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Balachandran A, Pei H, Beard J, Caspi A, Cohen A, Domingue BW, Eckstein Indik C, Ferrucci L, Furuya A, Kothari M, Moffitt TE, Ryan C, Skirbekk V, Zhang Y, Belsky DW. Pace of Aging in older adults matters for healthspan and lifespan. medRxiv 2024:2024.04.25.24306359. [PMID: 38712264 PMCID: PMC11071564 DOI: 10.1101/2024.04.25.24306359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
As societies age, policy makers need tools to understand how demographic aging will affect population health and to develop programs to increase healthspan. The current metrics used for policy analysis do not distinguish differences caused by early-life factors, such as prenatal care and nutrition, from those caused by ongoing changes in people's bodies due to aging. Here we introduce an adapted Pace of Aging method designed to quantify differences between individuals and populations in the speed of aging-related health declines. The adapted Pace of Aging method, implemented in data from N=13,626 older adults in the US Health and Retirement Study, integrates longitudinal data on blood biomarkers, physical measurements, and functional tests. It reveals stark differences in rates of aging between population subgroups and demonstrates strong and consistent prospective associations with incident morbidity, disability, and mortality. Pace of Aging can advance the population science of healthy longevity.
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Affiliation(s)
- A Balachandran
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - H Pei
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - J Beard
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Health Policy & Management, Columbia University Mailman School of Public Health, New York, NY, USA
| | - A Caspi
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Social, Genetic, and Developmental Psychiatry Unit, Institute of Psychiatry, Kings College, University of London, London, UK
| | - A Cohen
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - BW Domingue
- Graduate School of Education, Stanford University, Palo Alto, CA, USA
| | - C Eckstein Indik
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - L Ferrucci
- National Institute on Aging, Bethesda, MD, USA
| | - A Furuya
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - M Kothari
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - TE Moffitt
- Social, Genetic, and Developmental Psychiatry Unit, Institute of Psychiatry, Kings College, University of London, London, UK
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - C Ryan
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - V Skirbekk
- Norwegian Institute for Public Health, Oslo, Norway
| | - Y Zhang
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - DW Belsky
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Health Policy & Management, Columbia University Mailman School of Public Health, New York, NY, USA
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Kemoun P, Ader I, Planat-Benard V, Dray C, Fazilleau N, Monsarrat P, Cousin B, Paupert J, Ousset M, Lorsignol A, Raymond-Letron I, Vellas B, Valet P, Kirkwood T, Beard J, Pénicaud L, Casteilla L. A gerophysiology perspective on healthy ageing. Ageing Res Rev 2022; 73:101537. [PMID: 34883201 DOI: 10.1016/j.arr.2021.101537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 12/16/2022]
Abstract
Improvements in public health and health care have resulted in significant increases in lifespan globally, but also in a significant increase in chronic disease prevalence. This has led to a focus on healthy ageing bringing a shift from a pathology-centered to an intrinsic capacity and function-centered view. In parallel, the emerging field of geroscience has promoted the exploration of the biomolecular drivers of ageing towards a transverse vision by proposing an integrated set of molecular hallmarks. In this review, we propose to take a step further in this direction, highlighting a gerophysiological perspective that considers the notion of homeostasis/allostasis relating to robustness/fragility respectively. While robustness is associated with homeostasis achieved by an optimal structure/function relationship in all organs, successive repair processes occurring after daily injuries and infections result in accumulation of scar healing leading to progressive tissue degeneration, allostasis and frailty. Considering biological ageing as the accumulation of scarring at the level of the whole organism emphasizes three transverse and shared elements in the body - mesenchymal stroma cells/immunity/metabolism (SIM). This SIM tryptich drives tissue and organ fate to regulate the age-related evolution of body functions. It provides the basis of a gerophysiology perspective, possibly representing a better way to decipher healthy ageing, not only by defining a composite biomarker(s) but also by developing new preventive/curative strategies.
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Ruiz JG, Dent E, Morley JE, Merchant RA, Beilby J, Beard J, Tripathy C, Sorin M, Andrieu S, Aprahamian I, Arai H, Aubertin-Leheudre M, Bauer JM, Cesari M, Chen LK, Cruz-Jentoft AJ, De Souto Barreto P, Dong B, Ferrucci L, Fielding R, Flicker L, Lundy J, Reginster JY, Rodriguez-Mañas L, Rolland Y, Sanford AM, Sinclair AJ, Viña J, Waters DL, Won Won C, Woo J, Vellas B. Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines. J Nutr Health Aging 2021; 24:920-927. [PMID: 33155616 PMCID: PMC7568453 DOI: 10.1007/s12603-020-1492-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J G Ruiz
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University, SLUCare Academic Pavilion, Section 2500 1008 S. Spring Ave., 2nd Floor, St. Louis, MO 63110, USA, , Twitter: @drjohnmorley
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Ruiz JG, Dent E, Morley JE, Merchant RA, Beilby J, Beard J, Tripathy C, Sorin M, Andrieu S, Aprahamian I, Arai H, Aubertin-Leheudre M, Bauer JM, Cesari M, Chen LK, Cruz-Jentoft AJ, Barreto PDS, Dong B, Ferrucci L, Fielding R, Flicker L, Lundy J, Reginster JY, Rodriguez-Mañas L, Rolland Y, Sanford AM, Sinclair AJ, Viña J, Waters DL, Won CW, Woo J, Vellas B. Erratum to: Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines. J Nutr Health Aging 2020. [PMCID: PMC7790018 DOI: 10.1007/s12603-020-1547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Giudici KV, de Souto Barreto P, Beard J, Cantet C, Araujo de Carvalho I, Rolland Y, Vellas B. Effect of long-term omega-3 supplementation and a lifestyle multidomain intervention on intrinsic capacity among community-dwelling older adults: Secondary analysis of a randomized, placebo-controlled trial (MAPT study). Maturitas 2020; 141:39-45. [PMID: 33036701 DOI: 10.1016/j.maturitas.2020.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/19/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To investigate the effect of omega-3 (ω-3) polyunsaturated fatty acid supplementation and a multidomain intervention (MI) (physical activity counselling, cognitive training and nutritional advice) among community-dwelling older adults on levels of intrinsic capacity (IC), a construct recently proposed by the World Health Organization. STUDY DESIGN Secondary analysis from the factorial-design 3-year Multidomain Alzheimer Preventive Trial (MAPT) with 1445 subjects (64.2 % female, mean age 75.3 years, SD = 4.4) randomized to one group of MI plus ω-3 (800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid/day); MI plus placebo; ω-3 supplementation alone; or placebo alone. Data collection was held between 2008 and 2014. MAIN OUTCOME MEASURES IC domains were examined with the Geriatric Depression Scale (psychological); Short Physical Performance Battery (mobility); Z-score combining four tests (cognitive function); and handgrip strength (vitality). All domains were combined into a composite IC Z-score. RESULTS After 3 years, IC Z-score decreased among all groups when time was considered continuous (MI plus ω-3: -0.16, 95 %CI: -0.22 to -0.10; MI alone: -0.13, 95 %CI: -0.19 to -0.07; ω-3 alone: -0.19, 95 %CI: -0.25 to -0.10; placebo: -0.20, 95 %CI: -0.26 to -0.14; all p < 0.0001). There were no significant differences between groups. In a sensitivity analysis with categorical time, significant within-group declines were first identified at 24 months for all groups. CONCLUSIONS This trial designed to improve cognitive function was unable to find effects of the intervention on the composite IC Z-score. Further investigations are needed, especially trials providing stronger interventions (such as exercise training and a controlled diet) and also embracing the sensorial domain of IC.
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Affiliation(s)
- K V Giudici
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.
| | - P de Souto Barreto
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
| | - J Beard
- University of Sydney, Sydney, Australia
| | - C Cantet
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
| | - I Araujo de Carvalho
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | - Y Rolland
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
| | - B Vellas
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
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Tavassoli N, Piau A, Berbon C, De Kerimel J, Lafont C, De Souto Barreto P, Guyonnet S, Takeda C, Carrie I, Angioni D, Paris F, Mathieu C, Ousset P, Balardy L, Voisin T, Sourdet S, Delrieu J, Bezombes V, Pons-Pretre V, Andrieu S, Nourhashemi F, Rolland Y, Soto M, Beard J, Sumi Y, Araujo Carvalho I, Vellas B. Framework Implementation of the INSPIRE ICOPE-CARE program in collaboration with the World Health Organization (WHO) in the Occitania region. J Frailty Aging 2020; 10:103-109. [DOI: 10.14283/jfa.2020.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.
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Mulliniks T, Beard J. 274 Sustainable and economically viable management options for cow/calf production through enhanced beef cow metabolic efficiency. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Mulliniks
- University of Nebraska,Lincoln, NE, United States
| | - J Beard
- University of Nebraska,Lincoln, NE, United States
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Yule S, Gupta A, Gazarian D, Geraghty A, Smink DS, Beard J, Sundt T, Youngson G, McIlhenny C, Paterson-Brown S. Construct and criterion validity testing of the Non-Technical Skills for Surgeons (NOTSS) behaviour assessment tool using videos of simulated operations. Br J Surg 2018; 105:719-727. [DOI: 10.1002/bjs.10779] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/06/2017] [Accepted: 11/04/2017] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Surgeons' non-technical skills are an important part of surgical performance and surgical education. The most widely adopted assessment tool is the Non-Technical Skills for Surgeons (NOTSS) behaviour rating system. Psychometric analysis of this tool to date has focused on inter-rater reliability and feasibility rather than validation.
Methods
NOTSS assessments were collected from two groups of consultant/attending surgeons in the UK and USA, who rated behaviours of the lead surgeon during a video-based simulated crisis scenario after either online or classroom instruction. The process of validation consisted of assessing construct validity, scale reliability and concurrent criterion validity, and undertaking a sensitivity analysis. Central to this was confirmatory factor analysis to evaluate the structure of the NOTSS taxonomy.
Results
Some 255 consultant surgeons participated in the study. The four-category NOTSS model was found to have robust construct validity evidence, and a superior fit compared with alternative models. Logistic regression and sensitivity analysis revealed that, after adjusting for technical skills, for every 1-point increase in NOTSS score of the lead surgeon, the odds of having a higher versus lower patient safety score was 2·29 times. The same pattern of results was obtained for a broad mix of surgical specialties (UK) as well as a single discipline (cardiothoracic, USA).
Conclusion
The NOTSS tool can be applied in research and education settings to measure non-technical skills in a valid and efficient manner.
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Affiliation(s)
- S Yule
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - A Gupta
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - D Gazarian
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - A Geraghty
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
| | - D S Smink
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - J Beard
- Faculty of Medicine, University of Sheffield, Sheffield, UK
| | - T Sundt
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - G Youngson
- Department of Paediatric Surgery, Royal Aberdeen Children's Hospital, School of Medicine, University of Aberdeen, Aberdeen, UK
| | - C McIlhenny
- Scottish Centre for Simulation and Clinical Human Factors, Larbert, UK
| | - S Paterson-Brown
- Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
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Keating N, Beard J. CONTEXTUALIZING THE AGENDA FOR GLOBAL ACTION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N.C. Keating
- Swansea University, Swansea, United Kingdom,
- North West University, Potchefstroom, South Africa,
- University of Alberta, Edmonton, Alberta, Canada,
| | - J. Beard
- World Health Organization, Geneva, Switzerland
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Keating N, Beard J. KEYNOTE: BEYOND RHETORIC—TAKING GLOBAL ACTION ON AGEING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N.C. Keating
- Global Social Initiative on Ageing, Seoul, Korea (the Republic of)
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Walker A, Beard J. REALISING THE POTENTIAL OF ACTIVE AGEING IN EUROPE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Beard J. THE ROLE OF FUNCTIONAL ABILITY IN HEALTHY AGING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J. Beard
- Ageing and Life Course Department, World Health Organization, Geneva, Switzerland
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Beard J. THE INTERNATIONAL POLICY CONTEXT FOR ACTION ON LONG-TERM CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J. Beard
- World Health Organisation, Geneva, Switzerland,
- University of Sydney, Sydney, New South Wales, Australia,
- Southern Cross University, Sydney, New South Wales, Australia
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Beard J. THE WHO MODEL OF HEALTHY AGEING AND ITS IMPLICATIONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Beard
- World Health Organization, Geneva, Switzerland
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Hodin M, Beard J. ACHIEVING 21ST CENTURY FUNCTIONAL ABILITY THROUGH MORE EFFECTIVE ELDER CAREGIVING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M. Hodin
- Global Coalition on Aging, New York, New York
| | - J. Beard
- Ageing and Life Course Department, World Health Organization, Geneva, Switzerland
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Beard J, Feather J, Chan G. THE AGE-FRIENDLY COMMUNITIES MOVEMENT: CREATING, MANAGING, AND SUSTAINING COMMUNITIES FOR ALL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - G. Chan
- The Hong Kong Council of Social Service
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Araujode Carvalho I, Jotheeswaran A, Beard J, Prince M. PREVENTING AND STOPPING DECLINES IN INTRINSIC CAPACITY: INTERVENTIONS AND CLINICAL RECOMMENDATIONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A. Jotheeswaran
- Ageing and Life Course, World Health Organization, GENEVA, Switzerland,
| | - J. Beard
- Ageing and Life Course, World Health Organization, GENEVA, Switzerland,
| | - M. Prince
- Centre for Global Mental Health, London, United Kingdom
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Affiliation(s)
- J. Beard
- World Health Organization, Geneva, Switzerland
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Affiliation(s)
- J. Barratt
- International Federation on Ageing, Toronto, Ontario, Canada
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Patterson AL, Beard J, Herrington MC, Rosasco SL, Soares EM, Northrop EJ, Larimore EL, Rich JJJ, Amundson OL, McNeel AK, Chase CC, Perry GA, Summers AF, Cushman RA. 317 Investigation of ovarian reserve parameters in Bos indicus cows. J Anim Sci 2017. [DOI: 10.2527/asasmw.2017.317] [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: 11/13/2022] Open
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Ward M, Summers AF, Roscano S, Beard J, Soto-Navarro SA, Hallford DM. 0090 Effects of predation on cortisol and progesterone levels in gestating ewes. J Anim Sci 2016. [DOI: 10.2527/jam2016-0090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Beard J, Spafford C, Oakley C. A 12 Week Home Exercise Programme Augmented with Nordic Pole Walking Improves the Quality of Life and ABPIs of Claudicants. Most Patients Continue to Use Their Poles and Improve Their Walking Distance at One Year. Eur J Vasc Endovasc Surg 2016. [DOI: 10.1016/j.ejvs.2016.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hinchliffe R, D'Abate F, Abraham P, Alimi Y, Beard J, Bender M, Björck M, Edmundson C, Fernandez Garcia B, Cherry K, Álvarez Fernández L, Feugier P, Lee J, Palfreeman R, Passfield L, Peach G, Ricco JB, Rimpler H, Roake J, Rouviere O, Schep G, Spark I, Schumacher Y, Zierler R. Diagnosis and Management of Iliac Artery Endofibrosis: Results of a Delphi Consensus Study. Eur J Vasc Endovasc Surg 2016; 52:90-8. [DOI: 10.1016/j.ejvs.2016.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 04/06/2016] [Indexed: 11/25/2022]
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Michaels JA, Campbell WB, Rigby KA, Chan P, Beard J, Wood R, Lonsdale R, Sheriff S, Palfreyman S, Thompson J, Allington K, Brazier J, Shackley P, Niblett P, Peters A, Bickerton D. A New Pragmatic Classification System for Varicose Veins. Phlebology 2016. [DOI: 10.1177/026835550101600108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: An anatomical classification system for varicose veins which has a direct and pragmatic bearing on treatment. Methods: A group of trial participants from the two vascular units involved met to design a system. A consensus on the form and content of the system was reached. This process included forming a set of ideal classification criteria, a literature review of existing classification systems and a pilot study of the proposed system. Results: The identified classification systems were felt to be unsatisfactory for a number of reasons including being difficult to understand and use, requiring special investigations and not linking through to clinical management options. The pilot study demonstrated consensus between clinicians when using our system. Conclusion: A system has been developed that is easy to learn, use and understand. It can be employed in a busy outpatient setting and produces an acceptable degree of agreement regarding the anatomical nature of varicose veins.
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Affiliation(s)
- J. A. Michaels
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | | | - K. A. Rigby
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | - P. Chan
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | - J. Beard
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | - R. Wood
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | - R.J. Lonsdale
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | - S. Sheriff
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | - S. Palfreyman
- Sheffield Vascular Institute, Northern General Hospital, Sheffield
| | | | | | - J. Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - P. Shackley
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - A. Peters
- Royal Devon and Exeter Hospital, Exeter
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King C, Zamawe C, Banda M, Bar-Zeev N, Beard J, Bird J, Costello A, Kazembe P, Osrin D, Fottrell E. The quality and diagnostic value of open narratives in verbal autopsy: a mixed-methods analysis of partnered interviews from Malawi. BMC Med Res Methodol 2016; 16:13. [PMID: 26830814 PMCID: PMC4736636 DOI: 10.1186/s12874-016-0115-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/23/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Verbal autopsy (VA), the process of interviewing a deceased's family or caregiver about signs and symptoms leading up to death, employs tools that ask a series of closed questions and can include an open narrative where respondents give an unprompted account of events preceding death. The extent to which an individual interviewer, who generally does not interpret the data, affects the quality of this data, and therefore the assigned cause of death, is poorly documented. We aimed to examine inter-interviewer reliability of open narrative and closed question data gathered during VA interviews. METHODS During the introduction of VA data collection, as part of a larger study in Mchinji district, Malawi, we conducted partner interviews whereby two interviewers independently recorded open narrative and closed questions during the same interview. Closed questions were collected using a smartphone application (mobile-InterVA) and open narratives using pen and paper. We used mixed methods of analysis to evaluate the differences between recorded responses to open narratives and closed questions, causes of death assigned, and additional information gathered by open narrative. RESULTS Eighteen partner interviews were conducted, with complete data for 11 pairs. Comparing closed questions between interviewers, the median number of differences was 1 (IQR: 0.5-3.5) of an average 65 answered; mean inter-interviewer concordance was 92% (IQR: 92-99%). Discrepancies in open narratives were summarized in five categories: demographics, history and care-seeking, diagnoses and symptoms, treatment and cultural. Most discrepancies were seen in the reporting of diagnoses and symptoms (e.g., malaria diagnosis); only one pair demonstrated no clear differences. The average number of clinical symptoms reported was 9 in open narratives and 20 in the closed questions. Open narratives contained additional information on health seeking and social issues surrounding deaths, which closed questions did not gather. CONCLUSIONS The information gleaned during open narratives was subject to inter-interviewer variability and contained a limited number of symptom indicators, suggesting that their use for assigning cause of death is questionable. However, they contained rich information on care-seeking, healthcare provision and social factors in the lead-up to death, which may be a valuable source of information for promoting accountable health services.
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Affiliation(s)
- C King
- Institute for Global Health, University College London, 3rd Floor, 30 Guilford Street, London, WC1N 1EH, UK.
| | - C Zamawe
- Parent and Child Health Initiative, Lilongwe, Malawi.
| | - M Banda
- MaiMwana Project, Mchinji, Malawi.
| | - N Bar-Zeev
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi.
- Institute of Infection & Global Health, University of Liverpool, Liverpool, UK.
| | - J Beard
- Institute for Global Health, University College London, 3rd Floor, 30 Guilford Street, London, WC1N 1EH, UK.
- London School of Hygiene and Tropical Medicine, London, UK.
| | - J Bird
- Department of Computer Science, City University London, London, UK.
| | - A Costello
- Institute for Global Health, University College London, 3rd Floor, 30 Guilford Street, London, WC1N 1EH, UK.
| | - P Kazembe
- MaiMwana Project, Mchinji, Malawi.
- Baylor College of Medicine Children's Foundation, Lilongwe, Malawi.
| | - D Osrin
- Institute for Global Health, University College London, 3rd Floor, 30 Guilford Street, London, WC1N 1EH, UK.
| | - E Fottrell
- Institute for Global Health, University College London, 3rd Floor, 30 Guilford Street, London, WC1N 1EH, UK.
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Botten J, Beard J, Zorzi A, Thompson A. A simple intervention to improve antibiotic treatment times for neutropenic sepsis. Acute Med 2016; 15:3-6. [PMID: 27116580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Patients with suspected Neutropenic sepsis require rapid antibiotic administration, but despite extensive education, only 67% of patients received antibiotics within 60 minutes . METHODS A Neutropenic Sepsis Alert Card was created, as a Patient Specific Directive - this allows nurses to administer antibiotics to specific patients without prior medical review. RESULTS Since the intervention, 301 patients presented with suspected neutropenic sepsis. 277 patients (92%) received their first dose of intravenous antibiotics within 1 hour of arrival into hospital, compared to 95 out of 143 patients (67%) presenting between January and June of 2014 (p=0.036). CONCLUSION The Neutropenic Sepsis Alert Card can significantly improve door to antibiotic needle time for chemotherapy patients with suspected neutropenic sepsis. This intervention is inexpensive and easily replicable in other health care organisations.
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Affiliation(s)
- J Botten
- Musgrove Park Hospital, Parkfield Drive, Taunton, Somerset, TA1 5AD
| | - J Beard
- Musgrove Park Hospital, Parkfield Drive, Taunton, Somerset, TA1 5AD
| | - A Zorzi
- Musgrove Park Hospital, Parkfield Drive, Taunton, Somerset, TA1 5AD
| | - A Thompson
- Musgrove Park Hospital, Parkfield Drive, Taunton, Somerset, TA1 5AD
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Onyango MA, Adu-Sarkodie Y, Adjei R, Poku TA, Green K, Wambugu S, Falconer A, Kopelman CH, Beard J. O12.2 Understanding the relationship dynamics between female sex workers and their intimate partners in kumasi, ghana. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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King C, Beard J, Crampin AC, Costello A, Mwansambo C, Cunliffe NA, Heyderman RS, French N, Bar-Zeev N. Methodological challenges in measuring vaccine effectiveness using population cohorts in low resource settings. Vaccine 2015; 33:4748-55. [PMID: 26235370 PMCID: PMC4570930 DOI: 10.1016/j.vaccine.2015.07.062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/07/2015] [Accepted: 07/21/2015] [Indexed: 11/20/2022]
Abstract
We discuss methodological challenges for evaluating vaccine effectiveness using cohorts. No single set of definitions or analytical approach can address all possible biases. Careful consideration of denominator, exposure and outcome definitions is needed. Sensitivity analyses are crucial to examine assumptions and explore subtle relationships.
Post-licensure real world evaluation of vaccine implementation is important for establishing evidence of vaccine effectiveness (VE) and programme impact, including indirect effects. Large cohort studies offer an important epidemiological approach for evaluating VE, but have inherent methodological challenges. Since March 2012, we have conducted an open prospective cohort study in two sites in rural Malawi to evaluate the post-introduction effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against all-cause post-neonatal infant mortality and monovalent rotavirus vaccine (RV1) against diarrhoea-related post-neonatal infant mortality. Our study sites cover a population of 500,000, with a baseline post-neonatal infant mortality of 25 per 1000 live births. We conducted a methodological review of cohort studies for vaccine effectiveness in a developing country setting, applied to our study context. Based on published literature, we outline key considerations when defining the denominator (study population), exposure (vaccination status) and outcome ascertainment (mortality and cause of death) of such studies. We assess various definitions in these three domains, in terms of their impact on power, effect size and potential biases and their direction, using our cohort study for illustration. Based on this iterative process, we discuss the pros and cons of our final per-protocol analysis plan. Since no single set of definitions or analytical approach accounts for all possible biases, we propose sensitivity analyses to interrogate our assumptions and methodological decisions. In the poorest regions of the world where routine vital birth and death surveillance are frequently unavailable and the burden of disease and death is greatest We conclude that provided the balance between definitions and their overall assumed impact on estimated VE are acknowledged, such large scale real-world cohort studies can provide crucial information to policymakers by providing robust and compelling evidence of total benefits of newly introduced vaccines on reducing child mortality.
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Affiliation(s)
- C King
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom.
| | - J Beard
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - A C Crampin
- London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Karonga, Malawi
| | - A Costello
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - C Mwansambo
- MaiMwana Project Mchinji, Parent and Child Health Initiative, Lilongwe, Malawi; Ministry of Health, Lilongwe, Malawi
| | - N A Cunliffe
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - R S Heyderman
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Division of Infection & Immunity, University College London, London, United Kingdom
| | - N French
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - N Bar-Zeev
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
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Calvet D, Mas JL, Algra A, Becquemin JP, Bonati LH, Dobson J, Fraedrich G, Jansen O, Mali WP, Ringleb PA, Chatellier G, Brown MM, Calvet D, Mas JL, Algra A, Becquemin JP, Bonati L, Dobson J, Fraedrich G, Jansen O, Mali W, Ringleb P, Chatellier G, Brown M, Algra A, Becquemin J, Chatellier G, Mas JL, Fraedrich G, Ringleb P, Jansen O, Bonati LH, Brown MM, Mali WP, Mas JL, Chatellier G, Becquemin JP, Bonneville JF, Branchereau A, Crochet D, Gaux JC, Larrue V, Leys D, Watelet J, Hacke W, Hennerici M, Allenberg J, Maurer P, Eckstein HH, Zeumer H, Jansen O, Algra A, Bamford J, Beard J, Bland M, Bradbury A, Brown M, Clifton A, Gaines P, Hacke W, Halliday A, Malik I, Mas JL, McGuire A, Sidhu P, Venables G. Carotid Stenting. Stroke 2014; 45:527-32. [DOI: 10.1161/strokeaha.113.003526] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- David Calvet
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Jean-Louis Mas
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Ale Algra
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Jean-Pierre Becquemin
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Leo H. Bonati
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Joanna Dobson
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Gustav Fraedrich
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Olav Jansen
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Willem P. Mali
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Peter A. Ringleb
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Gilles Chatellier
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - Martin M. Brown
- From the Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France (D.C., J.-L.M.); Department of Neurology and Julius Centre for Health Sciences and Patient Care (A.A.) and Department of Radiology (W.P.M.), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Vascular Surgery, University Hospital Henri Mondor, Creteil, France (J.-P.B.); Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland (L.H.B.)
| | - D. Calvet
- Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France
| | - J.-L. Mas
- Department of Neurology, Hôpital Sainte-Anne, Université Paris Descartes, INSERM UMR894, Paris, France
| | - A. Algra
- Department of Neurology and Julius Centre for Health Sciences and Patient Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - J.-P. Becquemin
- Department of Vascular Surgery, University Hospital Henri Mondor, 94010 Creteil, France
| | - L.H. Bonati
- Department of Neurology and Stroke Unit, University Hospital Basel, Basel, Switzerland; and Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
| | - J. Dobson
- Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - G. Fraedrich
- Department of Vascular Surgery, Medical University, Innsbruck, Austria
| | - O. Jansen
- Department of Neuroradiology, Schleswig-Holstein University Hospital, Kiel, Germany
| | - W.P. Mali
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P.A. Ringleb
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - G. Chatellier
- Clinical Research Unit, Hôpital Européen Georges Pompidou, Université René Descartes, Paris, France
| | - M.M. Brown
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
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Sabin L, Agyarko-Poku T, Rahman YAA, Wambugu S, DeSilva MB, Esang M, Green K, Ashigbie PG, Beard J, Adu-Sarkodie Y. P3.427 Exploring the Beliefs, Attitudes, and Behaviours of MSM Engaged in Substance Use and Transactional Sex in Ghana. Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.0878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Baba-Djara M, Agyarko-Poku T, Opoku KB, Ashigbie PG, Breman A, Corneliess C, Akuoko K, Beard J, Adu-Sarkodie Y. P4.051 Vulnerability to HIV and Prevention Needs of Female Post-Secondary Students Engaged in Transactional Sex in Kumasi, Ghana - A Qualitative Study. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0949] [Citation(s) in RCA: 3] [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: 11/03/2022]
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Spafford C, Oakley C, Beard J. Commentary on 'Availability of supervised exercise programs and the role of structured home-based exercise in peripheral arterial disease'. Eur J Vasc Endovasc Surg 2012; 44:576. [PMID: 23040295 DOI: 10.1016/j.ejvs.2012.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/11/2012] [Indexed: 11/18/2022]
Affiliation(s)
- C Spafford
- STEPS Physiotherapy and Circulation Clinic, 32 Southbourne Road, Sheffield, S10 2QN, UK
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Abbott A, Adelman M, Alexandrov A, Barnett H, Beard J, Bell P, Björck M, Blacker D, Buckley C, Cambria R, Comerota A, Connolly E, Davies A, Eckstein H, Faruqi R, Fraedrich G, Gloviczki P, Hankey G, Harbaugh R, Heldenberg E, Kittner S, Kleinig T, Mikhailidis D, Moore W, Naylor R, Nicolaides A, Paraskevas K, Pelz D, Prichard J, Purdie G, Ricco J, Riles T, Rothwell P, Sandercock P, Sillesen H, Spence J, Spinelli F, Tan A, Thapar A, Veith F, Zhou W. Why the United States Center for Medicare and Medicaid Services (CMS) Should not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting. Eur J Vasc Endovasc Surg 2012; 43:247-51. [DOI: 10.1016/j.ejvs.2011.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 12/05/2011] [Indexed: 11/30/2022]
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Abbott AL, Adelman MA, Alexandrov AB, Barnett HJM, Beard J, Bell P, Björck M, Blacker D, Buckley CJ, Cambria RP, Comerota AJ, Sander E, Davies AH, Eckstein HH, Fraedrich G, Gloviczki P, Hankey GJ, Harbaugh RE, Heldenberg E, Kittner SJ, Kleinig TJ, Mikhailidis DP, Moore WS, Naylor R, Nicolaides A, Paraskevas KI, Pelz DM, Prichard JW, Purdie G, Ricco JB, Riles T, Rothwell P, Sandercock P, Sillesen H, Spence JD, Spinelli F, Tan A, Thapar A, Veith FJ, Zhou W. Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting. INT ANGIOL 2012; 31:85-89. [PMID: 22330629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Andrieu S, Aboderin I, Baeyens JP, Beard J, Benetos A, Berrut G, Brainin M, Cha HB, Chen LK, Du P, Forette B, Forette F, Franco A, Fratiglioni L, Gillette-Guyonnet S, Gold G, Gomez F, Guimaraes R, Gustafson D, Khachaturian A, Luchsinger J, Mangialasche F, Mathiex-Fortunet H, Michel JP, Richard E, Schneider LS, Solomon A, Vellas B. IAGG workshop: health promotion program on prevention of late onset dementia. J Nutr Health Aging 2011; 15:562-75. [PMID: 21808935 DOI: 10.1007/s12603-011-0142-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
IAGG, WHO, and SFGG organized a international workshop on Health promotion programs on prevention of late on-set dementia. Thirty world specialists coming from Europe, North America, Asia, South America, Africa and Australia, shared their experience on methods and results of large epidemiological interventions to reduce incidents of dementia or delay its on-set. Chaired by Laura FRATIGLIONI, an expert in Epidemiological studies on dementia issues, the workshop gave opportunity for discussions and controversies about the state-of-the-art. Based on different national and international trials (ADAPT, MAPT, FINGER, GUDIAGE, GEM etc) the questions remained opened for different aspects of methodology, the choice of domain or multi domain intervention, the choice and the definition of the target populations, the best age of candidates, the issues related to the discrepancy between late effects, and interventions' duration. We are please to publish in the Journal, the presentations presented to this workshop. These publications will complete previously task force published in the journal in the last two years on methodological issues for Alzheimer's trials including end point, biomarkers, and the experience of past therapeutic trials.
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Affiliation(s)
- S Andrieu
- Professor of Public Health at the Toulouse University Hospital and is Head of the Aging and Alzheimer Disease research team, France
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Beard J. Comments regarding ‘Outcome Following Carotid Endarterectomy: Lessons Learned From a Large International Vascular Registry’. Eur J Vasc Endovasc Surg 2011; 41:741. [DOI: 10.1016/j.ejvs.2011.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/09/2011] [Indexed: 10/18/2022]
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Beard J. Comments regarding 'Venous angioplasty is safe to perform and may have benefits forin patients with multiple sclerosis. Results of a pilotcase control pilot study'. Eur J Vasc Endovasc Surg 2011; 43:123. [PMID: 21555227 DOI: 10.1016/j.ejvs.2011.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/31/2011] [Indexed: 10/18/2022]
Affiliation(s)
- J Beard
- Sheffield Vascular Institute, Herries Road, Sheffield S5 7AU, UK.
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Rolland Y, Aquino JP, Andrieu S, Beard J, Benetos A, Berrut G, Coll-Planas L, Dartigues JF, Dong B, Forette F, Franco A, Franzoni S, Hornez T, Metais P, Ruault G, Stephan E, Swagerty D, Tolson D, Volicer L, Vellas B, Morley J. Identification of the main domains for quality of care and clinical research in nursing homes. J Nutr Health Aging 2011; 15:410-24. [PMID: 21528170 DOI: 10.1007/s12603-011-0091-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y Rolland
- Department of Geriatric Medicine, Toulouse University Hospital, Toulouse, France
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Beard J. THE ACTION OF TRYPSIN UPON THE LIVING CELLS OF JENSEN'S MOUSE-TUMOUR: A Preliminary Note upon a Research made (with a Grant from the Carnegie Trust). Br Med J 2011; 1:140-1. [PMID: 20762488 DOI: 10.1136/bmj.1.2351.140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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41
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Al-Jundi W, Durham-Hall A, Oakley E, Beard J. Intraoperative Buttock Ischemia with Postoperative Necrosis following Infrainguinal Bypass Surgery. Eur J Vasc Endovasc Surg 2010. [DOI: 10.1016/j.ejvs.2009.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yang T, Wu J, Rockett I, Abdullah A, Beard J, Ye J. Smoking patterns among Chinese rural–urban migrant workers. Public Health 2009; 123:743-9. [DOI: 10.1016/j.puhe.2009.09.021] [Citation(s) in RCA: 42] [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: 07/23/2009] [Revised: 09/16/2009] [Accepted: 09/24/2009] [Indexed: 11/26/2022]
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Oakley C, Zwierska I, Tew G, Beard J, Saxton J. Nordic poles immediately improve walking distance in claudicants. Br J Surg 2009. [DOI: 10.1002/bjs.6541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C Oakley
- Sheffield Hallam University and Vascular Institute, Sheffield
| | - I Zwierska
- Sheffield Hallam University and Vascular Institute, Sheffield
| | - G Tew
- Sheffield Hallam University and Vascular Institute, Sheffield
| | - J Beard
- Sheffield Hallam University and Vascular Institute, Sheffield
| | - J Saxton
- Sheffield Hallam University and Vascular Institute, Sheffield
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Khan MA, Beard J. Peripheral Vascular Disease in an Individual with Pseudoxanthoma Elasticum. Eur J Vasc Endovasc Surg 2007; 34:590-1. [PMID: 17543555 DOI: 10.1016/j.ejvs.2007.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Accepted: 04/03/2007] [Indexed: 10/23/2022]
Affiliation(s)
- M A Khan
- Sheffield Vascular Institute, Northern General Hospital, Sheffield, UK
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Khan MA, Beard J, Delbridge M. Ischaemic rest pain of the head: a case report. Eur J Vasc Endovasc Surg 2007; 35:11-2. [PMID: 17714963 DOI: 10.1016/j.ejvs.2007.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Accepted: 06/19/2007] [Indexed: 10/22/2022]
Abstract
A 54-year-old man presented with a 3-year history of rest pain of an ischaemic scalp ulcer. Angiography demonstrated that the only blood supply to his head was the left internal carotid artery. Stenting the left subclavian artery and subsequently allowing flow into his left vertebral artery alleviated his symptoms.
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Affiliation(s)
- M A Khan
- Senior House Officer, Sheffield Vascular Institute, Northern General Hospital, Sheffield, UK
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Roback P, Beard J, Baumann D, Gille C, Henry K, Krohn S, Wiste H, Voskuil M, Rainville C, Rutherford R. A predicted operon map for Mycobacterium tuberculosis. Nucleic Acids Res 2007; 35:5085-95. [PMID: 17652327 PMCID: PMC1976454 DOI: 10.1093/nar/gkm518] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The prediction of operons in Mycobacterium tuberculosis (MTB) is a first step toward understanding the regulatory network of this pathogen. Here we apply a statistical model using logistic regression to predict operons in MTB. As predictors, our model incorporates intergenic distance and the correlation of gene expression calculated for adjacent gene pairs from over 474 microarray experiments with MTB RNA. We validate our findings with known examples from the literature and experimentation. From this model, we rank each potential operon pair by the strength of evidence for cotranscription, choose a classification threshold with a true positive rate of over 90% at a false positive rate of 9.1%, and use it to construct an operon map for the MTB genome.
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Affiliation(s)
- P. Roback
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - J. Beard
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - D. Baumann
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - C. Gille
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - K. Henry
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - S. Krohn
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - H. Wiste
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - M.I. Voskuil
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - C. Rainville
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
| | - R. Rutherford
- Department of Mathematics, Statistics and Computer Science, Center for Interdisciplinary Research and Department of Biology St. Olaf College, Northfield MN 55057, Department of Microbiology, University of Colorado Health Sciences Center, Aurora, CO 80045 and Department of Biology, Seattle University, 901 12th Ave, Seattle, WA 98052, USA
- *To whom correspondence should be addressed.+1 206 296 2501+1 206 296 5634
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Beard J, Morgan G, Earnest A, Summerhayes R, Houlder P, Dunn T. Spatio-temporal Analysis of the Impact of Socioeconomic Status on Admissions for Acute Myocardial Infarction and Related Procedures, in New South Wales, Australia. Epidemiology 2006. [DOI: 10.1097/00001648-200611001-01021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rock G, Berger R, Bormanis J, Giulivi A, ElSaadany S, Afzal M, Beard J, Neurath D, Jones TG. A review of nearly two decades in an autologous blood programme: the rise and fall of activity. Transfus Med 2006; 16:307-11. [PMID: 16999752 DOI: 10.1111/j.1365-3148.2006.00696.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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: 11/29/2022]
Abstract
Autologous blood donation (ABD) has been widely recommended. Data from one of the oldest hospital-based programmes in Canada describe both activities and drawbacks. Data were compared over the nearly two decades of activity that peaked in 1996. A 5-year review of recent activity showed that of the 2410 patients referred for consideration, 1823 (75.64%) were accepted into the programme. Surgical services requested 5825 units of autologous blood. Of these, 3147 units were donated by 1536 patients, 803 units were transfused in the operating room and 558 units were given postoperatively. In total, only 1361 units (43.25%) were transfused. The mean age of the patients was 58 years (median 61 years and mode 69 years). The haemoglobin concentrations before donation were significantly higher, averaging 145.2 g L(-1) before donation and 114.9 g L(-1) immediately before surgery, whereas at the time of discharge, the haemoglobin concentration averaged 126.2 g L(-1) (P = 0.0001) in transfused patients. Data from this well-established ABD programme indicate less than 50% overall utilization. The activity in the programme increased until 1996 following which it dropped progressively. The low haemoglobin concentration after surgery is of concern and should foster a transfusion algorithm for these patients.
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Affiliation(s)
- G Rock
- University of Ottawa, Ottawa, ON, Canada.
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Choksy SA, Lee Chong P, Smith C, Ireland M, Beard J. A randomised controlled trial of the use of a tourniquet to reduce blood loss during transtibial amputation for peripheral arterial disease. Eur J Vasc Endovasc Surg 2006; 31:646-50. [PMID: 16750790 DOI: 10.1016/j.ejvs.2006.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Accepted: 03/08/2006] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the effects of an exsanguination tourniquet on blood loss during transtibial amputation in patients with peripheral arterial disease (PAD). DESIGN Prospective randomised blinded controlled trial. MATERIALS AND METHODS Sixty-four patients undergoing transtibial amputation for non-reconstructible PAD were randomised to either tourniquet or no tourniquet (control). Blood loss (primary outcome), fall in haemoglobin, transfusion requirements, wound healing, breakdown and revision (secondary outcomes) were also recorded. RESULTS Twenty-five patients in the tourniquet and 29 in the control group conformed to the trial protocol and completed the follow up. Intra-operative blood loss (median and IQR) was significantly greater in the control group compared to the tourniquet group (550 ml (255-1050) vs 255 ml (150-572.5), respectively, p=0.014, Mann-Whitney). There was a significantly greater drop in haemoglobin concentration (median and IQR) in the control compared to the tourniquet group (1.8 g/dl (0-1.2) vs 1.0 g/dl (0.6-2.4), p=0.035, t-test). Transfusion requirements were lower in the tourniquet group (p=0.05, Mann-Whitney). The rate of wound healing, breakdown and revision were similar in the tourniquet and control groups, respectively (59 vs 57%, 0 vs 9%, 14 vs 9%, p=NS). CONCLUSIONS The use of a tourniquet during transtibial amputation for severe PAD reduces blood loss and need for blood transfusion.
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Affiliation(s)
- S A Choksy
- Sheffield Vascular Institute, Northern General Hospital, Sheffield S5 7AU, UK
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Lincoln D, Morgan G, Sheppeard V, Jalaludin B, Corbett S, Beard J. Childhood asthma and return to school in Sydney, Australia. Public Health 2006; 120:854-62. [PMID: 16904142 DOI: 10.1016/j.puhe.2006.05.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2005] [Accepted: 05/17/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To describe the seasonal pattern of hospital admissions for childhood asthma in Sydney, Australia and investigate the relationship between these admissions and time of return to school. STUDY DESIGN Time-series analysis of daily hospital admissions for childhood asthma in Sydney from 1994 to 2000. METHODS We defined the time series of all asthma-related hospital admissions in Sydney between 1994 and 2000 for age groups 1-4 and 5-14 years. We analysed the time series for each age group using a generalized additive model with a log-link function, an offset term and quasi-likelihood estimation. Daily admissions were modelled using penalised regression splines adjusting for long term trends, school terms and holidays, weekday and influenza epidemics. RESULTS After adjusting for potential confounding, the risk of asthma admission increased to a peak between 2 and 4 weeks after the first day of school in each term and varied between 1.5 and 3 times the risk prior to return to school for both age groups. The largest increase in asthma risk occurring in term one after the long summer holiday. The increase in admission risk began soon after the first day of school of each term for school age children 5-14 years, but not in pre-school age children 1-4 years. CONCLUSIONS Returning to school after term holidays is strongly associated with increased risk of hospital admissions for asthma in children, especially following the long summer holiday. Preventive measures focused on return to school have the potential to substantially decrease admissions for asthma in children.
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Affiliation(s)
- D Lincoln
- Cancer and Population Studies Group, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Herston QLD 4029, Australia.
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