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Gutenschwager DW, Patel A, Soyad AT, Patel S, Szandzik EG, Kelly B, Smith ZR. Provision of ambrisentan from a health-system specialty pharmacy affiliated with a pulmonary hypertension Center of Comprehensive Care. Am J Health Syst Pharm 2024; 81:66-73. [PMID: 37611180 DOI: 10.1093/ajhp/zxad191] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Indexed: 08/25/2023] Open
Abstract
PURPOSE This descriptive report describes the process used to obtain access to providing ambrisentan from a health-system specialty pharmacy (HSSP) affiliated with a pulmonary hypertension Center of Comprehensive Care, develop a pulmonary arterial hypertension (PAH) care team at the HSSP, and characterize medication adherence and access metrics. SUMMARY PAH is a rare disease treated with several specialty medications requiring intensive monitoring. Historically, specialty medications used to treat PAH have been provided by only select specialty pharmacies due to restricted drug distribution channels. It is recommended that patients with PAH receive their care at centers with expertise in the diagnosis and management of this disorder, but the HSSPs at these expert centers are unable to provide specialty PAH medications. The current care model for PAH leads to patients receiving their medical and pharmaceutical care from separate entities. This descriptive report describes a multidisciplinary team's approach to gaining access to providing ambrisentan and developing a disease state care team within an established HSSP. After implementing this service, specialty pharmacy metrics were assessed, including proportion of days covered (PDC), time to first fill, patient contact rate, Risk Evaluation and Mitigation Strategy (REMS) program compliance, time to prior authorization (PA) approval, rate of optimal adherence (PDC of >80%), and PA renewal rate, to demonstrate a proof-of-concept HSSP model for PAH. In this model, the HSSP was able to demonstrate high-quality specialty pharmacy metrics with regard to medication adherence, medication access, and REMS program compliance. CONCLUSION The development of a PAH care team to provide ambrisentan at an existing HSSP was associated with high adherence rates, efficient and reliable medication access, and REMS program compliance.
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Affiliation(s)
| | - Anand Patel
- Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA
| | - Amanda T Soyad
- Clinical Pharmacy Services, Pharmacy Advantage, Rochester Hills, MI, USA
| | - Sweta Patel
- Clinical Pharmacy Services, Pharmacy Advantage, Rochester Hills, MI, USA
| | | | - Bryan Kelly
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Zachary R Smith
- Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA
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2
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Fronrath MJ, Hencken L, Martz CR, Kelly B, Smith ZR. Fluid resuscitation and relation to respiratory support escalation in patients with and without pulmonary hypertension with sepsis. Pharmacotherapy 2024; 44:61-68. [PMID: 37728179 DOI: 10.1002/phar.2879] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/14/2023] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
STUDY OBJECTIVE To compare guideline-based fluid resuscitation and need for respiratory support escalation in septic patients with pulmonary hypertension (PH) to those without PH. DESIGN Single-center, retrospective cohort study. SETTING Tertiary care academic medical center in Detroit, Michigan. PATIENTS Adult patients with or without PH hospitalized and diagnosed with sepsis from November 1, 2013 through December 31, 2019. Patients with sepsis were assigned to one of two groups based on a previous PH diagnosis or no PH diagnosis. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS The primary outcome was incidence of respiratory support escalation within 72 h from sepsis time zero. Respiratory support escalation included high-flow nasal cannula, bilevel positive airway pressure, or intubation. One-hundred and four patients were included with 52 patients in each study group. Patients with PH were more likely to require escalation of respiratory support compared to non-PH patients (32.7% vs. 11.5%; p = 0.009). Fewer patients with PH received 30 mL/kg of crystalloid within 6 h of time zero compared with non-PH patients (3.8% vs. 42.3%; p < 0.001). Vasopressor initiation was more common in patients with PH compared with the non-PH group (40.4% vs. 19.2%; p = 0.018). PH diagnosis was the only independent predictor of respiratory support escalation. CONCLUSIONS During initial sepsis management when compared with patients without PH, patients with PH had increased instances of respiratory support escalation within 72 h of sepsis time zero despite lower fluid resuscitation volumes.
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3
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Pen OV, Kelly B, Sullivan C, Heinzerling JH. Planning Considerations for the Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Radiotherapy for Locally-Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e48-e49. [PMID: 37785520 DOI: 10.1016/j.ijrobp.2023.06.754] [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) Phase III prospective randomized trial of primary lung tumor stereotactic body radiation therapy followed by concurrent mediastinal chemoradiation for locally-advanced non-small cell lung cancer (NRG LU-008), designed to lower the rates of radiation pneumonitis and improve the progression-free survival, is expected to become active nationally in July 2023. Due to the specific nature of the cases selected for this trial, a new approach to treatment planning had to be developed to satisfy the conditions of the trial. Levice Cancer Institute (Atrium Health, North Carolina) ran the initial Phase II trial and investigated several approaches, providing recommendations for the future dosimetry planning approach. MATERIALS/METHODS A total of 60 patients were selected for the initial trial and treated with a combination of SBRT treatment to the primary tumor (50-54 Gy in 3-5 fractions) and conventional IMRT treatment to 60 Gy to the involved lymph nodes for patients with stage 3 or unresectable stage II NSCLC, combined with chemotherapy. Depending on the location of the primary tumor, all cases could be subdivided into no overlap between the SBRT and IMRT targets, adjacent targets, and overlapping targets. All SBRT plans were done with a 6X-FFF beam, advanced dose calculation algorithm, and 0.1 cm grid size. IMRT targets were primarily treated with VMAT plans, though a minority of cases were planned with the DMLC technique, with a 6X beam, advanced dose calculation algorithm, and 0.25 cm grid size. Various approaches to the planning included target cropping, avoidance via adjusting optimization objectives and utilizing the base dose of the SBRT plan to optimize the dose for the IMRT nodal plan. Various geometries utilized in the plan included a variation in the number of arcs, covered arc angles, and the number of beams. RESULTS A significant reduction in the side effects was achieved throughout the trial, with only three patients experiencing grade 3 or higher pneumonitis, 3 patients experiencing grade 3 or higher cardiotoxicity, and 1 patient experiencing grade 3 esophagitis. For targets with no significant overlap between the primary tumor and nodal target, standard planning techniques proved to be sufficient. For the overlapping targets, the planning approach of utilizing 2 arcs, >180-degree coverage, for the SBRT plan, and using ¼ of the base SBRT dose to plan the IMRT nodal plan provided the best target coverage while achieving sufficient OAR sparing. CONCLUSION Planning the joint SBRT-IMRT plan in the cases of a significant target overlap requires a careful approach, but is feasible with the proposed guideline and should be achievable for any center electing to participate in the NRG LU-008 trial.
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Affiliation(s)
- O V Pen
- Levine Cancer Institute, Atrium Health, Concord, NC
| | - B Kelly
- Levine Cancer Institute, Atrium Health, Concord, NC
| | - C Sullivan
- Levine Cancer Institute, Atrium Health, Concord, NC
| | - J H Heinzerling
- Levine Cancer Institute, Atrium Health and Southeast Radiation Oncology Group, Charlotte, NC
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Butow P, Havard PE, Butt Z, Juraskova, Sharpe L, Dhillon H, Beatty L, Beale P, Cigolini M, Kelly B, Chan RJ, Kirsten L, Best M, Shaw J. The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study. Patient Educ Couns 2022; 105:2397-2403. [PMID: 35120797 PMCID: PMC8801619 DOI: 10.1016/j.pec.2022.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged. METHODS In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety and Stress Scale (carers and HPs) to assess emotional morbidity. Thematic analysis was undertaken on qualitative data. RESULTS 32 patients, 16 carers and 29 HPs participated. Qualitative analysis yielded three shared themes: fear and death anxiety, isolation, and uncertainty. For HPs, uncertainty incorporated the potential for moral distress and work-stress. Patients and carers scoring high on anxiety/depression measures were more likely to have advanced disease, expressed greater death anxiety, talked about taking more extreme precautionary measures, and felt more impacted by isolation. CONCLUSION Cancer and COVID-19 can have compounding psychological impacts on all those receiving or giving care. PRACTICE IMPLICATIONS Screening for distress in patients, and burnout in HPs, is recommended. Increased compassionate access and provision of creative alternatives to face-to-face support are warrented.
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Affiliation(s)
- P Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia.
| | - P E Havard
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - Z Butt
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - Juraskova
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - L Sharpe
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - H Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - L Beatty
- Flinders University, Órama Institute, College of Education, Psychology & Social Work, Adelaide, Australia
| | - P Beale
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW 2006 Australia
| | - M Cigolini
- Department of Palliative Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - B Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan NSW 2308, Australia
| | - R J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
| | - L Kirsten
- Nepean Cancer Care Centre, Penrith, NSW 2751, Australia
| | - M Best
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW 2007, Australia
| | - J Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
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Kelly B, Moua T, Escalante P. 0715 Diagnosis of Sleep Disordered Breathing in Patients with Interstitial Lung Disease: A Retrospective Evaluation of Polysomnogram and Home Sleep Apnea Testing Using Peripheral Arterial Tonometry. Sleep 2022. [DOI: 10.1093/sleep/zsac079.711] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Previous studies have shown that sleep disordered breathing (SDB) is common in patients with Interstitial Lung Disease (ILD), and oximetry is often used for screening prior to further diagnostic testing. Current guidelines recommend polysomnography (PSG) for diagnosis of SDB in patients with significant pulmonary disease, however, home sleep apnea tests (HSAT) are increasingly used in clinical practice for a variety of reasons despite lack of evidence regarding accuracy in this population. In this study, we evaluate the correlation between screening oximetry, a commercial brand HSAT (WatchPAT®) and PSG to examine the diagnostic accuracy of this HSAT technology in patients with ILD.
Methods
The institution electronic medical record was screened for patients with a diagnosis code for ILD who underwent screening oximetry followed by PSG or HSAT using peripheral arterial tonometry from July 1, 2012 to present. Clinical review confirmed presence of ILD according to American Thoracic Society guidelines. Among the respective cohorts, Paired Wilcoxon Test was used to compare the oximetry 4% oxygen desaturation index (ODI) to the HSAT ODI and PSG apnea-hypopnea index (AHI) as well as percent time spent below oxyhemoglobin saturation of 89%. Spearman correlation was used to correlate the oximetry ODI and parameters of SDB on HSAT and PSG.
Results
Data was analyzed for 25 patients who had undergone oximetry/HSAT and for 25 patients who had undergone oximetry/PSG. Oximetry ODI showed no significant difference from PSG AHI (p = 0.2635) or between HSAT ODI (p = 0.0755), and no difference was seen in hypoxic time between oximetry and PSG (p = 0.9789). Hypoxic time on HSAT was significantly longer than that on oximetry (p < 0.001). Using HSAT ODI as the standard, HSAT AHI and respiratory disturbance index (RDI) showed rs of 0.9638 and 0.8913 respectively, while oximetry ODI was 0.3893. Compared to PSG AHI, the PSG RDI and oximetry ODI rs were 0.9759 and 0.7407 respectively.
Conclusion
Among patients with ILD, screening oximetry appears to correlate more strongly with indices of SDB and hypoxic time on PSG rather than HSAT. Further studies are warranted to evaluate efficacy of additional HSAT testing modalities in this patient population.
Support (If Any)
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Chen K, O'Brien J, Jenjitranant P, Alghazo O, Kelly B, Murphy D, Moon D. Robotic partial nephrectomy for complex hilar renal masses - key techniques for a successful outcome. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01356-2] [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: 11/04/2022]
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O'Brien J, Manning T, Kelly B, Chen K, Merrilees D, Joseph J, Sengupta S, Goad J, Bolton D, Lawrenstchuk N. Sealing the leak: A 10-year multicentre experience managing refractory post retroperitoneal lymph node dissection chylous ascites. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00647-9] [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: 11/04/2022]
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8
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Ismail R, Hegab S, Kelly B, Franco-Palacios DJ, Grafton G, Smith ZR, Awdish RLA. Serious illness conversations in pulmonary hypertension. Pulm Circ 2021; 11:20458940211037529. [PMID: 34733492 PMCID: PMC8558806 DOI: 10.1177/20458940211037529] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
Pulmonary arterial hypertension has evolved from a fatal disease with few treatment options to a chronic condition with improved survival. This improvement is possible through development of effective therapies as well as the expansion of risk stratification scores to assist clinical decision making. Despite improved disease control, quality of life, and overall prognosis, many challenges remain. The treatment itself is burdensome, with significant impact on quality of life. Many patients with pulmonary arterial hypertension still present with advanced, often end-stage disease. Increased use of mechanical circulatory support and catheter-based interventions have expanded use of extracorporeal life support and right ventricle assist devices. For these reasons as well as the long-term relationships pulmonary hypertension physicians have with patients and their families, navigating the course of the illness in a considered, proactive way is essential. Understanding individual goals and revisiting them as they change over time requires comfort with the conversation itself. There are many barriers and challenges to having effective, compassionate conversations in the clinical setting with time constraints being the most often cited. Compressed visits are necessarily focused on the clinical aspects, therapy and medication adherence and tolerance. Clinicians are sometimes wary of diminishing hope in the face of ongoing treatment. Having sufficient experience and comfort with these discussions can be empowering. In this paper, we discuss the challenges involved and propose a framework to assist in incorporating these discussions into clinical care.
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Affiliation(s)
- Reem Ismail
- Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, USA
| | - Sara Hegab
- Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, USA
| | - Bryan Kelly
- Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, USA
| | | | - Gillian Grafton
- Advanced Heart Failure and Transplant Cardiology, CICU, Henry Ford Hospital, Detroit, USA
| | | | - Rana L A Awdish
- Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, USA
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Kunze KN, Polce EM, Ranawat AS, Randsborg PH, Williams RJ, Allen AA, Nwachukwu BU, Pearle A, Stein BS, Dines D, Kelly A, Kelly B, Rose H, Maynard M, Strickland S, Coleman S, Hannafin J, MacGillivray J, Marx R, Warren R, Rodeo S, Fealy S, O'Brien S, Wickiewicz T, Dines JS, Cordasco F, Altcheck D. Application of Machine Learning Algorithms to Predict Clinically Meaningful Improvement After Arthroscopic Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med 2021; 9:23259671211046575. [PMID: 34671691 PMCID: PMC8521431 DOI: 10.1177/23259671211046575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Understanding specific risk profiles for each patient and their propensity to experience clinically meaningful improvement after anterior cruciate ligament reconstruction (ACLR) is important for preoperative patient counseling and management of expectations. Purpose: To develop machine learning algorithms to predict achievement of the minimal clinically important difference (MCID) on the International Knee Documentation Committee (IKDC) score at a minimum 2-year follow-up after ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: An ACLR registry of patients from 27 fellowship-trained sports medicine surgeons at a large academic institution was retrospectively analyzed. Thirty-six variables were tested for predictive value. The study population was randomly partitioned into training and independent testing sets using a 70:30 split. Six machine learning algorithms (stochastic gradient boosting, random forest, neural network, support vector machine, adaptive gradient boosting, and elastic-net penalized logistic regression [ENPLR]) were trained using 10-fold cross-validation 3 times and internally validated on the independent set of patients. Algorithm performance was assessed using discrimination, calibration, Brier score, and decision-curve analysis. Results: A total of 442 patients, of whom 39 (8.8%) did not achieve the MCID, were included. The 5 most predictive features of achieving the MCID were body mass index ≤27.4, grade 0 medial collateral ligament examination (compared with other grades), intratunnel femoral tunnel fixation (compared with suspensory), no history of previous contralateral knee surgery, and achieving full knee extension preoperatively. The ENPLR algorithm had the best relative performance (C-statistic, 0.82; calibration intercept, 0.10; calibration slope, 1.15; Brier score, 0.068), demonstrating excellent predictive ability in the study’s data set. Conclusion: Machine learning, specifically the ENPLR algorithm, demonstrated good performance for predicting a patient’s propensity to achieve the MCID for the IKDC score after ACLR based on preoperative and intraoperative factors. The femoral tunnel fixation method was the only significant intraoperative variable. Range of motion and medial collateral ligament integrity were found to be important physical examination parameters. Increased body mass index and prior contralateral surgery were also significantly predictive of outcome.
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Affiliation(s)
- Kyle N Kunze
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Evan M Polce
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Anil S Ranawat
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Per-Henrik Randsborg
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Riley J Williams
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Answorth A Allen
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Benedict U Nwachukwu
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | | | - Andrew Pearle
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Beth S Stein
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - David Dines
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Anne Kelly
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Bryan Kelly
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Howard Rose
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Michael Maynard
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Sabrina Strickland
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Struan Coleman
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Jo Hannafin
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - John MacGillivray
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Robert Marx
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Russell Warren
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Scott Rodeo
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Stephen Fealy
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Stephen O'Brien
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Thomas Wickiewicz
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Joshua S Dines
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - Frank Cordasco
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
| | - David Altcheck
- Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,All authors are listed in the Authors section at the end of this article.,Investigation performed at the Hospital for Special Surgery, New York, New York, USA
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Dunn E, Hakim J, Check R, Arner K, Ridley K, Agresti D, Kelly B, Stankewicz H, Jeanmonod R. 226 Patient Sex and Race as Independent Predictors of HEART Score Documentation by Emergency Medicine Providers. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.238] [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: 11/15/2022]
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11
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Rauck RC, Apostolakos JM, Nwachukwu BU, Schneider BL, Williams RJ, Dines JS, Altchek DW, Pearle A, Allen A, Stein BS, Dines D, Ranawat A, Kelly A, Kelly B, Rose H, Maynard M, Strickland S, Coleman S, Hannafin J, MacGillivray J, Marx R, Warren R, Rodeo S, Fealy S, O'Brien S, Wickiewicz T. Return to Sport After Bone-Patellar Tendon-Bone Autograft ACL Reconstruction in High School-Aged Athletes. Orthop J Sports Med 2021; 9:23259671211011510. [PMID: 34250173 PMCID: PMC8239981 DOI: 10.1177/23259671211011510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Anterior cruciate ligament (ACL) injuries are occurring with increasing frequency in the adolescent population. Outcomes after ACL reconstruction (ACLR) are inconsistently reported in homogeneous patient populations. Purpose/Hypothesis: To evaluate outcomes after bone–patellar tendon–bone (BTB) autograft ACLR in competitive high school–aged athletes by examining return to sport (RTS), patient satisfaction, and reinjury rates. Our hypothesis was that RTS rates and satisfaction will be high and reinjury rates will be low. Study Design: Case series; Level of evidence, 4. Methods: An institutional ACL registry was utilized to identify competitive high school–aged athletes (14-18 years old) who underwent primary ACLR using BTB autograft with a minimum 2-year follow-up. A postoperative questionnaire was administered to determine rates and types of RTS, quality of sports performance, reinjury, and satisfaction. Uni- and multivariable analyses were used to identify demographic, sport-specific, and clinical factors related to RTS. Results: A total of 53 patients were included (mean ± SD age at the time of surgery, 16.6 ± 1.34 years). Mean follow-up was 3.78 ± 0.70 years (range, 2.60-4.94 years). The overall ipsilateral ACL retear rate was 7.5% (n = 4). There were 10 subsequent ACL tears to the contralateral knee (19%). Forty-four (83%) patients successfully returned to at least their prior level of sport at a mean 10.5 ± 8.7 months (range, 3-48 months). Overall satisfaction was high, with 91% of patients very satisfied with the outcome. Higher confidence levels regarding performance of the reconstructed knee were associated with increased probability of RTS on multivariate analysis. Conclusion: BTB autograft ACLR results in high rates of RTS and satisfaction and low rates of subsequent ipsilateral ACL injuries in competitive high school–aged athletes. Patients with higher confidence in performance of the reconstructed knee are more likely to return to at least their prior level of sport.
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Affiliation(s)
- Ryan C Rauck
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - John M Apostolakos
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Benedict U Nwachukwu
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Brandon L Schneider
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Riley J Williams
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Joshua S Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - David W Altchek
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | | | - Andrew Pearle
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Answorth Allen
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Beth Shubin Stein
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - David Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Anil Ranawat
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Anne Kelly
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Bryan Kelly
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Howard Rose
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Michael Maynard
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Sabrina Strickland
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Struan Coleman
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Jo Hannafin
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - John MacGillivray
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Robert Marx
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Russell Warren
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Scott Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Stephen Fealy
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Stephen O'Brien
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
| | - Thomas Wickiewicz
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.,Investigation performed at Hospital for Special Surgery, New York, New York, USA
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O’Donnell M, Pradeep V, Dunne C, Gulati G, Kelly B. To assess the confidence levels of psychiatrists in physical healthcare competencies in one irish region, and to explore whether confidence was related to learning opportunities. Eur Psychiatry 2021. [PMCID: PMC9471364 DOI: 10.1192/j.eurpsy.2021.1587] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction The bi-directional relationship between mental and physical illness is well established. Therefore, in order to lower the already high mortality rates associated with psychiatric disorders, physical health issues must be closely monitored in this population [1,2]. A recent Lancet commission highlights emerging strategies and recommendations for improvement of physical health outcomes in patients with chronic mental disorders. These strategies involve better integration of physical and mental health care, combined with broader implementation of lifestyle interventions to reduce elevated cardiometabolic risk and attenuate medication side-effects [3]. Objectives To assess psychiatrists’ confidence levels in physical healthcare competencies; to explore whether confidence was related to learning opportunities. Methods Physical healthcare learning objectives were extracted from the Irish College of Psychiatrists’ training curriculum. An electronic questionnaire was sent to 50 psychiatrists in one Irish healthcare region with a catchment area of c. 450,000. Participants had to rate confidence levels for each competency on a five-point Likert scale and the availability of learning opportunities for attaining each competency. Results 66% response rate was achieved. A majority reported confidence in cardiovascular examination, interpreting blood results and evaluating comorbidities. A minority reported confidence in interpreting imaging, electrocardiograms and recognising medical emergencies. This corresponds to a relative paucity of learning opportunities. Conclusions Clinical implication Programmes for trainee doctors and CME opportunities for consultant psychiatrists would benefit from an emphasis on physical health examination and modules on interpreting investigations and the recognition of medical emergencies.
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Martirosov AL, Smith ZR, Hencken L, MacDonald NC, Griebe K, Fantuz P, Grafton G, Hegab S, Ismail R, Jackson B, Kelly B, Miller M, Awdish R. Improving transitions of care for critically ill adult patients on pulmonary arterial hypertension medications. Am J Health Syst Pharm 2021; 77:958-965. [PMID: 32495842 DOI: 10.1093/ajhp/zxaa079] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The purpose of this report is to describe the activities of critical care and ambulatory care pharmacists in a multidisciplinary transitions-of-care (TOC) service for critically ill patients with pulmonary arterial hypertension (PAH) receiving PAH medications. SUMMARY Initiation of medications for treatment of PAH involves complex medication access steps. In the ambulatory care setting, multidisciplinary teams often have a process for completing these steps to ensure access to PAH medications. Patients with PAH are frequently admitted to an intensive care unit (ICU), and their home PAH medications are continued and/or new medications are initiated in the ICU setting. Inpatient multidisciplinary teams are often unfamiliar with the medication access steps unique to PAH medications. The coordination and completion of medication access steps in the inpatient setting is critical to ensure access to medications at discharge and prevent delays in care. A PAH-specific TOC bundle for patients prescribed a PAH medication who are admitted to the ICU was developed by a multidisciplinary team at an academic teaching hospital. The service involves a critical care pharmacist completing a PAH medication history, assessing for PAH medication access barriers, and referring patients to an ambulatory care pharmacist for postdischarge telephone follow-up. In collaboration with the PAH multidisciplinary team, a standardized workflow to be initiated by the critical care pharmacist was developed to streamline completion of PAH medication access steps. Within 3 days of hospital discharge, the ambulatory care pharmacist calls referred patients to ensure access to PAH medications, provide disease state and medication education, and request that the patient schedule a follow-up office visit to take place within 14 days of discharge. CONCLUSION Collaboration by a PAH multidisciplinary team, critical care pharmacist, and ambulatory care pharmacist can improve TOC related to PAH medication access for patients with PAH. The PAH TOC bundle serves as a model that may be transferable to other health centers.
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Affiliation(s)
| | | | | | | | | | | | | | - Sara Hegab
- Henry Ford Hospital, Detroit, MI, and Wayne State University School of Medicine, Detroit, MI
| | | | | | | | | | - Rana Awdish
- Henry Ford Hospital, Detroit, MI, and Wayne State University School of Medicine, Detroit, MI
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Bak GS, Shaffer BL, Madriago E, Allen A, Kelly B, Caughey AB, Pereira L. Impact of maternal obesity on fetal cardiac screening: which follow-up strategy is cost-effective? Ultrasound Obstet Gynecol 2020; 56:705-716. [PMID: 31614030 DOI: 10.1002/uog.21895] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To perform a cost-effectiveness analysis of different follow-up strategies for non-obese and obese women who had incomplete fetal cardiac screening for major congenital heart disease (CHD). METHODS Three decision-analytic models, one each for non-obese, obese and Class-III-obese women, were developed to compare five follow-up strategies for initial suboptimal fetal cardiac screening. The five strategies were: (1) no follow-up ultrasound (US) examination but direct referral to fetal echocardiography (FE); (2) one follow-up US, then FE if fetal cardiac views were still suboptimal; (3) up to two follow-up US, then FE if fetal cardiac views were still suboptimal; (4) one follow-up US and no FE; and (5) up to two follow-up US and no FE. The models were designed to identify fetuses with major CHD in a theoretical cohort of 4 000 000 births in the USA. Outcomes related to neonatal mortality and neurodevelopmental disability were evaluated. A cost-effectiveness willingness-to-pay threshold was set at US$100 000 per quality-adjusted life year (QALY). Base-case and sensitivity analysis and Monte-Carlo simulation were performed. RESULTS In our base-case models for all body mass index (BMI) groups, no follow-up US, but direct referral to FE led to the best outcomes, detecting 7%, 25% and 82% more fetuses with CHD in non-obese, obese and Class-III-obese women, respectively, compared with the baseline strategy of one follow-up US and no FE. However, no follow-up US, but direct referral to FE was above the US$100 000/QALY threshold and therefore not cost-effective. The cost-effective strategy for all BMI groups was one follow-up US and no FE. Both up to two follow-up US with no FE and up to two follow-up US with FE were dominated (being more costly and less effective), while one follow-up US with FE was over the cost-effectiveness threshold. One follow-up US and no FE was the optimal strategy in 97%, 93% and 86% of trials in Monte-Carlo simulation for non-obese, obese and Class-III-obese models, respectively. CONCLUSION For both non-obese and obese women with incomplete fetal cardiac screening, the optimal CHD follow-up screening strategy is no further US and immediate referral to FE; however, this strategy is not cost-effective. Considering costs, one follow-up US and no FE is the preferred strategy. For both obese and non-obese women, Monte-Carlo simulations showed clearly that one follow-up US and no FE was the optimal strategy. Both non-obese and obese women with initial incomplete cardiac screening examination should therefore be offered one follow-up US. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G S Bak
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - B L Shaffer
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - E Madriago
- Department of Pediatrics, Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, USA
| | - A Allen
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - B Kelly
- Department of Pediatrics, Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, USA
| | - A B Caughey
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - L Pereira
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
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Rivard L, Pester J, McMahon K, Balakrishnan V, Check R, Kelly B, Jeanmonod D, Jeanmonod R. 368 Efficacy of Continuous Use Disposable N95 Masks in Clinical Practice in the Emergency Department. Ann Emerg Med 2020. [PMCID: PMC7598380 DOI: 10.1016/j.annemergmed.2020.09.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Esmonde S, McCullagh D, Kelly B, McCann C. SGLT2 INHIBITORS - SOMETHING IN THE WATER, OR THE HEART OF THE MATTER? Ulster Med J 2020; 89:113. [PMID: 33093699 PMCID: PMC7576400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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17
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Kahwati L, Kelly B, Clark R, Viswanathan M. Conveying Results from Qualitative Comparative Analyses within Systematic Reviews: A Randomized Trial. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13487] [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: 11/27/2022] Open
Affiliation(s)
- L. Kahwati
- RTI International Research Triangle Park NC United States
| | - B. Kelly
- RTI International Washington DC United States
| | - R. Clark
- Cricket Health San Francisco United States
| | - M. Viswanathan
- RTI International Research Triangle Park NC United States
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Bak GS, Shaffer BL, Madriago E, Allen A, Kelly B, Caughey AB, Pereira L. Detection of fetal cardiac anomalies: cost-effectiveness of increased number of cardiac views. Ultrasound Obstet Gynecol 2020; 55:758-767. [PMID: 31945242 DOI: 10.1002/uog.21977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 12/22/2019] [Accepted: 12/31/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To compare the recommended three-view fetal heart screening method to detect major congenital heart disease (CHD) with more elaborate screening strategies to determine the cost-effective strategy in unselected (low-risk) pregnancies. METHODS A decision-analytic model was designed to compare four screening strategies to identify fetuses with major CHD in a theoretical cohort of 4 000 000 births in the USA. The four strategies were: (1) three views: four-chamber view (4CV) and views of the left (LVOT) and right (RVOT) ventricular outflow tracts; (2) five views: 4CV, LVOT, RVOT and longitudinal views of the ductal arch and aortic arch; (3) five axial views: 4CV, LVOT, RVOT, three-vessel (3V) view and three-vessels-and-trachea view; and (4) six views: 4CV, LVOT, RVOT and 3V views and longitudinal views of the ductal arch and aortic arch. Outcomes related to neonatal mortality and neurodevelopmental disability were evaluated. The analysis was performed from a healthcare-system perspective, with a cost-effectiveness willingness-to-pay threshold set at $100 000 per quality-adjusted life year (QALY). Baseline analysis, one-way sensitivity analysis and Monte-Carlo simulation were performed. RESULTS In our baseline model, screening with five axial views was the optimal strategy, detecting 3520 more CHDs, and resulting in 259 fewer children with neurodevelopmental disability, 40 fewer neonatal deaths and only slightly higher costs, compared with screening with the currently recommended three views. Screening with six views was more effective, but also cost considerably more, compared with screening with five axial views, and had an incremental cost of $490 023/QALY, which was over the willingness-to-pay threshold. The five-view strategy was dominated by the other three strategies, i.e. it was more costly and less effective in comparison. The data were robust when tested with Monte-Carlo and one-way sensitivity analysis. CONCLUSION Although current guidelines recommend a minimum of three views for detecting CHD during the mid-trimester anatomy scan, screening with five axial views is a cost-effective strategy that may lead to improved outcome compared with three-view screening. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G S Bak
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - B L Shaffer
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - E Madriago
- Department of Pediatrics, Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, USA
| | - A Allen
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - B Kelly
- Department of Pediatrics, Division of Pediatric Cardiology, Oregon Health & Science University, Portland, OR, USA
| | - A B Caughey
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - L Pereira
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
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Higginson R, MacConville S, Innes A, Kelly B. The effectiveness of a multi-disciplinary designed intervention to promote self-management of joint pain performed by non-clinicians: s service evaluation. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.192] [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: 10/24/2022]
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20
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Yeowell G, Staniford L, Powell S, Fatoye F, Kelly B. A qualitative study exploring the provider and patient perspective of two rehabilitation programmes following knee replacement surgery. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.119] [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: 10/24/2022]
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Doherty A, Kelly B. The Social and Psychological Correlates of Happiness in Seventeen European Countries: Analysis of Data from the European Social Survey. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)71141-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background:Happiness has been associated with a number of individual and societal factors, but much of the individual-to-individual variation in happiness remains unexplained. The purpose of this paper is to examine a broad range of social and psychological correlates of self-rated happiness in Europe.Methods:We used data from the European Social Survey to determine levels of happiness in individuals (n=30,816) from seventeen European countries and to identify associations between happiness and age, gender, family relationships, satisfaction with income, employment status, community trust, satisfaction with health, satisfaction with democracy, religious belief and country of residence.Results:Self-rated happiness varies significantly between European countries, with individuals in Denmark reporting the highest levels of happiness and individuals in Bulgaria reporting the lowest levels. On multi-variable analysis, happiness is positively correlated with younger age, satisfaction with household income, being employed, high community trust and religious belief. Overall, these factors account for 22.5% of the individual-to-individual variation in happiness in Europe.Conclusion:For the individual, this study highlights the strength of association between happiness and the individual's attitudes towards various aspects of their personal, household and societal circumstances. For social policy-makers, this study confirms the potential usefulness of civic measures to increase community trust and social capital. Further studies of the inter-relationships between individual and community-level variables would assist in further explaining the variance in happiness between individuals and countries.
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Nasstasia Y, Baker A, Lewin T, Halpin S, Hides L, Kelly B, Callister R. Motivational interviewing as a prelude to an exercise intervention enhances program engagement and self-efficacy in youth with major depression. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.125] [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: 11/28/2022]
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24
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Yaqub M, Kelly B, Stobart H, Napolitano R, Noble JA, Papageorghiou AT. Quality-improvement program for ultrasound-based fetal anatomy screening using large-scale clinical audit. Ultrasound Obstet Gynecol 2019; 54:239-245. [PMID: 30302849 PMCID: PMC6771606 DOI: 10.1002/uog.20144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/15/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE A large-scale audit and peer review of ultrasound images may improve sonographer performance, but is rarely performed consistently as it is time-consuming and expensive. The aim of this study was to perform a large-scale audit of routine fetal anatomy scans to assess if a full clinical audit cycle can improve clinical image-acquisition standards. METHODS A large-scale, clinical, retrospective audit was conducted of ultrasound images obtained during all routine anomaly scans performed from 18 + 0 to 22 + 6 weeks' gestation at a UK hospital during 2013 (Cycle 1), to build a baseline understanding of the performance of sonographers. Targeted actions were undertaken in response to the findings with the aim of improving departmental performance. A second full-year audit was then performed of fetal anatomy ultrasound images obtained during the following year (Cycle 2). An independent pool of experienced sonographers used an online tool to assess all scans in terms of two parameters: scan completeness (i.e. were all images archived?) and image quality using objective scoring (i.e. were images of high quality?). Both were assessed in each audit at the departmental level and at the individual sonographer level. A random sample of 10% of scans was used to assess interobserver reproducibility. RESULTS In Cycle 1 of the audit, 103 501 ultrasound images from 6257 anomaly examinations performed by 22 sonographers were assessed; in Cycle 2, 153 557 images from 6406 scans performed by 25 sonographers were evaluated. The analysis was performed including the images obtained by the 20 sonographers who participated in both cycles. Departmental median scan completeness improved from 72% in the first year to 78% at the second assessment (P < 0.001); median image-quality score for all fetal views improved from 0.83 to 0.86 (P < 0.001). The improvement was greatest for those sonographers who performed poorest in the first audit; with regards to scan completeness, the poorest performing 15% of sonographers in Cycle 1 improved by more than 30 percentage points, and with regards to image quality, the poorest performing 11% in Cycle 1 showed a more than 10% improvement. Interobserver repeatability of scan completeness and image-quality scores across different fetal views were similar to those in the published literature. CONCLUSIONS A clinical audit and a set of targeted actions helped improve sonographer scan-acquisition completeness and scan quality. Such adherence to recommended clinical acquisition standards may increase the likelihood of correct measurement and thereby fetal growth assessment, and should allow better detection of abnormalities. As such a large-scale audit is time consuming, further advantages would be achieved if this process could be automated. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. Yaqub
- Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
| | - B. Kelly
- Nuffield Department of Women's and Reproductive HealthUniversity of OxfordOxfordUK
| | - H. Stobart
- Nuffield Department of Women's and Reproductive HealthUniversity of OxfordOxfordUK
| | - R. Napolitano
- Nuffield Department of Women's and Reproductive HealthUniversity of OxfordOxfordUK
| | - J. A. Noble
- Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
| | - A. T. Papageorghiou
- Nuffield Department of Women's and Reproductive HealthUniversity of OxfordOxfordUK
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Milner A, King TL, Scovelle AJ, Batterham PJ, Kelly B, LaMontagne AD, Harvey SB, Gullestrup J, Lockwood C. A blended face-to-face and smartphone intervention for suicide prevention in the construction industry: protocol for a randomized controlled trial with MATES in Construction. BMC Psychiatry 2019; 19:146. [PMID: 31088405 PMCID: PMC6515600 DOI: 10.1186/s12888-019-2142-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 05/06/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Construction workers are at elevated risk of suicide. MATES in Construction (MATES) is one of the few suicide prevention programs that explicitly address this problem. The MATES program includes an integrated system of services that supports prevention, early intervention and recovery (i.e., primary, secondary and tertiary prevention) for mental health problems among construction workers. In this protocol, we describe a proposed evaluation of MATESmobile, an electronic platform which will be accessed by workers who have undergone MATES training. METHODS/DESIGN In this protocol, we describe a Randomised Controlled Trial (RCT) which seeks to assess whether MATESmobile results in improved literacy regarding suicide prevention, and improved help-seeking and help-offering attitudes among those who have attended MATES training. Secondary outcomes include changes in suicide ideation, suicide attempt and psychological distress. Workers will be recruited prior to MATES face-to-face training. In total, 295 workers will be randomly assigned to the intervention condition (MATESmobile + face-to-face training) and 295 will be randomly allocated to the control (face-to-face training). The intervention will run for 8 weeks. Assessments will be run immediately post intervention, and at 3, 6, and 12 months DISCUSSION: MATESmobile offers the potential to reinforce and enhance the effects of face-to-face training, resulting in greater skills and knowledge in suicide prevention, as well as a reduction in suicidality and distress. TRIAL REGISTRATION This trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12619000625178 ; 26 April 2019).
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Affiliation(s)
- A. Milner
- 0000 0001 2179 088Xgrid.1008.9Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, Victoria 3010 Australia
| | - T. L. King
- 0000 0001 2179 088Xgrid.1008.9Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, Victoria 3010 Australia
| | - A. J. Scovelle
- 0000 0001 2179 088Xgrid.1008.9Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, Victoria 3010 Australia
| | - P. J. Batterham
- 0000 0001 2180 7477grid.1001.0Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT 2601 Australia
| | - B. Kelly
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales 2308 Australia
| | - A. D. LaMontagne
- 0000 0001 0526 7079grid.1021.2Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, Victoria Australia
| | - S. B. Harvey
- 0000 0004 4902 0432grid.1005.4Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - J. Gullestrup
- MATES in Construction, Spring Hill, Queensland 4004 Australia
| | - C. Lockwood
- MATES in Construction, Spring Hill, Queensland 4004 Australia
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Sahota S, Kelly B. Editorial Commentary: Hip Arthroscopy in the Professional Athlete…Back in the Game. Arthroscopy 2019; 35:843-844. [PMID: 30827437 DOI: 10.1016/j.arthro.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 12/19/2018] [Accepted: 01/02/2019] [Indexed: 02/02/2023]
Abstract
With improved outcomes and expanding indications, the rate of hip arthroscopy for treatment of numerous pathologies has increased. There is significant interest from patients and providers alike regarding return to meaningful play after surgical intervention, particularly for the professional athlete. Although each athlete and each sport have unique obstacles, the literature suggests hip arthroscopy has a high success rate and allows for elite athletes to return to play without significant differences in postoperative performance scores.
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Squiers L, Lynch M, Dolina S, Ray S, Kelly B, Herrington J, Turner M, Chawla D, Becker-Dreps S, Stamm L, McCormack L. Zika and travel in the news: a content analysis of US news stories during the outbreak in 2016-2017. Public Health 2019; 168:164-167. [PMID: 30772009 DOI: 10.1016/j.puhe.2018.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 04/26/2018] [Revised: 11/08/2018] [Accepted: 12/02/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study aimed to understand what information the US media communicated about Zika virus (ZIKV) and travel in 2016 and 2017. STUDY DESIGN We conducted a content analysis of news coverage about ZIKV and travel from April 5, 2016 to March 31, 2017. METHODS We obtained a stratified, random sample of English language, US print newspaper and television news coverage about ZIKV and travel. We developed a coding scheme to assess key messages in the news, including how ZIKV is transmitted, the symptoms and outcomes of ZIKV infection, and recommended prevention behaviors. RESULTS Almost all news stories mentioned mosquito-borne transmission (96.8%) and just over half mentioned sexual transmission (55.3%). News stories were more likely to talk about ZIKV outcomes (78.8%) than ZIKV symptoms (40.6%). However, outcomes affecting babies were mentioned more frequently than outcomes affecting adults. Recommendations included a wide array of protective behaviors, such as delaying or avoiding travel (77.6%) and using mosquito repellent (41.0%). However, few studies (10.9%) mentioned barriers to practicing ZIKV prevention behaviors. CONCLUSIONS Public health organizations and professionals can use these findings to help improve communication about future outbreaks of mosquito-borne illnesses. We also recommend conducting real-time monitoring of news media and frequent content analysis of news stories to ensure coverage provides the information the public needs.
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Affiliation(s)
- L Squiers
- RTI International, P.O. Box 12194, Research Triangle Park, NC, USA.
| | - M Lynch
- RTI International, P.O. Box 12194, Research Triangle Park, NC, USA.
| | - S Dolina
- RTI International, P.O. Box 12194, Research Triangle Park, NC, USA.
| | - S Ray
- RTI International, P.O. Box 12194, Research Triangle Park, NC, USA.
| | - B Kelly
- RTI International, P.O. Box 12194, Research Triangle Park, NC, USA.
| | - J Herrington
- Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, USA.
| | - M Turner
- Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, USA.
| | - D Chawla
- Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, USA.
| | - S Becker-Dreps
- Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, USA; University of North Carolina School of Medicine, University of North Carolina, 321 S Columbia St., Chapel Hill, NC, USA.
| | - L Stamm
- Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, USA.
| | - L McCormack
- RTI International, P.O. Box 12194, Research Triangle Park, NC, USA.
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28
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Kelly B, West J, Yang TC, Mason D, Hasan T, Wright J. The association between body mass index, primary healthcare use and morbidity in early childhood: findings from the Born In Bradford cohort study. Public Health 2019; 167:21-27. [PMID: 30610958 DOI: 10.1016/j.puhe.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/08/2018] [Revised: 10/01/2018] [Accepted: 10/25/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The objective of the article was to examine the association between body mass index (BMI), health and general practice (GP) healthcare use in early childhood. STUDY DESIGN This study is a prospective cohort study. METHODS Multivariate Poisson and logistic regression models were used to explore the association between BMI and health outcomes using data from the Born In Bradford cohort study, linked to routine data capturing objective measures of BMI at age 5 years, alongside GP appointment rates, GP prescriptions and specific morbidities in the subsequent 3-year period. RESULTS Compared with healthy weight, children who were obese at the age of 5 years had significantly higher rates of GP appointments (incident rate ratio 1.14, 95% confidence interval [CI]: 1.06-1.23), GP prescriptions (incident rate ratio 1.15, 95% CI: 1.04-1.27), asthma (odds ratio 1.46, 95% CI: 1.21-1.77), sleep apnoea (odds ratio 2.50, 95% CI: 1.36-4.58), infections (incident rate ratio 1.19, 95% CI: 1.08-1.30), antibiotic prescriptions (incident rate ratio 1.25, 95% CI: 1.10-1.42) and accidents (incident rate ratio 1.20, 95% CI: 1.01-1.42) in the subsequent 3 years. Underweight children were found to have higher rates of GP appointments (incident rate ratio 1.25, 95% CI: 1.04-1.52), but there were no differences between overweight and healthy weight children. CONCLUSIONS Childhood obesity was found to be associated with increased primary healthcare use and a range of poorer health outcomes at the age of 8 years, underlining the importance of reducing childhood obesity in early childhood.
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Affiliation(s)
- B Kelly
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
| | - J West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - T C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - D Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - T Hasan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK; Department of Health Sciences, University of York, York, UK
| | - J Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Burns D, Dagnall N, Powell S, Clough P, Bailey R, Kelly B, Deniszczyc D. Personalising health advice: a pilot study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.261] [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: 11/12/2022] Open
Affiliation(s)
- D Burns
- Manchester Metropolitan University, Manchester, UK
| | - N Dagnall
- Manchester Metropolitan University, Manchester, UK
| | - S Powell
- Manchester Metropolitan University, Manchester, UK
| | - P Clough
- University of Huddersfield, Huddersfield, UK
| | - R Bailey
- Manchester Metropolitan University, Manchester, UK
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30
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Kelly B, Vandevijvere S, Hoe NS, Pravst I, Boyland E, Royo-Bordonada MA, Calleja P, Potvin Kent M, Jaichuen N, Karupaiah T, Allemandi L, Cosenza EL, Tutuo Wate J, Zamora-Corrales I, González-Zapata LI, Mchiza ZJR, Zeng L, Swinburn B. Benchmarking children’s potential exposures to television unhealthy food advertising globally. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.676] [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: 11/13/2022] Open
Affiliation(s)
- B Kelly
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - S Vandevijvere
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - NS Hoe
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - I Pravst
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - E Boyland
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - MA Royo-Bordonada
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - P Calleja
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - M Potvin Kent
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - N Jaichuen
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - T Karupaiah
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - L Allemandi
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - EL Cosenza
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - J Tutuo Wate
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - I Zamora-Corrales
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - LI González-Zapata
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - ZJR Mchiza
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - L Zeng
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
| | - B Swinburn
- INFORMAS: International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support
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Phadke R, Herron B, Hurrell D, Craig S, Kelly B, Sarkozy A, Sewry C, Muntoni F, McConnell V. CONGENITAL MYOPATHIES: NEMALINE AND TITINOPATHIES. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.285] [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: 10/28/2022]
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Dixon S, Agha K, Ali F, El-Hindi L, Kelly B, Locock L, Otoo-Oyortey N, Penny S, Plugge E, Hinton L. Female genital mutilation in the UK- where are we, where do we go next? Involving communities in setting the research agenda. Res Involv Engagem 2018; 4:29. [PMID: 30237901 PMCID: PMC6139895 DOI: 10.1186/s40900-018-0103-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Female Genital Mutilation (FGM) is all practices involving cutting, alteration or injury to the female genitalia for non-medical reasons. It is a form of violence against women and children, with no benefits and many harms. In 2014, the UK Government committed to working to eliminate FGM. Steps taken towards this aim included creation of educational and safeguarding resources for professionals, and legislative changes including a mandatory reporting duty for professionals in England and Wales (where if a girl under 18 discloses or is found on examination to have FGM then the professional is mandated to report this to the police), and an FGM Enhanced Dataset applicable to NHS organisations in England requiring the submission of personal data about women and girls who have had FGM to NHS Digital. To date, compliance with dataset returns from primary care services have been low. This report describes using patient and public involvement (PPI) to identify research and service priorities to support communities affected by FGM. METHODS We held a series of PPI events (4 focus groups, and a multi-agency seminar) in 2015-2016, following the introduction of these legislative changes, speaking to community members, and professionals involved in their care. We asked participants to consider what they identified as research, knowledge and service priorities to support communities affected by FGM. RESULTS The impact of these legislative and reporting requirements on the trust needed for community members to seek to consult health services was identified as important for further research. Priorities for service development were holistic services, that met a woman's needs throughout her lifecourse. Participants emphasised the importance of understanding how to listen, involve and utilise community voices in developing education for professionals, designing services, and developing policy. CONCLUSIONS There was a desire for change to develop from within affected communities; any learning and resources need to be co-created and constructed in such a way that they can be effectively shared between women, communities, and professionals. Questions remain about how to define community consultation, how to recognise when it was adequate, and how to hear beyond community activists to hear a wider range of voices.
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Affiliation(s)
- S. Dixon
- Nuffield department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - K. Agha
- Oxford Against Cutting, Oxford, UK
| | - F. Ali
- Midaye Somali Development Network, London, UK
| | | | - B. Kelly
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - L. Locock
- Nuffield department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - S. Penny
- English Creative Writing Department, Brunel University, London, UK
| | - E. Plugge
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - L. Hinton
- Nuffield department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Burbank J, Kelly B, Nilsson J, Power M. Tests of size and growth effects on Arctic charr (Salvelinus alpinus) otolith δ 18 O and δ 13 C values. Rapid Commun Mass Spectrom 2018; 32:1557-1564. [PMID: 29874707 DOI: 10.1002/rcm.8198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
RATIONALE Otolith δ18 O and δ13 C values have been used extensively to reconstruct thermal and diet histories. Researchers have suggested that individual growth rate and size may have an effect on otolith isotope ratios and subsequently confound otolith-based thermal and diet reconstructions. As few explicit tests of the effect on fish in freshwater environments exist, here we determine experimentally the potential for related growth rate and size effects on otolith δ18 O and δ13 C values. METHODS Fifty Arctic charr were raised in identical conditions for two years after which their otoliths were removed and analyzed for their δ18 O and δ13 C values. The potential effects of final length and the Thermal Growth Coefficient (TGC) on otolith isotope ratios were tested using correlation and regression analysis to determine if significant effects were present and to quantify effects when present. RESULTS The analyses indicated that TGC and size had significant and similar positive non-linear relationships with δ13 C values and explained 35% and 42% of the variability, respectively. Conversely, both TGC and size were found to have no significant correlation with otolith δ18 O values. There was no significant correlation between δ18 O and δ13 C values. CONCLUSIONS The investigation indicated the presence of linked growth rate and size effects on otolith δ13 C values, the nature of which requires further study. Otolith δ18 O values were unaffected by individual growth rate and size, confirming the applicability of these values to thermal reconstructions of fish habitat.
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Affiliation(s)
- J Burbank
- Department of Biology, University of Waterloo, 200 University Ave. West, Waterloo, ON, Canada, N2L 3G1
| | - B Kelly
- World Wildlife Fund Canada, 5251 Duke Street, Duke Tower, Suite 1202, Halifax, NS, Canada, B3J 1P3
| | - J Nilsson
- Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
| | - M Power
- Department of Biology, University of Waterloo, 200 University Ave. West, Waterloo, ON, Canada, N2L 3G1
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Kelly B, Moua T. Usual interstitial pneumonia: A distinct group within interstitial pneumonia with autoimmune features? - Reply. Respirology 2018; 23:959. [PMID: 30070408 DOI: 10.1111/resp.13379] [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] [Received: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Bryan Kelly
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Teng Moua
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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35
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Bhatia S, Ellman MB, Nho S, Mather RC, Bedi A, Aoki SK, Larson CM, Kelly B, Griffin DR, O'Donnell J, Mei-Dan O. Bilateral Hip Arthroscopy: Direct Comparison of Primary Acetabular Labral Repair and Primary Acetabular Labral Reconstruction. Arthroscopy 2018; 34:1748-1751. [PMID: 29804596 DOI: 10.1016/j.arthro.2018.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 03/27/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Sanjeev Bhatia
- Hip Arthroscopy and Joint Preservation Center, Cincinnati Sports Medicine and Orthopaedic Center-Mercy Health, Cincinnati, Ohio, U.S.A
| | - Michael B Ellman
- Hip Preservation Center, Panorama Orthopedics and Spine Center, Golden, Colorado, U.S.A
| | - Shane Nho
- Division of Sports Medicine, Rush University Department of Orthopaedics, Rush University, Chicago, Illinois, U.S.A
| | - Richard C Mather
- Division of Sports Medicine, Department of Orthopaedic Surgery, Duke Health, Durham, North Carolina, U.S.A
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Stephen K Aoki
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, U.S.A
| | - Christopher M Larson
- Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopaedics, Edina, Minnesota, U.S.A
| | - Bryan Kelly
- Hip Preservation Center, Hospital of Special Surgery, New York, New York, U.S.A
| | - Damian R Griffin
- University Hospitals of Coventry and Warwickshire NHS Trust and Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - John O'Donnell
- Hip Arthroscopy Australia, Richmond, Victoria, Australia
| | - Omer Mei-Dan
- Department of Orthopedics, Hip Preservation Service, University of Colorado School of Medicine, Boulder, Colorado, U.S.A
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Kelly B, Yang T, Truesdale K, Bryant M. 7.1-O7Discrepancy between measured and perceived weight in a multi-ethnic population in the UK: comparisons by ethnicity and migration. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.237] [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: 11/13/2022] Open
Affiliation(s)
- B Kelly
- Bradford Institute for Health Research, United Kingdom
| | - T Yang
- Bradford Institute for Health Research, United Kingdom
| | - K Truesdale
- University of North Carolina Gillings School of Global Public Health, United States
| | - M Bryant
- University of Leeds, United Kingdom
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Dixon S, Fazel M, Kelly B, Andersson M, Al-Hourani K, Dwivedi K, O'Higgins A, Reeves M. 1.10-P2The Oxford (UK) Refugee Health Initiative project: medical students supporting refugee families to provide healthcare advocacy and develop skills to care for vulnerable groups of patients. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.002] [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: 11/14/2022] Open
Affiliation(s)
- S Dixon
- Nuffield Department Of Primary Health Care Sciences, University Of Oxford, United Kingdom
| | - M Fazel
- Department of Psychiatry, Medical Sciences Division, University of Oxford, United Kingdom
| | - B Kelly
- Nuffield Department of Obstetrics and Gynaecology, Medical Sciences Division, University of Oxford, United Kingdom
| | - M Andersson
- Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, United Kingdom
| | - K Al-Hourani
- Oxford University Medical School, United Kingdom
| | - K Dwivedi
- Oxford University Medical School, United Kingdom
| | - A O'Higgins
- Department of Education, University of Oxford, United Kingdom
| | - M Reeves
- Cowley Road Medical Practice, Oxford, United Kingdom
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Smith ZR, Kelly B, Awdish RL, Hegab S. Transitioning Parenteral or Inhaled Treprostinil to Oral Treprostinil Diolamine: Case Series and Review of the Literature. J Pharm Pract 2018; 32:599-604. [PMID: 29558853 DOI: 10.1177/0897190018764585] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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] [Indexed: 11/15/2022]
Abstract
Treprostinil diolamine is the first oral dosage preparation of a prostacyclin analogue for use in treatment naive pulmonary arterial hypertension (PAH). This case series and review of the available literature describes the experience of patients with PAH receiving treprostinil by intravenous (IV), subcutaneous (SQ), or inhalation route who were transitioned to treprostinil diolamine. At our institution, 3 patients were transitioned to treprostinil diolamine who received treprostinil administered by each of the alternative routes: IV, SQ, and inhalation. All patients tolerated the transition without significant worsening of disease end points. In the literature, 5 additional reports representing 48 patients were transitioned to treprostinil diolamine from an alternate route of administration. A majority (92%) of patients were hospitalized during the cross-titration phase and tolerated the transition without changes in disease markers or significant adverse effect. Six (13%) patients required reinitiation of parenteral therapy due to clinical decline. The most common dosing frequency utilized for treprostinil diolamine was 3 times per day. In patients with stable PAH receiving parenteral or inhaled treprostinil, a transition to treprostinil diolamine was a safe approach in a highly select population meeting clinical end points. Additional studies are required to further describe this clinical strategy before accepted in clinical practice.
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Affiliation(s)
- Zachary R Smith
- Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA
| | - Bryan Kelly
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Rana L Awdish
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Sara Hegab
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI, USA
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Sidibé BY, Dembélé BT, Bah A, Maiga A, Coulibaly A, Traoré A, Konaté M, Kelly B, Traoré AA, Koné T, Karembé B, Kanté L, Diakité I, Almeimoune AH, Togo A. [Bilio-Digestives Derivative In The Palliative Surgery Of Pancreatic Head Cancer At The CHU Gabriel TOURE]. Mali Med 2018; 33:29-32. [PMID: 35897198] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Our objective was to determine the frequency of bilio-digestive bypass in palliative surgery in pancreatic head cancers, to determine the clinical and para-clinical aspects and to analyze the results of the treatment. METHODS This was a-15 year retrospective study from 1999 to 2014 including any patient with confirmed pancreatic cancer in the anatomo-pathology treated by palliative surgery in the department. RESULTS In 15 years, we operated152 cases of cancer of the head of the pancreas. The bilio-digestive derivation was performed in 78 patients, or 51.32%. The average age was 58.61 years ± 11.22 years with the extremes of 34 and 79 years old, the sex ratio was 1.44. The disease duration was 4.88 months on average with a standard deviation of 4.28 months and extremes of 1 and 24 months. Courvoisier-Terrier's disease was observed in 76 cases with lesions of the cases. The average pancreatic tumor size was 62.98 mm, and standard deviation = 8.68 with the extremes of45 and 121 mm. We performed a choledoco-duodenal anastomosis and a gastro-entero-anastomosis (GEA) in 85.90% of cases (n = 67), a choledocojejunal anastomosis and a GEA in 7 cases and a choledoco-duodenal anastomosis without GEA in 4 cases. The morbidity and the mortality rates were15.4% and 6.41%, respectively. At six (6) months postsurgery, a complete disappearance the majority of the functional signs was observed. CONCLUSION Pancreatic cancer is a slowly developing tumor. Therefore its diagnosis is late; the derivation makes it possible to improve the quality of life of the patients.
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Affiliation(s)
- B Y Sidibé
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - B T Dembélé
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - A Bah
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - A Maiga
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - A Coulibaly
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - A Traoré
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - M Konaté
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - B Kelly
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - A A Traoré
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - T Koné
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - B Karembé
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - L Kanté
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - I Diakité
- Département de chirurgie CHU Gabriel Touré de Bamako, Mali
| | - A H Almeimoune
- Département d'anesthésie, de réanimation et de médecine d'urgence CHU Gabriel Touré
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McNeilly P, Macdonald G, Kelly B. The participation of parents of disabled children and young people in health and social care decisions. Child Care Health Dev 2017; 43:839-846. [PMID: 28795422 DOI: 10.1111/cch.12487] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 06/08/2017] [Accepted: 06/21/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is widespread acceptance that parents should be fully involved in decisions about their son or daughter's health and social care. This is reflected in partnership models of practice as well as local and national policy across the United Kingdom. Previous research indicates that parents' experiences of decision making with professionals are mixed. AIM The research reported here aimed to explore parents' experiences of participating in decisions made with professionals about their disabled son or daughter's care. DESIGN This research used mixed methods including survey methodology and qualitative in depth interviews. SETTING AND PARTICIPANTS The research was conducted in one Trust in Northern Ireland. Participants were 77 parents of children and young people with a range of impairments aged between 3 and 28 years. RESULTS Three themes emerged from the data: taking the lead, not knowing, and getting the balance right. Parents wanted to be involved in all aspects of decision making. Although parents reported many examples of good practice, there were also times when they did not feel listened to or did not have enough information to inform decisions. DISCUSSION AND CONCLUSION Parents in this research recounted positive as well as negative experiences. Parents took on a protective role when decisions were made about their son or daughter and at times, reported the need to "fight" for their child. The provision of information remains problematic for these families, and at times, this created a barrier to parents' participation in decision making. Partnership approaches to care that recognize parents' expertise are particularly important to parents when decisions are made with professionals.
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Affiliation(s)
- P McNeilly
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - G Macdonald
- School for Policy Studies, University of Bristol, Bristol, UK
| | - B Kelly
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
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Foster R, Bright M, Heinzerling J, Moeller B, Kelly B, Finney J, Hampton C. Implementation and Analysis of a Prospective Dosimetrist Peer Review. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1925] [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: 12/01/2022]
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Kelly B, Kern R. Intrapleural Infection Causing Pleurodesis in a Patient With Refractory Chylothorax Related to Yellow Nail Syndrome. Chest 2017. [DOI: 10.1016/j.chest.2017.08.538] [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: 11/29/2022] Open
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Saeed A, Kelly B, Awdish R, Hegab S. Natural Killer Cell Lymphocytosis as a Cause of Pulmonary Arterial Hypertension: A Case Report. Chest 2017. [DOI: 10.1016/j.chest.2017.08.1048] [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: 11/28/2022] Open
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45
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Moss H, Brady C, Kelly B. A Fuller Picture: Evaluating an Art Therapy Programme in a Multi-disciplinary Mental Health Service. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.970] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Art therapy has a long history in mental health care but requires an enhanced evidence based in order to better identify its precise role in contemporary services. This paper describes an evaluation of an art therapy programme in an acute adult psychiatry admission unit in Ireland. A mixed method research design was used. Quantitative data were collected through a survey of 35 staff members and 11 service-users. Qualitative data included free-text comments collected in the survey and individual feedback from service-users. Both methods aimed to assess the role of art therapy as part of a multidisciplinary mental health service. Thematic content analysis was employed to analyse qualitative data. Staff demonstrated overwhelming support for art therapy as one element within multidisciplinary services available to patients in the acute psychiatry setting, qualitative feedback associated art therapy with improvements in quality of life and individual support, and emphasised its role as a nonverbal intervention, especially useful for those who find talking therapy difficult. Creative self-expression is valued by staff and service-users as part of the recovery process. Recommendations arising from the research include continuing the art therapy service, expanding it to include rehabilitation patients, provision of information and education sessions to staff and further research to identify other potential long-term effects. The low response of staff and small sample in this study, however, must be noted as limitations to these findings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pettigrew S, Talati Z, Hughes C, Miller C, Shilton T, Ball K, Neal B, Dixon H, Kelly B. Consumers’ assessments of different categories of front-of-pack food labels. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ehsanullah S, Kelly B, Shah Z. Zero ischaemia open partial nephrectomy: A suitable alternative to the minimally invasive approach. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.071] [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: 11/26/2022]
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Kelly B, Heneghan H, Carroll P, McDermott E. A complicated case of splenic injury after colonoscopy - a video vignette. Colorectal Dis 2016; 18:920-1. [PMID: 27454078 DOI: 10.1111/codi.13469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 06/08/2016] [Indexed: 02/08/2023]
Affiliation(s)
- B Kelly
- Department of Breast Endocrine and General Surgery, St Vincent's University Hospital, Dublin, Ireland.
| | - H Heneghan
- Department of Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - P Carroll
- Department of Breast Endocrine and General Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - E McDermott
- Department of Breast Endocrine and General Surgery, St Vincent's University Hospital, Dublin, Ireland
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Arnautovska U, McPhedran S, Kelly B, Reddy P, De Leo D. Geographic variation in suicide rates in Australian farmers: Why is the problem more frequent in Queensland than in New South Wales? Death Stud 2016; 40:367-372. [PMID: 26890223 DOI: 10.1080/07481187.2016.1153007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Research on farmer suicide is limited in explaining the variations in farmers' demographic characteristics. This study examines farmer suicides in two Australian states: Queensland (QLD) and New South Wales (NSW). Standardized suicide rates over 2000-2009 showed a 2 times higher prevalence of suicide in QLD than NSW (147 vs. 92 cases, respectively). Differences in age and suicide method were observed between states, although they do not appear to account for the sizeable intra- and interstate variations. Suicide prevention initiatives for farmers should account for different age groups and also specific place-based risk factors that may vary between and within jurisdictions.
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Affiliation(s)
- Urska Arnautovska
- a Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention , Griffith University , Brisbane , QLD , Australia
| | - S McPhedran
- a Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention , Griffith University , Brisbane , QLD , Australia
- b Violence Research and Prevention Program , Griffith University , Brisbane , QLD , Australia
| | - B Kelly
- c Faculty of Health and Medicine , University of New Castle , Callaghan , NSW , Australia
| | - P Reddy
- c Faculty of Health and Medicine , University of New Castle , Callaghan , NSW , Australia
| | - D De Leo
- a Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention , Griffith University , Brisbane , QLD , Australia
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Pakianathan MR, Lee MJ, Kelly B, Hegazi A. How to assess gay, bisexual and other men who have sex with men for chemsex. Sex Transm Infect 2016; 92:568-570. [PMID: 27102811 DOI: 10.1136/sextrans-2015-052405] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 12/29/2015] [Revised: 03/22/2016] [Accepted: 03/31/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Sexualised substance use, 'chemsex', is being increasingly reported by gay, bisexual and other men who have sex with men (GBMSM) in sexual health clinics. We aim to describe the evidence base and practical ways in which clinicians can assess and advise patients disclosing chemsex. METHODS We review published literature on chemsex, discuss vulnerability to substance use, highlight the importance of clinical communication and discuss a management approach. RESULTS GBMSM are vulnerable to substance use problems, which interplay with mental, physical and sexual health. Knowledge on sexualised drug use and related communication skills are essential to facilitating disclosure. Identifying sexual health and other consequences of harmful drug use may motivate patients to seek change. CONCLUSIONS Sexual health clinicians are well placed to make more holistic assessments of GBMSM accessing their services to promote broader sexual health and well-being beyond the management of HIV and sexually transmitted infections (STIs) alone.
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Affiliation(s)
- M R Pakianathan
- Department of Genitourinary Medicine, The Courtyard Clinic, Wandsworth Integrated Sexual Health, St. George's University Hospital Foundation Trust, London, UK
| | - M J Lee
- Department of Genitourinary Medicine, The Courtyard Clinic, Wandsworth Integrated Sexual Health, St. George's University Hospital Foundation Trust, London, UK
| | - B Kelly
- Department of Genitourinary Medicine, The Courtyard Clinic, Wandsworth Integrated Sexual Health, St. George's University Hospital Foundation Trust, London, UK
| | - A Hegazi
- Department of Genitourinary Medicine, The Courtyard Clinic, Wandsworth Integrated Sexual Health, St. George's University Hospital Foundation Trust, London, UK
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