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Oakeshott P, Kerry-Barnard S, Fleming C, Phillips R, Drennan VM, Adams EJ, Majewska W, Harding-Esch EM, Cousins EC, Planche T, Green A, Bartholomew RI, Sadiq ST, Reid F. 'Test n Treat' (TnT): a cluster randomized feasibility trial of on-site rapid Chlamydia trachomatis tests and treatment in ethnically diverse, sexually active teenagers attending technical colleges. Clin Microbiol Infect 2018; 25:865-871. [PMID: 30391581 DOI: 10.1016/j.cmi.2018.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES We conducted a cluster-randomized feasibility trial of 90-minute Chlamydia trachomatis tests and same day on-site treatment ('Test n Treat/TnT') in six technical colleges in London, England, to assess TnT uptake rates; follow-up rates; prevalence of C. trachomatis at baseline and 7 months; time to treatment; acceptability of TnT. METHODS Participants completed questionnaires and provided genitourinary samples at baseline and 7 months. Participants were informed that baseline samples would not be tested for 7 months and were advised to get screened independently. Colleges were randomly allocated 1:1 to intervention (TnT) or control (no TnT). One month and 4 months post recruitment, participants at intervention colleges were texted invitations for on-site free C. trachomatis tests. A purposive sample of students who did/did not attend for screening were interviewed (n = 26). RESULTS Five hundred and nine sexually active students were recruited: median age 17.9 years, 47% male, 50% black ethnicity, 55% reporting two or more sexual partners in the previous year. TnT uptake was 13% (33/259; 95% CI 8.9-17.4%) at 1 month and 10% (26/259; 6.7-14.4%) at 4 months with overall C. trachomatis positivity 5.1% (3/59; 1.1-14.2%). Follow-up at 7 months was 62% (317/509) for questionnaires and 52% (264/509) for samples. C. trachomatis prevalence was 6.2% (31/503) at baseline and 6.1% (16/264) at 7 months. Median time from test to treatment was 15 h. Interviews suggested low test uptake was associated with not feeling at risk, perceptions of stigma, and little knowledge of sexually transmitted infections (STIs). CONCLUSIONS Despite high C. trachomatis rates at baseline and follow-up, uptake of testing was low. Like many countries, England urgently needs better sex education, including making STI testing routine/normal. Trial registration ISRCTN58038795.
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Vasquez Osorio E, Aznar M, Green A, Faivre-Finn C, Van Herk M, McWilliam A. P1.17-01 Robustness of an Image-Based Data Mining Approach in Lung Cancer Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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78
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Brønserud M, Iachina M, Green A, Grønvold M, Jakobsen E. P3.15-05 Patient Reported Outcomes (PROs) as Performance Measures After Surgery for Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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79
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Udyavar R, Smink DS, Mullen JT, Kent TS, Green A, Harlow AF, Castillo-Angeles M, Columbus AB, Haider AH. Qualitative Analysis of a Cultural Dexterity Program for Surgeons: Feasible, Impactful, and Necessary. JOURNAL OF SURGICAL EDUCATION 2018; 75:1159-1170. [PMID: 29456075 DOI: 10.1016/j.jsurg.2018.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/19/2017] [Accepted: 01/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Ineffective cross-cultural communication contributes to adverse outcomes for minority patients. To address this, the authors developed a novel curriculum for surgical residents built on the principle of cultural dexterity, emphasizing adaptability to clinical and sociocultural circumstances to tailor care to the needs of the individual patient. This study's objective was to evaluate the feasibility, acceptability, and perception of this program upon conclusion of its first year. DESIGN, SETTING, AND PARTICIPANTS The curriculum was implemented at 3 general surgery programs. The flipped classroom model combined independent study via e-learning modules with interactive role-playing sessions. Sessions took place over 1 academic year. Four focus groups were held, each with 6 to 9 participants, to gain feedback on the curriculum. Focus groups were recorded and transcribed, and the data were analyzed using a grounded theory approach. RESULTS Five major themes emerged: (1) Role modeling from senior colleagues is integral in developing communication/interpersonal skills and attitudes toward cultural dexterity. (2) Cultural dexterity is relevant to the provision of high-quality surgical care. (3) Barriers to providing culturally dexterous care exist at the system level. (4) "Buy-in" at all levels of the institution is necessary to implement the principles of cultural dexterity. (5) The shared experience of discussing the challenges and triumphs of caring for a diverse population was engaging and impactful. CONCLUSION Early implementation of the curriculum revealed that the tension between surgical residents' desire to improve their cultural dexterity and systemic/practical obstacles can be resolved. Combining surgically relevant didactic materials with experiential learning activities can change the paradigm of cross-cultural training.
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Svensson A, Haugaa KH, Zareba W, Jensen HK, Bundgaard H, Gilljam T, Madsen T, Hansen J, Karlsson L, Green A, Polonsky B, Edvardsen T, Svendsen JH, Gunnarsson C, Platonov PG. P688Genetic variant score predicts cardiac events in arrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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81
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Green A. GDC v the dental profession. Br Dent J 2018; 225:198-199. [DOI: 10.1038/sj.bdj.2018.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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82
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Strain WD, Hope SV, Green A, Kar P, Valabhji J, Sinclair AJ. Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabet Med 2018; 35:838-845. [PMID: 29633351 DOI: 10.1111/dme.13644] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 12/25/2022]
Abstract
Rates of population ageing are unprecedented and this, combined with the progressive urbanization of lifestyles, has led to a dramatic shift in the epidemiology of diabetes towards old age, particularly to those aged 60-79 years. Both ageing and diabetes are recognized as important risk factors for the development of functional decline and disability. In addition, diabetes is associated with a high economic, social and health burden. Traditional macrovascular and microvascular complications of diabetes appear to account for less than half of the diabetes-related disability observed in older people. Despite this, older adults are under-represented in clinical trials. Guidelines from organizations such as the National Institute for Health and Care Excellence (NICE), the European Association for the Study of Diabetes, and the American Diabetes Association acknowledge the need for individualized care, but the glycaemic targets that are suggested to constitute good control [HbA1c 53-59 mmol/mol (7-7.5%)] are too tight for frail older individuals. We present a framework for the assessment of older adults and guidelines for the management of this population according to their frailty status, with the intention of reducing complications and improving quality of life for these people.
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Ali R, Al-kawaz A, Toss M, Green A, Miligy I, Mesquita KA, Seedhouse C, Mirza S, Rakha E, Madhusudan S. PO-014 Targeting PARP1 in XRCC1 deficient sporadic invasive breast cancer or pre-invasive ductal carcinoma in situ for synthetic lethality and chemoprevention. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.59] [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] Open
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84
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Green A, Cohen-Zion M, Dagan Y, Haim A. 0192 Sleep and Exposure to Screens of Digital Media Devices in Israel. Sleep 2018. [DOI: 10.1093/sleep/zsy061.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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85
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Green A, Kemer L, Dagan Y, Cohen-Zion M. 0729 Functional Consequences of Light Treatment in Healthy Older Adults living in Residential Facility: A Naturalistic Study. Sleep 2018. [DOI: 10.1093/sleep/zsy061.728] [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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86
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Vasquez Osorio E, Aznar M, McWilliam A, Cobben D, Green A, Van Herk M. PO-0906: Robust breast VMAT plan optimisation accounting for breast swelling and positional changes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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87
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Beasley W, Green A, McWilliam A, Vasquez Osorio E, Aznar M, Van Herk M. EP-2000: Image-based data mining with continuous outcome variables. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32309-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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88
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Green A, McWilliam A, Vasquez-Osorio E, Beasley W, Van Herk M. EP-2008: Image based data mining using per-voxel Cox regression. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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89
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Miligy I, Gaber A, Toss M, Hamad A, Nolan C, Diez-Rodriguez M, Ellis I, Green A, Rakha E. Aurora Kinase A (AURKA) is an independent predictor of recurrence in breast ductal carcinoma in situ (DCIS). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy047.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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90
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Dafkin C, Green A, Olivier B, McKinon W, Kerr S. Circadian variation of flexor withdrawal and crossed extensor reflexes in restless legs syndrome. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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91
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Dafkin C, McKinon W, Green A, Olivier B, Kerr S. Plantar reflex excitability fluctuations in restless legs syndrome patients. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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92
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Green A, Cohen-Zion M, Haim A, Dagan Y. Comparing the response to acute and chronic exposure to short wavelength lighting emitted from computer screens. Chronobiol Int 2017; 35:90-100. [DOI: 10.1080/07420528.2017.1387555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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93
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Blomberg M, He SY, Harwood C, Arron ST, Demehri S, Green A, Asgari MM. Research gaps in the management and prevention of cutaneous squamous cell carcinoma in organ transplant recipients. Br J Dermatol 2017; 177:1225-1233. [PMID: 29086412 PMCID: PMC5711582 DOI: 10.1111/bjd.15950] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 12/13/2022]
Abstract
Although tremendous progress has been made in recent years in skin cancer care for organ transplant recipients, significant gaps remain in data-driven clinical guidelines, particularly for the treatment and prevention of cutaneous squamous cell carcinoma (cSCC), the most common malignancy among this population. In this review, we aim to summarize current knowledge around the management of cSCC and highlight the most significant gaps in knowledge that continue to pose challenges in the delivery of skin cancer care for organ transplant recipients. We suggest future directions for research that will bridge existing gaps and establish evidence-driven guidelines for primary prevention, screening and treatment of cSCC in this high-risk patient population.
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Green A, Kerr S, Olivier B, Meiring R, Dafkin C, McKinon W. A simulated rugby match protocol induces physiological fatigue without decreased individual scrummaging performance. SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2017. [DOI: 10.17159/2078-516x/2017/v29i1a3084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: A rugby union game consists of 80 minutes of strenuous exertion. Forwards are required to participate in the arduous activity of scrummaging throughout a game.Objectives: The purpose of this study was to identify whether rugby-match simulated fatigue modified individual scrummaging technique and reduced performance.Methods: Twelve forwards (body mass 106.2±13.3 kg; stature 179.5±8.4 cm) had individual scrum kinetics and kinematics assessed prior to and following a protocol that simulated a rugby match. The simulated rugby match protocol required participants to run at various velocities and perform rugby specific tasks. Rating of Perceived Exertion (RPE) was assessed using a 6-20 Borg scale and Visual Analogue Scale (VAS). Blood lactate, heart rate and RPE were measured prior to, at mid-point and after the simulated game, while markers of muscle damage (blood creatine kinase activity (CK) and urea) were measured prior to and following the protocol.Results: RPE (p<0.0001) and VAS (p<0.0001) showed significant increases between the pre- and post-simulation values. Of the physiological markers, heart rate (p<0.0001) and blood urea concentration (p=0.004) increased following the match simulation. No significant differences were observed for blood CK (p=0.281), individual scrummaging forces (p=0.433) or in the kinematic variables following the protocol. While physiological fatigue and subjective ratings of physiological fatigue may develop during a rugby simulation, no differences were observed in peak forces or in body kinematics at peak force.Conclusion: Physiological fatigue does not influence individual scrummaging performance and technique.
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Beasley W, Thor M, McWilliam A, Green A, Mackay R, Slevin N, Olsson C, Pettersson N, Finizia C, Deasy J, van Herk M. Image-Based Data Mining for Identifying Regions Exhibiting a Dose-Response Relationship with Radiation-Induced Trismus. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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96
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Lowenstein S, Garrett G, Toland A, Jambusaria‐Pahlajani A, Asgari M, Green A, Engels E, Arron S. Risk prediction tools for keratinocyte carcinoma after solid organ transplantation: a review of the literature. Br J Dermatol 2017; 177:1202-1207. [DOI: 10.1111/bjd.15889] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2017] [Indexed: 01/21/2023]
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97
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Duvnjak S, Ravn P, Green A, Andersen P. Assessment of uterine fibroid infarction after embolization with tris-acryl gelatin microspheres. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1360543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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98
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Green A, Tatham KC, Yentis SM, Wilson J, Cox M. An analysis of the delivery of anaesthetic training sessions in the United Kingdom. Anaesthesia 2017; 72:1327-1333. [DOI: 10.1111/anae.13950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2017] [Indexed: 11/29/2022]
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99
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Green A, Cohen-Zion M, Haim A, Dagan Y. Evening light exposure to computer screens disrupts human sleep, biological rhythms, and attention abilities. Chronobiol Int 2017; 34:855-865. [DOI: 10.1080/07420528.2017.1324878] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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100
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Green A, Cohen-Zion M, Haim A, Dagan Y. 0062 EVENING LIGHT EXPOSURE FROM COMPUTER SCREENS DISRUPTS SLEEP, BIOLOGICAL RHYTHMS, AND ATTENTION ABILITIES. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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