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Griffiths C, Radley D, Gately P, South J, Sanders G, Morris MA, Clare K, Martin A, Heppenstall A, McCann M, Rodgers J, Nobles J, Coggins A, Cooper N, Cooke C, Gilthorpe MS, Ells L. A complex systems approach to obesity: a transdisciplinary framework for action. Perspect Public Health 2023; 143:305-309. [PMID: 37395317 PMCID: PMC10683338 DOI: 10.1177/17579139231180761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- C Griffiths
- Obesity Institute, School of Sport, Leeds Beckett University, Headingly Campus, Leeds LS6 3QS, Yorkshire, UK
| | - D Radley
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - P Gately
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - J South
- Centre for Health Promotion Research, School of health, Leeds Beckett University, UK
| | - G Sanders
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - MA Morris
- Leeds Institute for Data Analytics and Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - K Clare
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - A Martin
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - A Heppenstall
- School of Political and Social Sciences, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - M McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - J Rodgers
- International Business School, Teesside University, Middlesbrough, UK
| | - J Nobles
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - A Coggins
- Essex County Council, Chelmsford, UK
| | - N Cooper
- Suffolk County Council, Ipswich, UK
| | - C Cooke
- Obesity Institute, School of Sport, Leeds Beckett University, UK
| | - MS Gilthorpe
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - L Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
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Griffiths C, Scott WE, Ali S, Fisher AJ. Maximizing organs for donation: the potential for ex situ normothermic machine perfusion. QJM 2023; 116:650-657. [PMID: 31943119 DOI: 10.1093/qjmed/hcz321] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/13/2022] Open
Abstract
Currently, there is a shortfall in the number of suitable organs available for transplant resulting in a high number of patients on the active transplant waiting lists worldwide. To address this shortfall and increase the utilization of donor organs, the acceptance criteria for donor organs is gradually expanding including increased use of organs from donation after circulatory death. Use of such extended criteria donors and exposure of organs to more prolonged periods of warm or cold ischaemia also increases the risk of primary graft dysfunction occurring. Normothermic machine perfusion (NMP) offers a unique opportunity to objectively assess donor organ function outside the donor body and potentially recondition those deemed unsuitable on initial evaluation prior to implantation in the recipient. Furthermore, NMP provides a platform to support the use of established and novel therapeutics delivered directly to the organ, without the need to worry about potential deleterious 'off-target' side effects typically considered when treating the whole patient. This review will explore some of the novel therapeutics currently being added to perfusion platforms during NMP experimentally in an attempt to improve organ function and post-transplant outcomes.
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Affiliation(s)
- C Griffiths
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - W E Scott
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - S Ali
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - A J Fisher
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
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Al-Janabi A, Eyre S, Foulkes A, Khan A, Dand N, Smith C, Griffiths C, Morris A, Warren R. 269 Atopic polygenic risk score is associated with paradoxical eczema developing in psoriasis patients treated with biologics. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.281] [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: 11/19/2022]
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kiss O, Griffiths C, Wang R, Chien A, Kang S, O’Connor C, Watson R, Langton A. 515 Topical retinoids for the treatment of photoageing in skin of colour. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.530] [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: 11/19/2022]
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Hardman-Smart J, Ejarque RA, Solanky S, Tosi I, Grys K, Barker J, Griffiths C, Reynolds N, Smith C, Warren R, Di Meglio P, Consortium P. 115 The frequency of intermediate monocytes before treatment is a candidate biomarker of clinical response to secukinumab in of psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.125] [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: 11/19/2022]
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Christensen A, Radley D, Hobbs M, Gorse C, Griffiths C. Investigating how researcher-defined buffers and self-drawn neighbourhoods capture adolescent availability to physical activity facilities and greenspaces: An exploratory study. Spat Spatiotemporal Epidemiol 2022; 43:100538. [PMID: 36460456 DOI: 10.1016/j.sste.2022.100538] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/16/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Modifying the environment is considered an effective population-level approach for increasing healthy behaviours, but associations remain ambiguous. This exploratory study aims to compare researcher-defined buffers and self-drawn neighbourhoods (SDN) to objectively measured availability of physical activity (PA) facilities and greenspaces in adolescents. METHODS Seven consecutive days of GPS data were collected in an adolescent sample of 14-18 year olds (n = 69). Using Points of Interest and greenspace data, availability of PA opportunities within activity spaces were determined. We compared 30 different definitions of researcher-defined neighbourhoods and SDNs to objectively measured availability. RESULTS Findings showed low agreement for all researcher-defined buffers in measuring the availability of PA facilities in activity spaces. However, results were less clear for greenspace. SDNs also demonstrate low agreement for capturing availability to the PA environment. CONCLUSION This exploratory study highlights the inadequacy of researcher-defined buffers and SDNs to define availability to environmental features.
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Affiliation(s)
- A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK.
| | - D Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK
| | - M Hobbs
- Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK
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Rutkowski D, Warren R, Griffiths C, Paus R. 861 EGFR/MEK inhibitor therapy induces partial hair follicle immune privilege collapse in vivo and ex vivo. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.875] [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: 10/17/2022]
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Gajaweera HS, Griffiths C, Everitt LH, Evans HJ. Medical management of severe obstructive sleep apnoea in two cases during the coronavirus disease 2019 pandemic. J Laryngol Otol 2022; 136:1-2. [PMID: 35307044 DOI: 10.1017/s0022215121004230] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Severe paediatric obstructive sleep apnoea in typically developing children with adenotonsillar hypertrophy is primarily managed surgically. Non-emergency ENT surgery was paused early in the coronavirus disease 2019 pandemic and children were offered medical management for obstructive sleep apnoea. METHODS A service evaluation was performed to assess the impact of continuous positive airway pressure alongside medical management for severe obstructive sleep apnoea. RESULTS Over 5 months during 2020, in a tertiary care setting, two children (one boy and one girl), aged 2.7 years and 4.1 years, were offered continuous positive airway pressure and medical treatments for severe obstructive sleep apnoea whilst surgery was paused during the coronavirus disease 2019 pandemic. Both children failed to establish continuous positive airway pressure therapy because of ongoing disturbed sleep on ventilation, and they proceeded to adenotonsillectomy. Sleep-Related Breathing Disorder scale scores improved following surgical intervention. CONCLUSION Continuous positive airway pressure therapy is poorly tolerated in children with severe obstructive sleep apnoea secondary to adenotonsillar hypertrophy. Surgery remains the most appropriate treatment.
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Affiliation(s)
- H S Gajaweera
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
| | - C Griffiths
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
| | - L H Everitt
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
| | - H J Evans
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
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Ellison C, Griffiths C, Thompson J, Arapi I, Martens M, Gore E. P40.07 Immunotherapy Toxicity in Lung Cancer & the Impact of Thoracic Radiation Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Langton A, Chien A, Kang S, Rhodes L, O’Connor C, Bell M, Griffiths C, Watson R. 148 Fibrillin-rich microfibrils: Key components of dermal-epidermal junction architecture? J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Hopkinson NS, Stokes-Lampard H, Dixon J, Rae M, Bauld L, Woolnough S, Goddard A, de Gruchy J, Griffiths C, Walker I, Bennett J. Open letter to the prime minister and secretary of state on the second anniversary of England's announcement that it would be smoke-free by 2030. BMJ 2021; 374:n1839. [PMID: 34290035 DOI: 10.1136/bmj.n1839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Christensen A, Griffiths C, Hobbs M, Gorse C, Radley D. Accuracy of buffers and self-drawn neighbourhoods in representing adolescent GPS measured activity spaces: An exploratory study. Health Place 2021; 69:102569. [PMID: 33882372 DOI: 10.1016/j.healthplace.2021.102569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 09/26/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There continues to be a lack of understanding as to the geographical area at which the environment exerts influence on behaviour and health. This exploratory study compares different potential methods of both researcher- and participant-defined definitions of neighbourhood reflect an adolescent's activity space. METHODS Seven consecutive days of global positioning system (GPS) tracking data were collected at 15 s intervals using a small exploratory adolescent sample of 14-18 year olds (n = 69) in West Yorkshire, England. A total of 304,581 GPS tracking points were collected and compared 30 different definitions of researcher-defined neighbourhoods including radial, network and ellipse buffers at 400 m, 800 m, 1000 m, 1600 m and 3000 m, as well as participant-defined self-drawn neighbourhoods. RESULTS This exploratory study supports emerging evidence cautioning against the use of static neighbourhood definitions for defining exposure. Traditional buffers (network and radial) capture at most 67% of activity space (home radial), and at worst they captured only 3.5% (school network) and range from capturing between 3 and 88% of total time. Similarly, self-drawn neighbourhoods captured only 10% of actual daily movement. Interestingly, 40% of an adolescent's self-drawn neighbourhood was not used. We also demonstrate that buffers capture a range of space (22-95%) where adolescents do not go, thus misclassifying the exposure. CONCLUSION Our exploratory findings demonstrate that neither researcher- nor participant-defined definition of neighbourhood adequately captures adolescent activity space. Further research with larger samples are needed to confirm the findings of this exploratory study.
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Affiliation(s)
- A Christensen
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK; School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK.
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - D Radley
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
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Sanders GJ, Griffiths C, Flint S, Christensen A, Gately P. Implementation fidelity of an Integrated Healthy Lifestyle Service: a process evaluation. Perspect Public Health 2021; 142:278-286. [PMID: 33779407 PMCID: PMC9483679 DOI: 10.1177/1757913920986205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aims: The current study aimed to evaluate implementation fidelity of an
Integrated Healthy Lifestyle Service (IHLS). Methods: A pragmatic sample of 28 individual interviews and 11 focus groups
were conducted. This resulted in a total of 81 (22 male)
individuals comprising key stakeholders (n = 18), as well as
intervention staff across senior management (n = 4), team lead
(n = 14) and practitioner (n = 11) roles, and intervention
clients (n = 34). Results: A mixed degree of implementation fidelity was demonstrated
throughout the five a priori fidelity domains of study design,
provider training, intervention delivery, intervention receipt,
and enactment. Stakeholders, staff and clients alike noted a
high degree of intervention receipt across all services offered.
Contrastingly, practitioners noted that they received minimal
formal operational, data systems, clinical, and curriculum
training as well as a lack of personal development
opportunities. Consequently, practitioners reported low
confidence in delivering sessions and collecting and analysing
any data. A top-down approach to information dissemination
within the service was also noted among practitioners which
affected motivation and overall team morale. Conclusion: Results can be used to conceptualise best practices as a process to
further strengthen the design, delivery and recruitment
strategies of the IHLS.
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Affiliation(s)
- G J Sanders
- Carnegie School of Sport, Leeds Beckett University, Fairfax Hall Rm 230, Headingley Campus, Leeds LS6 3QS, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - S Flint
- School of Psychology, University of Leeds, Leeds, UK.,Scaled Insights, Nexus, University of Leeds, Leeds, UK
| | - A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - P Gately
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Hobbs M, Moltchanova E, Wicks C, Pringle A, Griffiths C, Radley D, Zwolinsky S. Investigating the environmental, behavioural, and sociodemographic determinants of attendance at a city-wide public health physical activity intervention: Longitudinal evidence over one year from 185,245 visits. Prev Med 2021; 143:106334. [PMID: 33227345 DOI: 10.1016/j.ypmed.2020.106334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/25/2020] [Revised: 09/23/2020] [Accepted: 11/18/2020] [Indexed: 10/23/2022]
Abstract
Understanding the determinants of attendance at public health interventions is critical for effective policy development. Most research focuses on individual-level determinants of attendance, while less is known about environmental-level determinants. Data were obtained from the Leeds Let's Get Active public health intervention in Leeds, England. Longitudinal data (April 2015-March 2016) on attendance were obtained for n = 25,745 individuals (n = 185,245 total visits) with baseline data on sociodemographic determinants and lifestyle practices obtained for n = 3621 individuals. This resulted in a total of n = 744,468 days of attendance and non-attendance. Random forests were used to explore the relative importance of the determinants on attendance, while generalised linear models were applied to examine specific associations (n = 3621). The probability that a person will attend more than once, the number of return visits, and the probability that a person will attend on a particular day were investigated. When considering if a person returned to the same leisure centre after one visit, the most influential determinant was the distance from their home. When considering number of return visits overall however, age group was the most influential. While distance to a leisure centre was less important for predicting the number of return visits, the difference between estimates for 300 m and 15,000 m was 7-10 visits per year. Finally, calendar month was the most important determinant of daily attendance. This longitudinal study highlights the importance of both individual and environmental determinants in predicting various aspects of attendance. It has implications for strategies aiming to increase attendance at public health interventions.
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Affiliation(s)
- M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand; Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - E Moltchanova
- School of Mathematics & Statistics, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - C Wicks
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
| | - A Pringle
- Sport, Outdoor & Exercise Sciences, University of Derby, Derby, United Kingdom
| | - C Griffiths
- Leeds Beckett University, Leeds, United Kingdom
| | - D Radley
- Leeds Beckett University, Leeds, United Kingdom
| | - S Zwolinsky
- West Yorkshire & Harrogate Cancer Alliance, Wakefield, United Kingdom
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Guest E, Paraskeva N, Griffiths C, Hansen E, Clarke A, Baker E, Harcourt D. The nature and importance of women's goals for immediate and delayed breast reconstruction. J Plast Reconstr Aesthet Surg 2021; 74:2169-2175. [PMID: 33495140 DOI: 10.1016/j.bjps.2020.12.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/11/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Increasingly, women undergo breast reconstruction (BR) surgery to restore health-related and psychosocial quality of life after mastectomy. Most research focuses on BR outcomes rather than women's pre-surgical expectations of, and goals for, immediate (IBR) or delayed (DBR) procedures, yet such information could support women's decision-making. This study aimed to investigate women's BR goals, whether they differed according surgery timing (IBR or DBR), and the importance women placed on them. METHODS Seventy-six women considering DBR (n = 50) or IBR (n = 26) at a UK hospital were encouraged to clarify their BR goals and rate the importance of achieving each one. Content analysis categorised and counted the frequency of the goals they reported. RESULTS Fifteen goal categories (7 surgical, e.g. scarring; 8 psychosocial/lifestyle, e.g. feeling feminine) were identified. Many (e.g. scarring, intimacy) were reported by a similar percentage of women in each surgical group, however, differences were identified (e.g. breast sensation was not mentioned by women considering IBR). Women reported more psychosocial (n = 206) than surgical goals (n = 160). Further, an independent t-tests revealed that women in both groups placed significantly more importance on the psychosocial (M = 9.4) than surgical goals (M = 8.5). CONCLUSIONS This study highlights the variety of goals women have for BR, the importance they attach to them, and differences and similarities between those seeking IBR and DBR. Future research should consider whether BR goals are met, how goal achievement influences satisfaction with outcome over time and how best to incorporate goals into pre-surgical treatment decision-making.
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Affiliation(s)
- E Guest
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom.
| | - N Paraskeva
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - C Griffiths
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - E Hansen
- Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| | - A Clarke
- Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| | - E Baker
- Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| | - D Harcourt
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
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17
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Yiu Z, Parisi R, Lunt M, Warren R, Griffiths C, Langan S, Ashcroft D. 399 Risk of hospitalization due to infection in patients with psoriasis: A population-based cohort study using the UK Clinical Practice Research Datalink. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.407] [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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18
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Mellody K, Bradley E, Bell M, Halai P, Cotterell L, Griffiths C, Watson R. 238 Retinol at a concentration of 0.3% restores fibrillin-rich microfibrils and modifies the epidermis in photoaged human skin in vivo in a manner similar to 1% retinol. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.243] [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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de Bruin-Weller M, Griffiths C, Prens E, Szepietowski J, Etoh T, Rossi A, Gadkari A, Chen Z, Eckert L. Le dupilumab améliore les signes, les symptômes et la qualité de vie chez des patients adultes atteints de dermatite atopique non parvenus à un score IGA de 0/1. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.581] [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: 10/25/2022]
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Burman M, Copas A, Zenner D, Hickson V, Gosce L, Trathen D, Ashcroft R, Martineau AR, Abubakar I, Griffiths C, Kunst H. Protocol for a cluster randomised control trial evaluating the efficacy and safety of treatment for latent tuberculosis infection in recent migrants within primary care: the CATAPuLT trial. BMC Public Health 2019; 19:1598. [PMID: 31783742 PMCID: PMC6884916 DOI: 10.1186/s12889-019-7983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background The identification and treatment of LTBI is a key component of the WHO’s strategy to eliminate TB. Recent migrants from high TB-incidence countries are recognised to be at risk TB reactivation, and many high-income countries have focused on LTBI screening and treatment programmes for this group. However, migrants are the group least likely to complete the LTBI cascade-of-care. This pragmatic cluster-randomised, parallel group, superiority trial investigates whether a model of care based entirely within a community setting (primary care) will improve treatment completion compared with treatment in specialist TB services (secondary care). Methods The CATAPuLT trial (Completion and Acceptability of Treatment Across Primary Care and the community for Latent Tuberculosis) randomised 34 general practices in London, England, to evaluate the efficacy and safety of treatment for LBTI in recent migrants within primary care. GP practices were randomised to either provide management for LTBI entirely within primary care (GPs and community pharmacists) or to refer patients to secondary care. The target recruitment number for individuals is 576. The primary outcome is treatment completion (defined as taking at least 90% of antibiotic doses). The secondary outcomes assess adherence, acceptance of treatment, the incidence of adverse effects including drug-induced liver injury, the rates of active TB, patient satisfaction and cost-effectiveness of LTBI treatment. This protocol adheres to the SPIRIT Checklist. Discussion The CATAPuLT trial seeks to provide implementation research evidence for a patient-centred intervention to improve treatment completion for LTBI amongst recent migrants to the UK. Trial registration NCT03069807, March 2017, registered retrospectively.
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Affiliation(s)
- M Burman
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
| | - A Copas
- Institute for Global Health, University College London, London, UK
| | - D Zenner
- Institute for Global Health, University College London, London, UK
| | - V Hickson
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - L Gosce
- Institute for Global Health, University College London, London, UK
| | - D Trathen
- Newham Clinical Commissioning Group, London, UK
| | - R Ashcroft
- School of Law, Queen Mary University of London, London, UK
| | - A R Martineau
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - I Abubakar
- Institute for Global Health, University College London, London, UK
| | - C Griffiths
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - H Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Barts Health NHS Trust, London, UK
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Rutkowski D, Hardman J, Warren R, Griffiths C, Paus R. 422 Human hair follicles express PD-L1, whose expression is down-regulated by EGFR and MEK inhibitors ex vivo. A potential mechanism for EGFR inhibitor induced sterile folliculitis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.424] [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: 10/26/2022]
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22
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Langton A, Chien A, Kang S, Griffiths C, Watson R. 098 Retinoids in the treatment of skin photoageing: A histological study of topical all-trans retinoic acid efficacy in black skin. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.102] [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: 10/26/2022]
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23
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Pilkington S, Langton A, Costello P, Newton V, Griffiths C, Watson R. 148 Increased skin viscoelastic creep following menopause is not driven by changes to the dermal elastic fibre network. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.152] [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: 11/16/2022]
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24
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Earnshaw C, Nagore E, Roeck K, Schneider S, Budden T, Craig S, Griffiths C, Furney S, Krutmann J, Viros A. 554 Skin ageing continues long after ultraviolet radiation damage. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.469] [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: 11/27/2022]
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Mellody K, Bradley E, Halai P, Cotterell L, Horn J, Griffiths C, Bell M, Watson R. 610 Hibiscus abelmoschus seed extract induces remodelling of the papillary dermal fibrillin-rich microfibrils. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.614] [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: 11/16/2022]
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Hobbs M, Green MA, Wilkins E, Lamb KE, McKenna J, Griffiths C. Associations between food environment typologies and body mass index: Evidence from Yorkshire, England. Soc Sci Med 2019; 239:112528. [PMID: 31499332 DOI: 10.1016/j.socscimed.2019.112528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/29/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
International research linking food outlets and body mass index (BMI) is largely cross-sectional, yielding inconsistent findings. However, addressing the exposure of food outlets is increasingly considered as an important adult obesity prevention strategy. Our study investigates associations between baseline food environment types and change in BMI over time. Survey data were used from the Yorkshire Health Study (n=8,864; wave one: 2010-2012, wave two: 2013-2015) for adults aged 18-86. BMI was calculated using self-reported height (cm) and weight (kg). Restaurants, cafés, fast-food, speciality, convenience and large supermarkets were identified from the Ordnance Survey Point of Interest database within 1600m radial buffer of home postcodes. K-means cluster analysis developed food environment typologies based on food outlets and population density. Large supermarkets, restaurants, cafés, fast-food, speciality and convenience food outlets all clustered together to some extent. Three neighbourhood typologies were identified. However, multilevel models revealed that relative to cluster one all were unrelated to change in BMI (cluster 2, b= -0.146 [-0.274, 0.566]; cluster 3, b= 0.065 [-0.224, 0.356]). There was also little evidence of gender-based differences in these associations when examined in a three-way interaction. Policymakers may need to begin to consider multiple types of food outlet clusters, while further research is needed to confirm how these relate to changed BMI.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand.
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - E Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - K E Lamb
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
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Griffiths C, Valant R, Elvin J, Gay L, Murray M, Almog N, Jimenez E, Chalas E. Bridging the actionability gap: Virtual molecular tumor board impact on integrating comprehensive genomic profiling in management of gynecologic malignancies. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.177] [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: 11/24/2022]
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Griffiths C, Charlton C, Scott W, Ali S, Fisher A. Evaluating the immunomodulatory potential of human amniotic epithelial cells as a therapeutic in ex vivo donor lung reconditioning. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Hobbs M, Griffiths C, Green M, Christensen A, McKenna J. Examining longitudinal associations between the recreational physical activity environment, change in body mass index, and obesity by age in 8864 Yorkshire Health Study participants. Soc Sci Med 2019; 227:76-83. [DOI: 10.1016/j.socscimed.2018.06.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/14/2018] [Accepted: 06/23/2018] [Indexed: 11/16/2022]
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Colby J, Bradley J, Durran-Dyer D, Read G, Griffiths C, Burch N. A model of an effective supportive Community Nursing Service for Tube fed patients. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, Christensen A, McKenna J. Fast-food outlet availability and obesity: Considering variation by age and methodological diversity in 22,889 Yorkshire Health Study participants. Spat Spatiotemporal Epidemiol 2018; 28:43-53. [PMID: 30739654 DOI: 10.1016/j.sste.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/11/2018] [Revised: 09/17/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
This study investigated if the relationship between residential fast-food outlet availability and obesity varied due to methodological diversity or by age. Cross-sectional data (n = 22,889) from the Yorkshire Health Study, England were used. Obesity was defined using self-reported height and weight (BMI ≥ 30). Food outlets ("fast-food", "large supermarkets", and "convenience or other food retail outlets") were mapped using Ordnance Survey Points of Interest (PoI) database. Logistic regression was used for all analyses. Methodological diversity included adjustment for other food outlets as covariates and continuous count vs. quartile. The association between residential fast-food outlets and obesity was inconsistent and effects remained substantively the same when considering methodological diversity. This study contributes to evidence by proposing the use of a more comprehensive conceptual model adjusting for wider markers of the food environment. This study offers tentative evidence that the association between fast-food outlets and obesity varies by age.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Ernest Rutherford Building, Christchurch, New Zealand.
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Leeds Beckett University formerly Public Health Team, Rotherham Borough Council, UK
| | - A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
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Zhao TX, Kostapanos M, Griffiths C, Arbon EL, Hubsch A, Kaloyirou F, Helmy J, Hoole SP, Rudd JHF, Wood G, Burling K, Bond S, Cheriyan J, Mallat Z. Low-dose interleukin-2 in patients with stable ischaemic heart disease and acute coronary syndromes (LILACS): protocol and study rationale for a randomised, double-blind, placebo-controlled, phase I/II clinical trial. BMJ Open 2018; 8:e022452. [PMID: 30224390 PMCID: PMC6144322 DOI: 10.1136/bmjopen-2018-022452] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Inflammation and dysregulated immune responses play a crucial role in atherosclerosis, underlying ischaemic heart disease (IHD) and acute coronary syndromes (ACSs). Immune responses are also major determinants of the postischaemic injury in myocardial infarction. Regulatory T cells (CD4+CD25+FOXP3+; Treg) induce immune tolerance and preserve immune homeostasis. Recent in vivo studies suggested that low-dose interleukin-2 (IL-2) can increase Treg cell numbers. Aldesleukin is a human recombinant form of IL-2 that has been used therapeutically in several autoimmune diseases. However, its safety and efficacy is unknown in the setting of coronary artery disease. METHOD AND ANALYSIS Low-dose interleukin-2 in patients with stable ischaemic heart disease and acute coronary syndromes is a single-centre, first-in-class, dose-escalation, two-part clinical trial. Patients with stable IHD (part A) and ACS (part B) will be randomised to receive either IL-2 (aldesleukin; dose range 0.3-3×106 IU) or placebo once daily, given subcutaneously, for five consecutive days. Part A will have five dose levels with five patients in each group. Group 1 will receive a dose of 0.3×106 IU, while the dose for the remaining four groups will be determined on completion of the preceding group. Part B will have four dose levels with eight patients in each group. The dose of the first group will be based on part A. Doses for each of the subsequent three groups will similarly be determined after completion of the previous group. The primary endpoint is safety and tolerability of aldesleukin and to determine the dose that increases mean circulating Treg levels by at least 75%. ETHICS AND DISSEMINATION The study received a favourable opinion by the Greater Manchester Central Research Ethics Committee, UK (17/NW/0012). The results of this study will be reported through peer-reviewed journals, conference presentations and an internal organisational report. TRIAL REGISTRATION NUMBER NCT03113773; Pre-results.
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Affiliation(s)
- Tian Xiao Zhao
- Department of Medicine, Division of Cardiovascular Medicine, University of Cambridge Medicine, Cambridge, UK
- Division of Experimental Medicine and Immunotherapeutics (EMIT), Department of Medicine, University of Cambridge Medicine, Cambridge, Cambridgeshire, UK
| | - Michalis Kostapanos
- Division of Experimental Medicine and Immunotherapeutics (EMIT), Department of Medicine, University of Cambridge Medicine, Cambridge, Cambridgeshire, UK
| | - Charmaine Griffiths
- Cambridge Clinical Trials Unit, Cambridge University Hospitals, Cambridge, Cambridgeshire, UK
| | - Emma L Arbon
- Cambridge Clinical Trials Unit, Cambridge University Hospitals, Cambridge, Cambridgeshire, UK
| | - Annette Hubsch
- Division of Experimental Medicine and Immunotherapeutics (EMIT), Department of Medicine, University of Cambridge Medicine, Cambridge, Cambridgeshire, UK
| | - Fotini Kaloyirou
- Division of Experimental Medicine and Immunotherapeutics (EMIT), Department of Medicine, University of Cambridge Medicine, Cambridge, Cambridgeshire, UK
| | - Joanna Helmy
- Division of Experimental Medicine and Immunotherapeutics (EMIT), Department of Medicine, University of Cambridge Medicine, Cambridge, Cambridgeshire, UK
| | - Stephen P Hoole
- Department of Interventional Cardiology, Royal Papworth Hospital NHS Trust, Cambridge, UK
| | - James H F Rudd
- Department of Medicine, Division of Cardiovascular Medicine, University of Cambridge Medicine, Cambridge, UK
| | - Graham Wood
- Department of Immunology, Cambridge University Hospitals, Cambridge, UK
| | - Keith Burling
- Clinical Biochemistry, Cambridge University Hospitals, Cambridge, UK
| | - Simon Bond
- Cambridge Clinical Trials Unit, Cambridge University Hospitals, Cambridge, Cambridgeshire, UK
| | - Joseph Cheriyan
- Division of Experimental Medicine and Immunotherapeutics (EMIT), Department of Medicine, University of Cambridge Medicine, Cambridge, Cambridgeshire, UK
- Cambridge Clinical Trials Unit, Cambridge University Hospitals, Cambridge, Cambridgeshire, UK
| | - Ziad Mallat
- Department of Medicine, Division of Cardiovascular Medicine, University of Cambridge Medicine, Cambridge, UK
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Griffiths C, Valant R, Ebling D, Haas J, Fazzari M, Villella J, Chalas E, Jimenez E. Cyberknife therapy for locally recurrent gynecologic cancers after external-beam radiation therapy. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.247] [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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34
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Griffiths C, Valant R, Ebling D, Haas J, Fazzari M, Villella J, Chalas E, Jimenez E. Cyberknife therapy for locally recurrent gynecologic cancers after external-beam radiation therapy. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.03.010] [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: 10/14/2022]
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35
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, McKenna J. Neighbourhood typologies and associations with body mass index and obesity: A cross-sectional study. Prev Med 2018; 111:351-357. [PMID: 29195761 DOI: 10.1016/j.ypmed.2017.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 07/06/2017] [Revised: 11/15/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
Little research has investigated associations between a combined measure of the food and physical activity (PA) environment, BMI (body-mass-index) and obesity. Cross-sectional data (n=22,889, age 18-86years) from the Yorkshire Health Study were used [2010-2013]. BMI was calculated using self-reported height and weight; obesity=BMI≥30. Neighbourhood was defined as a 2km radial buffer. Food outlets and PA facilities were sourced from Ordnance Survey Points of Interest (PoI) and categorised into 'fast-food', 'large supermarkets', 'convenience and other food retail outlets' and 'physical activity facilities'. Parks were sourced from Open Street Map. Latent class analysis was conducted on these five environmental variables and availability was defined by quartiles of exposure. Linear and logistic regressions were then conducted for BMI and obesity respectively for different neighbourhood types. Models adjusted for age, gender, ethnicity, area-level deprivation, and rural/urban classification. A five-class solution demonstrated best fit and was interpretable. Neighbourhood typologies were defined as; 'low availability', 'moderate availability', 'moderate PA, limited food', 'saturated' and 'moderate PA, ample food'. Compared to low availability, one typology demonstrated lower BMI (saturated, b=-0.50, [95% CI=-0.76, -0.23]), while three showed higher BMI (moderate availability, b=0.49 [0.27, 0.72]; moderate PA, limited food, b=0.30 [0.01, 0.59]; moderate PA, ample food, b=0.32 [0.08, 0.57]). Furthermore, compared to the low availability, saturated neighbourhoods showed lower odds of obesity (OR=0.86 [0.75, 0.99]) while moderate availability showed greater odds of obesity (OR=1.18 [1.05, 1.32]). This study supports population-level approaches to tackling obesity however neighbourhoods contained features that were health-promoting and -constraining.
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Affiliation(s)
- M Hobbs
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK.; School of Social and Health Sciences, Leeds Trinity University, Leeds, UK..
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
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36
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Griffiths C, Howell R, Boinpally H, Jimenez E, Chalas E, Musa F, Gorenstein S. Using advanced wound care and hyperbaric oxygen to manage wound complications following treatment of vulvovaginal carcinoma. Gynecol Oncol Rep 2018; 24:90-93. [PMID: 29915804 PMCID: PMC6003433 DOI: 10.1016/j.gore.2018.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/21/2022] Open
Abstract
Postoperative management of patients with vulvar cancer is associated with a high incidence of poor wound healing and radiation -induced late tissue necrosis. This case series demonstrates the impact on wound healing with the use of hyperbaric oxygen therapy and advanced wound care following radical vulvectomy and/or radiation therapy. A retrospective case series was performed of all patients from 2016 to 2017 with lower genital cancer who underwent radical surgery with or without chemoradiation treatment, experienced wound dehiscence or late tissue radionecrosis, and were treated with advanced wound care, including hyperbaric oxygen therapy (HBO). Five patients were included with a mean age of 63; four had squamous cell carcinoma and one patient had vaginal adenocarcinoma secondary to prior diethylstilbestrol exposure. Three patients underwent radical vulvectomy. All received pelvic radiation therapy, subsequently experienced wound complications, and were managed with advanced wound care and HBO. The mean reduction in wound area at the final wound follow up visit after completion of HBO therapy was found to be 76%, ranging 42-95%, with an average follow up of five months. The mean number of HBO sessions per patient was 58. Complete tissue granulation or significant improvement in tissue radionecrosis was present in all patients. Advanced wound care and hyperbaric oxygen therapy are beneficial in the management of postoperative wound complications. Prospective studies are needed to identify the optimal use of perioperative hyperbaric oxygen and appropriate wound care for patients with gynecologic malignancies.
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Affiliation(s)
- C. Griffiths
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - R.S. Howell
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - H. Boinpally
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - E. Jimenez
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - E. Chalas
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - F. Musa
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - S. Gorenstein
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
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Potter J, White V, Swinglehurst D, Griffiths C. 4.10-P7Did migrants with tuberculosis in the UK know their condition was exempt from charges? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- J Potter
- Queen Mary University London, United Kingdom
| | - V White
- Queen Mary University London, United Kingdom
| | | | - C Griffiths
- Queen Mary University London, United Kingdom
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Mac Giolla Phadraig C, Griffiths C, McCallion P, McCarron M, Donnelly-Swift E, Nunn J. Pharmacological behaviour support for adults with intellectual disabilities: Frequency and predictors in a national cross-sectional survey. Community Dent Oral Epidemiol 2018; 46:231-237. [DOI: 10.1111/cdoe.12365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 01/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- C. Mac Giolla Phadraig
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
| | - C. Griffiths
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - P. McCallion
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
- School of Social Work; Temple University; Philadelphia PA USA
| | - M. McCarron
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - E. Donnelly-Swift
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
| | - J. Nunn
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Dublin Ireland
- School of Dental Science; Trinity College Dublin; Dublin Ireland
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, McKenna J. Associations between the combined physical activity environment, socioeconomic status, and obesity: a cross-sectional study. Perspect Public Health 2017; 138:169-172. [PMID: 29281499 DOI: 10.1177/1757913917748353] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS This study investigates associations between the combined physical activity environment and obesity and explores any sub-group effects by individual-level socioeconomic status. METHODS In a large cross-sectional cohort ( n = 22,889) from the Yorkshire Health Study, body mass index was calculated using self-reported height and weight and obesity was defined as a body mass index ≥ 30. The physical activity environment was split into 'unfavourable physical activity', 'moderately favourable physical activity' and 'favourable physical activity' environments. This was based on the count of parks and physical activity facilities within a 2 km radial buffer centred on home addresses. A favourable physical activity environment was defined as having ≥1 physical activity facility and ≥1 park, unfavourable as having no physical activity facility and park and any other combinations defined as moderately favourable. Logistic regression (odds ratios) identified associations with obesity. RESULTS Relative to 'unfavourable physical activity environments', individuals within favourable physical activity environments were less likely to be obese (odds ratio = 0.90; 95% confidence interval = 0.82-0.97), and there was no effect for moderately favourable environment. Furthermore, once stratified by education level, this relationship was only present for those of higher education. CONCLUSION Our findings provide novel UK evidence and is one of the first papers internationally that highlights the importance of considering the interplay of individual-level socioeconomic factors when investigating associations between the physical activity environment and obesity.
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Affiliation(s)
- M Hobbs
- School of Social and Health Sciences, Leeds Trinity University, Leeds LS18 5HD, UK.,Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,Public Health Team, Rotherham Metropolitan Borough Council, Rotherham, UK
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Nobles J, Griffiths C, Pringle A, Gately P. Why consistent completion criterion are required in childhood weight management programmes. Public Health 2017; 152:79-85. [PMID: 28865288 DOI: 10.1016/j.puhe.2017.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/09/2017] [Revised: 07/14/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Current research in the field of childhood weight management (WM) effectiveness is hampered by inconsistent terminology and criterion for WM programme completion, alongside other engagement-related concepts (e.g. adherence, dropout and attrition). Evidence reviews are not able to determine conclusive intervention effectiveness because of this issue. This study aims to quantify how various completion criterion impacts upon on: 1) the percentage of WM completers; 2) the standardised body mass index (BMI SDS) reduction; and 3) the predictors of WM completion. STUDY DESIGN A methodological, sensitivity analysis to examine how differential completion criterion affect programme outcomes and predictors. METHODS Secondary data of 2948 children were used. All children attended a MoreLife WM programme between 2009 and 2014. The completion criterion was incrementally adjusted by 10% (i.e. completer attends 10%, 20%, 30%... of sessions) for research aims 1-2, with the percentage of completers and change in BMI SDS calculated at each increment. For aim 3, the stability (strength, direction and significance) of the predictors were examined when using the completion criterion of four alternative studies against our previous study (completion ≥70% attendance). RESULTS The volume of programme completers decreased in a linear manner as the completion criterion became more stringent (i.e. 70-100% attendance). The change in BMI SDS conversely became incrementally greater. The strength, direction and significance of the predictors was highly dependent on the completion criterion; the odds ratio varied by 24.2% across a single predictor variable (delivery period). The degree of change is evidenced in the paper. CONCLUSIONS Inconsistent completion criterion greatly limits the synthesis of programme effectiveness and explains some of the inconsistency in the predictors of engagement. Standardised criterion for engagement-related terminology are called for.
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Affiliation(s)
- J Nobles
- Institute of Sport, Physical Activity and Leisure, Centre of Active Lifestyles, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK; MoreLife (UK) Ltd., Churchwood Hall, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QJ, UK.
| | - C Griffiths
- Institute of Sport, Physical Activity and Leisure, Centre of Active Lifestyles, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK
| | - A Pringle
- Institute of Sport, Physical Activity and Leisure, Centre of Active Lifestyles, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK
| | - P Gately
- Institute of Sport, Physical Activity and Leisure, Centre of Active Lifestyles, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK; MoreLife (UK) Ltd., Churchwood Hall, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QJ, UK
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Hobbs M, Green MA, Griffiths C, Jordan H, Saunders J, Grimmer H, McKenna J. Access and quality of parks and associations with obesity: A cross-sectional study. SSM Popul Health 2017; 3:722-729. [PMID: 29349259 PMCID: PMC5769035 DOI: 10.1016/j.ssmph.2017.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 12/30/2022] Open
Abstract
Public health is increasingly engaging with multi-faceted obesity prevention efforts. Although parks represent key community assets for broader public health, they may not be distributed equitably and associations with obesity are equivocal. We investigated park access and quality relative to deprivation and obesity with individual-level data from the Yorkshire Health Study. Compared to the least deprived areas, the moderately and most deprived areas had a greater park access and park quality in terms of features and amenities. However, parks in the moderately and most deprived areas also had the most safety concerns and incivilities. Although deprivation was associated with obesity, contrary to current policy guidance, both park access and quality appear less important for understanding variations in obesity within this study. Although sub-group analyses by deprivation tertile revealed that low quality park amenities in highly and moderately deprived areas may be important for understanding obesity prevalence, all other associations were non-significant.
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Affiliation(s)
- M Hobbs
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK.,School of Social and Health Sciences, Leeds Trinity University, LS18 5HD, UK
| | - Mark A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - C Griffiths
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie, Leeds Beckett University, Leeds LS6 3QS, UK
| | - H Grimmer
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
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Langton A, Alessi S, Chien A, Kang S, Sherratt M, Griffiths C, Watson R. 749 Impact of chronic sun exposure on the elastic fiber network of African-American and Caucasian skin. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.773] [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: 10/19/2022]
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Madurasinghe VW, Sohanpal R, James W, Steed L, Eldridge S, Taylor SJC, Griffiths C, Walton R. Smoking treatment optimisation in pharmacies (STOP): a cluster randomised pilot trial of a training intervention. Pilot Feasibility Stud 2017; 3:1. [PMID: 28097016 PMCID: PMC5225568 DOI: 10.1186/s40814-016-0120-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND UK government policy aims to strengthen the role of community pharmacies in health promotion. Thus, we conducted feasibility studies for an intervention to enhance delivery of the NHS Smoking Cessation Service. METHODS The overall aims were to assess acceptability and feasibility of conducting the intervention in community pharmacies and piloting this with a cluster randomised trial. Specific objectives were (1) to estimate likely participation rates of pharmacies and stop smoking advisors, (2) to establish the potential impact of the training intervention on throughput and retention of smokers in smoking services, (3) to establish potential impact on smoking cessation outcomes, (4) to optimise logistics for conducting a cluster randomised trial in the next phase of the research programme and (5) to consider the feasibility of collecting pharmacy and service user data. In this cluster randomised parallel group pilot trial, 12 community pharmacies in East London were allocated to intervention or usual practice using simple randomisation (allocation ratio 2:1). Data were analysed descriptively. RESULTS Twelve of 54 (22.2%, 95% CI 12.0% to 35.6%) pharmacies and 20 of 23 (87.0%, 95% CI 66.4% to 97.2%) advisors invited, agreed to participate. Over 5 months, 302 smokers in intervention pharmacies (mean per pharmacy 43.1, 95% CI: -4.3 to 90.5) and 319 in usual practice pharmacies (mean per pharmacy 79.8, 95% CI: 19.0 to 140.5) joined the service. 51 of 621 smokers (6.3% in intervention vs 10.0% in usual practice) consented to provide additional data on smoking cessation. 17 of 19 smokers that consented were retained at 4 weeks in intervention arm (89.5%, 95% CI: 66.9% to 98.7%) and 24 of 32 in usual practice (75.0%, 95% CI: 56.6% to 88.5%). 10 of 19 in the intervention arm (52.6%, 95% CI: 28.9% to 75.6%) stopped smoking compared to 7 of 32 in usual practice arm (21.9%, 95% CI: 9.3% to 40.0%). The pilot was useful in providing insights on how best to conduct the definitive trial and shortcomings of our present logistical arrangements, including feasibility of collecting pharmacy and service user data. CONCLUSIONS Recruitment rates show that the main trial is feasible, and the results suggest that the intervention may improve retention and quit rates in smoking cessation services. We gained insights on how best to conduct the definitive trial which will proceed as planned.
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Affiliation(s)
- V. W. Madurasinghe
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
- Pragmatic Clinical Trials Unit (PCTU), Centre for Primary Care and Public Health, Blizard Institute, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Ratna Sohanpal
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Wai James
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Liz Steed
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Sandra Eldridge
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - SJC Taylor
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - C. Griffiths
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Robert Walton
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
- Pragmatic Clinical Trials Unit (PCTU), Centre for Primary Care and Public Health, Blizard Institute, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
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Gotimer K, Griffiths C, Jimenez E, Musa F, Villella J, Levine K, Chan K, Chalas E. Impact of Universal Screening Recommendation on Genetic Testing in Patients with Epithelial Ovarian, Fallopian Tube and Peritoneal Cancers. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.314] [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]
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Hobbs M, Griffiths C, Green M, Jordan H, McKenna J. P56 Associations between the physical activity and food environment and obesity: a cross sectional study of UK adults. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.155] [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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Busbridge M, Griffiths C, Ashby D, Gale D, Jayantha A, Sanwaiya A, Chapman RS. Development of a novel immunoassay for the iron regulatory peptide hepcidin. Br J Biomed Sci 2016; 66:150-7. [DOI: 10.1080/09674845.2009.11730263] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Busbridge
- Department of Clinical Biochemistry, Charing Cross Hospital; London
| | - C. Griffiths
- Department of Clinical Biochemistry, Charing Cross Hospital; London
| | - D. Ashby
- Imperial College Kidney and Transplant Institute, Imperial College Healthcare NHS Trust, London
| | - D. Gale
- Division of Medicine, University College London; London
| | - A. Jayantha
- Gastroenterology Department, Ealing Hospital NHS Trust, London
| | - A. Sanwaiya
- Gastroenterology Department, Ealing Hospital NHS Trust, London
| | - R. S. Chapman
- Department of Clinical Biochemistry, Charing Cross Hospital; London
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Griffiths C, Reich K, Lebwohl M, Van De Kerkhof P, Paul C, Menter A, Cameron G, Erickson J, Zhang L, Secrest R, Ball S, Braun D, Osuntokun O, Heffernan M, Nickoloff B, Papp K. Essai de phase 3 comparant l’ixekizumab au placebo et à l’étanercept dans le traitement du psoriasis en plaques modéré à sévère : résultats de la période d’induction de 12 semaines de l’essai UNCOVER-2. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Berki D, Choon SE, Burden AD, Griffiths C, Smith C, Barker J, Capon F. A unifying molecular mechanism underlying the association of CARD14 alleles with autoinflammatory and T-cell mediated skin disorders. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597261 DOI: 10.1186/1546-0096-13-s1-o50] [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: 11/17/2022] Open
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Zwolinsky S, McKenna J, Pringle A, Widdop P, Griffiths C. Physical activity assessment for public health: efficacious use of the single-item measure. Public Health 2015; 129:1630-6. [DOI: 10.1016/j.puhe.2015.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 05/13/2015] [Accepted: 07/13/2015] [Indexed: 11/25/2022]
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50
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Wayal S, Griffiths C, Mercer C, Gerrussu M, Hughes G. P01.11 Understanding the greater burden of stis among black caribbeans in the uk: evidence from a systematic review. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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