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Paterson C, Roberts C, Blackburn J, Jojo N, Northam HL, Wallis E, Hind A, Caulfield R, Barratt M, Toohey K, Kavanagh PS, Bacon R, Wilson RL. Understanding the needs and preferences for cancer care among First Nations people: An integrative review. J Adv Nurs 2024; 80:1776-1812. [PMID: 38018290 DOI: 10.1111/jan.15968] [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: 03/21/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
AIM This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people. DESIGN Integrative review. DATA SOURCES An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted. RESULTS Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs. CONCLUSION Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs. PATIENT OR PUBLIC CONTRIBUTION Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work. IMPLICATIONS FOR NURSING PRACTICE Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Blackburn
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - A Hind
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R Caulfield
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - M Barratt
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Justice and Society, University of South Australia, Magill, South Australia, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R L Wilson
- School of Nursing and Midwifery, University of Newcastle, Gosford, New South Wales, Australia
- School of Nursing, Massey University, Palmerston North, New Zealand
- Descendent of the Wiradjuri Nation (First Nations Person), New South Wales, Australia
- Department of Nursing, RMIT University, Melbourne, Victoria, Australia
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Paterson C, Davis D, Roberts C, Bail K, Wallis E, Northam HL, Frost J, Jojo N, McGrory C, Dombkins A, Kavanagh PS. Sense of coherence moderates job demand-resources and impact on burnout among nurses and midwives in the context of the COVID-19 pandemic: A cross-sectional survey. J Adv Nurs 2024. [PMID: 38426656 DOI: 10.1111/jan.16125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/04/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
AIM This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. DESIGN Cross-sectional quantitative survey. DATA SOURCES The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. RESULTS 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. CONCLUSION It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution in this study, as the focus was on nurses and midwives.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
| | - D Davis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Bail
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Frost
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Western Sydney University, Penrith South, New South Wales, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - C McGrory
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - A Dombkins
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
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Paterson C, Roberts C, Li J, Chapman M, Strickland K, Johnston N, Law E, Bacon R, Turner M, Mohanty I, Pranavan G, Toohey K. What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: A qualitative systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01401-5. [PMID: 37256499 DOI: 10.1007/s11764-023-01401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers. METHODS A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings. RESULTS A total of 33 studies were included which represented a total sample of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 individual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs. CONCLUSION This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with individualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services. IMPLICATIONS FOR CANCER SURVIVORS It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.
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Affiliation(s)
- C Paterson
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia.
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia.
- Canberra Health Services and ACT Health, Garran, Canberra, Australia.
- Robert Gordon University, Aberdeen, Scotland, UK.
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - J Li
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - M Chapman
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- Department of Palliative Care, Canberra Health Services, Garran, Canberra, Australia
- School of Medicine and Psychology, Australian National University, Canberra, Australia
| | - K Strickland
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, AUT, Auckland, New Zealand
| | - N Johnston
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - E Law
- Icon Cancer Centre, Canberra, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
| | - I Mohanty
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - G Pranavan
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
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Woodcock VK, Chen J, Purshouse K, Butcher C, Collins L, Haddon C, Verrall G, Elhussein L, Roberts C, Tarlton A, Rei M, Napolitani G, Salio M, Middleton MR, Cerundolo V, Crew J, Protheroe AS. PemBla: A Phase 1 study of intravesical pembrolizumab in recurrent non‐muscle‐invasive bladder cancer. BJUI Compass 2023; 4:322-330. [PMID: 37025470 PMCID: PMC10071078 DOI: 10.1002/bco2.220] [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] [Received: 11/30/2022] [Revised: 12/20/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives This study aimed to investigate the anti-PD-1 inhibitor pembrolizumab as a potential agent for use in non-muscle-invasive bladder cancer (NMIBC) by conducting a Phase 1 safety run-in study to assess the safety and tolerability of intravesical pembrolizumab after transurethral resection of the bladder tumour (TURBT). Patients and methods Eligible patients had recurrent NMIBC for which adjuvant treatment post TURBT was a reasonable treatment option, Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1 and adequate end-organ function. Pembrolizumab was administered by intravesical instillation once weekly for a total of six doses. Intra-patient dose escalation was performed in three paired patient cohorts with doses starting at 50 mg and increasing through 100 mg to a maximum of 200 mg. Adverse events (AEs) were assessed using Common Terminology Criteria for Adverse Events (CTCAE) v4.03 with dose limiting toxicity (DLT) defined as a clinically significant, drug-related, Grade 4 haematological or Grade 3 or higher non-haematological toxicity occurring within 7 days of administration of the first treatment at a given dose for that patient. Results Six patients were treated with no DLTs seen during dose escalation. Drug-related AEs were of low grade and included dysuria and fatigue. All patients completed six doses of treatment as planned. Pharmacokinetic and pharmacodynamic assays did not detect any pembrolizumab in the serum following repeated intravesical administration, and no changes in peripheral immune cell populations were observed. Conclusions Administration of intravesical pembrolizumab was well tolerated and did not raise any safety concerns in patients with NMIBC following TURBT. There was no evidence of systemic absorption or systemic immune effects following intravesical administration. Further studies are required to assess whether intravesical administration has anti-tumour activity.
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Affiliation(s)
- Victoria K. Woodcock
- Department of Oncology Churchill Hospital, University of Oxford Oxford UK
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Ji‐Li Chen
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Karin Purshouse
- Department of Oncology Churchill Hospital, University of Oxford Oxford UK
| | - Chrissie Butcher
- Oncology Clinical Trials Office, Department of Oncology University of Oxford Oxford UK
| | - Linda Collins
- Oncology Clinical Trials Office, Department of Oncology University of Oxford Oxford UK
| | - Caroline Haddon
- Department of Oncology Churchill Hospital, University of Oxford Oxford UK
| | | | - Leena Elhussein
- Centre for Statistics in Medicine University of Oxford Oxford UK
| | - Corran Roberts
- Centre for Statistics in Medicine University of Oxford Oxford UK
| | - Andrea Tarlton
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Margarida Rei
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Giorgio Napolitani
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Mariolina Salio
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Mark R. Middleton
- Department of Oncology Churchill Hospital, University of Oxford Oxford UK
- National Institute for Health Research Oxford Biomedical Research Centre Oxford UK
| | - Vincenzo Cerundolo
- MRC Human Immunology Unit MRC Weatherall Institute of Molecular Medicine Oxford UK
| | - Jeremy Crew
- Department of Urology Churchill Hospital Oxford UK
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Wright A, Amodie DM, Cernicchiaro N, Lascelles BDX, Pavlock AM, Roberts C, Bartram DJ. Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests. J Small Anim Pract 2022; 63:609-618. [PMID: 35385129 PMCID: PMC9543207 DOI: 10.1111/jsap.13500] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 08/04/2021] [Revised: 02/10/2022] [Accepted: 03/11/2022] [Indexed: 12/14/2022]
Abstract
Objectives To investigate the diagnostic value of an owner‐completed canine osteoarthritis screening checklist to help identify previously undiagnosed osteoarthritis cases, and assess their response to carprofen treatment by monitoring pain and functional mobility. Materials and Methods Dogs (n=500) whose owners reported ≥1 positive response to the osteoarthritis checklist were examined to identify dogs with previously undiagnosed osteoarthritis. Eligible dogs (n=133) were evaluated for pain and video mobility analysis by Helsinki Chronic Pain Index and visual analogue scale scores, respectively, following carprofen treatment, administered for 30 days (n=95) or up to 120 days (n=38). Dogs were filmed at clinics performing activities (walking, jogging, sitting/lying, walking up and down stairs), and scored at days 0, 30 and 120 using visual analogue scale by an independent blinded expert. Results A diagnosis of osteoarthritis was confirmed by a veterinarian in 38% (188 of 500) of dogs. Balance of sensitivity and specificity across the original group of nine screening questions was optimised to approximately 88 and 71%, respectively, after elimination of three questions. Pain measured by Helsinki Chronic Pain Index and functional mobility improved over time in response to treatment with carprofen. Mean ability scores for activities significantly improved between days 0 and 30 for walking, jogging, sitting/lying and walking down stairs, and days 0 and 120 for sitting/lying and walking up stairs. Clinical Significance More osteoarthritis cases were identified in study dogs than previous prevalence estimates, indicating the screening checklist's potential to help identify for further evaluation cases that could otherwise remain undiagnosed. Improvements in function were demonstrated after carprofen treatment.
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Affiliation(s)
- A Wright
- Outcomes Research, Zoetis Inc., Parsippany, New Jersey, 07054, USA
| | - D M Amodie
- Outcomes Research, Zoetis Inc., Parsippany, New Jersey, 07054, USA
| | - N Cernicchiaro
- Center for Outcomes Research and Epidemiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, 66506, USA
| | - B D X Lascelles
- Comparative Pain Research and Education Centre & Translational Research in Pain Program, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, 27606, USA
| | - A M Pavlock
- AMP Research Solutions, Parker Ford, Pennsylvania, 19457, USA
| | - C Roberts
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, GU2 7AL, UK
| | - D J Bartram
- Outcomes Research, Zoetis Inc., Parsippany, New Jersey, 07054, USA
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Hunjan MK, Roberts C, Karim S, Hague J. Pityriasis rubra pilaris-like eruption following administration of the BNT163b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine. Clin Exp Dermatol 2022; 47:188-190. [PMID: 34379821 PMCID: PMC8444918 DOI: 10.1111/ced.14878] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
We describe a case of a pityriasis rubra pilaris (PRP)-like eruption occurring following administration of the Pfizer-Biontech mRNA COVID-19 vaccine, with worsening of the condition following the second dose. To our knowledge, this is the first reported case of a PRP-like eruption as a cutaneous adverse event of the Pfizer-Biontech mRNA COVID-19 vaccine.
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Affiliation(s)
- M. K. Hunjan
- Department of DermatologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
| | - C. Roberts
- Department of HistopathologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
| | - S. Karim
- Department of HistopathologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
| | - J. Hague
- Department of DermatologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
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Azeez N, Roberts C, Bradbury H. Stakeholders (trainees & tutors) views on the introduction of a workplace-based assessment tool within the pre-registration pharmacy training programme in a large teaching hospital: A qualitative triangulation study. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.046] [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]
Abstract
Abstract
Introduction
Pre-registration pharmacy training in the UK is a competency-based programme1. Workplace-based assessment (WBA) tools are valid and reliable tools in assessing competency in the workplace,2 however no recognised WBA tools are used within pre-registration pharmacy training. Historically WBA have been used within healthcare training, including postgraduate pharmacy. A WBA tool was designed by amalgamating three recognised tools from postgraduate pharmacy training (case-based discussion, mini clinical examination and direct observed patient consultation), then piloted within the 2018/19 pre-registration pharmacy training year in a large teaching hospital.
Aim
To gather the views of pre-registration pharmacist trainees and tutors of their experiences of using the WBA tool in practice. From the views, to determine if the purposes of the tool had been met: allowing tutors to work directly with their trainee in the workplace and meet the GPhC performance standards1 that are more easily met through observation.
Methods
This research was carried out in a large teaching hospital in the North of England. The WBA tool which included a six-point Likert scale and comments boxes for feedback, was introduced to the stakeholders at the start of the 2018/19 training year in a training session. Data was collected 6 months after using the tool in practice. A triangulation method was used; a semi-structured interview with the pre-registration pharmacist manager and two focus groups were conducted, one with trainees (n=7) and one with tutors (n=5). Participants were recruited through an invitation email sent via a gatekeeper. The focus groups moderator set ground rules to ensure a safe space for discussion to reduce conflict. They also reduced possible bias by ensuring they were not a current tutor. Responses from the interview were used to support the design of the topic guide for the focus groups. Data was transcribed and thematic analysis was undertaken.
Results
Following thematic analysis, three global themes emerged: clarity of purpose of the tool, feedback to trainees and the WBA tool as an assessment. Overall, trainees found the WBA tool was the most valuable part of their training owing to the benefit of instant feedback. Tutors agreed the tool was valuable when directly observing their trainee in practice, supporting the initial aim of the tool. There were conflicting views on why the tool was introduced, therefore highlighting the importance of a good implementation strategy when making changes. Interestingly, the WBA tool was not perceived as an assessment by the majority of trainees, and the inclusion of the Likert scale on the tool was questioned, leading to possible changes being made for future use.
Conclusion
This is the first study that gathers stakeholders’ experiences of using a WBA tool within pre-registration pharmacy training within the UK. Overall, the WBA tool received positive responses from both trainees and tutors. With upcoming changes in foundation pharmacy training proposed, this study supports the use of a WBA tool as it allows for focused feedback which trainees’ value. Limitations include a small sample size and the WBA tool being piloted in one hospital.
References
1. GPhC. 2020. Pre-registration trainee. [Online]. Available from: https://www.pharmacyregulation.org/i-am-pre-registration-trainee
2. Norcini, J. and Burch, V. 2007. Workplace-based assessment as an educational tool: AMEE Guide No.31. Medical Teacher.29, pp. 855–871.
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Affiliation(s)
- N Azeez
- Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, UK
| | - C Roberts
- Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, UK
| | - H Bradbury
- School of Healthcare, University of Leeds, UK
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Dardenne E, Padilla F, Rasmussen S, Yang S, Mentes A, Ogawa L, Fiorenza R, Trombino A, Smith S, Romashko D, Ishiyama N, Chevtsova M, Thakur S, Rosfjord E, Buck E, Roberts C, Lucas M, Lin TA. 35MO Discovery and characterization of selective, FGFR1-sparing, inhibitors of FGFR2/3 oncogenic mutations for the treatment of cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.050] [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] Open
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Roberts C, Wheatley-Price P, Asmis T, Barton G, Greene T. P39.03 Developing A Collaborative Northern Roadmap for Lung Cancer Care. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.803] [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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Han YC, Ng P, Schulz R, Yang S, Lelo A, Ogawa L, O'Connor M, Ishiyama N, Jewett I, Romashko D, Salomatov A, Thakur S, Smith S, Buck E, Roberts C, Lucas M, Lin TA. 43P Pre-clinical evaluation of potent and orally bioavailable next-generation inhibitors targeting the family of mutants that drive oncogenic BRAF dimer formation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.058] [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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Roberts C, Kaplow J, Giroux M, Krause S, Kanekiyo M. Amyloid and APOE Status of Screened Subjects in the Elenbecestat MissionAD Phase 3 Program. J Prev Alzheimers Dis 2021; 8:218-223. [PMID: 33569570 DOI: 10.14283/jpad.2021.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/OBJECTIVES Elenbecestat, an oral BACE-1 inhibitor that has been shown to reduce Aβ levels in cerebrospinal fluid, was investigated in two global phase 3 studies in early AD. Here we report on differences observed in characteristics of APOE ε4 and amyloid positive subjects in the large screening cohort. DESIGN Screening was performed in 5 sequential tiers over a maximum of 80 days, as part of placebo controlled, double blind phase 3 studies. SETTING Subjects were evaluated at sites in 7 regions (29 countries). PARTICIPANTS Overall, 9758 subjects were screened. INTERVENTION All screened subjects that were eligible received either placebo or 50 mg QID elenbecestat post randomisation. MEASUREMENTS Gender, disease staging, APOE ε4 status, amyloid status, amyloid positron emission tomography (PET) standard uptake value ratio (SUVr) and amyloid PET Centiloid (CL) values were determined for screened subjects; by country and region. RESULTS In this program, 44% of subjects were APOE ε4 positive. Frequency of females was similar in both APOE ε4 positive and negative groups. However, early mild AD subjects were slightly higher in the APOE ε4 positive group compared with the APOE ε4 negative group. 56% of subjects were amyloid positive. The mean age in the amyloid positive group was slightly higher than the amyloid negative group. The gender distribution was similar between amyloid groups. A lower number of mild cognitive impairment was observed in the amyloid positive group along with a higher number of early mild AD. APOE ε4 positive subjects were higher in amyloid positive group compared to the amyloid negative group. China had the lowest APOE ε4 and amyloid positivity rates with Western Europe and Oceania performing best. Subjects received florbetapir, florbetaben or flutemetamol amyloid PET tracer. Amyloid negative and positive subjects CL values were normally distributed around their respective means of 1.5 CL and 83 CL. However, there was an appreciable overlap in the 20-40 CL range. CONCLUSIONS In this large cohort of cognitively impaired subjects, subject demographics characteristics were comparable regardless of APOE genotype or amyloid positivity. APOE ε4 positivity and amyloid positivity varied by country and by geographical region.
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Affiliation(s)
- C Roberts
- Claire Roberts, Eisai Ltd., Hatfield, UK, , Phone: +44 8456 761 590
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12
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Triant DA, Le Tourneau JJ, Diesh CM, Unni DR, Shamimuzzaman M, Walsh AT, Gardiner J, Goldkamp AK, Li Y, Nguyen HN, Roberts C, Zhao Z, Alexander LJ, Decker JE, Schnabel RD, Schroeder SG, Sonstegard TS, Taylor JF, Rivera RM, Hagen DE, Elsik CG. Using online tools at the Bovine Genome Database to manually annotate genes in the new reference genome. Anim Genet 2020; 51:675-682. [PMID: 32537769 PMCID: PMC7540445 DOI: 10.1111/age.12962] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/16/2022]
Abstract
With the availability of a new highly contiguous Bos taurus reference genome assembly (ARS-UCD1.2), it is the opportune time to upgrade the bovine gene set by seeking input from researchers. Furthermore, advances in graphical genome annotation tools now make it possible for researchers to leverage sequence data generated with the latest technologies to collaboratively curate genes. For many years the Bovine Genome Database (BGD) has provided tools such as the Apollo genome annotation editor to support manual bovine gene curation. The goal of this paper is to explain the reasoning behind the decisions made in the manual gene curation process while providing examples using the existing BGD tools. We will describe the sources of gene annotation evidence provided at the BGD, including RNA-seq and Iso-Seq data. We will also explain how to interpret various data visualizations when curating gene models, and will demonstrate the value of manual gene annotation. The process described here can be applied to manual gene curation for other species with similar tools. With a better understanding of manual gene annotation, researchers will be encouraged to edit gene models and contribute to the enhancement of livestock gene sets.
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Affiliation(s)
- D. A. Triant
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | | | - C. M. Diesh
- Department of BioengineeringUniversity of California, BerkeleyBerkeleyCA94720USA
| | - D. R. Unni
- Division of Environmental Genomics and Systems BiologyLawrence Berkeley National LaboratoryBerkeleyCA94608USA
| | - M. Shamimuzzaman
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - A. T. Walsh
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - J. Gardiner
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - A. K. Goldkamp
- Department of Animal and Food SciencesOklahoma State UniversityStillwaterOK74078USA
| | - Y. Li
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - H. N. Nguyen
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
| | - C. Roberts
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - Z. Zhao
- Division of Plant SciencesUniversity of MissouriColumbiaMO65211USA
| | - L. J. Alexander
- USDA‐ARS‐PA‐Livestock & Range Research LabMiles CityMT59301USA
| | - J. E. Decker
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
| | - R. D. Schnabel
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
| | - S. G. Schroeder
- USDA‐ARS Animal Genomics and Improvement LabBeltsvilleMD20705USA
| | | | - J. F. Taylor
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - R. M. Rivera
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - D. E. Hagen
- Department of Animal and Food SciencesOklahoma State UniversityStillwaterOK74078USA
| | - C. G. Elsik
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
- Division of Plant SciencesUniversity of MissouriColumbiaMO65211USA
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Paterson C, Roberts C, Toohey K, McKie A. Prostate Cancer Prehabilitation and the Importance of Multimodal Interventions for Person-centred Care and Recovery. Semin Oncol Nurs 2020; 36:151048. [PMID: 32709485 DOI: 10.1016/j.soncn.2020.151048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 12/11/2022]
Abstract
BACKGROUND Prostate cancer is the second most commonly diagnosed cancer globally. Cancer prehabilitation is defined as a process on the continuum of care that occurs between the time of a cancer diagnosis and the beginning of acute treatment. This article will discuss the importance of prostate cancer prehabilitation interventions in optimising physical and psychological recovery to enhance person-centred care. DATA SOURCES Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, professional websites, and grey literature were searched using Google Scholar. CONCLUSION Prehabilitation in cancer care aims to enhance perioperative care and recovery. An emerging field of research suggests that the preoperative period may be physically and psychologically salient to introduce modifiable self-management behaviours to optimise overall recovery. IMPLICATIONS FOR NURSING PRACTICE Prostate cancer specialist nurses provide the hub of person-centred care across the entire cancer care continuum embedded within the multidisciplinary team. Individually tailored interventions such as exercise and pelvic floor muscle training programmes, nutritional advice, anxiety and depression reduction, and sexual well-being interventions should be considered in the prehabilitation phase of the cancer care continuum.
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Affiliation(s)
- C Paterson
- School of Nursing, Midwifery, and Public Health, University of Canberra, Canberra, ACT, Australia; ACT Health and the Canberra Health Services, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia.
| | - C Roberts
- School of Nursing, Midwifery, and Public Health, University of Canberra, Canberra, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia
| | - K Toohey
- ACT Health and the Canberra Health Services, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - A McKie
- School of Nursing, Midwifery, and Public Health, University of Canberra, Canberra, ACT, Australia; School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
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Paterson C, Kozlovskaia M, Turner M, Strickland K, Roberts C, Ogilvie R, Pranavan G, Craft P. Identifying the supportive care needs of men and women affected by chemotherapy-induced alopecia? A systematic review. J Cancer Surviv 2020; 15:14-28. [PMID: 32683651 DOI: 10.1007/s11764-020-00907-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/11/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically evaluate evidence regarding the unmet supportive care needs of men and women affected by chemotherapy-induced alopecia (CIA) to inform clinical practice guidelines. METHODS We performed a review of CINAHL, MEDLINE, PsychINFO, Scopus, the Cochrane Library (CCRT and CDSR) controlled trial databases and clinicaltrials.gov from January 1990 to June 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Twenty-seven publications were selected for inclusion in this analysis. RESULTS Included reports used qualitative (ten) and quantitative (17) studies. Across these studies men and women reported the major impact that CIA had on their psychological well-being, quality of life and body image. Hair loss had a negative impact irrespective of gender, which resulted in feelings of vulnerability and visibility of being a "cancer patient". Men and women described negative feelings, often similar, related to CIA with a range of unmet supportive care needs. CONCLUSIONS Some patients are not well-prepared for alopecia due to a lack of information and resources to reduce the psychological burden associated with CIA. Hair loss will affect each patient and their family differently, therefore, intervention and support must be tailored at an individual level of need to optimise psychological and physical well-being and recovery. IMPLICATIONS FOR CANCER SURVIVORS People affected by CIA may experience a range of unmet supportive care needs, and oncology doctors and nurses are urged to use these findings in their everyday consultations to ensure effective, person-centred care and timely intervention to minimise the sequalae associated with CIA.
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Affiliation(s)
- C Paterson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia.
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia.
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia.
- Robert Gordon University, Aberdeen, Scotland.
| | - M Kozlovskaia
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - M Turner
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
| | - K Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - C Roberts
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - R Ogilvie
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - G Pranavan
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
| | - P Craft
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
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Roberts C, Paterson C. An Exploration of the Rs of Radiobiology in Prostate Cancer. Semin Oncol Nurs 2020; 36:151054. [PMID: 32669231 DOI: 10.1016/j.soncn.2020.151054] [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: 11/29/2022]
Abstract
OBJECTIVES To explore the four Rs of radiobiology (Repair, Reoxygenation, Reassortment, and Repopulation) as a means to understand the effects of ionising radiation on biological tissue and subsequently as the basis for conventional fractionated treatment schedules. These radiobiological principles will form a rationale for combined regimens in prostate cancer treatment involving androgen deprivation therapy and radiation therapy and the associated toxicities of this approach will be discussed. DATA SOURCES Electronic databases including CINAHL, MEDLINE, Scopus, professional websites, books and grey literature were searched using Google Scholar. CONCLUSION It is important for nurses to understand the four Rs of radiobiology to grasp the effects of ionising radiation on biological tissue as the basis for conventional fractionated treatment schedules in prostate cancer. Men can experience a sequalae of physical and psychological side effects of treatment that can negatively impact quality of life. IMPLICATIONS FOR NURSING PRACTICE Men can experience a range of unmet supportive care needs particularly related to informational, sexual, and psychological needs. For men affected by prostate cancer opting for radiation therapy (+/-) androgen deprivation therapy, nurses should ask targeted questions based on the Common Terminology Criteria for Adverse Events related to urinary and bowel function, potency and fatigue, and sexual health. We also recommend the use of holistic needs assessments to tailor self-management care plans. Evidence-based self-management advice should be provided in response to each man's unique needs.
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Affiliation(s)
- C Roberts
- Faculty of Health, University of Canberra, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, ACT, Australia.
| | - C Paterson
- Faculty of Health, University of Canberra, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, ACT, Australia; ACT Synergy Nursing and Midwifery Research Centre, Canberra Hospital, ACT, Australia
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Hallifax RJ, McKeown E, Sivakumar P, Fairbairn I, Peter C, Leitch A, Knight M, Stanton A, Ijaz A, Marciniak S, Cameron J, Bhatta A, Blyth KG, Reddy R, Harris MC, Maddekar N, Walker S, West A, Laskawiec-Szkonter M, Corcoran JP, Gerry S, Roberts C, Harvey JE, Maskell N, Miller RF, Rahman NM. Ambulatory management of primary spontaneous pneumothorax: an open-label, randomised controlled trial. Lancet 2020; 396:39-49. [PMID: 32622394 PMCID: PMC7607300 DOI: 10.1016/s0140-6736(20)31043-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Primary spontaneous pneumothorax occurs in otherwise healthy young patients. Optimal management is not defined and often results in prolonged hospitalisation. Data on efficacy of ambulatory options are poor. We aimed to describe the duration of hospitalisation and safety of ambulatory management compared with standard care. METHODS In this open-label, randomised controlled trial, adults (aged 16-55 years) with symptomatic primary spontaneous pneumothorax were recruited from 24 UK hospitals during a period of 3 years. Patients were randomly assigned (1:1) to treatment with either an ambulatory device or standard guideline-based management (aspiration, standard chest tube insertion, or both). The primary outcome was total length of hospital stay including re-admission up to 30 days after randomisation. Patients with available data were included in the primary analysis and all assigned patients were included in the safety analysis. The trial was prospectively registered with the International Standard Randomised Clinical Trials Number, ISRCTN79151659. FINDINGS Of 776 patients screened between July, 2015, and March, 2019, 236 (30%) were randomly assigned to ambulatory care (n=117) and standard care (n=119). At day 30, the median hospitalisation was significantly shorter in the 114 patients with available data who received ambulatory treatment (0 days [IQR 0-3]) than in the 113 with available data who received standard care (4 days [IQR 0-8]; p<0·0001; median difference 2 days [95% CI 1-3]). 110 (47%) of 236 patients had adverse events, including 64 (55%) of 117 patients in the ambulatory care arm and 46 (39%) of 119 in the standard care arm. All 14 serious adverse events occurred in patients who received ambulatory care, eight (57%) of which were related to the intervention, including an enlarging pneumothorax, asymptomatic pulmonary oedema, and the device malfunctioning, leaking, or dislodging. INTERPRETATION Ambulatory management of primary spontaneous pneumothorax significantly reduced the duration of hospitalisation including re-admissions in the first 30 days, but at the expense of increased adverse events. This data suggests that primary spontaneous pneumothorax can be managed for outpatients, using ambulatory devices in those who require intervention. FUNDING UK National Institute for Health Research.
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Affiliation(s)
- Rob J Hallifax
- Oxford Centre for Respiratory Medicine, University of Oxford, Oxford, UK.
| | - Edward McKeown
- Royal Berkshire National Health Service (NHS) Foundation Trust, Reading, UK
| | | | | | - Christy Peter
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Andrew Leitch
- Western General Hospital, NHS Lothian, Edinburgh, UK
| | | | - Andrew Stanton
- Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Asim Ijaz
- University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
| | | | | | - Amrithraj Bhatta
- Blackpool Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, UK
| | - Kevin G Blyth
- Queen Elizabeth University Hospital, Glasgow, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Raja Reddy
- Kettering General Hospital, Kettering, UK
| | | | | | - Steven Walker
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - Alex West
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | - Stephen Gerry
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Corran Roberts
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Nick Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - Robert F Miller
- Institute for Global Health, University College London, London, UK
| | - Najib M Rahman
- Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
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Odutayo A, Gryaznov D, Copsey B, Monk P, Speich B, Roberts C, Vadher K, Dutton P, Briel M, Hopewell S, Altman DG. Design, analysis and reporting of multi-arm trials and strategies to address multiple testing. Int J Epidemiol 2020; 49:968-978. [PMID: 32176282 DOI: 10.1093/ije/dyaa026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND It is unclear how multiple treatment comparisons are managed in the analysis of multi-arm trials, particularly related to reducing type I (false positive) and type II errors (false negative). METHODS We conducted a cohort study of clinical-trial protocols that were approved by research ethics committees in the UK, Switzerland, Germany and Canada in 2012. We examined the use of multiple-testing procedures to control the overall type I error rate. We created a decision tool to determine the need for multiple-testing procedures. We compared the result of the decision tool to the analysis plan in the protocol. We also compared the pre-specified analysis plans in trial protocols to their publications. RESULTS Sixty-four protocols for multi-arm trials were identified, of which 50 involved multiple testing. Nine of 50 trials (18%) used a single-step multiple-testing procedures such as a Bonferroni correction and 17 (38%) used an ordered sequence of primary comparisons to control the overall type I error. Based on our decision tool, 45 of 50 protocols (90%) required use of a multiple-testing procedure but only 28 of the 45 (62%) accounted for multiplicity in their analysis or provided a rationale if no multiple-testing procedure was used. We identified 32 protocol-publication pairs, of which 8 planned a global-comparison test and 20 planned a multiple-testing procedure in their trial protocol. However, four of these eight trials (50%) did not use the global-comparison test. Likewise, 3 of the 20 trials (15%) did not perform the multiple-testing procedure in the publication. The sample size of our study was small and we did not have access to statistical-analysis plans for the included trials in our study. CONCLUSIONS Strategies to reduce type I and type II errors are inconsistently employed in multi-arm trials. Important analytical differences exist between planned analyses in clinical-trial protocols and subsequent publications, which may suggest selective reporting of analyses.
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Affiliation(s)
- Ayodele Odutayo
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Dmitry Gryaznov
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Bethan Copsey
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Paul Monk
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Benjamin Speich
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Corran Roberts
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karan Vadher
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Peter Dutton
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Matthias Briel
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Douglas G Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Brown NF, Ng SM, Brooks C, Coutts T, Holmes J, Roberts C, Elhussein L, Hoskin P, Maughan T, Blagden S, Mulholland P. A phase II open label, randomised study of ipilimumab with temozolomide versus temozolomide alone after surgery and chemoradiotherapy in patients with recently diagnosed glioblastoma: the Ipi-Glio trial protocol. BMC Cancer 2020; 20:198. [PMID: 32164579 PMCID: PMC7068928 DOI: 10.1186/s12885-020-6624-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/11/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Median survival for patients with glioblastoma is less than a year. Standard treatment consists of surgical debulking if feasible followed by temozolomide chemo-radiotherapy. The immune checkpoint inhibitor ipilimumab targets cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and has shown clinical efficacy in preclinical models of glioblastoma. The aim of this study is to explore the addition of ipilimumab to standard therapy in patients with glioblastoma. METHODS/DESIGN Ipi-Glio is a phase II, open label, randomised study of ipilimumab with temozolomide (Arm A) versus temozolomide alone (Arm B) after surgery and chemoradiotherapy in patients with recently diagnosed glioblastoma. Planned accrual is 120 patients (Arm A: 80, Arm B: 40). Endpoints include overall survival, 18-month survival, 5-year survival, and adverse events. The trial is currently recruiting in seven centres in the United Kingdom. TRIAL REGISTRATION ISRCTN84434175. Registered 12 November 2018.
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Affiliation(s)
- Nicholas F Brown
- Department of Oncology, University College London Hospitals, 250 Euston Road, London, NW1 2PQ, UK
| | - Stasya M Ng
- Oncology Clinical Trials Office (OCTO), Department of Oncology, The University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Claire Brooks
- Oncology Clinical Trials Office (OCTO), Department of Oncology, The University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Tim Coutts
- Oncology Clinical Trials Office (OCTO), Department of Oncology, The University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Jane Holmes
- Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - Corran Roberts
- Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - Leena Elhussein
- Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, HA6 2RN, UK
| | - Tim Maughan
- Oxford Institute for Radiation Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Sarah Blagden
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Paul Mulholland
- Department of Oncology, University College London Hospitals, 250 Euston Road, London, NW1 2PQ, UK.
- Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, HA6 2RN, UK.
- UCL Cancer Institute, 72 Huntley St, London, WC1E 6AG, UK.
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Roberts C, Strauss VY, Kopijasz S, Gourley C, Hall M, Montes A, Abraham J, Clamp A, Kennedy R, Banerjee S, Folkes LK, Stratford M, Nicum S. Results of a phase II clinical trial of 6-mercaptopurine (6MP) and methotrexate in patients with BRCA-defective tumours. Br J Cancer 2020; 122:483-490. [PMID: 31813938 PMCID: PMC7028724 DOI: 10.1038/s41416-019-0674-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 10/04/2019] [Accepted: 11/15/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Tumour cells with BRCA1/2 gene mutations demonstrate increased sensitivity to platinum and poly (ADP-ribose) polymerase (PARP) inhibitors. 6-mercaptopurine (6MP) was found to selectively kill BRCA-defective cells in a xenograft model as effectively as the PARP inhibitor AG014699, even after these cells acquired resistance to a PARP inhibitor or cisplatin. METHODS This phase II single-arm trial investigated the activity of 6MP 55-75 mg/m2 per day, and methotrexate 15-20 mg/m2 per week in advanced breast or platinum-resistant ovarian cancer patients with a BRCA1/2 germline mutation, who had progressed after ≥1 previous line of chemotherapy. The primary outcome was objective response including stable disease (SD) as an assessment of clinical benefit rate (CBR), at 8 weeks, by RECIST v1.1. Secondary outcomes included overall survival (OS) and progression-free survival (PFS). RESULTS In total, 67 evaluable patients were recruited; 55 ovarian and 11 breast cancer patients. In total, 21 patients had SD (31%), one had a partial response (1.5%); CBR was 33% at 8 weeks. In total, 12/67 patients (18%) had SD at 16 weeks. In total, five ovarian cancer patients had SD for over 200 days. Median OS was 10.3 months (95% CI 6.9-14.5), median PFS 1.9 months (1.7-2.8). CONCLUSIONS The overall activity of 6MP and methotrexate in these patients was low; however, there was a small group of patients who appeared to derive longer-term clinical benefit. TRIAL REGISTRATION NCT01432145 http://www.ClinicalTrials.gov.
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Affiliation(s)
- Corran Roberts
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Victoria Y Strauss
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sylwia Kopijasz
- Oncology Clinical Trials Office (OCTO), Department of Oncology, University of Oxford, Oxford, UK
| | - Charlie Gourley
- Cancer Research UK Edinburgh Centre, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | - Marcia Hall
- Mount Vernon Cancer Centre, Northwood, Middlesex, UK
| | - Ana Montes
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Andrew Clamp
- The Christie NHS Foundation Trust and Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | - Richard Kennedy
- Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast, UK
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - Lisa K Folkes
- CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK
| | - Michael Stratford
- CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK
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Abbate A, Trankle CR, Lipinski MJ, Kadariya D, Canada JM, Carbone S, Buckley LF, Appleton D, Wohlford GF, Medina De Chazal H, Chiabrando JG, Roberts C, Turlington JS, Abouzaki NA, Van Tassell B. 5233Interleukin-1 blockade with Anakinra in ST-segment elevation acute myocardial infarction: Results from the VCUART3 study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0079] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
ST-segment elevation myocardial infarction (STEMI) is associated with an intense inflammatory response that predicts an increased risk of death and heart failure (HF). In the current study we tested whether anakinra, a recombinant Interleukin-1 (IL-1) receptor antagonist, given once daily (standard dose) or twice daily reduced systemic inflammation in patients with STEMI.
Methods
We enrolled patients with STEMI within 12 hours of presentation at 3 sites. After revascularization, patients were randomly assigned to receive anakinra 100 mg twice daily, anakinra 100 mg once daily alternating with placebo once daily every 12 hours, or placebo twice daily, for 14 days in a 1:1:1 ratio. The primary efficacy outcome was the area under the curve for C-reactive protein levels (CRP-AUC) using a high-sensitivity assay at 14 days comparing anakinra (both arms) versus placebo followed by a comparison between each of the anakinra arms with placebo. Two pre-specified exploratory clinical efficacy endpoints, adjudicated by a blinded event committee, were assessed: a composite endpoint of all-cause death for any reason or incidence of HF (defined as new-onset HF requiring hospitalization or a new prescription of a loop diuretic, D+HF) and a composite endpoint of death and HF hospitalization (D+HHF) at 1 year. Data are expressed as median and interquartile range or number and percentage. Kaplan-Meyer survival curves were compared using Log-rank test (Mantel-Cox). (ClinicalTrials.gov number, NCT01950299)
Results
Of 311 patients screened, 99 subjects (80 [81%] males, 57 [58%] Caucasians, 55 [49–62] years of age) were randomly assigned to anakinra twice daily (N=31), anakinra once daily (N=33) or placebo (N=35). There were no significant imbalances in the demographic characteristics between groups (all P>0.05). The CRP-AUC was significantly lower in the anakinra group than in the placebo group (67 [39–120] versus 214 [131–394] mg/dl, P<0.001; and P<0.001 for each anakinra arm versus placebo separately, without significant differences between the two anakinra arms, P=0.41). Treatment with anakinra was associated with a significant reduction versus placebo in the incidence of D+HF (6/64 [9.4%] versus 9/35 [25.7%], P=0.046), and of D+HHF (0/64 [0] versus 4/35 [11.4%], P=0.011), without any significant difference between the two anakinra arms. Anakinra was not associated with any treatment-related serious adverse events, nor with excess infections compared with placebo (14.1% vs 14.3%, P=0.87).
Conclusions
Among patients with STEMI, IL-1 blockade significantly reduced the systemic inflammatory response compared with placebo, without any significant difference between standard or high dose regimens. Prespecified exploratory analyses on clinical endpoints demonstrate reduced incidence of HF and reduced HF hospitalizations, supporting the concept of beneficial effects with IL-1 blockade in patients with acute myocardial infarction.
Acknowledgement/Funding
Funded by NHLBI 1R34HL121402; Drug supply from Swedish Orphan Biovitrum
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Affiliation(s)
- A Abbate
- Virginia Commonwealth University, Richmond, United States of America
| | - C R Trankle
- Virginia Commonwealth University, Richmond, United States of America
| | - M J Lipinski
- Medstar Research Institute, Washington, United States of America
| | - D Kadariya
- Medstar Research Institute, Washington, United States of America
| | - J M Canada
- Medstar Research Institute, Washington, United States of America
| | - S Carbone
- Medstar Research Institute, Washington, United States of America
| | - L F Buckley
- Brigham and Womens Hospital, Boston, United States of America
| | - D Appleton
- Virginia Cardiovascular Specialists, Richmond, United States of America
| | - G F Wohlford
- Virginia Commonwealth University, Richmond, United States of America
| | | | - J G Chiabrando
- Virginia Commonwealth University, Richmond, United States of America
| | - C Roberts
- Virginia Commonwealth University, Richmond, United States of America
| | - J S Turlington
- Virginia Commonwealth University, Richmond, United States of America
| | - N A Abouzaki
- Virginia Commonwealth University, Richmond, United States of America
| | - B Van Tassell
- Virginia Commonwealth University, Richmond, United States of America
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Roberts C, Bornais C, Wheatley-Price P, Asmis T, Nicholas G, Barton G. MA22.07 A Culturally Safe Advocacy Model of Care for Inuit Cancer Patients and Their Families. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.687] [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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Bornais C, Roberts C, Wheatley-Price P, Asmis T, Dennie C, Maziak D, Nicholas G, Barton G, Alie E, Greene T. EP1.11-01 Lung Cancer Screening and Canada’s Inuit: A Missed Opportunity. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2222] [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: 11/30/2022]
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Roberts C. Author Prop: Assisting the Creative Process with an Automated Intelligent Cognitive Prop for Writers. EAI Endorsed Transactions on Creative Technologies 2019. [DOI: 10.4108/eai.30-7-2019.162945] [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: 11/05/2022] Open
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Brierley CK, Staves J, Roberts C, Johnson H, Vyas P, Goodnough LT, Murphy MF. The effects of monoclonal anti-CD47 on RBCs, compatibility testing, and transfusion requirements in refractory acute myeloid leukemia. Transfusion 2019; 59:2248-2254. [PMID: 31183877 DOI: 10.1111/trf.15397] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND CD47 is a novel therapeutic target in the treatment of solid-organ and hematologic malignancies. CD47 is also expressed on RBCs. Here, we report our experience of the RBC effects and the impact on blood bank testing and transfusion management in a Phase 1 trial of the humanized anti-CD47 monoclonal antibody Hu5F9-G4 in relapsed or primary refractory acute myeloid leukemia (AML) (NCT02678338). STUDY DESIGN AND METHODS Nineteen patients with relapsed or primary refractory AML treated across five UK centers were included for analysis. Patients received escalating doses of Hu5F9-G4. Serial laboratory data were collected to evaluate impact on hemoglobin (Hb), markers of hemolysis (bilirubin, lactate dehydrogenase, reticulocyte count), transfusion requirements, and blood compatibility testing. RESULTS A decline in Hb was observed with drug administration (median Hb change, -1.0 g/dL; range, 0.4-1.6) with associated increase in transfusion requirements. Patients responded to transfusion with a median Hb increment per unit of 1.0 g/dL. RBC agglutination was seen in all cases without associated change in Hb, lactate dehydrogenase, bilirubin, or reticulocyte count. Nine of 19 (47%) patients developed a newly positive antibody screen with a pan-agglutinin identified in plasma. Invalid ABO blood grouping occurred in 4 of 12 (33%) non-group O patients due to anomalous reactivity in the reverse ABO-type results. CONCLUSIONS Treatment with Hu5F9-G4 in patients with AML resulted in an Hb decline and increased transfusion requirements. Problems with ABO blood typing and compatibility testing were widely observed and should be expected by centers treating recipients of Hu5F9-G4.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Anemia/chemically induced
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/pharmacology
- Blood Grouping and Crossmatching
- Blood Transfusion
- CD47 Antigen/antagonists & inhibitors
- Diagnostic Errors/prevention & control
- Erythrocytes/drug effects
- Humans
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/therapy
- Middle Aged
- Neoplasm Recurrence, Local/therapy
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Affiliation(s)
- C K Brierley
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- MRC Molecular Haematology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - J Staves
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - C Roberts
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - H Johnson
- Oncology Clinical Trials Office (OCTO), Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - P Vyas
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- MRC Molecular Haematology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - L T Goodnough
- Departments of Pathology and Medicine, Stanford University, Stanford, California
| | - M F Murphy
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
- National Health Service Blood and Transplant, Oxford, United Kingdom
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Old GH, Naden PS, Harman M, Bowes MJ, Roberts C, Scarlett PM, Nicholls DJE, Armstrong LK, Wickham HD, Read DS. Using dissolved organic matter fluorescence to identify the provenance of nutrients in a lowland catchment; the River Thames, England. Sci Total Environ 2019; 653:1240-1252. [PMID: 30759564 DOI: 10.1016/j.scitotenv.2018.10.421] [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] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/20/2018] [Accepted: 10/30/2018] [Indexed: 06/09/2023]
Abstract
Catchment based solutions are being sought to mitigate water quality pressures and achieve multiple benefits but their success depends on a sound understanding of catchment functioning. Novel approaches to monitoring and data analysis are urgently needed. In this paper we explore the potential of river water fluorescence at the catchment scale in understanding nutrient concentrations, sources and pathways. Data were collected from across the River Thames basin from January 2012 to March 2015. Analysing emission excitation matrices (EEMs) using both PARAFAC and optimal area averaging produced consistent results for humic-like component 1 and tryptophan-like component 4 in the absence of a subset of samples that exhibited an unusual peak; illustrating the importance of inspecting the entire EEM before using peak averaging methods. Strong relationships between fluorescence components and dissolved organic carbon (DOC), soluble reactive phosphorus (SRP), and ammonium clearly demonstrated its potential, in this study basin, as a field based surrogate for nutrients. Analysing relationships between fluorescence, catchment characteristics and boron from across the basin enabled new insights into the provenance of nutrients. These include evidence for diffuse sources of DOC from near surface hydrological pathways (i.e. soil horizons); point source inputs of nutrients from sewage effluent discharges; and diffuse contributions of nutrients from agriculture and/or sewage (e.g. septic tanks). The information gained by broad scale catchment wide monitoring of fluorescence could support catchment managers in (a) prioritising subcatchments for nutrient mitigation; (b) providing information on relative nutrient source contributions; and (c) providing evidence of the effectiveness of investment in pollution mitigation measures. The collection of high resolution fluorescence data at the catchment scale and, in particular, over shorter event timescales would complement broad scale assessments by enhancing our hydro-biogeochemical process understanding.
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Affiliation(s)
- G H Old
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK.
| | - P S Naden
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - M Harman
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - M J Bowes
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - C Roberts
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - P M Scarlett
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - D J E Nicholls
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - L K Armstrong
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - H D Wickham
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - D S Read
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
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Bedient C, Rodriguez D, Sidell N, Roberts C, Schutte S. Alterations in the invasive properties of peripheral blood monocytes from patients with endometriosis. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4333.2019] [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: 11/01/2022]
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Walker VA, Tranquille CA, Harris P, Roberts C, McEwen J, Murray RC. Do back kinematics of elite horses change over consecutive days of jumping the same course? PFERDEHEILKUNDE 2019. [DOI: 10.21836/pem20190306] [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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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Murray JK, Casey RA, Gale E, Buffington CAT, Roberts C, Kinsman RH, Gruffydd-Jones TJ. Cohort Profile: The 'Bristol Cats Study' (BCS)-a birth cohort of kittens owned by UK households. Int J Epidemiol 2018. [PMID: 28645213 DOI: 10.1093/ije/dyx066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- J K Murray
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - R A Casey
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK.,The Royal Veterinary College, Hawkshead Lane, North Mymms, Herts, AL9 7TA, UK
| | - E Gale
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK.,Ceva Animal Health Ltd, Unit 3 Anglo Office Park, White Lion Road, Amersham, Bucks, HP7 9FB, UK
| | | | - C Roberts
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - R H Kinsman
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK.,The Royal Veterinary College, Hawkshead Lane, North Mymms, Herts, AL9 7TA, UK
| | - T J Gruffydd-Jones
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
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Abbas M, de Kraker MEA, Aghayev E, Astagneau P, Aupee M, Behnke M, Bull A, Choi HJ, de Greeff SC, Elgohari S, Gastmeier P, Harrison W, Koek MBG, Lamagni T, Limon E, Løwer HL, Lyytikäinen O, Marimuthu K, Marquess J, McCann R, Prantner I, Presterl E, Pujol M, Reilly J, Roberts C, Segagni Lusignani L, Si D, Szilágyi E, Tanguy J, Tempone S, Troillet N, Worth LJ, Pittet D, Harbarth S. Impact of participation in a surgical site infection surveillance network: results from a large international cohort study. J Hosp Infect 2018; 102:267-276. [PMID: 30529703 DOI: 10.1016/j.jhin.2018.12.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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: 09/26/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Surveillance of surgical site infections (SSIs) is a core component of effective infection control practices, though its impact has not been quantified on a large scale. AIM To determine the time-trend of SSI rates in surveillance networks. METHODS SSI surveillance networks provided procedure-specific data on numbers of SSIs and operations, stratified by hospitals' year of participation in the surveillance, to capture length of participation as an exposure. Pooled and procedure-specific random-effects Poisson regression was performed to obtain yearly rate ratios (RRs) with 95% confidence intervals (CIs), and including surveillance network as random intercept. FINDINGS Of 36 invited networks, 17 networks from 15 high-income countries across Asia, Australia and Europe participated in the study. Aggregated data on 17 surgical procedures (cardiovascular, digestive, gynaecological-obstetrical, neurosurgical, and orthopaedic) were collected, resulting in data concerning 5,831,737 operations and 113,166 SSIs. There was a significant decrease in overall SSI rates over surveillance time, resulting in a 35% reduction at the ninth (final) included year of surveillance (RR: 0.65; 95% CI: 0.63-0.67). There were large variations across procedure-specific trends, but strong consistent decreases were observed for colorectal surgery, herniorrhaphy, caesarean section, hip prosthesis, and knee prosthesis. CONCLUSION In this large, international cohort study, pooled SSI rates were associated with a stable and sustainable decrease after joining an SSI surveillance network; a causal relationship is possible, although unproven. There was heterogeneity in procedure-specific trends. These findings support the pivotal role of surveillance in reducing infection rates and call for widespread implementation of hospital-based SSI surveillance in high-income countries.
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Affiliation(s)
- M Abbas
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - M E A de Kraker
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - E Aghayev
- Swiss RDL, Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland; Schulthess Klinik, Zürich, Switzerland
| | - P Astagneau
- Reference Centre for Prevention and Control of Healthcare-associated Infections, APHP University Hospital, Paris, France
| | - M Aupee
- Coordination Center for Prevention and Control of Nosocomial Infections (CClin) Ouest, Rennes, France
| | - M Behnke
- Institute of Hygiene and Environmental Medicine, National Reference Centre for the Surveillance of Nosocomial Infections, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Bull
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Victoria, Australia
| | - H J Choi
- Division of Infectious Diseases, Office of Infection Control, Ewha Woman's University Medical Center, Seoul, Republic of Korea
| | - S C de Greeff
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Control (CIb), Epidemiology and Surveillance (EPI), Bilthoven, the Netherlands
| | - S Elgohari
- National Infection Service, Public Health England, London, UK
| | - P Gastmeier
- Institute of Hygiene and Environmental Medicine, National Reference Centre for the Surveillance of Nosocomial Infections, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - W Harrison
- Welsh Healthcare Associated Infection Programme (WHAIP), Public Health Wales, Cardiff, UK
| | - M B G Koek
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Control (CIb), Epidemiology and Surveillance (EPI), Bilthoven, the Netherlands
| | - T Lamagni
- National Infection Service, Public Health England, London, UK
| | - E Limon
- VINCat Coordinator Center, Catalan Health Department, University of Barcelona, Barcelona, Spain
| | - H L Løwer
- Norwegian Institute of Public Health, Department of Infectious Disease Epidemiology, Oslo, Norway
| | - O Lyytikäinen
- Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - K Marimuthu
- Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J Marquess
- Epidemiology and Research Unit, Communicable Diseases Branch, Department of Health, Queensland, Australia
| | - R McCann
- Healthcare Associated Infection Unit, Communicable Diseases Control Directorate, Department of Health Western Australia, Australia
| | - I Prantner
- National Center for Epidemiology, Budapest, Hungary
| | - E Presterl
- Medical University of Vienna, Department of Infection Control and Hospital Epidemiology, Vienna, Austria
| | - M Pujol
- VINCat Coordinator Center, Catalan Health Department, University of Barcelona, Barcelona, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - J Reilly
- Healthcare Associated Infection, Antimicrobial Resistance, Decontamination and Infection Control Group, Health Protection Scotland, NHS National Services Scotland, Glasgow, UK; Safeguarding Health Through Infection Prevention (SHIP) Research Group, Glasgow Caledonian University, Glasgow, UK
| | - C Roberts
- Welsh Healthcare Associated Infection Programme (WHAIP), Public Health Wales, Cardiff, UK
| | | | - D Si
- Epidemiology and Research Unit, Communicable Diseases Branch, Department of Health, Queensland, Australia
| | - E Szilágyi
- National Public Health and Medical Officer Service, Budapest, Hungary
| | - J Tanguy
- Coordination Center for Prevention and Control of Nosocomial Infections (CClin) Ouest, Rennes, France
| | - S Tempone
- Healthcare Associated Infection Unit, Communicable Diseases Control Directorate, Department of Health Western Australia, Australia
| | - N Troillet
- Swissnoso, National Center for Infection Prevention, Bern, Switzerland; Service of Infectious Diseases, Central Institute of the Valais Hospital, Sion, Switzerland
| | - L J Worth
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Victoria, Australia; Department of Medicine, University of Melbourne, Victoria, Australia
| | - D Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - S Harbarth
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Patterson F, Roberts C, Hanson MD, Hampe W, Eva K, Ponnamperuma G, Magzoub M, Tekian A, Cleland J. 2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions. Med Teach 2018; 40:1091-1101. [PMID: 30251906 DOI: 10.1080/0142159x.2018.1498589] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Selection and recruitment into healthcare education and practice is a key area of interest for educators with significant developments in research, policy, and practice in recent years. This updated consensus statement, developed through a multi-stage process, examines future opportunities and challenges in selection and recruitment. There is both a gap in the literature around and a compelling case for further theoretical and empirical literature to underpin the development of overall selection philosophes and policies and their enactment. More consistent evidence has emerged regarding the quality of different selection methods. Approaches to selection are context-dependent, requiring the consideration of an institution's philosophy regarding what they are trying to achieve, the communities it purports to serve, along with the system within which they are used. Diversity and globalization issues continue to be critically important topics. Further research is required to explore differential attainment and explain why there are substantial differences in culturally acceptable ways of approaching diversity and widening access. More sophisticated evaluation approaches using multi-disciplinary theoretical frameworks are required to address the issues. Following a discussion of these areas, 10 recommendations are presented to guide future research and practice and to encourage debate between colleagues across the globe.
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Affiliation(s)
- F Patterson
- a Work Psychology Group, Derby United Kingdom of Great Britain and Northern Ireland, UK
| | - C Roberts
- b Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - M D Hanson
- c Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - W Hampe
- d Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Eva
- e Centre for Health Education Scholarship and Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - G Ponnamperuma
- f Centre for Medical Education, Yong Loo Lin School of Medicine, Singapore
| | - M Magzoub
- g Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A Tekian
- h Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois, USA
| | - J Cleland
- i Centre for Healthcare Research and Innovation (CHERI), University of Aberdeen, UK
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Morgan K, Hawkins J, Hallingberg B, Roberts C, Murphy S, Moore G. Energy drink use and health complaints: findings from the 2013/14 HBSC study in Wales. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.514] [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)
| | | | | | | | | | - G Moore
- Cardiff University, Cardiff, UK
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Andonian N, Lee CC, Blanchard E, Roberts C, Singh S, Russell M, Bojalian M, Castle SC. GEROFIT PREHABILITATION TO IMPROVE POST-OPERATIVE OUTCOMES IN AN OLDER/AT-RISK POPULATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.007] [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)
- N Andonian
- UCLA, Los Angeles, California, United States
| | - C C Lee
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
| | - E Blanchard
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
| | - C Roberts
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
| | - S Singh
- UCLA Department of Anesthesiology and Perioperative Medicine, Los Angeles, CA, USA; Greater Los Angeles VA Health System, Los Angeles, CA, USA
| | - M Russell
- Greater Los Angeles VA Health System, Los Angeles, CA, USA
| | - M Bojalian
- Greater Los Angeles VA Health System, Los Angeles, CA, USA
| | - S C Castle
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
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Walker V, Tranquille C, Harris P, Roberts C, McEwen J, Murray R. Back kinematics at take-off in elite showjumping horses over an upright and parallel-spread fence forming part of a three-fence combination. Comparative Exercise Physiology 2018. [DOI: 10.3920/cep180005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study was to evaluate head, neck and back kinematics during take-off in elite level horses jumping, and to compare these over an upright and parallel spread fence. Ten mixed-breed elite-level showjumping horses were opportunistically evaluated jumping the same 15-fence course (1.35 m) during a British Equestrian Federation World Class Performance three-day training session. Two fences were evaluated using high-speed motion-capture (250 Hz). Head, neck and back kinematics of the horse were determined at take-off, at vertical orientation of leading and trailing third metacarpus/tarsus and as the trailing hindlimb left the floor. Very consistent patterns between all horses over both upright and spread fences were observed in neck-trunk (NT) angle, lumbosacral (LS) angle, the angle of the thoracolumbar (TL) to horizontal and of LS to horizontal. Head-neck (HN), TL angle and distance to fence showed moderate variation between horses. There were no significant differences between fence-type in HN, NT, TL, LS angle or distance to the fence, but TL to the horizontal angle was greater over the spread for all stride phases. LS to the horizontal angle was greater over the upright when the leading forelimb was vertical at take-off and when the trailing hindlimb was vertical at take-off. These findings suggest that elite horses may use some similar strategies to achieve a successful jump. Further understanding regions which are most influenced by velocity, rider, and horse stability could enable us to modify jumping patterns for the performance and welfare of jumping horses.
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Affiliation(s)
- V.A. Walker
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, CB8 7UU, United Kingdom
| | - C.A. Tranquille
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, CB8 7UU, United Kingdom
| | - P. Harris
- Equine Studies Group, WALTHAM Centre for Pet Nutrition, Freeby Lane, Waltham-on-the-Wolds, Leicestershire LE14 4RT, United Kingdom
| | - C. Roberts
- Sidney Sussex College, Cambridge University, Sidney Street, Cambridge, Cambridgeshire CB2 3HU,United Kingdom
| | - J. McEwen
- British Equestrian Federation, Abbey Park, Stareton, Kenilworth, Warwickshire CV8 2RH, United Kingdom
| | - R.C. Murray
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, CB8 7UU, United Kingdom
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Kumar K, Roberts C, Bartle E, Eley DS. Correction to: Testing for medical school selection: What are prospective doctors' experiences and perceptions of the GAMSAT and what are the consequences of testing? Adv Health Sci Educ Theory Pract 2018; 23:547. [PMID: 29435698 DOI: 10.1007/s10459-018-9813-6] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The wrong acknowledgement and funding information were provided in the original publication.
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Affiliation(s)
- K Kumar
- Prideaux Centre for Research in Health Professions Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - C Roberts
- Sydney Medical School - Northern, The University of Sydney, Sydney, Australia
| | - E Bartle
- School of Dentistry, University of Queensland, Brisbane, Australia
| | - D S Eley
- Office of Medical Education, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Kumar K, Roberts C, Bartle E, Eley DS. Testing for medical school selection: What are prospective doctors' experiences and perceptions of the GAMSAT and what are the consequences of testing? Adv Health Sci Educ Theory Pract 2018; 23:533-546. [PMID: 29388087 DOI: 10.1007/s10459-018-9811-8] [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] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 01/22/2018] [Indexed: 06/07/2023]
Abstract
Written tests for selection into medicine have demonstrated reliability and there is accumulating evidence regarding their validity, but we know little about the broader impacts or consequences of medical school selection tests from the perspectives of key stakeholders. In this first Australian study of its kind, we use consequential validity as a theoretical lens to examine how medical school students and applicants view and experience the Graduate Medical Schools Admission Test (GAMSAT), and the consequences of testing. Participants (n = 447) were recruited from five graduate-entry medical schools across Australia and a publicly available online test preparation forum. An online survey was used to gather demographic information, and quantitative and qualitative data. Quantitative data were analysed via descriptive statistics and qualitative data were thematically analysed. The findings showed there was a considerable financial burden associated with preparing for and sitting the GAMSAT and moderate agreement regarding the GAMSAT as a fair selection method. The main unintended consequences of using the GAMSAT as a selection tool included barriers related to test affordability and language, and socialisation into the hidden curriculum of medicine. Selection tools such as the GAMSAT have some limitations when the goals are to support equitable participation in medicine and professional identity development. Our study highlights the value interpretive and theoretically-informed research in contributing to the evidence base on medical school selection.
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Affiliation(s)
- K Kumar
- Prideaux Centre for Research in Health Professions Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - C Roberts
- Sydney Medical School - Northern, The University of Sydney, Sydney, Australia
| | - E Bartle
- School of Dentistry, University of Queensland, Brisbane, Australia
| | - D S Eley
- Office of Medical Education, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Hughes M, Moore T, Manning J, Wilkinson J, Watson S, Samraj P, Dinsdale G, Roberts C, Rhodes LE, Herrick AL, Murray A. A feasibility study of a novel low-level light therapy for digital ulcers in systemic sclerosis. J DERMATOL TREAT 2018; 30:251-257. [PMID: 29862855 PMCID: PMC6484448 DOI: 10.1080/09546634.2018.1484875] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Locally acting, well-tolerated treatments for systemic sclerosis (SSc) digital ulcers (DUs) are needed. Objectives: Our primary aim was to investigate the safety, feasibility, and tolerability of a novel low-level light therapy (LTTT). A secondary aim was to tentatively assess efficacy. Methods: A custom-built device comprising infrared (850 nm), red (660 nm), and violet (405 nm) LEDs was utilized. DUs were irradiated with 10 J/cm2 twice weekly for 3 weeks, with follow-up at weeks 4 and 8. Any safety concerns were documented. Patient opinion on time to deliver, feasibility, and pain visual analogue score (VAS; 0–100, 100 most severe) was collected. Patient and clinician DU global assessment VAS were documented. DUs were evaluated by laser Doppler perfusion imaging pre- and post-irradiation. Results: In all, 14 DUs in eight patients received a total of 46 light exposures, with no safety concerns. All patients considered LTTT ‘took just the right amount of time’ and was ‘feasible’, with a low associated mean pain VAS of 1.6 (SD: 5.2). Patient and clinician global DC VAS improved during the study (mean change: –7.1 and –5.2, respectively, both p < .001). DU perfusion significantly increased post-irradiation. Conclusions: LTTT for DUs is safe, feasible, and well tolerated. There was an early tentative suggestion of treatment efficacy.
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Affiliation(s)
- M Hughes
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK
| | - T Moore
- b Department of Rheumatology , Salford Royal NHS Foundation Trust , Salford , UK
| | - J Manning
- b Department of Rheumatology , Salford Royal NHS Foundation Trust , Salford , UK
| | - J Wilkinson
- c Research and Development , Salford Royal NHS Foundation Trust , Salford , UK
| | - S Watson
- d Medical Physics Department and University of Manchester , Manchester Academic Health Science Centre , Salford Royal NHS Foundation Trust , UK
| | - P Samraj
- e Medical Physics Department , Salford Royal NHS Foundation Trust , UK
| | - G Dinsdale
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK
| | - C Roberts
- f Centre for Biostatistics , Institute of Population Health, School of Medicine, The University of Manchester , Manchester , UK
| | - L E Rhodes
- g Photobiology Unit, Dermatology Centre, Division of Musculoskeletal and Dermatological Sciences , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK
| | - A L Herrick
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.,h NIHR Manchester Musculoskeletal Biomedical Research Centre , Central Manchester NHS Foundation Trust , Manchester Academic Health Science Centre , UK
| | - A Murray
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.,i Photon Science Institute , The University of Manchester , UK
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Thompson A, Roberts C, Edwards A, Morgan J. Outpatient removal of ureteric stents in renal transplant patients improves patient outcomes. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.517] [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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Wreglesworth N, Roberts C, Innominato P. A retrospective review of neutrophil-lymphocyte ratio as a predictive prognostic marker in upper gastrointestinal cancers in three UK hospitals over a nine year period. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.101] [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: 11/14/2022] Open
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Moorhouse HL, Read DS, McGowan S, Wagner M, Roberts C, Armstrong LK, Nicholls DJE, Wickham HD, Hutchins MG, Bowes MJ. Characterisation of a major phytoplankton bloom in the River Thames (UK) using flow cytometry and high performance liquid chromatography. Sci Total Environ 2018; 624:366-376. [PMID: 29258037 DOI: 10.1016/j.scitotenv.2017.12.128] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
Recent river studies have observed rapid phytoplankton dynamics, driven by diurnal cycling and short-term responses to storm events, highlighting the need to adopt new high-frequency characterisation methods to understand these complex ecological systems. This study utilised two such analytical methods; pigment analysis by high performance liquid chromatography (HPLC) and cell counting by flow cytometry (FCM), alongside traditional chlorophyll spectrophotometry and light microscopy screening, to characterise the major phytoplankton bloom of 2015 in the River Thames, UK. All analytical techniques observed a rapid increase in chlorophyll a concentration and cell abundances from March to early June, caused primarily by a diatom bloom. Light microscopy identified a shift from pennate to centric diatoms during this period. The initial diatom bloom coincided with increased HPLC peridinin concentrations, indicating the presence of dinoflagellates which were likely to be consuming the diatom population. The diatom bloom declined rapidly in early June, coinciding with a storm event. There were low chlorophyll a concentrations (by both HPLC and spectrophotometric methods) throughout July and August, implying low biomass and phytoplankton activity. However, FCM revealed high abundances of pico-chlorophytes and cyanobacteria through July and August, showing that phytoplankton communities remain active and abundant throughout the summer period. In combination, these techniques are able to simultaneously characterise a wider range of phytoplankton groups, with greater certainty, and provide improved understanding of phytoplankton functioning (e.g. production of UV inhibiting pigments by cyanobacteria in response to high light levels) and ecological status (through examination of pigment degradation products). Combined HPLC and FCM analyses offer rapid and cost-effective characterisation of phytoplankton communities at appropriate timescales. This will allow a more-targeted use of light microscopy to capture phytoplankton peaks or to investigate periods of rapid community succession. This will lead to greater system understanding of phytoplankton succession in response to biogeochemical drivers.
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Affiliation(s)
- H L Moorhouse
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom; Lancaster Environment Centre, Library Avenue, Lancaster University, Lancaster LA1 4YQ, United Kingdom
| | - D S Read
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - S McGowan
- School of Geography, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - M Wagner
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - C Roberts
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - L K Armstrong
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - D J E Nicholls
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - H D Wickham
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - M G Hutchins
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - M J Bowes
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom.
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Merola J, Wager C, Hamann S, Zhang X, Thai A, Roberts C, Lam C, Musselli C, Marsh G, Rabah D, Barbey C, Franchimont N, Reynolds T. 1096 Non-invasive tape sampling reveals a type I interferon RNA signature in cutaneous lupus erythematosus that distinguishes affected from unaffected and healthy volunteer skin. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1109] [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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Craddock CF, Houlton AE, Quek LS, Ferguson P, Gbandi E, Roberts C, Metzner M, Garcia-Martin N, Kennedy A, Hamblin A, Raghavan M, Nagra S, Dudley L, Wheatley K, McMullin MF, Pillai SP, Kelly RJ, Siddique S, Dennis M, Cavenagh JD, Vyas P. Outcome of Azacitidine Therapy in Acute Myeloid Leukemia Is not Improved by Concurrent Vorinostat Therapy but Is Predicted by a Diagnostic Molecular Signature. Clin Cancer Res 2017; 23:6430-6440. [PMID: 28765326 DOI: 10.1158/1078-0432.ccr-17-1423] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/30/2017] [Accepted: 07/26/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Azacitidine (AZA) is a novel therapeutic option in older patients with acute myeloid leukemia (AML), but its rational utilization is compromised by the fact that neither the determinants of clinical response nor its mechanism of action are defined. Co-administration of histone deacetylase inhibitors, such as vorinostat (VOR), is reported to improve the clinical activity of AZA, but this has not been prospectively studied in patients with AML.Experimental Design: We compared outcomes in 259 adults with AML (n = 217) and MDS (n = 42) randomized to receive either AZA monotherapy (75 mg/m2 × 7 days every 28 days) or AZA combined with VOR 300 mg twice a day on days 3 to 9 orally. Next-generation sequencing was performed in 250 patients on 41 genes commonly mutated in AML. Serial immunophenotyping of progenitor cells was performed in 47 patients.Results: Co-administration of VOR did not increase the overall response rate (P = 0.84) or overall survival (OS; P = 0.32). Specifically, no benefit was identified in either de novo or relapsed AML. Mutations in the genes CDKN2A (P = 0.0001), IDH1 (P = 0.004), and TP53 (P = 0.003) were associated with reduced OS. Lymphoid multipotential progenitor populations were greatly expanded at diagnosis and although reduced in size in responding patients remained detectable throughout treatment.Conclusions: This study demonstrates no benefit of concurrent administration of VOR with AZA but identifies a mutational signature predictive of outcome after AZA-based therapy. The correlation between heterozygous loss of function CDKN2A mutations and decreased OS implicates induction of cell-cycle arrest as a mechanism by which AZA exerts its clinical activity. Clin Cancer Res; 23(21); 6430-40. ©2017 AACR.
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Affiliation(s)
- Charles F Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom.
| | - Aimee E Houlton
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Lynn Swun Quek
- MRC Molecular Haematology Unit and Centre for Haematology, Weatherall Institute of Molecular Medicine, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Paul Ferguson
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Emma Gbandi
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Corran Roberts
- Centre for Statistics in Medicine, Oxford, United Kingdom
| | - Marlen Metzner
- MRC Molecular Haematology Unit and Centre for Haematology, Weatherall Institute of Molecular Medicine, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Natalia Garcia-Martin
- MRC Molecular Haematology Unit and Centre for Haematology, Weatherall Institute of Molecular Medicine, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Alison Kennedy
- MRC Molecular Haematology Unit and Centre for Haematology, Weatherall Institute of Molecular Medicine, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Angela Hamblin
- MRC Molecular Haematology Unit and Centre for Haematology, Weatherall Institute of Molecular Medicine, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Manoj Raghavan
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Sandeep Nagra
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Louise Dudley
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Keith Wheatley
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | | | - Srinivas P Pillai
- University Hospitals of North Midlands, Stoke on Trent, United Kingdom
| | | | - Shamyla Siddique
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Michael Dennis
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Jamie D Cavenagh
- Department of Haemato-Oncology, St Bartholomew's Hospital, Bart's Health NHS Trust, London, United Kingdom
| | - Paresh Vyas
- MRC Molecular Haematology Unit and Centre for Haematology, Weatherall Institute of Molecular Medicine, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
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Judd A, Zangerle R, Touloumi G, Warszawski J, Meyer L, Dabis F, Mary Krause M, Ghosn J, Leport C, Wittkop L, Reiss P, Wit F, Prins M, Bucher H, Gibb D, Fätkenheuer G, Julia DA, Obel N, Thorne C, Mocroft A, Kirk O, Stephan C, Pérez-Hoyos S, Hamouda O, Bartmeyer B, Chkhartishvili N, Noguera-Julian A, Antinori A, d’Arminio Monforte A, Brockmeyer N, Prieto L, Rojo Conejo P, Soriano-Arandes A, Battegay M, Kouyos R, Mussini C, Tookey P, Casabona J, Miró JM, Castagna A, Konopnick D, Goetghebuer T, Sönnerborg A, Quiros-Roldan E, Sabin C, Teira R, Garrido M, Haerry D, de Wit S, Miró JM, Costagliola D, d’Arminio-Monforte A, Castagna A, del Amo J, Mocroft A, Raben D, Chêne G, Judd A, Pablo Rojo C, Barger D, Schwimmer C, Termote M, Wittkop L, Campbell M, Frederiksen CM, Friis-Møller N, Kjaer J, Raben D, Salbøl Brandt R, Berenguer J, Bohlius J, Bouteloup V, Bucher H, Cozzi-Lepri A, Dabis F, d’Arminio Monforte A, Davies MA, del Amo J, Dorrucci M, Dunn D, Egger M, Furrer H, Grabar S, Guiguet M, Judd A, Kirk O, Lambotte O, Leroy V, Lodi S, Matheron S, Meyer L, Miro JM, Mocroft A, Monge S, Nakagawa F, Paredes R, Phillips A, Puoti M, Rohner E, Schomaker M, Smit C, Sterne J, Thiebaut R, Thorne C, Torti C, van der Valk M, Wittkop L, Tanser F, Vinikoor M, Macete E, Wood R, Stinson K, Garone D, Fatti G, Giddy J, Malisita K, Eley B, Fritz C, Hobbins M, Kamenova K, Fox M, Prozesky H, Technau K, Sawry S, Benson CA, Bosch RJ, Kirk GD, Boswell S, Mayer KH, Grasso C, Hogg RS, Richard Harrigan P, Montaner JSG, Yip B, Zhu J, Salters K, Gabler K, Buchacz K, Brooks JT, Gebo KA, Moore RD, Moore RD, Rodriguez B, Horberg MA, Silverberg MJ, Thorne JE, Rabkin C, Margolick JB, Jacobson LP, D’Souza G, Klein MB, Rourke SB, Rachlis AR, Cupido P, Hunter-Mellado RF, Mayor AM, John Gill M, Deeks SG, Martin JN, Patel P, Brooks JT, Saag MS, Mugavero MJ, Willig J, Eron JJ, Napravnik S, Kitahata MM, Crane HM, Drozd DR, Sterling TR, Haas D, Rebeiro P, Turner M, Bebawy S, Rogers B, Justice AC, Dubrow R, Fiellin D, Gange SJ, Anastos K, Moore RD, Saag MS, Gange SJ, Kitahata MM, Althoff KN, Horberg MA, Klein MB, McKaig RG, Freeman AM, Moore RD, Freeman AM, Lent C, Kitahata MM, Van Rompaey SE, Crane HM, Drozd DR, Morton L, McReynolds J, Lober WB, Gange SJ, Althoff KN, Abraham AG, Lau B, Zhang J, Jing J, Modur S, Wong C, Hogan B, Desir F, Liu B, You B, Cahn P, Cesar C, Fink V, Sued O, Dell’Isola E, Perez H, Valiente J, Yamamoto C, Grinsztejn B, Veloso V, Luz P, de Boni R, Cardoso Wagner S, Friedman R, Moreira R, Pinto J, Ferreira F, Maia M, Célia de Menezes Succi R, Maria Machado D, de Fátima Barbosa Gouvêa A, Wolff M, Cortes C, Fernanda Rodriguez M, Allendes G, William Pape J, Rouzier V, Marcelin A, Perodin C, Tulio Luque M, Padgett D, Sierra Madero J, Crabtree Ramirez B, Belaunzaran P, Caro Vega Y, Gotuzzo E, Mejia F, Carriquiry G, McGowan CC, Shepherd BE, Sterling T, Jayathilake K, Person AK, Rebeiro PF, Giganti M, Castilho J, Duda SN, Maruri F, Vansell H, Ly PS, Khol V, Zhang FJ, Zhao HX, Han N, Lee MP, Li PCK, Lam W, Chan YT, Kumarasamy N, Saghayam S, Ezhilarasi C, Pujari S, Joshi K, Gaikwad S, Chitalikar A, Merati TP, Wirawan DN, Yuliana F, Yunihastuti E, Imran D, Widhani A, Tanuma J, Oka S, Nishijima T, Na S, Choi JY, Kim JM, Sim BLH, Gani YM, David R, Kamarulzaman A, Syed Omar SF, Ponnampalavanar S, Azwa I, Ditangco R, Uy E, Bantique R, Wong WW, Ku WW, Wu PC, Ng OT, Lim PL, Lee LS, Ohnmar PS, Avihingsanon A, Gatechompol S, Phanuphak P, Phadungphon C, Kiertiburanakul S, Sungkanuparph S, Chumla L, Sanmeema N, Chaiwarith R, Sirisanthana T, Kotarathititum W, Praparattanapan J, Kantipong P, Kambua P, Ratanasuwan W, Sriondee R, Nguyen KV, Bui HV, Nguyen DTH, Nguyen DT, Cuong DD, An NV, Luan NT, Sohn AH, Ross JL, Petersen B, Cooper DA, Law MG, Jiamsakul A, Boettiger DC, Ellis D, Bloch M, Agrawal S, Vincent T, Allen D, Smith D, Rankin A, Baker D, Templeton DJ, O’Connor CC, Thackeray O, Jackson E, McCallum K, Ryder N, Sweeney G, Cooper D, Carr A, Macrae K, Hesse K, Finlayson R, Gupta S, Langton-Lockton J, Shakeshaft J, Brown K, Idle S, Arvela N, Varma R, Lu H, Couldwell D, Eswarappa S, Smith DE, Furner V, Smith D, Cabrera G, Fernando S, Cogle A, Lawrence C, Mulhall B, Boyd M, Law M, Petoumenos K, Puhr R, Huang R, Han A, Gunathilake M, Payne R, O’Sullivan M, Croydon A, Russell D, Cashman C, Roberts C, Sowden D, Taing K, Marshall P, Orth D, Youds D, Rowling D, Latch N, Warzywoda E, Dickson B, Donohue W, Moore R, Edwards S, Boyd S, Roth NJ, Lau H, Read T, Silvers J, Zeng W, Hoy J, Watson K, Bryant M, Price S, Woolley I, Giles M, Korman T, Williams J, Nolan D, Allen A, Guelfi G, Mills G, Wharry C, Raymond N, Bargh K, Templeton D, Giles M, Brown K, Hoy J. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study. Clin Infect Dis 2017; 65:1316-1326. [PMID: 28531260 PMCID: PMC5850623 DOI: 10.1093/cid/cix480] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). RESULTS We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. CONCLUSIONS Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.
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Nicum S, Strauss V, McGregor N, McNeish I, Roux R, Hall M, Michael A, Roberts C. OCTOVA: A randomised phase II trial of olaparib, chemotherapy, or olaparib and cediranib in patients with BRCA-mutated platinum-resistant ovarian cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lampejo T, Turner R, Roberts C, Allen K, Watson L, Caverley-Frost L, Scott P, Ostridge E, Cooney G, Hardy J, Nulty K, Day S. Novel outreach settings to enhance sexually transmitted infection/HIV awareness, diagnosis and treatment in hard-to-reach populations. Int J STD AIDS 2017; 29:266-272. [PMID: 28768469 DOI: 10.1177/0956462417723816] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite recent rises in the number of cases of sexually transmitted infections (STIs) such as syphilis and gonorrhoea in England and increasing rates of HIV diagnosis among several men who have sex with men populations, many individuals are still not engaging with sexual health services. The John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London set up outreach clinics at the two world's largest adult lifestyle exhibitions in 2013 and 2015. This was the first time that a sexual health screening and promotion service was available at these large-scale (over 10,000 attendees at each) adult lifestyle events. A total of 381 individuals underwent STI screening across the two events. Nineteen (5.0%) patients were diagnosed with an infection. Twelve (3.1%) patients with Chlamydia trachomatis, three (0.8%) patients with syphilis, one (0.3%) patient with Neisseria gonorrhoeae, one (0.3%) patient with HIV, one (0.3%) patient with hepatitis B and one (0.3%) patient with hepatitis C. All 19 patients were promptly contacted with their results and had arrangements made for treatment or were referred for specialist follow up. Where possible, contact tracing was also performed. Implementing such outreach-based projects is challenged by lack of on-site laboratory support, high staffing demands and potentially high costs. However, we achieved a total HIV screening uptake rate of 94.5% amongst our outreach clinic attendees (versus 67% nationally in conventional sexual health clinic attendees) with an HIV positivity rate of 0.3% (versus 0.2% nationally in high HIV prevalence band populations). Additionally, 30.7% had never been tested for HIV previously (versus 20.7% nationally). Our work demonstrates that these strategies can help to address issues related to lack of STI/HIV screening in hard-to-reach populations and promote risk reduction behaviour.
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Affiliation(s)
- T Lampejo
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - R Turner
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - C Roberts
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - K Allen
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - L Watson
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - L Caverley-Frost
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - P Scott
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - E Ostridge
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - G Cooney
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - J Hardy
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - K Nulty
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
| | - S Day
- John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London, UK
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Stengel D, Mauffrey C, Civil I, Gray AC, Roberts C, Pape HC, Evans C, Kool B, Mauffrey OJ, Giannoudis P. Recruitment rates in orthopaedic trauma trials: Zen or the art of riding dead horses. Injury 2017; 48:1719-1721. [PMID: 28807412 DOI: 10.1016/j.injury.2017.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Dirk Stengel
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany.
| | - Cyril Mauffrey
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - Ian Civil
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - A C Gray
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - C Roberts
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - Hans-Christoph Pape
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - C Evans
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - Bridget Kool
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - O J Mauffrey
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
| | - Peter Giannoudis
- BG Kliniken Group of Hospitals, BG Klinikum Unfallkrankenhaus Berlin gGmH, Warener Str. 7, 12683 Berlin, Germany
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Petty RD, Dahle-Smith A, Stevenson DAJ, Osborne A, Massie D, Clark C, Murray GI, Dutton SJ, Roberts C, Chong IY, Mansoor W, Thompson J, Harrison M, Chatterjee A, Falk SJ, Elyan S, Garcia-Alonso A, Fyfe DW, Wadsley J, Chau I, Ferry DR, Miedzybrodzka Z. Gefitinib and EGFR Gene Copy Number Aberrations in Esophageal Cancer. J Clin Oncol 2017; 35:2279-2287. [PMID: 28537764 DOI: 10.1200/jco.2016.70.3934] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024] Open
Abstract
Purpose The Cancer Esophagus Gefitinib trial demonstrated improved progression-free survival with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib relative to placebo in patients with advanced esophageal cancer who had disease progression after chemotherapy. Rapid and durable responses were observed in a minority of patients. We hypothesized that genetic aberration of the EGFR pathway would identify patients benefitting from gefitinib. Methods A prespecified, blinded molecular analysis of Cancer Esophagus Gefitinib trial tumors was conducted to compare efficacy of gefitinib with that of placebo according to EGFR copy number gain (CNG) and EGFR, KRAS, BRAF, and PIK3CA mutation status. EGFR CNG was determined by fluorescent in situ hybridization (FISH) using prespecified criteria and EGFR FISH-positive status was defined as high polysomy or amplification. Results Biomarker data were available for 340 patients. In EGFR FISH-positive tumors (20.2%), overall survival was improved with gefitinib compared with placebo (hazard ratio [HR] for death, 0.59; 95% CI, 0.35 to 1.00; P = .05). In EGFR FISH-negative tumors, there was no difference in overall survival with gefitinib compared with placebo (HR for death, 0.90; 95% CI, 0.69 to 1.18; P = .46). Patients with EGFR amplification (7.2%) gained greatest benefit from gefitinib (HR for death, 0.21; 95% CI, 0.07 to 0.64; P = .006). There was no difference in overall survival for gefitinib versus placebo for patients with EGFR, KRAS, BRAF, and PIK3CA mutations, or for any mutation versus none. Conclusion EGFR CNG assessed by FISH appears to identify a subgroup of patients with esophageal cancer who may benefit from gefitinib as a second-line treatment. Results of this study suggest that anti-EGFR therapies should be investigated in prospective clinical trials in different settings in EGFR FISH-positive and, in particular, EGFR-amplified esophageal cancer.
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Affiliation(s)
- Russell D Petty
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Asa Dahle-Smith
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - David A J Stevenson
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Aileen Osborne
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Doreen Massie
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Caroline Clark
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Graeme I Murray
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Susan J Dutton
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Corran Roberts
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Irene Y Chong
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Wasat Mansoor
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Joyce Thompson
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Mark Harrison
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Anirban Chatterjee
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Stephen J Falk
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Sean Elyan
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Angel Garcia-Alonso
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - David Walter Fyfe
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Jonathan Wadsley
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Ian Chau
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - David R Ferry
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
| | - Zosia Miedzybrodzka
- Russell D. Petty, University of Dundee; Asa Dahle-Smith, Ninewells Hospital and Medical School, Dundee; David A.J. Stevenson, Aileen Osborne, Doreen Massie, Caroline Clark, Zosia Miedzybrodzka, and Graeme I. Murray, University of Aberdeen, Aberdeen; Susan J. Dutton and Corran Roberts, Centre for Statistics in Medicine, University of Oxford, Oxford; Mark Harrison, Mount Vernon Hospital, Northwood; Irene Y. Chong and Ian Chau, Royal Marsden Hospital, London and Surrey; Wasat Mansoor, Christie Hospital, Manchester; Joyce Thompson, Birmingham Heartland Hospital, Heart of England National Health Service Trust, Birmingham; Anirban Chatterjee, Royal Shrewsbury Hospital, Shrewsbury; Stephen J. Falk, Bristol Oncology Centre, Bristol; Sean Elyan, Cheltenham General Hospital, Cheltenham; Angel Garcia-Alonso, Clan Clwyd Hospital, Rhyl; David Walter Fyfe, Furness General Hospital, Furness; Jonathan Wadsley, Weston Park Hospital, Sheffield, United Kingdom; and David R. Ferry, Eli Lilly and Company, Bridgewater, NJ
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Akpan A, Banerjee J, Roberts C. DEFINING A STANDARD SET OF PATIENT-CENTERED OUTCOMES FOR OLDER PERSONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1077] [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)
- A. Akpan
- Aintree University Hospitals NHS Foundation Trust, Aintree, United Kingdom,
- ICHOM Older Person Working Group, London, United Kingdom,
| | - J. Banerjee
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- ICHOM Older Person Working Group, London, United Kingdom,
| | - C. Roberts
- ICHOM Older Person Working Group, London, United Kingdom,
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Banerjee J, Akpan A, Reynish E, Roberts C. THE IMPLEMENTATION OF ICHOM STANDARD SET OF OUTCOMES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1078] [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
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Affiliation(s)
- E. Reynish
- Stirling University, Stirling, United Kingdom
- ICHOM Dementia Working Group, London, United Kingdom,
| | - A. Burns
- ICHOM Dementia Working Group, London, United Kingdom,
| | - C. Roberts
- ICHOM Dementia Working Group, London, United Kingdom,
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