1
|
Martino AM, Yeates EO, Grigorian A, Chinn J, Young H, Colin Escobar J, Glavis-Bloom J, Anavim A, Yaghmai V, Nguyen NT, Dolich M, Schubl SD, Goodman LF, Guner YS, Nahmias J. Comparing Accuracy of Night Radiology Interpretations for Pediatric Trauma: Radiology Residents Versus Attending Teleradiologists. Am Surg 2024:31348241248794. [PMID: 38655777 DOI: 10.1177/00031348241248794] [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: 04/26/2024]
Abstract
Background: Overnight radiology coverage for pediatric trauma patients (PTPs) is addressed with a combination of on-call radiology residents (RRs) and/or attending teleradiologists (ATs); however, the accuracy of these two groups has not been investigated for PTPs. We aimed to compare the accuracy of RRs vs AT interpretations of computed tomography (CT) scans for PTPs. Methods: Pediatric trauma patients (<18 years old) at a single level-I adult/level-II pediatric trauma center were studied in a retrospective analysis (3/2019-5/2020). Computed tomography scans interpreted by both RRs and ATs were included. Radiology residents were compared to ATs for time to interpretation (TTI) and accuracy compared to faculty attending radiologist interpretation, using the validated RADPEER scoring system. Additionally, RR and AT accuracies were compared to a previously studied adult cohort during the same time-period. Results: 42 PTPs (270 interpretations) and 1053 adults (8226 interpretations) were included. Radiology residents had similar rates of discrepancy (13.3% vs 13.3%), major discrepancy (4.4% vs 4.4%), missed findings (9.6% vs 12.6%), and overcalls (3.7% vs .7%) vs ATs (all P > .05). Mean TTI was shorter for RRs (55.9 vs 90.4 minutes, P < .001). Radiology residents had a higher discrepancy rate for PTPs (13.3% vs 7.5%, P = .01) than adults. Attending teleradiologists had a similar discrepancy rate for PTPs and adults (13.3% vs 8.9%, P = .07). Discussion: When interpreting PTP CT imaging, RRs had similar discrepancy rates but faster TTI than ATs. Radiology residents had a higher discrepancy rate for PTP CTs than RR interpretation of adult patients, indicating both RRs and ATs need more focused training in the interpretation of PTP studies.
Collapse
Affiliation(s)
- Alice M Martino
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Eric O Yeates
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Areg Grigorian
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Justine Chinn
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Hayley Young
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Jessica Colin Escobar
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Justin Glavis-Bloom
- Department of Radiology, University of California Irvine Medical Center, Orange, CA, USA
| | - Arash Anavim
- Department of Radiology, University of California Irvine Medical Center, Orange, CA, USA
| | - Vahid Yaghmai
- Department of Radiology, University of California Irvine Medical Center, Orange, CA, USA
| | - Ninh T Nguyen
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Matthew Dolich
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Sebastian D Schubl
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Laura F Goodman
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
- Department of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, USA
| | - Yigit S Guner
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
- Department of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, USA
| | - Jeffry Nahmias
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| |
Collapse
|
2
|
Pandit C, Kennedy B, Waters K, Young H, Jones K, Fitzgerald DA. Can postural changes in spirometry in children with Duchenne muscular dystrophy predict sleep hypoventilation? Paediatr Respir Rev 2024; 49:9-13. [PMID: 37696714 DOI: 10.1016/j.prrv.2023.08.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
AIM To explore the relationship between postural changes in lung function and polysomnography (PSG) in children with Duchenne muscular dystrophy (DMD). METHODS In this prospective cross-sectional study, children with DMD performed spirometry in sitting and supine positions. A control group of age and gender matched healthy children also underwent postural lung function testing. PSG was performed within six months of spirometry. RESULTS Seventeen children with DMD, aged 12.3 ± 3 years performed sitting spirometry. 14 (84%) performed acceptable spirometry in the supine position. Mean FEV1sit and FVCsit were 77% (SD ± 22) and 74% (SD ± 20.4) respectively, with mean% ΔFVC(sit-sup) 9% (SD ± 11) (range 2% to 20%), and was significantly greater than healthy controls 4% (n = 30, SD ± 3, P < 0.001). PSG data on the 14 DMD children with acceptable supine spirometry showed total AHI 6.9 ± 5.9/hour (0.3 to 29), obstructive AHI 5.2 ± 4.0/hour (0.2 to 10), and REM AHI 14.1 ± -5.3/hour (0.1 to 34.7). ΔFVC(sit-sup) had poor correlation with hypoventilation on polysomnography. CONCLUSION Children with DMD and mild restrictive lung disease showed greater postural changes in spirometry than healthy controls but lower supine spirometry was not predictive of sleep hypoventilation.
Collapse
Affiliation(s)
- C Pandit
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| | - B Kennedy
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - K Waters
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - H Young
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Neurogenetics Service, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - K Jones
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Neurogenetics Service, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - D A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Lin DY, Xu Y, Gu Y, Zeng D, Wheeler B, Young H, Moore Z, Sunny SK. Effects of COVID-19 vaccination and previous SARS-CoV-2 infection on omicron infection and severe outcomes in children under 12 years of age in the USA: an observational cohort study. Lancet Infect Dis 2023; 23:1257-1265. [PMID: 37336222 PMCID: PMC10275621 DOI: 10.1016/s1473-3099(23)00272-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/22/2023] [Accepted: 04/14/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Data on the protection conferred by COVID-19 vaccination and previous SARS-CoV-2 infection against omicron (B.1.1.529) infection in young children are scarce. We aimed to estimate the time-varying effects of primary and booster COVID-19 vaccination and previous SARS-CoV-2 infection on subsequent omicron infection and severe illness (hospital admission or death) in children younger than 12 years of age. METHODS In this observational cohort study, we obtained individual-level records on vaccination with the BNT162b2 and mRNA-1273 vaccines and clinical outcomes from the North Carolina COVID-19 Surveillance System and the COVID-19 Vaccine Management System for 1 368 721 North Carolina residents aged 11 years or younger from Oct 29, 2021 (Oct 29, 2021 for children aged 5-11 years and June 17, 2022 for children aged 0-4 years), to Jan 6, 2023. We used Cox regression to estimate the time-varying effects of primary and booster vaccination and previous infection on the risks of omicron infection, hospital admission, and death. FINDINGS For children 5-11 years of age, the effectiveness of primary vaccination against infection, compared with being unvaccinated, was 59·9% (95% CI 58·5-61·2) at 1 month, 33·7% (32·6-34·8) at 4 months, and 14·9% (95% CI 12·3-17·5) at 10 months after the first dose. Compared with primary vaccination only, the effectiveness of a monovalent booster dose after 1 month was 24·4% (14·4-33·2) and that of a bivalent booster dose was 76·7% (45·7-90·0). The effectiveness of omicron infection against reinfection was 79·9% (78·8-80·9) after 3 months and 53·9% (52·3-55·5) after 6 months. For children 0-4 years of age, the effectiveness of primary vaccination against infection, compared with being unvaccinated, was 63·8% (57·0-69·5) at 2 months and 58·1% (48·3-66·1) at 5 months after the first dose, and the effectiveness of omicron infection against reinfection was 77·3% (75·9-78·6) after 3 months and 64·7% (63·3-66·1) after 6 months. For both age groups, vaccination and previous infection had better effectiveness against severe illness as measured by hospital admission or death as a composite endpoint than against infection. INTERPRETATION The BNT162b2 and mRNA-1273 vaccines were effective against omicron infection and severe outcomes in children younger than 12 years, although the effectiveness decreased over time. Bivalent boosters were more effective than monovalent boosters. Immunity acquired via omicron infection was high and waned gradually over time. These findings can be used to develop effective prevention strategies against COVID-19 in children younger than 12 years. FUNDING US National Institutes of Health.
Collapse
Affiliation(s)
- Dan-Yu Lin
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Yangjianchen Xu
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yu Gu
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bradford Wheeler
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Hayley Young
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Zack Moore
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Shadia K Sunny
- Centers for Disease Control and Prevention Foundation at North Carolina Department of Health and Human Services, Raleigh, NC, USA
| |
Collapse
|
4
|
Park S, Lebby E, Rupasinghe M, Cortes G, Bui TL, Young H, Kakish D, Farzaneh T, Houshyar R. Imaging uterine lipoleiomyomas: A case series and review of the literature. Heliyon 2023; 9:e15970. [PMID: 37305513 PMCID: PMC10256895 DOI: 10.1016/j.heliyon.2023.e15970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 06/13/2023] Open
Abstract
Background Lipoleiomyomas are uncommon uterine lesions containing adipose and smooth muscle tissue. They have a variable presentation and are usually found incidentally on imaging or post-hysterectomy tissue analysis. Given their low prevalence, there is a dearth of literature describing imaging characteristics for uterine lipoleiomyomas. In this image-rich case series, we summarize an example of an initial presentation as well as present ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) findings for 36 patients. Case presentation We present the detailed clinical course of a representative patient evaluated for uterine lipoleiomyoma and describe imaging findings seen in another 35 patients. This includes ultrasound findings from 16 patients, CT findings from 25 patients, and MRI findings from 5 patients. Among the 36 total patients, symptoms at the time of diagnosis were variable but often included abdominal or pelvic pain; however, most patients were asymptomatic, and the lipoleiomyomas were incidentally discovered on imaging. Conclusions Uterine lipoleiomyomas are rare and benign tumors with variable presentations. Ultrasound, CT, and MRI findings can assist in diagnosis. Findings on ultrasound typically include well-circumscribed hyperechoic and septated lesions with minimal to no internal blood flow. CT shows fat-containing either homogeneous or heterogeneous circumscribed lesions depending on their ratio of fat and smooth muscle tissue. Lastly, on MRI, uterine lipoleiomyomas commonly appear heterogenous with loss of signal on fat-suppressed sequences. These imaging findings are highly specific for lipoleiomyomas, and familiarity with these findings may reduce unnecessary and potentially invasive procedures.
Collapse
Affiliation(s)
- Sungmee Park
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - Elliott Lebby
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - Mark Rupasinghe
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - Gillean Cortes
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - Thanh-Lan Bui
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - Hayley Young
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - David Kakish
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| | - Ted Farzaneh
- University of California, Irvine Department of Pathology and Laboratory Medicine, University of California Irvine, School of Medicine, Irvine, CA, 92697, USA
| | - Roozbeh Houshyar
- University of California, Irvine Department of Radiological Sciences, 101 the City Drive South, Orange, CA, 92868, USA
| |
Collapse
|
5
|
Romijn AR, Young H, Latulippe ME, Snetselaar L, Willatts P, Melanson L, Gershon R, Tangney C. Perspective: Advancing dietary guidance for cognitive health - focus on solutions to harmonization of test selection, implementation, and evaluation. Adv Nutr 2023; 14:366-378. [PMID: 36997091 DOI: 10.1016/j.advnut.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
This perspective paper is a product of a workshop of experts convened by Institute for the Advancement of Food and Nutrition Sciences (IAFNS), a non-profit organization that brings together scientists from government, academia, and industry to catalyze science relevant to food and nutrition. An expert group was convened in March 2022 to discuss the current issues surrounding cognitive task selection in nutrition research, with a focus on solutions towards informing dietary guidance for cognitive health, to address a gap identified in the 2020 US DGAC report, specifically the "considerable variation in testing methods used, [and] inconsistent validity and reliability of cognitive testing methods" (p.31). To address this issue, we firstly undertook an umbrella review of relevant reviews already undertaken; these indicate agreement on some of the issues that affect heterogeneity in task selection, and on many of the fundamental principles underlying selection of cognitive outcome measures. However, resolving the points of disagreement is critical to ensuring meaningful impact on the issue of heterogeneity in task selection; these issues hamper evaluation of existing data for informing dietary guidance. This summary of the literature is therefore followed by the expert group's perspective in the form of a discussion of potential solutions to these challenges, with the aim of building on the work of previous reviews in the area and advancing dietary guidance for cognitive health. STATEMENT OF SIGNIFICANCE: Despite several high-quality reviews in this field over the last two decades, there has been little in the way of substantive change in the methods being used to conduct studies, hampering harmonization of the evidence and thus, its utility for informing dietary guidance. The present paper comprehensively updates the field by firstly providing an umbrella review of the published reviews, followed by the IAFNS expert group's perspective on how to move the field forward by addressing the challenges and areas of disagreement in the existing reviews. REGISTERED ON PROSPERO: CRD42022348106. Data described in the manuscript, code book, and analytic code will be made publicly and freely available without restriction at doi.org/10.17605/OSF.IO/XRZCK.
Collapse
|
6
|
Affiliation(s)
- Dan-Yu Lin
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Yangjianchen Xu
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Yu Gu
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Donglin Zeng
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Bradford Wheeler
- North Carolina Department of Health and Human Services, Raleigh, NC
| | - Hayley Young
- North Carolina Department of Health and Human Services, Raleigh, NC
| | - Shadia K Sunny
- North Carolina Department of Health and Human Services, Raleigh, NC
| | - Zack Moore
- North Carolina Department of Health and Human Services, Raleigh, NC
| |
Collapse
|
7
|
Stahler K, Snowden J, Young H. Death due to congenital syphilis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
8
|
McKissack LB, Appell LE, Young H, Modi A, Boyanton B. Time to positivity of blood cultures and correlation with clinical outcomes in pediatric patients: a retrospective chart review. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00570-0] [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: 01/28/2023]
|
9
|
Nguyen C, Cantu R, Alamarat Z, Dahl S, Young H, Maples H, McMinn C, Snowden J. Impact of acyclovir ordering restriction on neonatal HSV evaluations. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00690-0] [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: 01/28/2023]
|
10
|
Lin DY, Gu Y, Xu Y, Wheeler B, Young H, Sunny SK, Moore Z, Zeng D. Association of Primary and Booster Vaccination and Prior Infection With SARS-CoV-2 Infection and Severe COVID-19 Outcomes. JAMA 2022; 328:1415-1426. [PMID: 36155617 PMCID: PMC9513711 DOI: 10.1001/jama.2022.17876] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Data about the association of COVID-19 vaccination and prior SARS-CoV-2 infection with risk of SARS-CoV-2 infection and severe COVID-19 outcomes may guide prevention strategies. OBJECTIVE To estimate the time-varying association of primary and booster COVID-19 vaccination and prior SARS-CoV-2 infection with subsequent SARS-CoV-2 infection, hospitalization, and death. DESIGN, SETTING, AND PARTICIPANTS Cohort study of 10.6 million residents in North Carolina from March 2, 2020, through June 3, 2022. EXPOSURES COVID-19 primary vaccine series and boosters and prior SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES Rate ratio (RR) of SARS-CoV-2 infection and hazard ratio (HR) of COVID-19-related hospitalization and death. RESULTS The median age among the 10.6 million participants was 39 years; 51.3% were female, 71.5% were White, and 9.9% were Hispanic. As of June 3, 2022, 67% of participants had been vaccinated. There were 2 771 364 SARS-CoV-2 infections, with a hospitalization rate of 6.3% and mortality rate of 1.4%. The adjusted RR of the primary vaccine series compared with being unvaccinated against infection became 0.53 (95% CI, 0.52-0.53) for BNT162b2, 0.52 (95% CI, 0.51-0.53) for mRNA-1273, and 0.51 (95% CI, 0.50-0.53) for Ad26.COV2.S 10 months after the first dose, but the adjusted HR for hospitalization remained at 0.29 (95% CI, 0.24-0.35) for BNT162b2, 0.27 (95% CI, 0.23-0.32) for mRNA-1273, and 0.35 (95% CI, 0.29-0.42) for Ad26.COV2.S and the adjusted HR of death remained at 0.23 (95% CI, 0.17-0.29) for BNT162b2, 0.15 (95% CI, 0.11-0.20) for mRNA-1273, and 0.24 (95% CI, 0.19-0.31) for Ad26.COV2.S. For the BNT162b2 primary series, boosting in December 2021 with BNT162b2 had the adjusted RR relative to primary series of 0.39 (95% CI, 0.38-0.40) and boosting with mRNA-1273 had the adjusted RR of 0.32 (95% CI, 0.30-0.34) against infection after 1 month and boosting with BNT162b2 had the adjusted RR of 0.84 (95% CI, 0.82-0.86) and boosting with mRNA-1273 had the adjusted RR of 0.60 (95% CI, 0.57-0.62) after 3 months. Among all participants, the adjusted RR of Omicron infection compared with no prior infection was estimated at 0.23 (95% CI, 0.22-0.24) against infection, and the adjusted HRs were 0.10 (95% CI, 0.07-0.14) against hospitalization and 0.11 (95% CI, 0.08-0.15) against death after 4 months. CONCLUSIONS AND RELEVANCE Receipt of primary COVID-19 vaccine series compared with being unvaccinated, receipt of boosters compared with primary vaccination, and prior infection compared with no prior infection were all significantly associated with lower risk of SARS-CoV-2 infection (including Omicron) and resulting hospitalization and death. The associated protection waned over time, especially against infection.
Collapse
Affiliation(s)
- Dan-Yu Lin
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Yu Gu
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Yangjianchen Xu
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Hayley Young
- North Carolina Department of Health and Human Services, Raleigh
| | - Shadia Khan Sunny
- CDC Foundation at North Carolina Department of Health and Human Services, Raleigh
| | - Zack Moore
- North Carolina Department of Health and Human Services, Raleigh
| | - Donglin Zeng
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| |
Collapse
|
11
|
Affiliation(s)
- Dan-Yu Lin
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Yu Gu
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Yangjianchen Xu
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Donglin Zeng
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Bradford Wheeler
- North Carolina Department of Health and Human Services, Raleigh, NC
| | - Hayley Young
- North Carolina Department of Health and Human Services, Raleigh, NC
| | | | - Zack Moore
- North Carolina Department of Health and Human Services, Raleigh, NC
| |
Collapse
|
12
|
Yeates EO, Grigorian A, Chinn J, Young H, Colin Escobar J, Glavis-Bloom J, Anavim A, Yaghmai V, Nguyen NT, Nahmias J. Night Radiology Coverage for Trauma: Residents, Teleradiology, or Both? J Am Coll Surg 2022; 235:500-509. [PMID: 35972171 DOI: 10.1097/xcs.0000000000000280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Overnight radiology coverage for trauma patients is often addressed with a combination of on-call radiology residents (RR) and a teleradiology service; however, the accuracy of these 2 readers has not been studied for trauma. We aimed to compare the accuracy of RR versus teleradiologist interpretations of CT scans for trauma patients. STUDY DESIGN A retrospective analysis (March 2019 through May 2020) of trauma patients presenting to a single American College of Surgeons Level I trauma center was performed. Patients whose CT scans were performed between 10 pm to 8 am were included, because their scans were interpreted by both a RR and teleradiologist. Interpretations were compared with the final attending faculty radiologist's interpretation and graded for accuracy based on the RADPEER scoring system. Discrepancies were characterized as traumatic injury or incidental findings and missed findings or overcalls. Turnaround time was also compared. RESULTS A total of 1,053 patients and 8,226 interpretations were included. Compared with teleradiologists, RR had a lower discrepancy (7.7% vs 9.0%, p = 0.026) and major discrepancy rate (3.8% vs 5.2%, p = 0.003). Among major discrepancies, RR had a lower rate of traumatic injury discrepancies (3.2% vs 4.4%, p = 0.004) and missed findings (3.4% vs 5.1%, p < 0.001), but a higher rate of overcalls (0.5% vs 0.1%, p < 0.001) compared with teleradiologists. The mean turnaround time was shorter for RR (51.3 vs 78.8 minutes, p < 0.001). The combination of both RR and teleradiologist interpretations had a lower overall discrepancy rate than RR (5.0% vs 7.7%, p < 0.001). CONCLUSIONS This study identified lower discrepancy rates and a faster turnaround time by RR compared with teleradiologists for trauma CT studies. The combination of both interpreters had an even lower discrepancy rate, suggesting this combination is optimal when an in-house attending radiologist is not available.
Collapse
Affiliation(s)
- Eric O Yeates
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
| | - Areg Grigorian
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
- Department of Surgery, University of Southern California (USC), Los Angeles, CA (Grigorian)
| | - Justine Chinn
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
| | - Hayley Young
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
| | - Jessica Colin Escobar
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
| | - Justin Glavis-Bloom
- Department of Radiology (Glavis-Bloom, Anavim, Yaghmai), University of California, Irvine (UCI), Orange, CA
| | - Arash Anavim
- Department of Radiology (Glavis-Bloom, Anavim, Yaghmai), University of California, Irvine (UCI), Orange, CA
| | - Vahid Yaghmai
- Department of Radiology (Glavis-Bloom, Anavim, Yaghmai), University of California, Irvine (UCI), Orange, CA
| | - Ninh T Nguyen
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
| | - Jeffry Nahmias
- From the Department of Surgery (Yeates, Grigorian, Chinn, Young, Colin Excobar, Nguyen, Nahmias)
| |
Collapse
|
13
|
Young H, Bui TL, Cramer SE, O'Connell R, Houshyar R. Ruptured endometrioma in a nonpregnant patient: a case report. J Med Case Rep 2022; 16:161. [PMID: 35459195 PMCID: PMC9034528 DOI: 10.1186/s13256-022-03361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/05/2022] [Indexed: 11/23/2022] Open
Abstract
Background Endometriomas are a type of ovarian cyst composed of degenerated blood products from hemorrhage of ectopic endometrial tissue. Endometriomas can rupture, causing hemoperitoneum, and present with signs and symptoms similar to other, more common abdominal emergencies. Therefore, they are not often diagnosed preoperatively. Ultrasound and cross-sectional imaging can assist in diagnosis of endometriomas. We present a case of ruptured endometrioma causing massive hemoperitoneum that was initially suspected to represent malignancy with carcinomatosis. Case presentation A 32-year-old Hispanic woman presented with sharp abdominal pain and 15-pound unintentional weight loss over 6 months. Laboratory work was significant for a negative pregnancy test and elevated cancer antigen-125. Computed tomography of the abdomen and pelvis demonstrated a 13-cm complex cystic mass in the left adnexa with moderate hyperdense ascites and omental nodularity. Ultrasound demonstrated a large left adnexal complex cystic structure with internal echoes, and chest computed tomography showed no signs of intrathoracic neoplastic or infectious processes. Her presentation was concerning for malignancy with carcinomatosis. Fluid from a paracentesis was sent for culture and cytology. Diagnostic laparoscopy revealed that the left ovary had been completely replaced by an endometrioma, which had a small ruptured area superiorly. Brown deposits of endometriosis were present on the cyst, omentum, and various peritoneal linings. Tissue samples of the endometrium, myometrium, cervix, ovaries, fallopian tubes, peritoneum, omentum, and paracolic spaces were taken and showed no hyperplastic, dysplastic, or malignant cells on pathology. Conclusions Ruptured endometrioma and ruptured hemorrhagic cyst should be included in the differential diagnosis when a premenopausal female presents with hemoperitoneum in combination with complex adnexal cystic masses in the absence of trauma. Cancer antigen-125 and cancer antigen 19-9 can be falsely elevated in the setting of ruptured endometrioma.
Collapse
Affiliation(s)
- Hayley Young
- Department of Radiological Sciences, University of California Irvine, 101 The City Dr S Building 55, Box 140, Orange, CA, 92868, USA
| | - Thanh-Lan Bui
- Department of Radiological Sciences, University of California Irvine, 101 The City Dr S Building 55, Box 140, Orange, CA, 92868, USA
| | - Scott E Cramer
- Department of Radiological Sciences, University of California Irvine, 101 The City Dr S Building 55, Box 140, Orange, CA, 92868, USA
| | - Ryan O'Connell
- Department of Pathology, University of California Irvine, 101 The City Dr S Building 1, Rm 3003, Orange, CA, 92868, USA
| | - Roozbeh Houshyar
- Department of Radiological Sciences, University of California Irvine, 101 The City Dr S Building 55, Box 140, Orange, CA, 92868, USA.
| |
Collapse
|
14
|
Abstract
BACKGROUND The duration of protection afforded by coronavirus disease 2019 (Covid-19) vaccines in the United States is unclear. Whether the increase in postvaccination infections during the summer of 2021 was caused by declining immunity over time, the emergence of the B.1.617.2 (delta) variant, or both is unknown. METHODS We extracted data regarding Covid-19-related vaccination and outcomes during a 9-month period (December 11, 2020, to September 8, 2021) for approximately 10.6 million North Carolina residents by linking data from the North Carolina Covid-19 Surveillance System and the Covid-19 Vaccine Management System. We used a Cox regression model to estimate the effectiveness of the BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and Ad26.COV2.S (Johnson & Johnson-Janssen) vaccines in reducing the current risks of Covid-19, hospitalization, and death, as a function of time elapsed since vaccination. RESULTS For the two-dose regimens of messenger RNA (mRNA) vaccines BNT162b2 (30 μg per dose) and mRNA-1273 (100 μg per dose), vaccine effectiveness against Covid-19 was 94.5% (95% confidence interval [CI], 94.1 to 94.9) and 95.9% (95% CI, 95.5 to 96.2), respectively, at 2 months after the first dose and decreased to 66.6% (95% CI, 65.2 to 67.8) and 80.3% (95% CI, 79.3 to 81.2), respectively, at 7 months. Among early recipients of BNT162b2 and mRNA-1273, effectiveness decreased by approximately 15 and 10 percentage points, respectively, from mid-June to mid-July, when the delta variant became dominant. For the one-dose regimen of Ad26.COV2.S (5 × 1010 viral particles), effectiveness against Covid-19 was 74.8% (95% CI, 72.5 to 76.9) at 1 month and decreased to 59.4% (95% CI, 57.2 to 61.5) at 5 months. All three vaccines maintained better effectiveness in preventing hospitalization and death than in preventing infection over time, although the two mRNA vaccines provided higher levels of protection than Ad26.COV2.S. CONCLUSIONS All three Covid-19 vaccines had durable effectiveness in reducing the risks of hospitalization and death. Waning protection against infection over time was due to both declining immunity and the emergence of the delta variant. (Funded by a Dennis Gillings Distinguished Professorship and the National Institutes of Health.).
Collapse
Affiliation(s)
- Dan-Yu Lin
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Yu Gu
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Bradford Wheeler
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Hayley Young
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Shannon Holloway
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Shadia-Khan Sunny
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Zack Moore
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| | - Donglin Zeng
- From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh
| |
Collapse
|
15
|
Ponsford R, Bragg S, Meiksin R, Tilouche N, Van Dyck L, Sturgess J, Allen E, Elbourne D, Hadley A, Lohan M, Mercer CH, Melendez Torres GJ, Morris S, Young H, Campbell R, Bonell C. Feasibility and acceptability of a whole-school social-marketing intervention to prevent unintended teenage pregnancies and promote sexual health: evidence for progression from a pilot to a phase III randomised trial in English secondary schools. Pilot Feasibility Stud 2022; 8:52. [PMID: 35246272 PMCID: PMC8895534 DOI: 10.1186/s40814-022-00971-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Reducing unintended teenage pregnancy and promoting adolescent sexual health remains a priority in England. Both whole-school and social-marketing interventions are promising approaches to addressing these aims. However, such interventions have not been rigorously trialled in the UK and it is unclear if they are appropriate for delivery in English secondary schools. We developed and pilot trialled Positive Choices, a new whole-school social marketing intervention to address unintended teenage pregnancy and promote sexual health. Our aim was to assess the feasibility and acceptability of the intervention and trial methods in English secondary schools against pre-defined progression criteria (relating to randomisation, survey follow-up, intervention fidelity and acceptability and linkage to birth/abortion records) prior to carrying out a phase III trial of effectiveness and cost-effectiveness. Methods Pilot RCT with integral process evaluation involving four intervention and two control schools in south-east England. The intervention comprised a student needs survey; a student/staff-led school health promotion council; a classroom curriculum for year-9 students (aged 13–14); whole-school student-led social-marketing activities; parent information; and a review of local and school-based sexual health services. Baseline surveys were conducted with year 8 (aged 12–13) in June 2018. Follow-up surveys were completed 12 months later. Process evaluation data included audio recording of staff training, surveys of trained staff, staff log books and researcher observations of intervention activities. Survey data from female students were linked to records of births and abortions to assess the feasibility of these constituting a phase III primary outcome. Results All six schools were successfully randomised and retained in the trial. Response rates to the survey were above 80% in both arms at both baseline and follow-up. With the exception of the parent materials, the fidelity target for implementation of essential elements in three out of four schools was achieved. Student surveys indicated 80% acceptability among those who reported awareness of the programme and interviews with staff suggested strong acceptability. Linkage to birth/abortion records was feasible although none occurred among participants. Conclusions The criteria for progression to a phase III trial were met. Our data suggest that a whole-school social-marketing approach may be appropriate for topics that are clearly prioritised by schools. A phase III trial of this intervention is now warranted to establish effectiveness and cost-effectiveness. Births and terminations are not an appropriate primary outcome measure for such a trial. Trial registration ISRCTN65324176.
Collapse
Affiliation(s)
- R Ponsford
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - S Bragg
- Department of Education, Practice and Society, University College London, 20 Bedford Way, WC1H 0AL, London, UK
| | - R Meiksin
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - N Tilouche
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - L Van Dyck
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - J Sturgess
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - E Allen
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - D Elbourne
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - A Hadley
- Teenage Pregnancy Knowledge Exchange, University of Bedfordshire, University Square, Luton, LU1 3JU, UK
| | - M Lohan
- School of Nursing and Midwifery, Queens University Belfast, University Road, Belfast, BT7 1NN, UK
| | - C H Mercer
- University College London, Gower Street, London, WC1E 6BT, UK
| | | | - S Morris
- Department of Health and Primary Care, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - H Young
- School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - R Campbell
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - C Bonell
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| |
Collapse
|
16
|
Bourion-Bédès S, Marchand E, Boulier S, Young H, Beltrand C, Baumann C, Martrille L. Determinants of total incapacity to work duration among 231 victims of school violence in France. Arch Pediatr 2022; 29:272-276. [DOI: 10.1016/j.arcped.2022.02.003] [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] [Received: 08/18/2021] [Accepted: 02/20/2022] [Indexed: 11/25/2022]
|
17
|
Slader M, Young H, Barker M, Prentice K, Bogaard K, Yuan C, Saadat S, Lahham S. A comparison of handheld and standard ultrasound in Swiss medical students. World J Emerg Med 2022; 13:85-90. [PMID: 35237360 PMCID: PMC8861347 DOI: 10.5847/wjem.j.1920-8642.2022.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/20/2021] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND The use of ultrasound (US) within healthcare has inspired the development of new US technology. There have been few studies comparing the use of handheld US to standard US for medical education. This research aims to determine whether a handheld US device can provide a comparable primary learning experience to that of a standard US machine. METHODS Over two days of instruction, participants were taught and evaluated on core US fundamentals. The standard group received instruction on standard US machines, while the handheld group received instruction on handheld US devices. Participants completed a qualitative survey regarding their experience. Six hundred and four images were obtained and graded by two emergency medicine physicians. RESULTS A total of 119 Swiss medical students were enrolled in our study. There was no statistically significant difference in the US assessment measurements, except for faster endpoint septal separation (EPSS) vascular setup time in the handheld group (P=0.001). There was no statistically significant difference in participants' perceived difficulty of US learning (P=0.198), comfort level (P=0.188), or self-estimated capability to perform US in the future (P=0.442). There was no statistically significant difference in the percentage of correctly obtained images (P=0.211) or images that were clinically useful (P=0.256). The median quality score of images obtained by the standard group was eight compared to seven in handheld group (P<0.01). CONCLUSION Our data suggest a handheld US machine can perform as well as a standard US machine as an educational tool despite sacrifices in image quality.
Collapse
Affiliation(s)
- Mark Slader
- School of Medicine, University of California, Irvine 92617, USA
| | - Hayley Young
- School of Medicine, University of California, Irvine 92617, USA
| | - Margot Barker
- School of Medicine, University of California, Irvine 92617, USA
| | - Kylie Prentice
- School of Medicine, University of California, Irvine 92617, USA
| | | | - Charlene Yuan
- School of Medicine, University of California, Irvine 92617, USA
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine 92868, USA
| | - Shadi Lahham
- Department of Emergency Medicine, University of California, Irvine 92868, USA
| |
Collapse
|
18
|
Young H, March D, Highton P, Graham-Brown M, Goodliffe S, Greenwood S, Helen E, Conroy S, Singh S, Smith A, Burton J. Exercise interventions for people living with frailty and receiving haemodialysis: A mixed-methods randomised controlled feasibility study. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.226] [Citation(s) in RCA: 1] [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: 11/24/2022]
|
19
|
Wong CA, Dowler S, Moore AF, Sosne EF, Young H, Tenenbaum JD, Burns CE, Jones S, Smelyanskaya M, Kinsley KH. COVID-19 Vaccine Administration, by Race and Ethnicity - North Carolina, December 14, 2020-April 6, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:991-996. [PMID: 34264909 PMCID: PMC8314707 DOI: 10.15585/mmwr.mm7028a2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
COVID-19 has disproportionately affected non-Hispanic Black or African American (Black) and Hispanic persons in the United States (1,2). In North Carolina during January-September 2020, deaths from COVID-19 were 1.6 times higher among Black persons than among non-Hispanic White persons (3), and the rate of COVID-19 cases among Hispanic persons was 2.3 times higher than that among non-Hispanic persons (4). During December 14, 2020-April 6, 2021, the North Carolina Department of Health and Human Services (NCDHHS) monitored the proportion of Black and Hispanic persons* aged ≥16 years who received COVID-19 vaccinations, relative to the population proportions of these groups. On January 14, 2021, NCDHHS implemented a multipronged strategy to prioritize COVID-19 vaccinations among Black and Hispanic persons. This included mapping communities with larger population proportions of persons aged ≥65 years among these groups, increasing vaccine allocations to providers serving these communities, setting expectations that the share of vaccines administered to Black and Hispanic persons matched or exceeded population proportions, and facilitating community partnerships. From December 14, 2020-January 3, 2021 to March 29-April 6, 2021, the proportion of vaccines administered to Black persons increased from 9.2% to 18.7%, and the proportion administered to Hispanic persons increased from 3.9% to 9.9%, approaching the population proportion aged ≥16 years of these groups (22.3% and 8.0%, respectively). Vaccinating communities most affected by COVID-19 is a national priority (5). Public health officials could use U.S. Census tract-level mapping to guide vaccine allocation, promote shared accountability for equitable distribution of COVID-19 vaccines with vaccine providers through data sharing, and facilitate community partnerships to support vaccine access and promote equity in vaccine uptake.
Collapse
|
20
|
Gaylor C, Young H, Benton D. The Impact of Glycemic Load on Cognitive Performance in Adults: A Systematic Review and Meta-Analysis. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab049_018] [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: 11/12/2022] Open
Abstract
Abstract
Objectives
A systematic review and meta-analysis compared the effects of high (HGL) and low glycemic load (LGL) breakfasts on the cognitive performance of adults. In particular, the time after eating that cognition was assessed and the influence of pre-existing glucose tolerance (GT) were considered.
Methods
A systematic search for randomized and non-randomized acute breakfast studies was conducted using PubMed, Scopus, and Cochrane Library. Data were available from 15 studies (1,100 participants, age 20–80 years). Episodic memory (e.g., word list recall), working memory (e.g., Serial Sevens), and attention/vigilance (e.g., Trails Part A) were examined. Better and poorer GT were defined as fasting glucose < or > 6.1 mmol/L (110 mg/dL) and/or two-hour postprandial glucose < or > 7 mmol/L (126 mg/dL). All analyses were performed using RevMan 5.3 (Cochrane) and a random-effects model.
Results
Five to 110 minutes after eating a HGL or LGL breakfast there were no differences cognition. However, between 120 and 195 minutes, immediate episodic memory was significantly better following a LGL breakfast (SMD = 0.16, 95% confidence interval [CI] = –0.00–0.32, P = 0.05, I2 = 0%). Pre-existing glucose tolerance (GT) status moderated this effect. In those with better GT, immediate episodic memory was significantly better following a LGL breakfast (SMD = 0.26, 95% CI = 0.00–0.52, P = 0.05, I2 = 0%), whereas there was no difference in those with poorer GT (SMD = 0.12, 95% CI = –0.21–0.45, P = 0.47, I2 = 0%).
Conclusions
A LGL breakfast improved memory later in the morning, especially in those with better GT. The phenomenon is unlikely to occur in pre-diabetics or type 2 diabetics and as such there are no clinical implications. There is, however, a possibility of exploring the nature of breakfast, or developing functional foods, to improve memory and work performance. If a similar phenomenon was found in children, there could be positive consequences for school performance.
Funding Sources
This study was not funded.
Collapse
|
21
|
Dahlberg A, Young H, Delaney C, Salit RB, Redman M, Thur L, Baker K, Milano F. T-Receptor Excisional Circle (TREC) Levels Are Associated with OS, NRM and Relapse in Cord Blood Transplant (CBT) Patients. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
22
|
Davies J, Ugwudike P, Young H, Hurrell C, Raynor P. A Pragmatic Study of the Impact of a Brief Mindfulness Intervention on Prisoners and Staff in a Category B Prison and Men Subject to Community-Based Probation Supervision. Int J Offender Ther Comp Criminol 2021; 65:136-156. [PMID: 32684055 PMCID: PMC7780272 DOI: 10.1177/0306624x20944664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES This article presents two studies assessing the impact of mindfulness in prison (prisoners and staff) and non-custodial settings. METHOD Study 1-prisoners (n = 17) and staff (n = 15) in a UK prison completed a mindfulness program; 16 individuals acted as a single time point comparison. Data were collected using self-report, computer based and physiological measurement. Study 2-men under community probation supervision were allocated to mindfulness (completed, n = 28) or TAU (n = 27). Data were collected using self-report mindfulness measures. RESULTS Study 1-statistically significant (increases in mindfulness skills (η2p = .234 to η2p = .388), cognitive control (η2p = .28), and heart rate variability (SDNN; η2p = .41) along with significant decreases in stress (η2p = .398) were found. In study 2, the mindfulness group showed non-significant improvements in mindfulness skills. CONCLUSION The findings suggest brief mindfulness interventions could make an important contribution to offender rehabilitation and custodial staff wellbeing.
Collapse
|
23
|
Schofield C, Evans K, Young H, Paguinto SG, Carroll K, Townsend E, Kiefer M, McGuire M, Sodhi J, Bray P, Bayley K, Vorster NM, Downs J. The development of a consensus statement for the prescription of powered wheelchair standing devices in Duchenne muscular dystrophy. Disabil Rehabil 2020; 44:1889-1897. [DOI: 10.1080/09638288.2020.1810786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Schofield
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | | | - H. Young
- The Children’s Hospital at Westmead, Westmead, Australia
| | | | - K. Carroll
- The Royal Children’s Hospital, Parkville, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - E. Townsend
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - M. Kiefer
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - M. McGuire
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | - J. Sodhi
- Institute of Genetic Medicine, International Centre for Life, John Walton Muscular Dystrophy Research Centre, Newcastle Upon Tyne, UK
| | - P. Bray
- The Children’s Hospital at Westmead, Westmead, Australia
- School of Health Sciences, The University of Sydney, Sydney, Australia
| | - K. Bayley
- Centre for Community-Driven Research, Perth, Australia
| | - N. M. Vorster
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - J. Downs
- Telethon Kids Institute, University of Western Australia, Perth, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| |
Collapse
|
24
|
Edwards DJ, Young H, Curtis A, Johnston R. Corrigendum: The Immediate Effect of Therapeutic Touch and Deep Touch Pressure on Range of Motion, Interoceptive Accuracy and Heart Rate Variability: A Randomized Controlled Trial With Moderation Analysis. Front Integr Neurosci 2020; 14:28. [PMID: 32508602 PMCID: PMC7251474 DOI: 10.3389/fnint.2020.00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Darren J Edwards
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| | - Hayley Young
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Annabel Curtis
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| | - Ross Johnston
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| |
Collapse
|
25
|
Davies J, McKenna M, Bayley J, Denner K, Young H. Using engagement in sustainable construction to improve mental health and social connection in disadvantaged and hard to reach groups: a new green care approach. J Ment Health 2020; 29:350-357. [PMID: 32036713 DOI: 10.1080/09638237.2020.1714001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The positive impact of the outdoors on physical and mental health is increasingly being evidenced. However, the impact on vulnerable and disadvantaged individuals engaging in group based sustainable building construction has not been examined.Aim: To provide the first pragmatic examination of the impact of engaging in a brief (8 days over 8 weeks) outdoor sustainable construction project on the mental health and social connectedness of hard to reach and disadvantaged groups.Methods: In study 1, 93 young people not in education, employment or training took part whilst study 2 comprised 55 adults who were asylum seekers, long-term unemployed or men with longstanding depression. Self-report data were collected at baseline and towards the end of the programme.Results: Those with poor mental health and social connection at baseline showed statistically and clinically significant improvements in depression, anxiety, resilience and social connection by the end of the brief intervention.Conclusion: Engagement in a group based sustainable construction project can provide significant mental health and social benefits to a range of vulnerable and hard to reach groups with difficulties in these areas. Building on these findings could be important for health and social care policy for marginalised groups.
Collapse
Affiliation(s)
- Jason Davies
- Department of Psychology, College of Human and Health Sciences, Vivian Tower, Swansea University, Swansea, UK
| | | | | | | | - Hayley Young
- Department of Psychology, College of Human and Health Sciences, Vivian Tower, Swansea University, Swansea, UK
| |
Collapse
|
26
|
Young H. School Health Research Network Wales: Development, implementation & contributing to public health policy. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.516] [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: 11/12/2022] Open
Abstract
Abstract
The School Health Research Network (SHRN) was launched in Wales in 2013 as a strategic partnership between Cardiff University, Welsh Government, Public Health Wales (part of the National Health Service) and Cancer Research UK (a research-focused charity). SHRN is led by a multidisciplinary team in the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) at Cardiff University.
SHRN aims to: 1) provide health and well-being data from a biennial survey for national, regional and local stakeholders, including schools; 2) co-produce school-based health improvement research for Wales; and 3) build capacity for evidence-informed public health policy and practice.
Building on and integrating with HBSC infrastructure, a transdisciplinary complex adaptive systems (T-CAS) approach has been employed to develop SHRN, for a national culture of prevention for school health improvement. The T-CAS approach focuses on key stages and activities within a continuous network cycle to facilitate systems level change. The five key stages involve establishing transdisciplinary strategic partnerships, resource investment and linkage, network development, coproduction activities and reciprocal outputs.
SHRN has successfully established new cross-sector stakeholder partnerships at multiple levels, and embedded network activity within national and local policy. It has established a programme of school engagement activities to secure membership of 212 (100%) secondary schools in Wales and building on HBSC systems and structures has developed a national data infrastructure with the biennial collection of student and school-level health and wellbeing data. SHRN has co-produced scientific evidence and established a new data-led planning system (e.g. 56 research studies co-produced). It has also secured sustainability funding from health and education, while developing research capacity to generate evidence and support professional practice.
Collapse
Affiliation(s)
- H Young
- DECIPHer, Cardiff University, Cardiff, UK
| |
Collapse
|
27
|
Murrow J, Brizendine J, Djire B, Young H, Rathbun S, Nilsson K, McCully K. P4700Work during treadmill rehabilitation predicts clinical benefit and muscle mitochondrial improvements in intermittent claudication. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1081] [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: 11/13/2022] Open
Abstract
Abstract
Background
Supervised exercise training is recommended for intermittent claudication in peripheral artery disease (PAD), but the relationship between work achieved during exercise and clinical outcomes is not well described. As in other training modalities, increased effort measured by cumulative work production is expected to be translate into to positive performance adaptations. In settings of constrained limb blood flow, this relationship is unknown. In addition, the impact of exercise on skeletal muscle oxygen use capacity changes is unknown. Near infrared spectroscopy (NIRS) offers a method of characterizing skeletal muscle mitochondrial adaptations before and after training programs.
Methods
We enrolled subjects (n=17, age 71±8.8 years, 20% female) with PAD and intermittent claudication (ankle brachial index [ABI]=0.76±0.21) in a 12-week supervised training program, randomized to traditional pain-based training strategy versus hypoxia-based training (using NIRS to direct training). Muscle work was calculated based on training performance. NIRS-based determination of mitochondrial capacity and microvascular flow were measured at baseline and after 12 weeks.
Results
Subjects trained for an average of 32.9±5.9 sessions walking at 54.4±13.4 m/min per session. Subjects achieved a mean of average workload of 4767±5112 kilogram force meter (kpm) per session and an aggregate of 148536±148020 kpm for the training program. Baseline pain-free walking time of 2.95±2.10 minutes increased by a mean of 3.74±2.47 minutes. Increase in walking time was proportional to the average work level achieved per session, with a correlating trend to the overall work level performed over 12 weeks (r=0.543, p=0.024). There was no increase in blood flow measured by ABI or limb microcirculation perfusion index over the training period. Skeletal muscle mitochondrial capacity increased over the training period and correlated with the overall work performed (r=0.573, p=0.016).
Figure 1
Conclusions
Treadmill exercise rehabilitation for intermittent claudication may be guided by total dose of exercise and NIRS-based indices of mitochondrial capacity rather than pain-levels achieved or changes in perfusion measures.
Acknowledgement/Funding
American Heart Association
Collapse
Affiliation(s)
- J Murrow
- Augusta University - University of Georgia Medical Partnership, Athens, United States of America
| | - J Brizendine
- University of Alabama Birmingham, Birmingham, United States of America
| | - B Djire
- University of Georgia, Athens, United States of America
| | - H Young
- University of Alabama Birmingham, Birmingham, United States of America
| | - S Rathbun
- University of Georgia, Athens, United States of America
| | - K Nilsson
- Augusta University - University of Georgia Medical Partnership, Athens, United States of America
| | - K McCully
- University of Georgia, Kinesiology, Athens, United States of America
| |
Collapse
|
28
|
King R, Young H, Kwok J. The Use of L-PRF in the Prophylaxis of Osteoradionecrosis and Medication-Related Osteonecrosis of the Jaw. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
29
|
Majeed-Ariss R, McPhee M, McAteer H, Griffiths CEM, Young H. The top 10 research priorities for psoriasis in the U.K.: results of a James Lind Alliance psoriasis Priority Setting Partnership. Br J Dermatol 2019; 181:871-873. [PMID: 31162641 PMCID: PMC6973084 DOI: 10.1111/bjd.18209] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Majeed-Ariss
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, U.K
| | - M McPhee
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Nottingham, U.K
| | - H McAteer
- Psoriasis Association, Dick Coles House, 2 Queensbridge, Northampton, U.K
| | - C E M Griffiths
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, U.K
| | - H Young
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, U.K
| |
Collapse
|
30
|
Benton D, Cousins A, Young H. Small Differences in Everyday Hydration Status Influence Mood (P04-134-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz051.p04-134-19] [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: 11/12/2022] Open
Abstract
Abstract
Objectives
Reviews consistently find that a loss of about 2% of body mass was needed before either athletic or psychological functioning is disrupted. However, although it is usually assumed that the minor changes in hydration status, that occur during normal life, do not impact on performance, experimentally the topic has been virtually ignored. The impact of everyday variations in hydration was therefore examined.
Methods
168 subjects were randomly allocated to drinking water, or not drinking, and in addition consume capsules containing either 300 mg of sodium chloride or a placebo. Subjects were monitored over a three-hour period, during which urine osmolality, loss of body mass and urine production were monitored. Repeatedly subjects reported their mood.
Results
Subjects came having consumed their normal diet, without any restriction on fluid intake: on average 0.5% body mass was lost during the study. The major finding was that the hydration status on arrival had a greater influence, than subsequent fluid intake and changes in osmolality during the study. With ratings of being agreeable rather than hostile, those with lower baseline osmolality who drank water had better mood than if baseline osmolality was high. As another example, the mood of those who did not drink water only declined during the study when baseline osmolality was high rather than low. With measures of being composed rather than anxious, and being confidence rather than unsure, those who had lower baseline osmolality had a better mood, irrespective of whether water was consumed. Thus, baseline osmolality had an impact greater than drink induced changes in osmolality. Traditionally the normal range of urine osmolality has been said to be 200–800 mOsmoles/kg, yet the critical point at which the response to fluid intake changed was 600 mOsmoles/kg: 61% had a baseline osmolality over 600 and 38% over 800 mOsmoles/kg.
Conclusions
Some individuals are in a state of dehydration that adversely influences mood; a state not reversed by acute fluid consumption. The pattern of consumption associated with mild-dehydration and its functional consequences needs to be established.
Funding Sources
There was no funding external other than provided by ** University.
Collapse
|
31
|
Cathcart E, McSweeney T, Johnston R, Young H, Edwards DJ. Immediate biomechanical, systemic, and interoceptive effects of myofascial release on the thoracic spine: A randomised controlled trial. J Bodyw Mov Ther 2019; 23:74-81. [DOI: 10.1016/j.jbmt.2018.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 08/01/2018] [Accepted: 08/25/2018] [Indexed: 12/22/2022]
|
32
|
Cousins A, Young H, Benton D. Habitual water intake is associated with improved mood, cognition and cardiovascular health in older adults. Appetite 2018. [DOI: 10.1016/j.appet.2018.05.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
33
|
Edwards DJ, Young H, Cutis A, Johnston R. The Immediate Effect of Therapeutic Touch and Deep Touch Pressure on Range of Motion, Interoceptive Accuracy and Heart Rate Variability: A Randomized Controlled Trial With Moderation Analysis. Front Integr Neurosci 2018; 12:41. [PMID: 30297988 PMCID: PMC6160827 DOI: 10.3389/fnint.2018.00041] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/06/2018] [Indexed: 12/20/2022] Open
Abstract
Background: There is paucity in the literature regarding the role of the interoceptive pathway through the insular cortex (IC), as well as heart rate variability (HRV) in relation to Osteopathic Manipulative Therapy (OMT) and deep-touch. Aims: The present study investigated whether both OMT treatment and deep-touch (a newly hypothesized treatment option) was effective at altering the interoceptive pathway and HRV, whilst OMT was only expected to be effective for increasing Range of Motion (ROM). Methods: Thirty-five healthy volunteers were randomly allocated into three conditions in a repeated measures crossover design; a control (laying supine on a plinth); deep-touch (head cradling); and an osteopathic mobilization therapeutic technique on the temporomandibular joint (TMJ). Interoceptive accuracy (IAc), HRV, as well as range of motion (ROM) for the TMJ area as well as the cervical spine (Csp) right and left measures were taken pre and post each condition setting. Results: Significant condition effects emerged from the deep-touch and mobilization interventions for IAc where increases were identified through planned comparisons. For the HRV measure (RMSSD), a significant effect emerged in the deep-touch condition (increase) but not in the mobilization or control conditions. ROM did not increase for any condition. IAc correlated with post-ROM outcomes in many cases and HRV moderated some of these relations. Conclusion: These results are discussed in the context of clinical practice, where cranial deep-touch maybe an effective treatment and modulator of the parasympathetic nervous systems, as well as the interoceptive system.
Collapse
Affiliation(s)
- Darren J Edwards
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| | - Hayley Young
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Annabel Cutis
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| | - Ross Johnston
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| |
Collapse
|
34
|
Majeed-Ariss R, McPhee M, Bundy C, Griffiths C, Young H. 制定方案以识别银屑病研究问题,并对其进行优先级排序:James Lind联盟优先级设立合作伙伴关系. Br J Dermatol 2018. [DOI: 10.1111/bjd.16759] [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]
|
35
|
Majeed-Ariss R, McPhee M, Bundy C, Griffiths C, Young H. Developing a protocol to identify and prioritize research questions for psoriasis: a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2018. [DOI: 10.1111/bjd.16747] [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]
|
36
|
|
37
|
Majeed-Ariss R, McPhee M, Bundy C, Griffiths C, Young H. Developing a protocol to identify and prioritize research questions for psoriasis: a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2018; 178:1383-1387. [DOI: 10.1111/bjd.15992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- R. Majeed-Ariss
- Department of Dermatology; The University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | - M. McPhee
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus; Nottingham U.K
| | - C. Bundy
- School of Healthcare Sciences; College of Biomedical and Life Sciences; Cardiff University; Cardiff U.K
| | - C.E.M. Griffiths
- Department of Dermatology; The University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | - H. Young
- Department of Dermatology; The University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | | |
Collapse
|
38
|
Moawad G, Khalil EA, Young H, Park D, Frost A, Tyan P. 27: Predictors of inpatient admission after robot-assisted and laparoscopic hysterectomy. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.046] [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]
|
39
|
Moawad G, Winters M, Khalil EA, Young H, Tyan P. 83: Safety and efficiency of robot-assisted transabdominal cerclage in the prevention of preterm birth. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Moawad G, Khalil EA, Young H, Park D, Frost A, Tyan P. 66: PREDICTORS of inpatient admission after robot-assisted and laparoscopic myomectomy. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.085] [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: 10/18/2022]
|
41
|
Young H, Abi Khalil E, Tyan P, Park D, Vargas M, Marfori C, Moawad G. Predictors of Post-Operative Admission for Minimally Invasive Hysterectomies. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
42
|
Bilimoria R, Young H, Patel D, Kwok J. The role of piezoelectric surgery and platelet-rich fibrin in treatment of ORN and MRONJ: a clinical case series. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/ors.12318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- R. Bilimoria
- Oral Surgery Department; Guy's Hospital; London England
| | - H. Young
- Oral Surgery Department; Guy's Hospital; London England
| | - D. Patel
- Oral Surgery Department; Guy's Hospital; London England
| | - J. Kwok
- Oral Surgery Department; Guy's Hospital; London England
| |
Collapse
|
43
|
Young H, Kwok J, Patel D, Patel V. Immediate Dental Implant Placement Following Sinus Elevation in Maxillary Bone Levels Less Than 6mm. J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.joms.2017.07.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
44
|
Naunton M, Peterson GM, Deeks LS, Young H, Kosari S. We have had a gutful: The need for deprescribing proton pump inhibitors. J Clin Pharm Ther 2017; 43:65-72. [PMID: 28895169 DOI: 10.1111/jcpt.12613] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 08/03/2017] [Indexed: 12/14/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Proton pump inhibitor (PPI) prescribing may often be inappropriate and expose patients to a risk of adverse effects, while incurring unnecessary healthcare expenditure. Our objective was to determine PPI usage in Australia since 2002 and review international studies investigating inappropriate PPI prescribing, including those that discussed interventions to address this issue. METHODS Australian Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data were analysed. A narrative literature review relevant to the objective was conducted. Time series analysis was also used to examine the trend of reported PPI appropriate use across the international studies included in this review. RESULTS AND DISCUSSION Proton pump inhibitor use in Australia increased between 2002 and 2010 and then gradually decreased. Estimates of the extent of inappropriate use in the international literature had a wide variation (11-84%). There appeared to be little change in the extent of appropriate PPI use reported through 34 international studies from 2000 to 2016. Interventions to address inappropriate use included patient-centred deprescribing, academic detailing, educational programmes and drug safety notifications. WHAT IS NEW AND CONCLUSION Proton pump inhibitors continue to be overused worldwide and should be a focus for deprescribing programmes. Ongoing education and awareness campaigns for health professionals and patients, including electronic reminders at the point of prescribing, are strategies that have potential to reduce PPI use in individuals who do not have an evidence-based clinical indication for their long-term use.
Collapse
Affiliation(s)
- M Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - G M Peterson
- University of Tasmania, Faculty of Health, University of Tasmania, Hobart, Tas., Australia
| | - L S Deeks
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - H Young
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - S Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| |
Collapse
|
45
|
Young H, Tyan P, Khalil EA, Vargas M, Marfori C, Moawad G. Reduced port robotic myomectomy: feasibility and safety. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1145] [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: 10/18/2022]
|
46
|
Young H, Khalil EDA, Tyan P, Park D, Vargas M, Marfori C, Moawad G. Predictors of post-operative admission for minimally invasive myomectomies. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.609] [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: 10/18/2022]
|
47
|
Nelson PA, Kane K, Pearce CJ, Bundy C, Chisholm A, Hilton R, Thorneloe R, Young H, Griffiths CEM, Cordingley L. 'New to me': changing patient understanding of psoriasis and identifying mechanisms of change. The Pso Well ® patient materials mixed-methods feasibility study. Br J Dermatol 2017; 177:758-770. [PMID: 28403510 PMCID: PMC5637913 DOI: 10.1111/bjd.15574] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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] [Accepted: 04/06/2017] [Indexed: 12/27/2022]
Abstract
Background Psoriasis is an inflammatory long‐term condition involving comorbidities, unhealthy lifestyle and significant life impact. Patients’ understanding of psoriasis is limited and support lacking. The Common‐Sense Model of Self‐Regulation of Health and Illness emphasizes the role of illness and treatment beliefs on coping and self‐management. New ‘Pso Well®’ patient materials informed by the model, addressed psoriasis as a long‐term condition, medication management and lifestyle behaviours. Objectives To investigate whether Pso Well® materials (i) broaden understanding of psoriasis without increasing anxiety; (ii) are acceptable; and (iii) comprise features that appear to effect change. Methods The Revised Illness Perceptions Questionnaire (IPQ‐R modified) and the Hospital Anxiety and Depression Scale (HADS) were administered in patients before and after intervention. Numerical rating scales assessed perceptions of change in understanding and anxiety resulting from engagement with the materials. Qualitative interviews explored acceptability and perceived ‘active ingredients’. Results Fifty‐five patients completed pre‐ and postintervention questionnaires (56% female; median age 59 years). Postintervention, a large effect size was indicated in two IPQ‐R domains – illness coherence [t(55) = −3·48, P = 0·001 (two‐tailed), η2 = 0·19] and personal control [t(55) = −2·98, P = 0·004 (two‐tailed), η2 = 0·14] – and a medium effect in one, treatment control [t(55) = −2·08, P = 0·042 (two‐tailed), η2 = 0·08]. HADS scores did not change. For numerical rating scales, 80% of participants reported increased understanding of psoriasis and none reported increased anxiety. Interviews with 19 patients indicated the materials were acceptable and usable. Factors reported to broaden understanding and promote engagement with self‐management included linking of related disease aspects, personally relevant content and high‐quality design. Conclusions High‐quality, theory‐based psoriasis materials are acceptable to patients and can improve understanding and sense of control without increasing anxiety. What's already known about this topic? Psoriasis is associated with comorbidities, unhealthy lifestyle and significant life impact. Patients’ understanding of psoriasis is limited, self‐management support is lacking and disengagement from healthcare services is common.
What does this study add? The new, theory‐informed Pso Well® patient materials address psoriasis as a long‐term condition; medications management and lifestyle behaviour. The Pso Well® patient materials can increase understanding of psoriasis, promote feelings of self‐worth and encourage a desire to engage in self‐management and behaviour change, without increasing anxiety or depression.
What are the clinical implications of this work? The Pso Well® patient materials could support clinical consultations by helping patients recognize the remitting–relapsing nature of psoriasis. This will help to improve understanding of the disease, as well as providing a clearer rationale for treatment adherence and lifestyle behaviour change.
Linked Comment: Prinsen. Br J Dermatol 2017; 177:616–617
Collapse
Affiliation(s)
- P A Nelson
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K
| | - K Kane
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K
| | - C J Pearce
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K
| | - C Bundy
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K
| | - A Chisholm
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K
| | - R Hilton
- Bridgewater Community Healthcare Trust, Wigan, U.K
| | - R Thorneloe
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K
| | - H Young
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K.,Salford Royal NHS Foundation Trust, Greater Manchester, U.K
| | - C E M Griffiths
- Dermatology Centre, Division of Musculoskeletal and Dermatological Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.,Manchester Academic Health Science Centre, Manchester, U.K.,Salford Royal NHS Foundation Trust, Greater Manchester, U.K
| | - L Cordingley
- Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K.,Division of Musculoskeletal and Dermatological Research, University of Manchester, Manchester, U.K
| | | |
Collapse
|
48
|
Murrow J, Brizendine J, Djire B, Young H, Rathbun S, McCully K. P3420Clinical and mitochondrial adaptations after near infrared spectroscopy-guided exercise training for claudication in peripheral arterial disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Blauvelt A, Puig L, Chimenti S, Vender R, Rajagopalan M, Romiti R, Skov L, Zachariae C, Young H, Prens E, Cohen A, van der Walt J, Wu JJ. Biosimilars for psoriasis: clinical studies to determine similarity. Br J Dermatol 2017; 177:23-33. [PMID: 27639072 DOI: 10.1111/bjd.15067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2016] [Indexed: 11/29/2022]
Abstract
Biosimilars are drugs that are similar, but not identical, to originator biologics. Preclinical analytical studies are required to show similarity on a molecular and structural level, but efficacy and safety studies in humans are essential to determining biosimilarity. In this review, written by members of the International Psoriasis Council, we discuss how biosimilars are evaluated in a clinical setting, with emphasis on extrapolation of indication, interchangeability and optimal clinical trial design.
Collapse
Affiliation(s)
- A Blauvelt
- Oregon Medical Research Center, Portland, OR, U.S.A
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Chimenti
- University of Rome Tor Vergate, Rome, Italy
| | - R Vender
- Dermatrials Research Inc., Hamilton, ON, Canada.,Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | | | - R Romiti
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | - L Skov
- Herllev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - C Zachariae
- Herllev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H Young
- Manchester Academic Health Science Centre, Department of Dermatology, University of Manchester, Salford Royal Hospital, Manchester, U.K
| | - E Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | | | - J J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, U.S.A
| |
Collapse
|
50
|
Goedhart M, Cornelissen A, Kuijk C, Kleijer M, Geerman S, Pascutti F, Huveneers S, van Buul J, Young H, Wolkers M, Nolte M, Voermans C. Interferon-gamma impairs expansion and hematopoietic support of bone marrow mesenchymal stromal cells. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|