUCore compared to the DUPeriphery (ratio of 0.52). The microvessels of the DUCore were responsive to GTN, with an increase in perfusion, with a similar effect in both fingertip and extensor DUs. The AUC and peak/baseline perfusion difference in means (ratio, 95% confidence interval) between GTN and placebo at the DUCore were 1.2 (1.0–1.6) and 1.2 (1.0–1.5) respectively, and at the DUPeriphery were 1.1 (0.8–1.6) and 1.0 (0.9–1.2) respectively. Conclusion DUs (both fingertip and extensor) were responsive to topical GTN, with an increase in perfusion to the ischaemic DU centre. If both fingertip and extensor DUs have a (potentially reversible) ischaemic aetiology, this has important treatment implications. SSc fingertip DUs are believed to be ischaemic, whereas, extensor surface DUs are a result of mechanical factors/microtrauma. DUs (both fingertip and extensor) were responsive to topical GTN, in particular the ischaemic centre. If both fingertip and extensor DUs have a ischaemic aetiology, this has important treatment implications.
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Gillett K, Lippiett K, Astles C, Longstaff J, Orlando R, Lin SX, Powell A, Roberts C, Chauhan AJ, Thomas M, Wilkinson TM. Managing complex respiratory patients in the community: an evaluation of a pilot integrated respiratory care service. BMJ Open Respir Res 2016; 3:e000145. [PMID: 28074134 PMCID: PMC5174798 DOI: 10.1136/bmjresp-2016-000145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/14/2016] [Accepted: 09/23/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction In the UK, there is significant variation in respiratory care and outcomes. An integrated approach to the management of high-risk respiratory patients, incorporating specialist and primary care teams' expertise, is the basis for new integrated respiratory services designed to reduce this variation; however, this model needs evaluating. Methods To evaluate an integrated service managing high-risk respiratory patients, electronic searches for patients with asthma and chronic obstructive pulmonary disease at risk of poor outcomes were performed in two general practitioner (GP) practices in a local service-development initiative. Patients were reviewed at joint clinics by primary and secondary care professionals. GPs also nominated patients for inclusion. Reviews were delivered to best standards of care including assessments of diagnosis, control, spirometry, self-management, education, medication, inhaler technique and smoking cessation support. Follow-up of routine clinical data collected at 9-months postclinic were compared with seasonally matched 9-months prior to integrated review. Results 82 patients were identified, 55 attended. 13 (23.6%) had their primary diagnosis changed. In comparison with the seasonally adjusted baseline period, in the 9-month follow-up there was an increase in inhaled corticosteroid prescriptions of 23.3%, a reduction in short-acting β2-agonist prescription of 33.3%, a reduction in acute respiratory exacerbations of 67.6%, in unscheduled GP surgery visits of 53.3% and acute respiratory hospital admissions reduced from 3 to 0. Only 4 patients (7.3%) required referral to secondary care. Health economic evaluation showed respiratory-related costs per patient reduced by £231.86. Conclusions Patients with respiratory disease in this region at risk of suboptimal outcomes identified proactively and managed by an integrated team improved outcomes without the need for hospital referral.
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Mair FS, Goldstein P, May C, Angus R, Shiels C, Hibbert D, O'Connor J, Boland A, Roberts C, Haycox A, Capewell S. Patient and provider perspectives on home telecare: Preliminary results from a randomized controlled trial. J Telemed Telecare 2016; 11 Suppl 1:95-7. [PMID: 16036011 DOI: 10.1258/1357633054461976] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A randomized controlled trial of home telecare for the management of acute exacerbations of chronic obstructive pulmonary disease has been undertaken in the north-west of England. A videophone was used that communicates via the ordinary telephone network. The intervention period for each participant was two weeks. Participants in the telecare arm of the trial were asked to complete logbooks to record their experiences of each telecare encounter. A simple, self-completed, 10–item questionnaire was used that consisted of a Likert scale, ranging from 1 (totally disagree) to 5 (totally agree). Fourteen nurses completed 150 logbooks and 22 patients completed 145 logbooks. These results demonstrate significant differences in perception between patients and their health-care providers with regard to telecare encounters across all the domains addressed. Participating patients consistently demonstrated more positive views of the telecare encounters than their health-care providers.
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Mair FS, Goldstein P, Shiels C, Roberts C, Angus R, O'Connor J, Haycox A, Capewell S. Recruitment difficulties in a home telecare trial. J Telemed Telecare 2016; 12 Suppl 1:26-8. [PMID: 16884571 DOI: 10.1258/135763306777978371] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We analysed the difficulties encountered in recruiting predominantly older patients, suffering from an acute exacerbation of a chronic illness, to a randomized controlled trial of home telecare. Of 653 patients approached for study participation, after full assessment, 80% (519) met the trial eligibility criteria. Of these, 104 (20%) consented to study participation and 415 (80%) refused. A logistic regression model was constructed to examine independent effects of patient factors on probability of trial participation. Only two independent variables were associated with decreased likelihood of consent: increasing age (1 year older: odds ratio [OR] = 0.96); and being on inhaled steroid medication (OR = 0.60). The most common reason for refusal to participate, accounting for almost one-third of respondents, was a stated preference for a face-to-face nurse visiting service rather than a telecare service. Perhaps home telecare services should continue to be targeted at the more stable chronically ill population and not at those suffering from acute illness.
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Wilson R, Middleton M, Houlden J, Van Schaeybroeck S, Rolfo C, Elez E, Taieb J, André T, Bardelli A, Laurent-Puig P, Tabernero J, Peeters M, Maughan T, Roberts C, Love S, Lawler M, Salto-Tellez M, Grayson M, Popovici V, Di Nicolantonio F. MErCuRIC1: A phase 1a study of MEK1/2 inhibitor PD-0325901 with cMET inhibitor crizotinib in patients with advanced solid tumours. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hughes-Morley A, Hann M, Frasier C, Lovell K, Meade O, Young B, Roberts C, Cree L, More D, Bower P. OP78 Improving trial recruitment through improved communication about patient and public involvement: an embedded cluster randomised recruitment trial. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.78] [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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Lawley C, Lain S, Figtree G, Sholler G, Winlaw D, Roberts C. Hospital Readmissions and Costs in Children With a Cardiac Procedure in the First Year of Life. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.728] [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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Hughes M, Roberts C, Tracey A, Dinsdale G, Murray A, Herrick AL. Does the Clinical Context Improve the Reliability of Rheumatologists Grading Digital Ulcers in Systemic Sclerosis? Arthritis Care Res (Hoboken) 2016; 68:1340-5. [PMID: 26748825 PMCID: PMC5006886 DOI: 10.1002/acr.22833] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 12/01/2015] [Accepted: 01/05/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Digital ulcers (DUs) are often a primary end point in systemic sclerosis (SSc; scleroderma) clinical trials, although the reliability of rheumatologists grading DUs is poor to moderate at best. DU assessment in recent trials has been based upon visual inspection alone, which potentially misses "real-world" clinical contextual information. Our aim was to investigate whether this clinical information improves the reliability of rheumatologists grading DUs. A secondary aim was to assess agreement between patients and rheumatologists. METHODS Eighty images of a range of digital lesions were collected from patients with SSc with the clinical context: pain (severity and temporal relationship), lesion duration, and discharge (patient reported and clinician observed). Raters received all images either with or without the clinical context, and graded these images (using a custom-built interface) on an ordinal scale of severity: no ulcer, inactive ulcer, or active ulcer. Patients also graded their lesion(s) on the same scale. RESULTS Fifty-one rheumatologists from 15 countries completed the study (26 without and 25 with context): 4,590 (including 510 repeated) image gradings were obtained. Context did not significantly increase (without and with context) either intra- (0.64, 0.71) or interrater (0.32, 0.36) reliability. Pain (visual analog scale and temporal relationship) and discharge (patient reported and clinician observed) were associated with increased lesion severity, and duration with reduced severity. Agreement between individual patients and rheumatologists was poor without and with context (0.19, 0.28). CONCLUSION The overall intra- and interrater reliability of DU grading did not significantly improve with the clinical context. Agreement between patients and rheumatologists was poor.
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Abstract
The Information Management and Technology (IM&T) Strategy for the UK National Health Service (NHS) is one of systems integration with an emphasis on improved communications and data accessibility using a common operational system. This strategy is examined within the framework of strategic analysis. The suitability of the IM&T strategy, as applied to quality assurance in primary care, is discussed in terms of strategic logic, research evidence and cultural fit. Emerging technologies such as expert systems and the Internet, require further research evidence before considering their suitability for inclusion in an NHS wide strategy.
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Roberts C, Roberts GA, Löbner K, Bearzatto M, Clark A, Bonifacio E, Christie MR. Expression of the Protein Tyrosine Phosphatase-like Protein IA-2 During Pancreatic Islet Development. J Histochem Cytochem 2016; 49:767-76. [PMID: 11373323 DOI: 10.1177/002215540104900610] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A tyrosine phosphatase-like protein, IA-2, is a major autoantigen in Type 1 diabetes but its role in islet function is unclear. Tyrosine phosphorylation mediates regulation of cellular processes such as exocytosis, cell growth, and cell differentiation. To investigate the potential involvement of IA-2 in islet differentiation and insulin secretion, we analyzed by immunohistochemistry expression of IA-2 during islet development in fetal rats and during the maturation of insulin secretory responses after birth. In the fetus, IA-2 immunoreactivity was detected in primitive islets positive for insulin and glucagon at 12 days' gestation. Subsequently, IA-2 was only weakly detectable in the fetal pancreas. In neonatal rat, a progressive increase in IA-2 immunoreactivity was observed in islets from very low levels at 1 day of age to moderate labeling at 10 days. In the adult, relatively high levels of IA-2 were detected in islets, with heterogeneous expression in individual cells within each islet. IA-2 marks a population of endocrine cells that transiently appear early in pancreatic ontogeny. Islet IA-2 expression reappears after birth concomitant with the development of mature insulin secretory responses, consistent with a role for this protein in regulated hormone secretion.
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Hallingberg B, Fletcher A, Murphy S, Morgan K, Littlecott HJ, Roberts C, Moore GF. Do stronger school smoking policies make a difference? Analysis of the health behaviour in school-aged children survey. Eur J Public Health 2016; 26:964-968. [PMID: 27335332 PMCID: PMC5172489 DOI: 10.1093/eurpub/ckw093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Associations of the strength of school smoking policies with
cigarette, e-cigarette and cannabis use in Wales were examined. Methods:
Nationally representative cross-sectional survey of pupils aged 11–16 years
(N=7376) in Wales. Senior management team members from 67
schools completed questionnaires about school smoking policies, substance use
education and tobacco cessation initiatives. Multi-level, logistic regression
analyses investigated self-reported cigarette, e-cigarette and cannabis use, for all
students and those aged 15–16 years. Results: Prevalence of
current smoking, e-cigarette use and cannabis use in the past month were 5.3%,
11.5% and 2.9%, respectively. Of schools that provided details about
smoking policies (66/67), 39.4% were strong (written policy applied to
everyone in all locations), 43.9% were moderate (written policy not applied to
everyone in all locations) and 16.7% had no written policy. There was no
evidence of an association of school smoking policies with pupils’ tobacco or
e-cigarette use. However, students from schools with a moderate policy [OR =
0.47; 95% (confidence interval) CI: 0.26–0.84] were less likely to have
used cannabis in the past month compared to schools with no written policy. This
trend was stronger for students aged 15–16 years (moderate policy: OR =
0.42; 95% CI: 0.22–0.80; strong policy: OR = 0.45; 95% CI:
0.23–0.87). Conclusions: School smoking policies may exert less
influence on young people’s smoking behaviours than they did during times of
higher adolescent smoking prevalence. Longitudinal studies are needed to examine the
potential influence of school smoking policies on cannabis use and mechanisms
explaining this association.
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Dinsdale G, Moore T, O'Leary N, Manning J, Murray A, Berks M, Tresadern P, Allen J, Anderson M, Cutolo M, Hesselstrand R, Howell K, Pizzorni C, Pyrkotsch P, Smith V, Sulli A, Wildt M, Taylor C, Roberts C, Herrick A. FRI0530 Intra-and Inter-Observer Reliability of Nailfold Videocapillaroscopy – A Possible Outcome Measure for Systemic Sclerosis-Related Microangiopathy?: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2248] [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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Ranger A, Allaire N, Colman P, Wager C, Li H, Thai A, Cullen P, Otoul C, Czerkowicz J, Roberts C, Chamberlain C, Burkly L, Johnston G. OP0040 Peripheral Blood Transcriptional Changes Elicited by Treatment of Systemic Lupus Erythematosus (SLE) Patients with Dapirolizumab Pegol (A Pegylated Anti-CD40L Fab'). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1292] [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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Sivalingam VN, Kitson S, McVey R, Roberts C, Pemberton P, Gilmour K, Ali S, Renehan AG, Kitchener HC, Crosbie EJ. Measuring the biological effect of presurgical metformin treatment in endometrial cancer. Br J Cancer 2016; 114:281-9. [PMID: 26794276 PMCID: PMC4742583 DOI: 10.1038/bjc.2015.453] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/26/2015] [Accepted: 12/02/2015] [Indexed: 12/25/2022] Open
Abstract
Background: Preclinical studies in endometrial cancer (EC) show that metformin reduces cellular proliferation by PI3K-AKT-mTOR inhibition. We tested the hypothesis that short-term presurgical metformin reduces cellular proliferation in atypical endometrial hyperplasia (AEH) and endometrioid EC, and assessed the feasibility of using phosphorylated PI3K-AKT-mTOR proteins as tissue end points. Methods: Women with AEH or EC received metformin 850 mg twice a day or no drug in the presurgical window between diagnosis and hysterectomy. Before and after the window, tissue samples were obtained; serum markers of insulin resistance (e.g. homeostasis model of assessment of insulin resistance index) were determined; and anthropometrics measured (e.g. BMI). Cell proliferation (Ki-67) and PI3K-AKT-mTOR phosphostatus were assessed by immunohistochemistry and scored blinded to treatment. Results: Twenty-eight metformin-treated and 12 untreated patients, well matched for age and BMI, completed the study. Metformin treatment (median 20 days, range 7–34) was associated with a 17.2% reduction in tumour Ki-67 (95% CI −27.4, −7.0, P=0.002), in a dose-dependent manner. Tumour PI3K-AKT-mTOR protein phosphostatus varied but the effects were not significant after adjusting for changes in controls. Conclusions: Short-term metformin was associated with reduced Ki-67 expression in EC. Changes in tumour PI3K-AKT-mTOR protein phosphostatus were seen in both groups. Future studies should address the variability attributed to different sampling techniques including devascularisation of the uterus at hysterectomy.
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Heffernan SM, Kilduff LP, Erskine RM, Day SH, McPhee JS, McMahon GE, Stebbings GK, Neale JPH, Lockey SJ, Ribbans WJ, Cook CJ, Vance B, Raleigh SM, Roberts C, Bennett MA, Wang G, Collins M, Pitsiladis YP, Williams AG. Association of ACTN3 R577X but not ACE I/D gene variants with elite rugby union player status and playing position. Physiol Genomics 2016; 48:196-201. [PMID: 26757799 PMCID: PMC4929273 DOI: 10.1152/physiolgenomics.00107.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/07/2016] [Indexed: 12/30/2022] Open
Abstract
We aimed to quantify the ACE I/D and ACTN3 R577X (rs1815739) genetic variants in elite rugby athletes (rugby union and league) and compare genotype frequencies to controls and between playing positions. The rugby athlete cohort consisted of 507 Caucasian men, including 431 rugby union athletes that for some analyses were divided into backs and forwards and into specific positional groups: front five, back row, half backs, centers, and back three. Controls were 710 Caucasian men and women. Real-time PCR of genomic DNA was used to determine genotypes using TaqMan probes and groups were compared using χ2 and odds ratio (OR) statistics. Correction of P values for multiple comparisons was according to Benjamini-Hochberg. There was no difference in ACE I/D genotype between groups. ACTN3 XX genotype tended to be underrepresented in rugby union backs (15.7%) compared with forwards (24.8%, P = 0.06). Interestingly, the 69 back three players (wings and full backs) in rugby union included only six XX genotype individuals (8.7%), with the R allele more common in the back three (68.8%) than controls (58.0%; χ2 = 6.672, P = 0.04; OR = 1.60) and forwards (47.5%; χ2 = 11.768, P = 0.01; OR = 2.00). Association of ACTN3 R577X with playing position in elite rugby union athletes suggests inherited fatigue resistance is more prevalent in forwards, while inherited sprint ability is more prevalent in backs, especially wings and full backs. These results also demonstrate the advantage of focusing genetic studies on a large cohort within a single sport, especially when intrasport positional differences exist, instead of combining several sports with varied demands and athlete characteristics.
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McGrogan D, David M, Roberts C, Borman A, Nath J, Inston N, Mellor S. Pseudotumoral presentation of fungating mycetoma caused byPhaeoacremonium fuscumin a renal transplant patient. Transpl Infect Dis 2015; 17:897-903. [DOI: 10.1111/tid.12462] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/09/2015] [Accepted: 09/06/2015] [Indexed: 11/27/2022]
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Gwilliam B, Keeley V, Todd C, Gittens M, Roberts C, Kelly L, Barclay S, Stone P. Comparison of clinicians' and advanced cancer patients' estimates of survival. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2011-000020.53rep] [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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Ulloa JL, Morgan AR, Lacey T, Roberts C, Parker GJM. P284 V/Q scanning using oxygen-enhanced Magnetic Resonance Imaging. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.420] [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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Fletcher S, Waterman H, Nelson L, Carter L, Dwyer L, Roberts C, Torgerson D, Kitchener H. Holistic assessment of women with hyperemesis gravidarum: A randomised controlled trial. Int J Nurs Stud 2015. [DOI: 10.1016/j.ijnurstu.2015.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Wold B, Littlecott H, Tynjälä J, Samdal O, Moore L, Roberts C, Kannas L, Villberg J, Aarø LE. Changes from 1986 to 2006 in reasons for liking leisure-time physical activity among adolescents. Scand J Med Sci Sports 2015. [PMID: 26220306 DOI: 10.1111/sms.12528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reasons for participating in physical activity (PA) may have changed in accordance with the general modernization of society. The aim is to examine changes in self-reported reasons for liking leisure-time physical activity (LTPA) and their association with self-reported LTPA over a 20-year period. Data were collected among nationally representative samples of 13-year-olds in Finland, Norway, and Wales in 1986 and 2006 (N = 9252) as part of the WHO cross-national Health Behaviour in School-aged Children (HBSC) study. Univariate ANOVAs to establish differences according to gender, year, and country were conducted. In all countries, 13-year-olds in 2006 tended to report higher importance in terms of achievement and social reasons than their counterparts in 1986, while changes in health reasons were minor. These reasons were associated with LTPA in a similar way at both time points. Health reasons for liking LTPA were considered most important, and were the strongest predictor of LTPA. The findings seem robust as they were consistent across countries and genders. Health education constitutes the most viable strategy for promoting adolescents' motivation for PA, and interventions and educational efforts could be improved by an increased focus on LTPA and sport as a social activity.
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Roberts C, Guillard G, Bowes M, O'Connor R, Maguire N, Morgan A, Parker G, Hodgson R, Vital E, Bird P, Vincent G, Emery P, Conaghan P. SAT0601 A Novel, Fully 3-Dimensional Dynamic Contrast MRI Method in the Hand Reveals Details of Synovial Inflammation and Provides a Sensitive Measure of Change. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6400] [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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Lawley C, Lain S, Algert C, Sholler G, Winlaw D, Roberts C, Figtree G. An exploration of the health outcomes of children who have undergone a cardiac procedure in the first year of life. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Goodall M, Barton GR, Bower P, Byrne P, Cade JE, Capewell S, Cleghorn CL, Kennedy LA, Martindale AM, Roberts C, Woolf S, Gabbay MB. Food for thought: pilot randomized controlled trial of lay health trainers supporting dietary change to reduce cardiovascular disease in deprived communities. J Public Health (Oxf) 2014; 36:635-43. [PMID: 24277778 DOI: 10.1093/pubmed/fdt112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) accounts for 30% of UK deaths. It is associated with modifiable lifestyle factors, including insufficient consumption of fruit and vegetables (F&V). Lay health trainers (LHTs) offer practical support to help people develop healthier behaviour and lifestyles. Our two-group pilot randomized controlled trial (RCT) investigated the effectiveness of LHTs at promoting a heart-healthy lifestyle among adults with at least one risk factor for CVD to inform a full-scale RCT. METHODS Eligible adults (aged 21-78 years), recruited from five practices serving deprived populations, were randomized to health information leaflets plus LHTs' support for 3 months (n = 76) versus health information leaflets alone (n = 38). RESULTS We recruited 114 participants, with 60% completing 6 month follow-up. Both groups increased their self-reported F&V consumption and we found no evidence for LHTs' support having significant added impact. Most participants were relatively less deprived, as were the LHTs we were able to recruit and train. CONCLUSIONS Our pilot demonstrated that an LHT's RCT whilst feasible faces considerable challenges. However, to justify growing investment in LHTs, any behaviour changes and sustained impact on those at greatest need should be demonstrated in an independently evaluated, robust, fully powered RCT.
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Green J, Biehal N, Roberts C, Dixon J, Kay C, Parry E, Rothwell J, Roby A, Kapadia D, Scott S, Sinclair I. Authors' reply. Br J Psychiatry 2014; 205:498-9. [PMID: 25452605 DOI: 10.1192/bjp.205.6.498b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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