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Smith KE, Cowan L, Taylor B, McAusland L, Heatley M, Yant L, Murchie EH. Physiological adaptation to irradiance in duckweeds is species and accession specific and depends on light habitat niche. J Exp Bot 2024; 75:2046-2063. [PMID: 38217537 DOI: 10.1093/jxb/erad499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
Duckweeds span 36 species of free-floating aquatic organisms with body sizes ranging from 2 mm to 10 mm, where each plant body plan is reduced to a largely leaf-like structure. As an emerging crop, their fast growth rates offer potential for cultivation in closed systems. We describe a novel UK collection derived from low light (dLL) or high light (dHL) habitats, profiled for growth, photosynthesis, and photoprotection (non-photochemical quenching, NPQ) responses. Twenty-three accessions of three Lemna species and one Spirodela polyrhiza were grown under relatively low light (LL: 100 μmol m-2 s-1) and high light (HL: 350 μmol m-2 s-1) intensities. We observed broad within- and between-species level variation in photosynthesis acclimation. Duckweeds grown under HL exhibited a lower growth rate, biomass, chlorophyll, and quantum yield of photosynthesis. In HL compared with LL, carotenoid de-epoxidation state and NPQ were higher, whilst PSII efficiency (φPSII) and Chl a:b ratios were unchanged. The dLL plants showed relatively stronger acclimation to HL compared with dHL plants, especially Lemna japonica accessions. These achieved faster growth in HL with concurrent higher carotenoid levels and NPQ, and less degradation of chlorophyll. We conclude that these data support local adaptation to the light environment in duckweed affecting acclimation in controlled conditions.
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Affiliation(s)
- Kellie E Smith
- Division of Plant and Crop Sciences, School of Biosciences, University of Nottingham, Sutton Bonington LE12 5RD, UK
- School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Laura Cowan
- School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Beth Taylor
- Division of Plant and Crop Sciences, School of Biosciences, University of Nottingham, Sutton Bonington LE12 5RD, UK
| | - Lorna McAusland
- Division of Plant and Crop Sciences, School of Biosciences, University of Nottingham, Sutton Bonington LE12 5RD, UK
| | - Matthew Heatley
- School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Levi Yant
- School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Erik H Murchie
- Division of Plant and Crop Sciences, School of Biosciences, University of Nottingham, Sutton Bonington LE12 5RD, UK
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Robertson S, King R, Taylor B, Laker S, Wood E, Senek M, Tod A, Ryan T. Trainee nursing associates in England: A multisite qualitative study of higher education institution perspectives. Int Nurs Rev 2024; 71:130-139. [PMID: 37534431 DOI: 10.1111/inr.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
AIM To explore the experiences of university employees on the development and implementation of the nursing associate programme. BACKGROUND As part of wider policy initiatives to address workforce shortages, provide progression for healthcare assistants and offer alternative routes into nursing, England recently introduced the nursing associate level of practice. Little research has yet considered university perspectives on this new programme. METHODS An exploratory qualitative study reported following COREQ criteria. Twenty-seven university staff working with trainee nursing associates in five universities across England were recruited. Data, collected via semi-structured interviews from June to September 2021, were analysed through a combined framework and thematic analysis. RESULTS Three themes developed: 'Centrality of partnerships' considered partnerships between employers and universities and changing power dynamics. 'Adapting for support' included responding to new requirements and changing pedagogical approaches. 'Negotiating identity' highlighted the university's role in advocacy and helping trainees develop a student identity. CONCLUSIONS Nursing associate training in England has changed the dynamics between universities and healthcare employers, shifting learners' identity more to 'employee' rather than 'student'. Universities have adapted to support trainees in meeting academic and professional standards whilst also meeting employer expectations. While challenges remain, the ability of nurse educators to make adjustments, alongside their commitment to quality educational delivery, is helping establish this new training programme and thereby meet government policy initiatives. IMPLICATIONS FOR NURSING POLICY The international movement of apprenticeship models in universities has the potential to change the status of the learner in nursing educational contexts. National policies that encourage this model should ensure that the implications and challenges this change of status brings to learners, employers and education institutions are fully considered prior to their implementation.
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Affiliation(s)
- Steve Robertson
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
- Leeds Beckett University, Leeds, UK
| | - Rachel King
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
| | - Beth Taylor
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
| | - Sara Laker
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
- Department of Nursing, Winona State University, Winona, Minnesota, USA
| | - Emily Wood
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
| | - Michaela Senek
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
| | - Angela Tod
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
| | - Tony Ryan
- RCN Strategic Research Alliance, Division of Nursing and Midwifery, Health Sciences School, Sheffield, UK
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Davies TW, Kelly E, van Gassel RJJ, van de Poll MCG, Gunst J, Casaer MP, Christopher KB, Preiser JC, Hill A, Gundogan K, Reintam-Blaser A, Rousseau AF, Hodgson C, Needham DM, Schaller SJ, McClelland T, Pilkington JJ, Sevin CM, Wischmeyer PE, Lee ZY, Govil D, Chapple L, Denehy L, Montejo-González JC, Taylor B, Bear DE, Pearse RM, McNelly A, Prowle J, Puthucheary ZA. A systematic review and meta-analysis of the clinimetric properties of the core outcome measurement instruments for clinical effectiveness trials of nutritional and metabolic interventions in critical illness (CONCISE). Crit Care 2023; 27:450. [PMID: 37986015 PMCID: PMC10662687 DOI: 10.1186/s13054-023-04729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND CONCISE is an internationally agreed minimum set of outcomes for use in nutritional and metabolic clinical research in critically ill adults. Clinicians and researchers need to be aware of the clinimetric properties of these instruments and understand any limitations to ensure valid and reliable research. This systematic review and meta-analysis were undertaken to evaluate the clinimetric properties of the measurement instruments identified in CONCISE. METHODS Four electronic databases were searched from inception to December 2022 (MEDLINE via Ovid, EMBASE via Ovid, CINAHL via Healthcare Databases Advanced Search, CENTRAL via Cochrane). Studies were included if they examined at least one clinimetric property of a CONCISE measurement instrument or recognised variation in adults ≥ 18 years with critical illness or recovering from critical illness in any language. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for systematic reviews of Patient-Reported Outcome Measures was used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in line with COSMIN guidance. The COSMIN checklist was used to evaluate the risk of bias and the quality of clinimetric properties. Overall certainty of the evidence was rated using a modified Grading of Recommendations, Assessment, Development and Evaluation approach. Narrative synthesis was performed and where possible, meta-analysis was conducted. RESULTS A total of 4316 studies were screened. Forty-seven were included in the review, reporting data for 12308 participants. The Short Form-36 Questionnaire (Physical Component Score and Physical Functioning), sit-to-stand test, 6-m walk test and Barthel Index had the strongest clinimetric properties and certainty of evidence. The Short Physical Performance Battery, Katz Index and handgrip strength had less favourable results. There was limited data for Lawson Instrumental Activities of Daily Living and the Global Leadership Initiative on Malnutrition criteria. The risk of bias ranged from inadequate to very good. The certainty of the evidence ranged from very low to high. CONCLUSIONS Variable evidence exists to support the clinimetric properties of the CONCISE measurement instruments. We suggest using this review alongside CONCISE to guide outcome selection for future trials of nutrition and metabolic interventions in critical illness. TRIAL REGISTRATION PROSPERO (CRD42023438187). Registered 21/06/2023.
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Affiliation(s)
- T W Davies
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK.
- Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK.
| | - E Kelly
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
- Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - R J J van Gassel
- Department of Intensive Care Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - M C G van de Poll
- Department of Intensive Care Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - J Gunst
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - M P Casaer
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - K B Christopher
- Division of Renal Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - J C Preiser
- Medical Direction, Erasme University Hospital, Universite Libre de Bruxelles, Brussels, Belgium
| | - A Hill
- Department of Intensive Care Medicine, University Hospital RWTH, 52074, Aachen, Germany
- Department of Anesthesiology, University Hospital RWTH, 52074, Aachen, Germany
| | - K Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - A Reintam-Blaser
- Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia
- Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - A-F Rousseau
- Department of Intensive Care, University Hospital of Liège, Liege, Belgium
| | - C Hodgson
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 3/553 St Kilda Rd, Melbourne, VIC, 3004, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - D M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA
- Pulmonary and Critical Care Medicine, Department of Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S J Schaller
- Department of Anesthesiology and Intensive Care Medicine (CVK, CCM), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - T McClelland
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
- Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - J J Pilkington
- Centre for Bioscience, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, UK
| | - C M Sevin
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - P E Wischmeyer
- Department of Anesthesiology, Duke University School of Medicine, DUMC, Box 3094 Mail # 41, 2301 Erwin Road, Durham, NC, 5692 HAFS27710, USA
| | - Z Y Lee
- Department of Anesthesiology, University of Malaya, Kuala Lumpur, Malaysia
- Department of Cardiac, Anesthesiology & Intensive Care Medicine, Charité, Berlin, Germany
| | - D Govil
- Institute of Critical Care and Anesthesia, Medanta: The Medicty, Gurugram, Haryana, India
| | - L Chapple
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - L Denehy
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Allied Health, Peter McCallum Cancer Centre, Melbourne, Australia
| | - J C Montejo-González
- Instituto de Investigación I+12, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - B Taylor
- Department of Research for Patient Care Services, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - D E Bear
- Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R M Pearse
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
- Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - A McNelly
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
| | - J Prowle
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
- Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - Z A Puthucheary
- Faculty of Medicine & Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
- Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
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Sim VR, Gupta M, Taylor B, Mullassery V, Winship A, Chan K, Galante J, White I. Single Institute Experience Treating Uterine Carcinosarcoma: Outcome Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e543-e544. [PMID: 37785677 DOI: 10.1016/j.ijrobp.2023.06.1840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Uterine carcinosarcoma (UCS) is rare with a poor prognosis. We report over 10 years' experience, reporting prognostic and predictive factors for overall survival (OS) and disease-free survival (DFS). MATERIALS/METHODS Patient, tumor, treatment and relapse characteristics of 168 women with stages I-IVB UCS treated at our institute between 2010 and 2020 were analyzed. OS and DFS at 2 and 5 years were the primary outcomes, estimated with Kaplan-Meier. The benefit of adjuvant chemotherapy and radiotherapy in the curative cohort was estimated using the log rank test. RESULTS Median follow up was 23 months (range 1-137 months). 34% had FIGO stage IA disease, 10% IB, 8% II. 16% IIIA-IIIC1, and 10% IIIC2 and 22% IVB. The overall 2-year OS was 52% and 5-year OS 30%. 2-year OS by FIGO stage were: IA 66%; IB 63%; II 54%; IIIA-IIIC1 54%; IIIC2 45%; IVB 26%. Within the curative cohort who were surgically staged, 2-year DFS was 47% and 5-year was 30%. 2-year DFS were 61% in IA disease, 53% IB, 12% II, 51% IIIA-IIIC1, and 45% IIIC2 and 4% IVB. A greater risk of death was conferred by lack of adjuvant treatment (lack of chemo > lack of radiotherapy). The most common chemotherapy regimen used was Carboplatin Paclitaxel and pelvic radiotherapy 45Gy 25F over 5 weeks. The combination of surgery and chemotherapy +/- radiotherapy significantly improved OS compared to surgery +/- radiotherapy (HR 0.5 with CI 0.3 - 0.9) p<0.05. Radiotherapy improved OS compared to surgery only (HR 0.4 with CI 0.2 - 1.1) p<0.05. Relapse rate in all patients following curative treatment is 72% within year 1 and 86% within year 2 from diagnosis. In 52 patients with stage 1A disease treated with surgery +/- radiotherapy only, 42.4% relapsed, median time to relapse was 8 months from diagnosis. Relapse occurred despite 69.2 % stage 1A patients receiving adjuvant pelvic EBRT and in these patients relapse within the pelvis occurred in 50%. CONCLUSION This study constitutes the largest retrospective analyses of long-term mortality outcomes in UCS and confirms poor outcomes despite curative surgery and adjuvant therapy. Most patients relapse within the first year following curative treatment. The use of adjuvant chemotherapy improves OS in all stages. In stage 1A disease 42 % patients relapse locally and distantly. This is an area of controversy and this data would strongly suggest that the addition of adjuvant paclitaxel-carboplatin or cisplatin-doxorubicin chemotherapy to EBRT should be considered in all patients including earliest stage disease.
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Affiliation(s)
- V R Sim
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - M Gupta
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - B Taylor
- Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - V Mullassery
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - A Winship
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - K Chan
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - J Galante
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - I White
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
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Cooper S, Gupta M, Sim VR, Mullasery V, Winship A, Taylor B, White I. Single Institute Experience with MRI-Guided Adaptive Brachytherapy for Locally Advanced Cervix Cancer: Long Term Outcomes and Toxicity Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e508. [PMID: 37785591 DOI: 10.1016/j.ijrobp.2023.06.1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We report over 10 years' experience of MRI-guided adaptive brachytherapy (MRIGABT) in locally advanced cervix cancer (LACC). MATERIALS/METHODS A total of 162 patients with LACC FIGO stage IB-IVB were treated at our institute between 2010 and 2020. Treatment consisted of chemoradiotherapy (weekly intravenous cisplatin 40 mg/m², 5 cycles, 1 day per cycle, 45-50.4 Gy external beam radiotherapy (EBRT) in 1·8-2 Gy fractions, followed by MRIGABT. Target volume definition and dose reporting for MRIGABT was according to GEC-ESTRO recommendations. MRIGABT dose prescription was according to our institutional practice. Overall survival (OS) and disease-free survival (DFS) were the primary endpoints. Kaplan-Meier estimates were calculated for OS and DFS at 2, 5 and 10-years. Organ-specific late toxicity grade ≥3 (≥G3) (CTCAEv5.0) was reported, alongside rates of bowel fistula, stricture, and perforation. Using logistic regression, we explored the relationship between EQD2 D2cc bladder and ≥G3 genitourinary (GU) toxicity. We compared patient proportions developing ≥ G3 GU toxicity in those who received EQD2 ≥85 Gy versus <85 Gy. We examined the following predictors of ≥G3 gastrointestinal (GI) toxicity: EQD2 dose (≥65 Gy versus <65 Gy), pre-existing bowel conditions, nodal boost, and extended field EBRT. RESULTS Median follow up was 4.7 years (IQR 3.3-7.1 years). Median EBRT dose was 50.4 Gy (IQR 50.4-50.4 Gy); 91% received chemotherapy. Median high-risk clinical target volume (HRCTV) was 23.6 cm3 (IQR 16.6-31.3 cm3). Median doses were as follows; D90 HRCTV 88.9 Gy EQD210 (IQR 84.1-91.3 Gy), median D2cc bladder 81.6 (IQR 76.9-85.7 Gy), rectum 62.2 (IQR 57.9-65.3 Gy), sigmoid 67.4 (IQR 60.8-71.1 Gy), and bowel 55 (IQR 49.9-63.2 Gy), (all EQD23). The 2, 5 and-10-year OS were 98%, 80% and 75%. The 2, 5 and 10-year DFS were 98%, 75% and 60%. Late toxicity ≥G3 was 9% GU, 6% GI and 3% vaginal. There was a significant relationship between EQD2 and ≥G3 GU toxicity (OR: 1.11, 95% CI: 1.01-1.25; P = 0.04). When comparing those who received EQD2≥ 85Gy versus <85Gy, higher doses were associated with a greater proportion of ≥G3 GU toxicity (13% vs 6%). No significant predictors of ≥ G3 GI toxicity were observed. CONCLUSION We observed excellent LC and OS. A significant relationship was found between EQD2 >85 Gy and bladder toxicity, although ≥G3 toxicity was low. We did not identify predictors of bowel toxicity. New predictors of bowel toxicity are required. Mean EBRT dose, D1.0 cc rectum, sigmoid and bowel are being investigated further.
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Affiliation(s)
- S Cooper
- Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - M Gupta
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - V R Sim
- Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - V Mullasery
- Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - A Winship
- Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - B Taylor
- Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - I White
- Guy's and St Thomas' NHS Trust, London, United Kingdom
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Marshall AP, Van Scoy LJ, Chaboyer W, Chew M, Davidson J, Day AG, Martinez A, Patel J, Roberts S, Skrobik Y, Taylor B, Tobiano G, Heyland DK. A randomised controlled trial of a nutrition and a decision support intervention to enable partnerships with families of critically ill patients. J Clin Nurs 2023; 32:6723-6742. [PMID: 37161555 DOI: 10.1111/jocn.16752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/14/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
AIMS AND OBJECTIVES The aim of the study was to investigate the effect of supporting family members to partner with health professionals on nutrition intakes and decision-making and to evaluate intervention and study feasibility. BACKGROUND Family partnerships can improve outcomes for critically ill patients and family members. Interventions that support families to engage with health professionals require evaluation. DESIGN A multi-centre, randomised, parallel group superiority Phase II randomised controlled trial. METHODS In nine intensive care units (ICUs) across three countries, critically ill patients ≥60 years, or those 55-59 years with advanced chronic diseases and expected ICU length of stay >72 h and their family member were enrolled between 9 May 2017 and 31 March 2020. Participants were randomised (1:1:1) to either a decision support or nutrition optimisation family-centred intervention, or usual care. Primary outcomes included protein and energy intake during ICU and hospital stay (nutrition intervention) and family satisfaction (decision support). Study feasibility was assessed as a composite of consent rate, intervention adherence, contamination and physician awareness of intervention assignment. RESULTS We randomised 135 patients/family members (consent rate 51.7%). The average rate of randomisation was 0.5 (0.13-1.53) per month. Unavailability (staff/family) was the major contributor to families not being approached for consent. Declined consent was attributed to families feeling overwhelmed (58/126, 46%). Pandemic visitor restrictions contributed to early study cessation. Intervention adherence for the decision support intervention was 76.9%-100.0% and for the nutrition intervention was 44.8%-100.0%. Nutritional adequacy, decisional conflict, satisfaction with decision-making and overall family satisfaction with ICU were similar for all groups. CONCLUSIONS Active partnerships between family members and health professionals are important but can be challenging to achieve in critical care contexts. We were unable to demonstrate the efficacy of either intervention. Feasibility outcomes suggest further refinement of interventions and study protocol may be warranted. RELEVANCE TO CLINICAL PRACTICE Interventions to promote family partnerships in critical illness are needed but require a greater understanding of the extent to which families want and are able to engage and the activities in which they have most impact. REPORTING METHOD This study has been reported following the Consolidated Standards of Reporting Trials (CONSORT) and the Template for Intervention Description and Replication (TIDieR) guidelines. PATIENT OR PUBLIC CONTRIBUTION Patients and caregivers were engaged in and contributed to the development and subsequent iterations of the two family-centred interventions use in this study. CLINICAL TRIAL REGISTRATION NUMBER Trial registration. CLINICALTRIALS gov, ID: NCT02920086. Registered on 30 September 2016. First patient enrolled on 9 May 2017 https://clinicaltrials.gov/ct2/results?cond=&term=NCT02920086&cntry=&state=&city=&dist=.
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Affiliation(s)
- Andrea P Marshall
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- Intensive Care Unit, Gold Coast Health, Southport, Queensland, Australia
| | - Lauren J Van Scoy
- Department of Medicine, Humanities, and Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Wendy Chaboyer
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Mary Chew
- Phoenix VA Healthcare System, Phoenix, Arizona, USA
| | - Judy Davidson
- San Diego Health, University of California, San Diego, California, USA
| | - Andrew G Day
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
| | - Angelly Martinez
- Intensive Care Unit, Gold Coast Health, Southport, Queensland, Australia
| | - Jayshil Patel
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shelley Roberts
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- Gold Coast Health, Southport, Queensland, Australia
| | - Yoanna Skrobik
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Beth Taylor
- Barnes Jewish Hospital, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Georgia Tobiano
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- Gold Coast Health, Southport, Queensland, Australia
| | - Daren K Heyland
- Department of Critical Care Medicine, Queens's University, Kingston, Ontario, Canada
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Tymkew H, Taylor B, Vyers K, Costantinou E, Arroyo C, Schallom M. Original Research: Patient Perception of Fall Risk in the Acute Care Setting. Am J Nurs 2023; 123:20-25. [PMID: 37166161 DOI: 10.1097/01.naj.0000937184.96893.a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE Hospitals are implementing a variety of fall prevention programs to reduce the fall rates of hospitalized patients. But if patients don't perceive themselves to be at risk for falling and don't adhere to fall prevention strategies, such programs are likely to be less effective. The purpose of this study was to describe the perceptions of fall risk among hospitalized patients across four acute care specialty services. METHODS One hundred patients who had been admitted to the study hospital and who had a Morse Fall Scale score over 45 were asked to complete the Patient Perception Questionnaire, a tool designed to explore a patient's confidence regarding their fall risk, fear of falling, and intention to engage in fall prevention activities. Morse Fall Scale scores were collected via retrospective chart review. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and independent sample t tests. RESULTS Participants' mean age was 65 years; 52% were male, 48% female. Although all 100 participants were deemed at risk for falls per their Morse Fall Scale scores, only 55% considered themselves to be at such risk. As patients' confidence in their ability to perform mobility tasks increased, their intention to ask for help and fear of falling significantly decreased. Patients who had been admitted as the result of a fall demonstrated significantly lower confidence scores and higher fear scores. CONCLUSIONS Patients who score high on fall risk assessments often don't perceive themselves to be at high risk for falling, and thus might not engage in fall prevention activities. Developing a fall risk assessment method that incorporates both a patient's physiological condition and their perception of their fall risk could help reduce fall rates in the acute care setting.
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Affiliation(s)
- Heidi Tymkew
- Heidi Tymkew , Beth Taylor , and Marilyn Schallom are research scientists at Barnes-Jewish Hospital, St. Louis, where Cassandra Arroyo is a statistician and at the time of this study Kara Vyers was the research coordinator and Eileen Costantinou was a practice specialist. Contact author: Heidi Tymkew, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise
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Nanchal R, Subramanian R, Alhazzani W, Dionne JC, Peppard WJ, Singbartl K, Truwit J, Al-Khafaji AH, Killian AJ, Alquraini M, Alshammari K, Alshamsi F, Belley-Cote E, Cartin-Ceba R, Hollenberg SM, Galusca DM, Huang DT, Hyzy RC, Junek M, Kandiah P, Kumar G, Morgan RL, Morris PE, Olson JC, Sieracki R, Steadman R, Taylor B, Karvellas CJ. Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations. Crit Care Med 2023; 51:657-676. [PMID: 37052436 DOI: 10.1097/ccm.0000000000005824] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To develop evidence-based recommendations for clinicians caring for adults with acute liver failure (ALF) or acute on chronic liver failure (ACLF) in the ICU. DESIGN The guideline panel comprised 27 members with expertise in aspects of care of the critically ill patient with liver failure or methodology. We adhered to the Society of Critical Care Medicine standard operating procedures manual and conflict-of-interest policy. Teleconferences and electronic-based discussion among the panel, as well as within subgroups, served as an integral part of the guideline development. INTERVENTIONS In part 2 of this guideline, the panel was divided into four subgroups: neurology, peri-transplant, infectious diseases, and gastrointestinal groups. We developed and selected Population, Intervention, Comparison, and Outcomes (PICO) questions according to importance to patients and practicing clinicians. For each PICO question, we conducted a systematic review and meta-analysis where applicable. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence to decision framework to facilitate recommendations formulation as strong or conditional. We followed strict criteria to formulate best practice statements. MEASUREMENTS AND MAIN RESULTS We report 28 recommendations (from 31 PICO questions) on the management ALF and ACLF in the ICU. Overall, five were strong recommendations, 21 were conditional recommendations, two were best-practice statements, and we were unable to issue a recommendation for five questions due to insufficient evidence. CONCLUSIONS Multidisciplinary, international experts formulated evidence-based recommendations for the management ALF and ACLF patients in the ICU, acknowledging that most recommendations were based on low quality and indirect evidence.
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Affiliation(s)
- Rahul Nanchal
- Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI
| | | | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Joanna C Dionne
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | - David T Huang
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Mats Junek
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Gagan Kumar
- Northeast Georgia Medical Center, Gainesville, GA
| | - Rebecca L Morgan
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Peter E Morris
- University of Kentucky College of Medicine, Lexington, KY
| | - Jody C Olson
- Kansas University Medical Center, Kansas City, KS
| | | | - Randolph Steadman
- University of California Los Angeles Medical Center, Los Angeles, CA
| | | | - Constantine J Karvellas
- Department of Critical Care Medicine and Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, AB, Canada
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Nanchal R, Subramanian R, Alhazzani W, Dionne JC, Peppard WJ, Singbartl K, Truwit J, Al-Khafaji AH, Killian AJ, Alquraini M, Alshammari K, Alshamsi F, Belley-Cote E, Cartin-Ceba R, Hollenberg SM, Galusca DM, Huang DT, Hyzy RC, Junek M, Kandiah P, Kumar G, Morgan RL, Morris PE, Olson JC, Sieracki R, Steadman R, Taylor B, Karvellas CJ. Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations. Crit Care Med 2023; 51:653-656. [PMID: 37052435 DOI: 10.1097/ccm.0000000000005825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- Rahul Nanchal
- Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI
| | | | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Joanna C Dionne
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | - David T Huang
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Mats Junek
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Gagan Kumar
- Northeast Georgia Medical Center, Gainesville, GA
| | - Rebecca L Morgan
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Peter E Morris
- University of Kentucky College of Medicine, Lexington, KY
| | - Jody C Olson
- Kansas University Medical Center, Kansas City, KS
| | | | - Randolph Steadman
- University of California Los Angeles Medical Center, Los Angeles, CA
| | | | - Constantine J Karvellas
- Department of Critical Care Medicine and Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, AB, Canada
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Cilhoroz BT, Zaleski A, Taylor B, Fernandez AB, Santos LP, Vonk T, Thompson PD, Pescatello LS. The Relationship between Postexercise Hypotension and Heart Rate Variability before and after Exercise Training. J Cardiovasc Dev Dis 2023; 10:jcdd10020064. [PMID: 36826560 PMCID: PMC9958830 DOI: 10.3390/jcdd10020064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023] Open
Abstract
Because data are scarce, we examined the relationship between postexercise hypotension (PEH) and heart rate variability (HRV) before and after aerobic exercise training among adults with hypertension. Participants completed a 12 w aerobic training program. Before and after training, they performed a peak graded exercise stress test (GEST) and nonexercise control (CONTROL) and were left attached to an ambulatory BP monitor. Prior to CONTROL, HRV was measured supine for 5 min using a 12-lead electrocardiogram (ECG). The participants (n = 18) were middle-aged (52.1 ± 11.7 y) and 50% men with hypertension (131.7 ± 9.8/85.9 ± 8.5 mmHg) and obesity (30.0 ± 3.7 kg·m-2). Before training, ambulatory systolic BP (ASBP) and diastolic ABP (ADBP) decreased by 3.2 ± 2.1 mmHg and 2.5 ± 1.5 mmHg, respectively, from baseline after the GEST versus CONTROL (p < 0.05). After training, ASBP tended to decrease by 3.5 ± 2.2 mmHg (p = 0.055) and ADBP decreased by 1.7 ± 2.5 mmHg (p = 0.001) from baseline after the GEST versus CONTROL. Before training, HRV high frequency (HFms2) (β = -0.441), age (β = 0.568), and resting SBP (β = 0.504) accounted for 66.8% of the ASBP response (p = 0.001), whereas the low frequency (LF)/HF ratio (β = 0.516) and resting DBP (β = 0.277) accounted for 35.7% of the ADBP response (p = 0.037). After training, the standard deviation of NN intervals (SDNN) (β = -0.556), age (β = 0.506), and resting SBP (β = 0.259) accounted for 60.7% of the ASBP response (p = 0.004), whereas SDNN (β = -0.236) and resting DBP (β = 0.785) accounted for 58.5% of the ADBP response (p = 0.001). Our preliminary findings show that adults with hypertension and parasympathetic suppression (i.e., lower SDNN and HFms2 and higher LF/HF) may elicit PEH to the greatest degree independent of training status versus adults with parasympathetic predominance, suggesting that resting HRV may be an important determinant of PEH.
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Affiliation(s)
- Burak T. Cilhoroz
- Department of Exercise Science, Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA
- Correspondence: ; Tel.: +1-516-725-6889; Fax: +1-315-443-2562
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06106, USA
| | - Beth Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | - Lucas P. Santos
- Exercise Pathophysiology Laboratory, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-003, Brazil
| | - Thijs Vonk
- Department of Physiology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Paul D. Thompson
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06106, USA
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Diba P, Bowden J, Divers A, Taylor B, Newbury-Birch D, Ling J. A co-production approach to exploring an integrated service model in UK local authorities. JICA 2023. [DOI: 10.1108/jica-06-2022-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PurposeIntegrated service models aim to simplify access, enable effective delivery, remove duplication and provide a holistic and person-centred approach. This project explored the development of integrated well-being services in two local authorities in North-East England. The purpose of this paper is to address this issue.Design/methodology/approachUnderpinned by public health and co-production approaches, the project utilised a mixed-methods approach. Data were collected via online surveys (n = 95), virtual interviews with members of the local population (n = 8) and practitioners and commissioners (n = 8) to explore needs for a new service. Thematic analysis was used to identify key themes and issues.FindingsSeveral benefits of an integrated service were highlighted by both staff and service users, with a central anticipated benefit being the provision of holistic care. Improvement in information sharing was also seen to increase the efficiency of services and communication barriers between services. Beneficial aspects and barriers related to the COVID-19 pandemic on current service provision were reported that have informed our future recommendations.Originality/valueThe authors’ findings provide a much deeper insight into function, care, social inclusion and ongoing support needs, from both the perspectives of staff and service users. Service users and staff saw value in an integrated model for themselves, as well as the wider community. The authors’ findings indicate that the integrated service model is a promising one for the development of services within local authorities.
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Gardiner C, Harrison M, Hargreaves S, Taylor B. Palliative care roles and responsibilities of mesothelioma clinical nurse specialists in the UK. Progress in Palliative Care 2022. [DOI: 10.1080/09699260.2022.2158286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Clare Gardiner
- Mesothelioma UK Research Centre, Health Sciences School, The University of Sheffield, Sheffield S102TP, UK
| | - Madeleine Harrison
- Mesothelioma UK Research Centre, Health Sciences School, The University of Sheffield, Sheffield S102TP, UK
| | - Sarah Hargreaves
- Mesothelioma UK Research Centre, Health Sciences School, The University of Sheffield, Sheffield S102TP, UK
| | - Beth Taylor
- Mesothelioma UK Research Centre, Health Sciences School, The University of Sheffield, Sheffield S102TP, UK
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Ben-Joseph R, Saad R, Black J, Dabrowski E, Taylor B, Gallucci S, Somers V. CardioVascular Burden Of Narcolepsy Disease (CV-BOND): A Real-World Evidence Study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bellon J, Quinlan C, Taylor B, Nemecek D, Borden E, Needs P. Association of Outpatient Behavioral Health Treatment With Medical and Pharmacy Costs in the First 27 Months Following a New Behavioral Health Diagnosis in the US. JAMA Netw Open 2022; 5:e2244644. [PMID: 36472875 PMCID: PMC9856223 DOI: 10.1001/jamanetworkopen.2022.44644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Outpatient behavioral health treatment (OPBHT) is an effective treatment for behavioral health conditions (BHCs) that may also be associated with improved medical health outcomes, but evidence regarding the cost-effectiveness of OPBHT across a large population has not been established. OBJECTIVE To investigate whether individuals newly diagnosed with a BHC who used OPBHT incurred lower medical and pharmacy costs over 15 and 27 months of follow-up compared with those not using OPBHT. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study of commercially insured individuals in the US was conducted using administrative insurance claims data for individuals newly diagnosed with 1 or more BHCs between January 1, 2017, and December 31, 2018. Data were examined using a 12-month period before BHC diagnosis and 15- and 27-month follow-up periods. Participants included individuals aged 1 to 64 years who received any OPBHT with or without behavioral medication or who did not receive OPBHT or behavioral medication in the 15 months following diagnosis. Data were analyzed from May to October 2021. EXPOSURES Receipt of OPBHT both as a dichotomous variable and categorized by number of OPBHT visits. MAIN OUTCOMES AND MEASURES The main outcome was the association between OPBHT treatment and 15- and 27-month medical and pharmacy costs, assessed using a generalized linear regression model with γ distribution, controlling for potential confounders. RESULTS The study population included 203 401 individuals, of whom most were male (52%), White, non-Hispanic (75%), and 18 to 64 years of age (67%); 22% had at least 1 chronic medical condition in addition to a BHC. Having 1 or more OPBHT visits was associated with lower adjusted mean per-member, per-month medical and pharmacy costs across follow-up over 15 months (no OPBHT: $686 [95% CI, $619-$760]; ≥1 OPBHT: $571 [95% CI, $515-$632]; P < .001) and 27 months (no OPBHT: $464 [95% CI, $393-$549]; ≥1 OPBHT: $391 [95% CI, $331-$462]; P < .001). Furthermore, almost all doses of OPBHT across the 15 months following diagnosis were associated with lower costs compared with no OPBHT. CONCLUSIONS AND RELEVANCE In this cohort study, medical cost savings were associated with OPBHT among patients newly diagnosed with a BHC in a large, commercially insured population. The findings suggest that promoting and optimizing OPBHT may be associated with reduced overall medical spending among patients with BHCs.
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Affiliation(s)
| | | | | | | | - Eva Borden
- Evernorth Health, Inc, St Louis, Missouri
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16
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Darvish R, Winn H, Merriman A, Taylor B. Congenital Dysplastic Kidney with Ectopic Ureter to the Uterine Cervix. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Kardoulaki E, White J, Williams J, Taylor B, Croell A, Rosales J, Taylor C, Widgeon Paisner S, Coons T, Byler D, Volz M, McClellan K. Synthesis, thermal conductivity, and hydrogen compatibility of a high melt point solid solution uranium carbide, (U0.2Zr0.8)C. Nuclear Materials and Energy 2022. [DOI: 10.1016/j.nme.2022.101290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Simillis C, Taylor B, Ahmad A, Lal N, Afxentiou T, Powar MP, Smyth EC, Fearnhead NS, Wheeler J, Davies RJ. A systematic review and meta-analysis assessing the impact of body mass index on long-term survival outcomes after surgery for colorectal cancer. Eur J Cancer 2022; 172:237-251. [DOI: 10.1016/j.ejca.2022.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/02/2022] [Accepted: 05/15/2022] [Indexed: 01/27/2023]
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19
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Cilhoroz BT, Zaleski A, Taylor B, Fernandez AB, Santos L, Volk T, Thompson PD, Pescatello L. PARASYMPATHATIC PREDOMINANCE IS ASSOCIATED WITH POSTEXERCISE HYPOTENSION BEFORE AND AFTER TRAINING AMONG ADULTS WITH HYPERTENSION. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880688.28227.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Davies TW, van Gassel RJJ, van de Poll M, Gunst J, Casaer MP, Christopher KB, Preiser JC, Hill A, Gundogan K, Reintam-Blaser A, Rousseau AF, Hodgson C, Needham DM, Castro M, Schaller S, McClelland T, Pilkington JJ, Sevin CM, Wischmeyer PE, Lee ZY, Govil D, Li A, Chapple L, Denehy L, Montejo-González JC, Taylor B, Bear DE, Pearse R, McNelly A, Prowle J, Puthucheary ZA. Core outcome measures for clinical effectiveness trials of nutritional and metabolic interventions in critical illness: an international modified Delphi consensus study evaluation (CONCISE). Crit Care 2022; 26:240. [PMID: 35933433 PMCID: PMC9357332 DOI: 10.1186/s13054-022-04113-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/25/2022] [Indexed: 01/06/2023] Open
Abstract
Background Clinical research on nutritional and metabolic interventions in critically ill patients is heterogenous regarding time points, outcomes and measurement instruments used, impeding intervention development and data syntheses, and ultimately worsening clinical outcomes. We aimed to identify and develop a set of core outcome domains and associated measurement instruments to include in all research in critically ill patients.
Methods An updated systematic review informed a two-stage modified Delphi consensus process (domains followed by instruments). Measurement instruments for domains considered ‘essential’ were taken through the second stage of the Delphi and a subsequent consensus meeting. Results In total, 213 participants (41 patients/caregivers, 50 clinical researchers and 122 healthcare professionals) from 24 countries contributed. Consensus was reached on time points (30 and 90 days post-randomisation). Three domains were considered ‘essential’ at 30 days (survival, physical function and Infection) and five at 90 days (survival, physical function, activities of daily living, nutritional status and muscle/nerve function). Core ‘essential’ measurement instruments reached consensus for survival and activities of daily living, and ‘recommended’ measurement instruments for physical function, nutritional status and muscle/nerve function. No consensus was reached for a measurement instrument for Infection. Four further domains met criteria for ‘recommended,’ but not ‘essential,’ to measure at 30 days post-randomisation (organ dysfunction, muscle/nerve function, nutritional status and wound healing) and three at 90 days (frailty, body composition and organ dysfunction). Conclusion The CONCISE core outcome set is an internationally agreed minimum set of outcomes for use at 30 and 90 days post-randomisation, in nutritional and metabolic clinical research in critically ill adults.
Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-04113-x.
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Affiliation(s)
- T W Davies
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - R J J van Gassel
- Department of Intensive Care Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands.,Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - M van de Poll
- Department of Intensive Care Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands.,Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - J Gunst
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - M P Casaer
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - K B Christopher
- Division of Renal Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, USA
| | - J C Preiser
- Medical Direction, Erasme University Hospital, Universite Libre de Bruxelles, Brussels, Belgium
| | - A Hill
- Departments of Intensive Care and Anesthesiology, University Hospital RWTH Aachen University, 52074, Aachen, Germany
| | - K Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - A Reintam-Blaser
- Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia.,Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - A F Rousseau
- Department of Intensive Care, University Hospital of Liège, Liege, Belgium
| | - C Hodgson
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 3/553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - D M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA.,Pulmonary and Critical Care Medicine, Department of Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M Castro
- Clinical Nutrition, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - S Schaller
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK, CCM), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany.,School of Medicine, Klinikum Rechts Der Isar, Department of Anesthesiology and Intensive Care, Technical University of Munich, Munich, Germany
| | - T McClelland
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - J J Pilkington
- Centre for Bioscience, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, UK
| | - C M Sevin
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - P E Wischmeyer
- Department of Anesthesiology, Duke University School of Medicine, DUMC, Box 3094 Mail # 41, 2301 Erwin Road, Durham, NC, 5692 HAFS27710, USA
| | - Z Y Lee
- Department of Anesthesiology, University of Malaya, Kuala Lumpur, Malaysia
| | - D Govil
- Institute of Critical Care and Anesthesia, Medanta: The Medicty, Gurugram, Haryana, India
| | - A Li
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore.,Department of Intensive Care Medicine, Woodlands Health, Singapore, Singapore
| | - L Chapple
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - L Denehy
- The University of Melbourne, School of Health Sciences, Melbourne, Australia.,Department of Allied Health, Peter McCallum Cancer Centre, Melbourne, Australia
| | - J C Montejo-González
- Department of Intensive Care Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - B Taylor
- Department of Research for Patient Care Services, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - D E Bear
- Department of Critical Care and Department of Nutrition and Dietetics, Guy´S and St Thomas' NHS Foundation Trust, London, UK
| | - R Pearse
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - A McNelly
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - J Prowle
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK
| | - Z A Puthucheary
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. .,Critical Care and Perioperative Medicine Research Group, Adult Critical Care Unit, Royal London Hospital, London, E1 1BB, UK.
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Rojas-Bracho L, Taylor B, Booth C, Thomas L, Jaramillo-Legorreta A, Nieto-García E, Cárdenas Hinojosa G, Barlow J, Mesnick SL, Gerrodette T, Olson P, Henry A, Rizo H, Hidalgo-Pla E, Bonilla-Garzón A. More vaquita porpoises survive than expected. ENDANGER SPECIES RES 2022. [DOI: 10.3354/esr01197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In 2018, it was estimated that fewer than 20 of Mexico’s endemic vaquita porpoise Phocoena sinus remained, and the species was declining by 47% yr-1. Entanglement in gillnets is the sole threat to the species, and since the last population size estimate, gillnetting has increased in the small area where most vaquitas remain—a 12 × 24 km area in the Gulf of California near San Felipe, Mexico. We conducted research efforts in 2019 and 2021 in that area to estimate the minimum numbers of adults and calves and look for any signs that vaquitas are unhealthy. Through expert elicitation, we estimated between 7 and 15 unique individuals were seen in 2019 and 5-13 were seen in 2021. Calves were seen in both years, and all vaquitas appeared healthy. Population projections from the last full survey indicated that more vaquitas have survived than expected. We suggest that these surviving adult vaquitas may have learned to avoid entanglement in gillnets. These vaquitas and their calves provide hope that the species can survive. However, given the high levels of illegal gillnetting and the theft of equipment which hindered our monitoring efforts, and with only around 10 individuals remaining, survival can only be assured if vaquita habitat is made gillnet-free.
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Affiliation(s)
- L Rojas-Bracho
- PNUD/Sinergiaen en la Comisión Nacional de Áreas Naturales Protegidas, Ensenada, BC, México
| | - B Taylor
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - C Booth
- SMRU Consulting, St Andrews, Fife KY16 8LB, UK
| | - L Thomas
- Centre for Research into Ecological and Environmental Modelling, University of St Andrews, St Andrews, Fife KY16 9LZ, UK
| | | | - E Nieto-García
- Comisión Natural de Áreas Naturales Protegidas, Ensenada, BC, México
| | | | - J Barlow
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - SL Mesnick
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - T Gerrodette
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - P Olson
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - A Henry
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - H Rizo
- Museo de la Ballena y Ciencias del Mar, La Paz, BC 23000, México
| | - E Hidalgo-Pla
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA 92037, USA
| | - A Bonilla-Garzón
- K. Lisa Yang Center for Conservation Bioacoustics, Ithaca, NY 14850, USA
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22
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Abstract
BACKGROUND Family caregivers provide the majority of palliative care. The impact of family caregiving on employment and finances has received little research attention in the field of palliative care. AIM The aim of this study was to explore perspectives and experiences of combining paid employment with palliative care family caregiving, and to assess the availability and suitability of employment support across three countries - the United Kingdom (UK), Aotearoa New Zealand and Canada. DESIGN A qualitative descriptive study design was used. Semi-structured interviews were held with 30 key informants with professional or personal experience in palliative care from the UK (n = 15), Aotearoa New Zealand (n = 6) and Canada (n = 9). Interviews were recorded, transcribed and analysed using the principles of thematic analysis. RESULTS Four main themes were identified: (1) significant changes to working practices are required to enable end of life family carers to remain in work; (2) the negative consequences of combining caregiving and employment are significant, for both patient and carer; (3) employer support for working end of life caregivers is crucial but variable and; (4) national, federal and government benefits for working end of life family carers are necessary. CONCLUSION Supporting carers to retain employment whilst providing care has potential benefits for the patient at end of life, the caregiver, and the wider economy and labour market. Employers, policymakers and governments have a role to play in developing and implementing policies to support working carers to remain in employment.
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Affiliation(s)
- Clare Gardiner
- Health Sciences School, The University of Sheffield, Sheffield, UK
| | - Beth Taylor
- Health Sciences School, The University of Sheffield, Sheffield, UK
| | - Hetty Goodwin
- School of Nursing, The University of Auckland, Auckland, Aotearoa New Zealand
| | - Jackie Robinson
- School of Nursing, The University of Auckland, Auckland, Aotearoa New Zealand
| | - Merryn Gott
- School of Nursing, The University of Auckland, Auckland, Aotearoa New Zealand
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23
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Gardiner C, Harrison M, Hargreaves S, Taylor B. Clinical nurse specialist role in providing generalist and specialist palliative care: A qualitative study of mesothelioma clinical nurse specialists. J Adv Nurs 2022; 78:2973-2982. [PMID: 35485237 PMCID: PMC9542160 DOI: 10.1111/jan.15277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/14/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
Aim To explore perspectives of Mesothelioma UK clinical nurse specialists (CNSs) on their role in providing palliative care for patients with mesothelioma and their families. Design A qualitative descriptive approach using focus group and interview methods. Methods Focus groups and semi‐structured interviews were conducted with 16 Mesothelioma UK clinical nurse specialists using the online software Google Meet. Data collection was carried out in Jan‐Feb 2021 and data were analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) was used as the reporting guideline for this paper. Results Four main themes were identified from the data: Mesothelioma UK clinical nurse specialist role in relation to palliative care; joint working with specialist palliative care and community services; patients and family carer's willingness to engage with palliative care services; and the impact of COVID‐19 on palliative care for mesothelioma patients. Conclusion This study provides valuable insights into palliative care needs in mesothelioma. Patients with mesothelioma and their families have significant palliative care needs throughout the course of their illness from diagnosis to the end of life. Mesothelioma UK CNS's play a crucial role in supporting patients' and families palliative care needs, and are highly skilled in providing this care. Impact By acknowledging the role of Mesothelioma UK CNS's in palliative care provision, and supporting collaborative working between specialist and generalist palliative care providers, there is the capacity to significantly improve palliative care in mesothelioma and improve outcomes for patients and their families.
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Affiliation(s)
- Clare Gardiner
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
| | - Madeleine Harrison
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
| | - Sarah Hargreaves
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
| | - Beth Taylor
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
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24
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Mundi MS, Mechanick JI, Mohamed Elfadi O, Patel J, Bonnes SL, Blackmer AB, Christian VJ, Hennessy SA, Hurt RT, Jain A, Kaspar MB, Katz J, Labossiere R, Limketkai B, McCarthy PJ, Morrison CA, Newberry C, Pimiento JM, Rosenthal MD, Taylor B, McClave SA. Optimizing the Nutrition Support Care Model: Analysis of Survey Data. JPEN J Parenter Enteral Nutr 2022; 46:1709-1724. [PMID: 35040154 DOI: 10.1002/jpen.2326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/30/2021] [Accepted: 12/17/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Malnutrition is under-recognized and under-diagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high-risk patients with malnutrition remains low, despite evidence demonstrating lower complication rates with nutrition support team (NST) management. To facilitate solutions, a survey was designed to elucidate the nature of NSTs and physician involvement and identify needs for novel nutrition support care models. METHODS This survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth. RESULTS Of 255 respondents, 235 complete surveys were analyzed. The geographic distribution of respondents correlated with population concentrations of the United States (r = 90.8%, p-value <0.0001). Most responding physicians (80.7%) reported being a member of NSTs, compared with 56.5% of dietitians. Of those not practicing in NSTs (N = 81, 34.4%), 12.3% reported an NST was previously present at their institution but had been disbanded. Regarding NSTs, financial concerns were common (48.9%), followed by leadership (30.6%), and healthcare professional (HCP) interest (23.4%). A majority (73.6%) of all respondents wanted additional training in nutrition, but reported insufficient protected time, ability to travel, or support from administrators or other HCPs. CONCLUSION Core actions resulting from this survey focused on formalizing physician roles, increasing inter-disciplinary nutrition support expertise, utilizing cost-effective screening for malnutrition, and implementing intervention protocols. Additional actions included increasing funding for clinical practice, education, and research, all within an expanded portfolio of pragmatic nutrition support care models. CLINICAL RELEVANCY STATEMENT Physician engagement in nutrition support continues to remain low despite the increasing prevalence of malnutrition. This problem, and the working solution, is in the context of decreased engagement of other healthcare professionals in nutrition support, as well as declining Nutrition Support Team utilization. To address these issues, the ASPEN Physician Engagement Committee (PEC) conducted a survey of healthcare professionals (HCPs) involved in nutrition support. Key findings include: (1) lack of financial support and physician champions with financial knowledge; (2) inadequate valuation of physicians and other nutrition support HCPs and NSTs, and their impact on clinical outcomes; and (3) significant barriers to primary and supplementary training for physicians in nutrition. Accordingly, the PEC recommends: (1) development of cost-effective screening and intervention for malnutrition; (2) expansion of nutrition support care models appropriately scaled to the available resources and expertise; and (3) development of a knowledge translation platform to foster transmission of novel breakthroughs while addressing research, knowledge, and practice gaps. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - Jeffrey I Mechanick
- Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Osman Mohamed Elfadi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - Jayshil Patel
- Division of Pulmonary & Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wi
| | - Sara L Bonnes
- General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Allison B Blackmer
- American Society for Parenteral and Enteral Nutrition, Silver Spring, MD.,University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO
| | - Vikram J Christian
- Division of Pediatric Gastroenterology, University of Minnesota, Minneapolis, MN
| | - Sara A Hennessy
- Division of Burn, Trauma, Acute & Critical Care Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Ryan T Hurt
- General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Ajay Jain
- Division of Pediatric Gastroenterology, Saint Louis University, Saint Louis, Missouri, USA
| | - Matthew B Kaspar
- Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Jennifer Katz
- Division of Gastroenterology and Hepatology, Montefiore Medical Center, Bronx, New York, USA
| | | | - Berkeley Limketkai
- Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA
| | - Paul J McCarthy
- Division of Cardiovascular Critical Care, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Chet A Morrison
- Division of Trauma and Critical Care, Central Michigan University College of Medicine
| | - Carolyn Newberry
- Innovative Center for Health and Nutrition in Gastroenterology (ICHANGE), Weill Cornell Medical Center, New York, NY
| | - Jose M Pimiento
- GI Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Martin D Rosenthal
- Division of Trauma and Acute Care Surgery, University of Florida, Gainesville, Florida
| | - Beth Taylor
- Department of Research for Patient Care Services, Barnes-Jewish Hospital, St. Louis, Missouri, USA
| | - Stephen A McClave
- Division of Gastroenterology, Hepatology, and Nutrition, School of Medicine, University of Louisville, Louisville, Kentucky, USA
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Taylor B, Cohen J, Tejeda J, Wang T. Belumosudil for chronic graft-versus-host disease. Drugs Today (Barc) 2022; 58:203-212. [DOI: 10.1358/dot.2022.58.5.3400705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cochrane A, Booth A, Walker I, Morgan S, Mitchell A, Barlow-Pay M, Hewitt C, Taylor B, Chapman C, Raftery J, Fleming J, Torgerson D, Parkes J. Examining the effectiveness of Gateway-an out-of-court community-based intervention to reduce recidivism and improve the health and well-being of young adults committing low-level offences: study protocol for a randomised controlled trial. Trials 2021; 22:939. [PMID: 34923999 PMCID: PMC8684788 DOI: 10.1186/s13063-021-05905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young adult offenders represent a third of the UK prison population and are at risk of poor health outcomes including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of formal criminal justice sanctions and focus resources on addressing the root causes of offending. Although diversions are widely used, evidence of their effectiveness has not yet been established. Hampshire Constabulary, working together with local charities, have developed the Gateway programme, an out-of-court intervention aimed at improving the life chances of young adults. Issued as a conditional caution, participants undertake a health and social care needs assessment, attend workshops encouraging analysis of own behaviour and its consequences and agree not to re-offend during the 16-week caution. METHODS This is a pragmatic, multi-site, parallel-group, superiority randomised controlled trial with a target sample size of 334. Participants are aged 18-24, reside in Hampshire and Isle of Wight and are being questioned for an eligible low-level offence. Police investigators offer potential participants a chance to receive the Gateway caution, and those interested are also invited to take part in the study. Police officers obtain Stage 1 consent and carry out an eligibility check, after which participants are randomised on a 1:1 basis either to receive Gateway or follow the usual process, such as court appearance or a different conditional caution. Researchers subsequently obtain Stage 2 consent and collect data at weeks 4 and 16, and 1 year post-randomisation. The primary outcome is the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes include health status, alcohol and drug use, recidivism and resource use. The primary analysis will compare the WEMWBS score between the two groups at 12 months. DISCUSSION This pioneering trial aims to address the evidence gap surrounding diversion in 18-24-year-olds. The findings will inform law enforcement agencies, third sector organisations, policymakers and commissioners, as well as researchers working in related fields and with vulnerable target populations. TRIAL REGISTRATION International Standard Randomised Controlled Trial Register ( ISRCTN 11888938 ).
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Affiliation(s)
- A Cochrane
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - A Booth
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - I Walker
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - S Morgan
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - A Mitchell
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - M Barlow-Pay
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - C Hewitt
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - B Taylor
- Hampshire Constabulary, Southampton Central Police Station, Southampton, SO15 1AN, UK
| | - C Chapman
- Hampshire Constabulary, Southampton Central Police Station, Southampton, SO15 1AN, UK
| | - J Raftery
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - J Fleming
- Department of Sociology, Social Policy and Criminology, University of Southampton, Southampton, SO17 1BJ, UK
| | - D Torgerson
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - J Parkes
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
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Dicks R, Choi J, Waszynski C, Collins-Fletcher K, Taylor B, Martinez C, O'Sullivan D. Health Disparities in Delirium. Innov Aging 2021. [PMCID: PMC8682256 DOI: 10.1093/geroni/igab046.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Racial and ethnic minority populations in the US experience greater cumulative disease burden, as well as social and economic barriers, stressors, and limited advocacy/access to culturally informed healthcare. This increased risk burden is expected to be associated with an increased risk for delirium during acute care encounters. Previous studies on health disparity and delirium are limited and report equivocal findings regarding delirium incidence, possibly related to sample bias or non-validated measures. Risk for delirium during acute care in health disparity populations (HDP) that include Black African Americans (BAA) and Hispanic-Latinx (HL) has not been systematically studied using validated measures. We conducted a retrospective analysis utilizing our delirium program (ADAPT) registry that systematically assessed all hospitalized patients through their entire hospital stay for the years 2018-2019 (36K patients, 80% NHW, 11% HL, 9% BAA). The Confusion Assessment Method (CAM and CAM-ICU) and Richmond Agitation Sedation Scale (RASS) were used as screening assessments to identify delirium. We know from previous studies that negative CAM results in our environment have high specificity. The incidence of delirium between populations was compared using a chi-square test. Delirium incidence was higher in HDP (BAA combined with HL) compared to NHW in 71-80yo (16.0% vs 12.6%, p=0.003). Delirium incidence was not different in all other age groups compared; <65yo (p=0.191), 61-70yo (p=0.223), 81-90yo (p=0.644). Understanding the association, or lack thereof, between health disparities, ethnic and race-based risks for delirium is expected to provide important insights into more focused delirium assessment, prevention and mitigation strategies in these populations.
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Affiliation(s)
- Robert Dicks
- Hartford Hospital, West Simsbury, Connecticut, United States
| | - Jimmy Choi
- Institute of Living, Institute of Living, Hartford, Connecticut, United States
| | | | | | - Beth Taylor
- Evernorth, Saint Louis, Missouri, United States
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Ball A, Mansfield A, Taylor B, Sheerin F, Wickins J, Akhtar Z, Bhangu A, Karandikar S. COVID-19 opens the door for right iliac fossa pain treatment pathway. Ann R Coll Surg Engl 2021; 104:302-307. [PMID: 34882012 DOI: 10.1308/rcsann.2021.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has increased the risks of surgery and management of common surgical conditions has changed, with greater reliance on imaging and conservative management. The negative appendectomy rate (NAR) in the UK has previously remained high. The aim of this study was to quantify pandemic-related changes in the management of patients with suspected appendicitis, including the NAR. METHODS A retrospective study was performed at a single high volume centre of consecutive patients aged over five years presenting to general surgery with right iliac fossa pain in two study periods: for two months before lockdown and for four months after lockdown. Pregnant patients and those with previous appendectomy, including right colonic resection, were excluded. Demographic, clinical, imaging and histological data were captured, and risk scores were calculated, stratifying patients into higher and lower risk groups. Data were analysed by age, sex and risk subgroups. RESULTS The mean number of daily referrals with right iliac fossa pain or suspected appendicitis reduced significantly between the study periods, from 2.92 before lockdown to 2.07 after lockdown (p<0.001). Preoperative computed tomography (CT) rates increased significantly from 22.9% to 37.2% (p=0.002). The NAR did not change significantly between study periods (25.5% prior to lockdown, 11.1% following lockdown, p=0.159). Twelve (75%) out of sixteen negative appendectomies were observed in higher risk patients aged 16-45 years who did not undergo preoperative CT. The NAR in patients undergoing CT was 0%. CONCLUSIONS Greater use of preoperative CT should be considered in risk stratified patients in order to reduce the NAR.
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Affiliation(s)
- A Ball
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - A Mansfield
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - B Taylor
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - F Sheerin
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - J Wickins
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - Z Akhtar
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - A Bhangu
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Karandikar
- University Hospitals Birmingham NHS Foundation Trust, UK
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Cassidy C, Langley J, Steenbeek A, Taylor B, Kennie-Kaulbach N, Grantmyre H, Stratton L, Isenor J. A Behavioral analysis of nurses' and pharmacists' role in addressing vaccine hesitancy: scoping review. Hum Vaccin Immunother 2021; 17:4487-4504. [PMID: 34406908 PMCID: PMC8828075 DOI: 10.1080/21645515.2021.1954444] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 12/30/2022] Open
Abstract
The purpose of this review was to identify, characterize, and map the existing knowledge on a) nurses' and pharmacists' perceived barriers and enablers to addressing vaccine hesitancy among patients; and b) strategies or interventions for nurses and pharmacists to address vaccine hesitancy in their practice. Our comprehensive search strategy targeted peer-reviewed and grey literature. Two independent reviewers screened papers and extracted data. We coded narrative descriptions of barriers and enablers and interventions using the Behavior Change Wheel. Sixty-six records were included in our review. Reported barriers (n = 9) and facilitators (n = 6) were identified in the capability, opportunity and motivation components. The majority of the reported interventions were categorized as education (n = 47) and training (n = 26). This current scoping review offers a detailed behavioral analysis of known barriers and enablers for nurses and pharmacists to address vaccine hesitancy and interventions mapped onto these behavioral determinants.
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Affiliation(s)
- Christine Cassidy
- School of Nursing, Dalhousie University, Halifax, Canada
- Children's Health Program, IWK Health Centre, Halifax, Canada
| | - Jodi Langley
- School of Nursing, Dalhousie University, Halifax, Canada
| | | | - Beth Taylor
- School of Nursing, Dalhousie University, Halifax, Canada
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Lovell D, Merriman A, Benjamin K, Taylor B. Recurrent Paravaginal Abscess: An Unusual Presentation of a Distal Ectopic Ureteral Remnant after Prior Nephrectomy. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cull K, Bowles SK, MacDonald N, McNeil S, Taylor B, Slayter K, Steenbeek A, Taddio A, Bucci LM, Isenor JE. Patient perspectives of pain mitigation strategies for adult vaccine injections. Can J Pain 2021. [DOI: 10.1080/24740527.2021.1967113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Kathryn Cull
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Susan K. Bowles
- Department of Pharmacy, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Noni MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shelly McNeil
- Division of Infectious Diseases, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Beth Taylor
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kathryn Slayter
- Department of Pharmacy, IWK Health, Halifax, Nova Scotia, Canada
| | - Audrey Steenbeek
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Lucie M. Bucci
- Immunize Canada, Canadian Public Health Association, Ottawa, Ontario, Canada
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Little J, Ahmad S, Skwarski M, Smith D, Taylor B, Vasiliadou I, Vivekanandan S. MA06.02 Impact of Heart and Lung Radiation Dose and Lymphopenia on Non-Small Cell Lung Cancer Outcomes. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cilhoroz B, Zaleski A, Taylor B, Fernandez A, Santos L, Leister K, Thompson PD, Pescatello LS. THE RELATIONSHIP BETWEEN POST-EXERCISE HYPOTENSION AND HEART RATE VARIABILITY BEFORE AND AFTER TRAINING. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000760124.24363.6a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bass GA, Dzierba AL, Taylor B, Lane-Fall M, Kaplan LJ. Tertiary peritonitis: considerations for complex team-based care. Eur J Trauma Emerg Surg 2021; 48:811-825. [PMID: 34302503 PMCID: PMC8308068 DOI: 10.1007/s00068-021-01750-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/18/2021] [Indexed: 12/14/2022]
Abstract
Peritonitis, as a major consequence of hollow visceral perforation, anastomotic disruption, ischemic necrosis, or other injuries of the gastrointestinal tract, often drives acute care in the emergency department, operating room, and the ICU. Chronic critical illness (CCI) represents a devastating challenge in modern surgical critical care where successful interventions have fostered a growing cohort of patients with prolonged dependence on mechanical ventilation and other organ supportive therapies who would previously have succumbed much earlier in the acute phase of critical illness. An important subset of CCI patients are those who have survived an emergency abdominal operation, but who subsequently require prolonged open abdomen management complicated by persistent peritoneal space infection or colonization, fistula formation, and gastrointestinal (GI) tract dysfunction; these patients are described as having tertiary peritonitis (TP).The organ dysfunction cascade in TP terminates in death in between 30 and 64% of patients. This narrative review describes key—but not all—elements in a framework for the coordinate multiprofessional team-based management of a patient with tertiary peritonitis to mitigate this risk of death and promote recovery. Given the prolonged critical illness course of this unique patient population, early and recurrent Palliative Care Medicine consultation helps establish goals of care, support adjustment to changes in life circumstance, and enable patient and family centered care.
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Affiliation(s)
- Gary Alan Bass
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 N. 39th Street, MOB 1, Suite 120, Philadelphia, PA 19104 USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA
- European Society of Trauma and Emergency Surgery, Visceral Trauma Section, Philadelphia, USA
| | - Amy L. Dzierba
- Department of Pharmacy, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY USA
| | - Beth Taylor
- Department of Research for Patient Care Services, Barnes-Jewish Hospital, St. Louis, MO USA
| | - Meghan Lane-Fall
- Department of Anesthesia and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 5 Dulles, Philadelphia, PA 19104 USA
| | - Lewis J. Kaplan
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 N. 39th Street, MOB 1, Suite 120, Philadelphia, PA 19104 USA
- Surgical Services, Section of Surgical Critical Care, Corporal Michael J Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104 USA
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Cartwright AC, Tompkins M, Boncey J, Hastie C, Grant R, Leakey D, Simpson IG, Cockbill S, Taylor B, Beaman M, Craig J, Lange CA. Patient information on covid-19 vaccines-a vaccine centre lottery. BMJ 2021; 373:n1310. [PMID: 34035008 DOI: 10.1136/bmj.n1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Mary Tompkins
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Jenny Boncey
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Christine Hastie
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Rosalind Grant
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Diane Leakey
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Ian G Simpson
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Sarah Cockbill
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Beth Taylor
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Mike Beaman
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Joan Craig
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
| | - Carol Ann Lange
- Royal Pharmaceutical Society Retired Pharmacists Group Committee, London, UK
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Wu Y, Senk C, Coll P, Glenney S, Zaborowski K, Fortinsky R, Taylor B, Park C, Benson K, McGowan M, DiBiasi S, Chen MH, Pescatello L. A comparison of two Tai Chi interventions tailored for different health outcomes. Complement Ther Med 2021; 59:102731. [PMID: 33989797 DOI: 10.1016/j.ctim.2021.102731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 03/31/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES We compared the health benefits of two different Tai Chi interventions tailored for improving blood pressure (BP) (PRESSURE) or balance (BALANCE). DESIGN randomized controlled trial. SETTING Community dwelling older adults (≥60yr) practiced Tai Chi at the fitness center of a continuous care community. INTERVENTIONS We tailored PRESSURE to emphasize breathing techniques and mental relaxation and BALANCE to emphasize movement principles that challenged balance. Subjects were randomized to PRESSURE (n = 12), BALANCE (n = 13), or CONTROL (n = 10). Tai Chi was practiced 3 sessions/wk, 60 min/session for 12 wk. CONTROL performed normal daily activities. MAIN OUTCOME MEASURES We compared the change in cardiometabolic health, balance, and functional fitness between groups with ANCOVA using baseline values, age, and body mass index as covariates. RESULTS Subjects were physically active, Tai Chi naive (97.1 %), white, mostly female (82.9 %), and older (78.9 ± 5.7 yr) with resting systolic BP (SBP) of 126.5 ± 14.4 mmHg and diastolic BP of 69.3 ± 8.4 mmHg. PRESSURE significantly improved Chair Sit-to-Stand Test (CSTS) (1.0 ± 1.8 vs.-0.6 ± 0.8times/30s,p = 0.03) versus CONTROL, and gait speed (12.8±43.3 vs.-24.1±22.4cm/sec, p = 0.02) versus BALANCE. Meanwhile, BALANCE significantly improved Single Leg Stance Test (5.4±18.0 vs.-8.2±10.3 s, p = 0.049) and CSTS (1.0±1.7 vs.-0.6±0.8times/30s, p = 0.03), and tended to lower SBP (-4.2±16.0 vs. 3.5±8.3mmHg, p = 0.052) versus CONTROL. CONCLUSION Within 3 months, Tai Chi improved several health outcomes independent of the type of practice among physically active, Tai Chi naive older adults. Therefore, healthcare and exercise professionals may recommend Tai Chi to physically active older adults without specifying the type of practice.
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Affiliation(s)
- Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
| | - Cindy Senk
- Seabury Continuous Care Community, Bloomfield, CT, USA
| | - Patrick Coll
- Seabury Continuous Care Community, Bloomfield, CT, USA; Center on Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Susan Glenney
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Ken Zaborowski
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Richard Fortinsky
- Center on Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Beth Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Crystal Park
- Department of Psychological Science, University of Connecticut, Storrs, CT, USA
| | | | - Matt McGowan
- Seabury Continuous Care Community, Bloomfield, CT, USA
| | | | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT, USA
| | - Linda Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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Al-Mufti F, Amuluru K, Sahni R, Bekelis K, Karimi R, Ogulnick J, Cooper J, Overby P, Nuoman R, Tiwari A, Berekashvili K, Dangayach N, Liang J, Gupta G, Khandelwal P, Dominguez JF, Sursal T, Kamal H, Dakay K, Taylor B, Gulko E, El-Ghanem M, Mayer SA, Gandhi C. Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study. AJNR Am J Neuroradiol 2021; 42:1196-1200. [PMID: 33888450 DOI: 10.3174/ajnr.a7134] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/23/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is associated with hypercoagulability. We sought to evaluate the demographic and clinical characteristics of cerebral venous thrombosis among patients hospitalized for coronavirus disease 2019 (COVID-19) at 6 tertiary care centers in the New York City metropolitan area. MATERIALS AND METHODS We conducted a retrospective multicenter cohort study of 13,500 consecutive patients with COVID-19 who were hospitalized between March 1 and May 30, 2020. RESULTS Of 13,500 patients with COVID-19, twelve had imaging-proved cerebral venous thrombosis with an incidence of 8.8 per 10,000 during 3 months, which is considerably higher than the reported incidence of cerebral venous thrombosis in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI, 36-62 years; range, 17-95 years). Only 1 patient (8%) had a history of thromboembolic disease. Neurologic symptoms secondary to cerebral venous thrombosis occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging. Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%. CONCLUSIONS Early evidence suggests a higher-than-expected frequency of cerebral venous thrombosis among patients hospitalized for COVID-19. Cerebral venous thrombosis should be included in the differential diagnosis of neurologic syndromes associated with SARS-CoV-2 infection.
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Affiliation(s)
- F Al-Mufti
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.) .,Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - K Amuluru
- Department of Radiology (K.A.), Goodman Campbell Brain and Spine, Indianapolis, Indiana
| | - R Sahni
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.).,Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - K Bekelis
- Department of Neurosurgery (K. Bekelis), Catholic Health Services and Good Samaritan Hospital, West Islip, New York
| | - R Karimi
- Department of Neurosurgery (R.K.), Hackensack University Medical Center, Hackensack, New Jersey
| | - J Ogulnick
- Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - J Cooper
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.)
| | - P Overby
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.)
| | - R Nuoman
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.)
| | - A Tiwari
- Department of Neurosurgery (A.T., K. Berekashvili), New York University, New York, New York
| | - K Berekashvili
- Department of Neurosurgery (A.T., K. Berekashvili), New York University, New York, New York
| | - N Dangayach
- Department of Neurosurgery (N.D., J.L.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - J Liang
- Department of Neurosurgery (N.D., J.L.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - G Gupta
- Department of Neurological Surgery (G.G., P.K., B.T.), Rutgers University, New Brunswick, New Jersey
| | - P Khandelwal
- Department of Neurological Surgery (G.G., P.K., B.T.), Rutgers University, New Brunswick, New Jersey
| | - J F Dominguez
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.)
| | - T Sursal
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.)
| | - H Kamal
- Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - K Dakay
- Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - B Taylor
- Department of Neurological Surgery (G.G., P.K., B.T.), Rutgers University, New Brunswick, New Jersey
| | - E Gulko
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.).,Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - M El-Ghanem
- Department of Neurology (M.E.-G.), University of Arizona-Tuscon, Tuscon, Arizona
| | - S A Mayer
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.).,Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
| | - C Gandhi
- From the Departments of Neurosurgery (F.A.-M., R.S., J.C., P.O., R.N., J.F.D., T.S., E.G., S.A.M., C.G.).,Neurology (F.A.-M., R.S., J.O., H.K., K.D., E.G., S.A.M., C.G.), Westchester Medical Center at New York Medical College, Valhalla, New York
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Haslett K, Koh P, Hudson A, Ryder W, Falk S, Mullan D, Taylor B, Califano R, Blackhall F, Faivre-Finn C. Phase I trial of the MEK inhibitor selumetinib in combination with thoracic radiotherapy in non-small cell lung cancer. Clin Transl Radiat Oncol 2021; 28:24-31. [PMID: 33748440 PMCID: PMC7970011 DOI: 10.1016/j.ctro.2021.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 12/25/2022] Open
Abstract
Background The RAS/RAF/MEK/ERK signalling pathway has a pivotal role in cancer proliferation and modulating treatment response. Selumetinib inhibits MEK and enhances effects of radiotherapy in preclinical studies. Patients and methods Single-arm, single-centre, open-label phase I trial. Patients with stage III NSCLC unsuitable for concurrent chemo-radiotherapy, or stage IV with dominant thoracic symptoms, were recruited to a dose-finding stage (Fibonacci 3 + 3 design; maximum number = 18) then an expanded cohort (n = 15). Oral selumetinib was administered twice daily (starting dose 50 mg) commencing 7 days prior to thoracic radiotherapy, then with radiotherapy (6-6.5 weeks; 60-66 Gy/30-33 fractions). The primary objective was to determine the recommended phase II dose (RP2D) of selumetinib in combination with thoracic radiotherapy. Results 21 patients were enrolled (06/2010-02/2015). Median age: 62y (range 50-73). M:F ratio 12(57%):9(43%). ECOG PS 0:1, 7(33%):14(67%). Stage III 16(76%); IV 5(24%). Median GTV 64 cm3 (range 1-224 cm3). 15 patients comprised the expanded cohort at starting dose. All 21 patients completed thoracic radiotherapy as planned and received induction chemotherapy. 13 (62%) patients received the full dose of selumetinib.In the starting cohort no enhanced radiotherapy-related toxicity was seen. Two patients had dose-limiting toxicity (1x grade 3 diarrhoea/fatigue and 1x pulmonary embolism). Commonest grade 3-4 adverse events: lymphopaenia (19/21 patients) and hypertension (7/21 patients). One patient developed grade 3 oesophagitis. No patients developed grade ≥3 radiation pneumonitis. Two patients were alive at the time of analysis (24 and 26 months follow-up, respectively). Main cause of first disease progression: distant metastases ± locoregional progression (12/21 [57.1%] patients). Six patients had confirmed/suspected pneumocystis jiroveci pneumonia. Conclusion We report poor outcome and severe lymphopenia in most patients treated with thoracic radiotherapy and selumetinib at RP2D in combination, contributing to confirmed/clinically suspected pneumocystis jiroveci pneumonia. These results suggest that this combination should not be pursued in a phase II trial.ClinicalTrials.gov reference: NCT01146756.
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Affiliation(s)
- K. Haslett
- The Christie NHS Foundation Trust, United Kingdom
| | - P. Koh
- University of Manchester, United Kingdom
- New Cross Hospital, United Kingdom
| | - A. Hudson
- The Christie NHS Foundation Trust, United Kingdom
| | - W.D. Ryder
- University of Manchester, United Kingdom
| | - S. Falk
- The Christie NHS Foundation Trust, United Kingdom
| | - D. Mullan
- The Christie NHS Foundation Trust, United Kingdom
| | - B. Taylor
- The Christie NHS Foundation Trust, United Kingdom
| | - R. Califano
- The Christie NHS Foundation Trust, United Kingdom
- University of Manchester, United Kingdom
| | - F. Blackhall
- The Christie NHS Foundation Trust, United Kingdom
- University of Manchester, United Kingdom
| | - C. Faivre-Finn
- The Christie NHS Foundation Trust, United Kingdom
- University of Manchester, United Kingdom
- Corresponding author at: The Christie NHS Foundation Trust, United Kingdom.
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Rae JWB, Gray WR, Wills RCJ, Eisenman I, Fitzhugh B, Fotheringham M, Littley EFM, Rafter PA, Rees-Owen R, Ridgwell A, Taylor B, Burke A. Overturning circulation, nutrient limitation, and warming in the Glacial North Pacific. Sci Adv 2020; 6:6/50/eabd1654. [PMID: 33298448 PMCID: PMC7725469 DOI: 10.1126/sciadv.abd1654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
Although the Pacific Ocean is a major reservoir of heat and CO2, and thus an important component of the global climate system, its circulation under different climatic conditions is poorly understood. Here, we present evidence that during the Last Glacial Maximum (LGM), the North Pacific was better ventilated at intermediate depths and had surface waters with lower nutrients, higher salinity, and warmer temperatures compared to today. Modeling shows that this pattern is well explained by enhanced Pacific meridional overturning circulation (PMOC), which brings warm, salty, and nutrient-poor subtropical waters to high latitudes. Enhanced PMOC at the LGM would have lowered atmospheric CO2-in part through synergy with the Southern Ocean-and supported an equable regional climate, which may have aided human habitability in Beringia, and migration from Asia to North America.
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Affiliation(s)
- J W B Rae
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK.
| | - W R Gray
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK
- Laboratoire des Sciences du Climat et de l'Environnement (LSCE/IPSL), Université Paris-Saclay, Gif-sur-Yvette, France
| | - R C J Wills
- Department of Atmospheric Sciences, University of Washington, Seattle, WA 98195, USA
| | - I Eisenman
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA 92093, USA
| | - B Fitzhugh
- Department of Anthropology, University of Washington, Seattle, WA 98195, USA
| | - M Fotheringham
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK
| | - E F M Littley
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK
| | - P A Rafter
- Department of Earth System Science, University of California, Irvine, Irvine, CA 92697, USA
| | - R Rees-Owen
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK
| | - A Ridgwell
- Department of Earth Sciences, University of California, Riverside, Riverside, CA 92521, USA
| | - B Taylor
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK
| | - A Burke
- School of Earth and Environmental Sciences, University of St Andrews, St Andrews, UK
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Hanumanthappa N, Goldsmith C, Mullassery V, Morris S, Aggarwal A, Taylor B, Gaya A, Smith D, Dunne E, GuerreroUrbano T, Qureshi A, Staykova V, Thomas C, Williams C, Hartill C, Taylor L, Harris V, Edwards C, Grandi V, Vivekanandan S, Sisodia C, Ahmad S. PO-1248: Preliminary safety and survival report of Stereotactic radiotherapy to oligometastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01266-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Cilhoroz B, Giles D, Zaleski A, Taylor B, Fernhall B, Pescatello L. Validation of the Polar V800 heart rate monitor and comparison of artifact correction methods among adults with hypertension. PLoS One 2020; 15:e0240220. [PMID: 33031480 PMCID: PMC7544136 DOI: 10.1371/journal.pone.0240220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/22/2020] [Indexed: 11/18/2022] Open
Abstract
Heart rate variability (HRV) measurements via ambulatory monitors have become common. We examined the validity of recording R-R intervals using the Polar V800™ compared to 12-lead electrocardiograms (ECG) among middle-aged (44.7±10.1years); overweight to obese (29.8±4.3 kg.m-2) adults (n = 25) with hypertension (132.3±12.2/ 84.3±10.2 mmHg). After resting for 5-min in the supine position, R-R intervals were simultaneously recorded using the Polar V800™ and the 12-lead ECG. Artifacts present in uncorrected (UN) R-R intervals were corrected with the Kubios HRV Premium (ver. 3.2.) automatic (AC) and threshold-based (TBC) correction, and manual correction (MC) methods. Intra-class correlation coefficients (ICC), Bland-Altman limits of agreement (LoA), and effect sizes (ES) were calculated. We detected 71 errors with the Polar V800™ for an error rate of 0.85%. The bias (LoAs), ES, and ICC between UN and ECG R-R intervals were 0.69ms (-215.80 to +214.42ms), 0.004, and 0.79, respectively. Correction of artifacts improved the agreeability between the Polar V800™ and ECG HRV measures. The biases (LoAs) between the AC, TBC, and MC and ECG R-R intervals were 3.79ms (-130.32 to +137.90ms), 1.16ms (-92.67 to +94.98ms), and 0.37ms (-41.20 to +41.94ms), respectively. The ESs of AC, TBC, and MC were 0.024, 0.008, and 0.002, and ICCs were 0.91, 0.95, and 1.00, respectively. R-R intervals measured using the Polar V800™ compared to 12-lead ECG were comparable in adults with hypertension, especially after the artifacts corrected by MC. However, TBC correction also yielded acceptable results.
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Affiliation(s)
- Burak Cilhoroz
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, United States of America
- Department of Exercise Science, Syracuse University, Syracuse, New York, United States of America
- * E-mail:
| | - David Giles
- Health and Social Care Research Centre, University of Derby, Derby, United Kingdom
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, United States of America
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut, United States of America
| | - Beth Taylor
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, United States of America
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut, United States of America
| | - Bo Fernhall
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Linda Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, United States of America
- Institute for Systems Genomics, University of Connecticut, Storrs, Connecticut, United States of America
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Martindale R, Patel JJ, Taylor B, Arabi YM, Warren M, McClave SA. Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019. JPEN J Parenter Enteral Nutr 2020; 44:1174-1184. [PMID: 32462719 PMCID: PMC7283713 DOI: 10.1002/jpen.1930] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 02/06/2023]
Abstract
In the midst of a coronavirus disease 2019 (COVID‐19) pandemic, a paucity of data precludes derivation of COVID‐19–specific recommendations for nutrition therapy. Until more data are available, focus must be centered on principles of critical care nutrition modified for the constraints of this disease process, ie, COVID‐19–relevant recommendations. Delivery of nutrition therapy must include strategies to reduce exposure and spread of disease by providing clustered care, adequate protection of healthcare providers, and preservation of personal protective equipment. Enteral nutrition (EN) should be initiated early after admission to the intensive care unit (ICU) using a standard isosmolar polymeric formula, starting at trophic doses and advancing as tolerated, while monitoring for gastrointestinal intolerance, hemodynamic instability, and metabolic derangements. Intragastric EN may be provided safely, even with use of prone‐positioning and extracorporeal membrane oxygenation. Clinicians should have a lower threshold for switching to parenteral nutrition in cases of intolerance, high risk of aspiration, or escalating vasopressor support. Although data extrapolated from experience in acute respiratory distress syndrome warrants use of fiber additives
and probiotic organisms, the lack of benefit precludes a recommendation for micronutrient supplementation. Practices that increase exposure or contamination of equipment, such as monitoring gastric residual volumes, indirect calorimetry to calculate requirements, endoscopy or fluoroscopy to achieve enteral access, or transport out of the ICU for additional imaging, should be avoided. At all times, strategies for nutrition therapy need to be assessed on a risk/benefit basis, paying attention to risk for both the patient and the healthcare provider.
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Affiliation(s)
- Robert Martindale
- Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Jayshil J Patel
- Division of Pulmonary & Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Beth Taylor
- Barnes-Jewish Hospital, St Louis, Missouri, USA
| | - Yaseen M Arabi
- King Abdullah International Medical Research Center, King Saud Din Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Malissa Warren
- Department of Surgery, Oregon Health and Science University and Portland VA Health Care Center, Portland, Oregon, USA
| | - Stephen A McClave
- Division of Gastroenterology Hepatology and Nutrition, School of Medicine, University of Louisville, Louisville, Kentucky, USA
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Vo T, Blackwell T, Kats A, Langsetmo L, Taylor B, Schousboe J, Redline S, Stone K, Smagula S, Chu H, Rodriguez R, Schommer J, Carlson A, Ensrud K. 0388 Predictors of Incident Reduced Sleep Efficiency in Community-Dwelling Older Women. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
There is a paucity of longitudinal studies with sleep efficiency (SE) as an outcome measure. Our objective was to examine potential risk factors for incident reduced SE among community-dwelling women in late life.
Methods
We studied 700 women (mean age 82.5 [SD=3.0] years) with a SE ≥70% at the Year 16 (2002-04) visit of the Study of Osteoporotic Fractures with a follow-up measure of SE at the Year 20 (2006-08) visit. SE (percentage of time sleeping while in bed) at both visits was measured using a wrist actigraph with data collected for an average of four 24-hour periods. Women were classified as having incident reduced SE if they had SE <70% at Year 20. Logistic regression was used to estimate the associations between potential risk factors (demographics, lifestyle, use of medications, self-reported medical conditions, functional impairment, frailty, mental and physical health) at Year 16 and reduced SE at Year 20. The association of each candidate risk factor with reduced SE at Year 20 was examined in models adjusted for age, clinical site and continuous SE at Year 16. Candidate risk factors with Benjamin Hochberg false-discovery rate q-values <0.10 were included in a final multivariate model.
Results
Among the 700 eligible women, 62 (8.9%) developed incident reduced SE between the Year 16 and Year 20 visits. After adjusting for age, site and baseline SE, antidepressant use [OR=3.06; 95% CI: 1.50-6.25], benzodiazepine use [OR=2.97; 95% CI: 1.30-6.80] and the presence of hypertension [OR=2.83; 95% CI: 1.47-5.45] at Year 16 were independently associated with a higher odds of having reduced SE at follow-up.
Conclusion
These findings suggest that antidepressant use, benzodiazepine use and hypertension are risk factors or markers for the development of reduced sleep efficiency in older women. Future studies are warranted to examine the underlying mechanisms for these associations.
Support
The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576.
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Affiliation(s)
- T Vo
- University of Minnesota, Minneapolis, MN
| | - T Blackwell
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - A Kats
- University of Minnesota, Minneapolis, MN
| | | | - B Taylor
- University of Minnesota, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - J Schousboe
- University of Minnesota, Minneapolis, MN
- HealthPartners Institute, Bloomington, MN
| | - S Redline
- Brigham and Women’s Hospital, Boston, MA
| | - K Stone
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - S Smagula
- University of Pittsburgh, Pittsburgh, PA
| | - H Chu
- University of Minnesota, Minneapolis, MN
| | | | - J Schommer
- University of Minnesota, Minneapolis, MN
| | - A Carlson
- University of Minnesota, Minneapolis, MN
| | - K Ensrud
- University of Minnesota, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
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45
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Taylor A, Taylor B, Parkes J, Fagan JJ. How should health resource allocation be applied during the COVID-19 pandemic in South Africa? S Afr Med J 2020; 110:12950. [PMID: 32880316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023] Open
Affiliation(s)
- A Taylor
- Head of Clinical Unit, Division of Neurosurgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
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Affiliation(s)
- R.A. Block
- Napa Valley Dialysis Ctr. 3230 Beard Road Napa. CA 94558
| | - B. Taylor
- Napa Valley Dialysis Ctr. 3230 Beard Road Napa. CA 94558
| | - G. Frederick
- Napa Valley Dialysis Ctr. 3230 Beard Road Napa. CA 94558
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Compher C, Jain AK, Nichol PF, Blackmer A, Earthman C, Evans DC, McCarthy MS, Taylor B, Mehta N. Research Agenda 2018: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr 2020; 42:838-844. [PMID: 30001460 DOI: 10.1002/jpen.1312] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 05/17/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Charlene Compher
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Ajay K Jain
- Department of Pediatrics, Cardinal Glennon Children's Medical Center, Saint Louis University, St. Louis, Missouri, USA
| | - Peter F Nichol
- Department of Pediatric Surgery, University of Wisconsin, Madison, Wisconsin, USA
| | - Allison Blackmer
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, Colorado, USA
| | - Carrie Earthman
- Food Science and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - David C Evans
- Department of Surgery, Ohio State University Medical Center, Columbus, Ohio, USA
| | - Mary S McCarthy
- Center for Nursing Science & Clinical Inquiry, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Beth Taylor
- Department of Research, Barnes-Jewish Hospital, Saint Louis, Missouri, USA
| | - Nilesh Mehta
- Faculty in Critical Care, Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts, USA
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Choi J, Taylor B, Fiszdon JM, Kurtz MM, Tek C, Dewberry MJ, Haber LC, Shagan D, Assaf M, Pearlson GD. The synergistic benefits of physical and cognitive exercise in schizophrenia: Promoting motivation to enhance community effectiveness. Schizophr Res Cogn 2019; 19:100147. [PMID: 31828021 PMCID: PMC6889253 DOI: 10.1016/j.scog.2019.100147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/18/2019] [Accepted: 04/17/2019] [Indexed: 11/16/2022]
Abstract
Emerging research highlights the potential cognitive benefits of physical exercise (PE) programs for schizophrenia (SCZ). The few recent efficacy studies that examined augmenting cognitive training (CT) with PE suggest superior effects of the combination. The next step is to consider strategies to enhance adherence in real-world settings if this type of combined treatment is going to be effective. We present the first community effectiveness data for PE and CT that included a motivationally-enhancing, self-determined approach to exercise, in lieu of participant payment. Eighty-five outpatients with schizophrenia attending an intensive outpatient program were randomized to 18 h of either (A) self-determined PE regimen with choice from a menu of different activities; (B) tablet-based neurofeedback CT focused on processing speed (PS) and working memory (WM), or (C) a time-matched combination of PE and CT. Assessments were conducted at baseline, post, and follow-up (2 mo). All groups improved in WM from baseline to post, with greatest gains in the PE only group. At follow-up, cognitive gains originally observed in the PE-only group disappeared, while the PE + CT group evidenced improvements in WM and psychotic symptoms. Notably, attrition for PE was only 7%. Our data shows that combining PE and CT leads to lasting effects that are superior to those of either intervention alone. The low PE drop-out rate suggests a self-determined approach to the exercise regimen was tolerable, and may be an important component of future community implementation efforts.
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Affiliation(s)
- Jimmy Choi
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America
| | - Beth Taylor
- UCONN Institute for Collaboration on Health, Intervention and Policy, Storrs, CT, United States of America
| | - Joanna M Fiszdon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America.,Psychology Service, VA Connecticut Healthcare System, West Haven, CT, United States of America
| | - Matthew M Kurtz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America.,Department of Psychology and Neuroscience, Wesleyan University, Middletown, CT, United States of America
| | - Cenk Tek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America
| | | | - Lawrence C Haber
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America
| | - Dana Shagan
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America
| | - Michal Assaf
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America
| | - Godfrey D Pearlson
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America
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49
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aharchi J, Aldridge I, Arling V, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Rucker C, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 996.14 Assurance® Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Assurance®Listeria Polyclonal Enzyme Immunoassay (EIA) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 23 collaborators, representing government agencies, as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 550 test portions and controls was analyzed and confirmed, of which 207 were positive and 336 were negative by both methods. Six test portions were positive by culture, but negative by the EIA. Three test portions were negative by culture, but positive by the EIA. Two test portions were negative by EIA and by culture, but confirmed positive when EIA enrichment broths were subcultured to selective agars. The data reported here indicate that the Assurance®Listeria EIA method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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50
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aguilar G, Aharchi J, Aldridge I, Arling V, Bitner B, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Dombroski P, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, Martensen D, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Robertson M, Rogers P, Rucker C, Sacca J, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, Vess R, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 997.03 Visual Immunoprecipitate Assay (VIP®) for Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Visual Immunoprecipitate assay (VIP®) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 27 laboratories, representing government agencies as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 615 test portions and controls was analyzed and confirmed, of which 227 were positive and 378 were negative by both methods. Nine test portions were positive by culture, but negative by the VIP. Five test portions were negative by culture, but positive by the VIP. Four test portions were negative by VIP and by culture, but confirmed positive when VIP enrichment broths were subcultured to selective agars. The data reported here indicate that the VIP method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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