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Celaya MF, Madhivanan P, McClelland J, Zahlan A, Rock C, Nathan A, Acharya A. Individual and community-level risk factors for maternal morbidity and mortality among Native American women in the USA: protocol for systematic review. BMJ Open 2023; 13:e072671. [PMID: 38159960 PMCID: PMC10759105 DOI: 10.1136/bmjopen-2023-072671] [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: 02/10/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Incidents of maternal morbidity and mortality (MMM) continue to rise in the USA. Significant racial and ethnic health inequities exist, with Native American (NA) women being three to four times more likely to die than white, non-Hispanic women, and three to five times more likely to experience an incident of severe maternal morbidity. Few studies have identified individual and community-level risk factors of MMM experienced by NA women. Therefore, this systematic review will identify said risk factors of MMM experienced by NA women in the USA. METHODS AND ANALYSIS This systematic review will be conducted according to the Cochrane Handbook for Systematic Reviews, and the findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The search strategy will include searches from electronic databases: PUBMED, EMBASE, CINAHL and SCOPUS, from 1 January 2012 to 10 October 2022. The search strategy will include terms related to the search concepts: 'maternal', 'Native American' and 'MMM'. Bibliographies of selected articles, previously published reviews and high-yield journals will also be searched. All included papers will be evaluated for quality and bias using NIH Quality Assessment Tools for Observational Studies. A description of the study findings will be presented in a tabular format organised by outcome of interest along with study characteristics. ETHICS AND DISSEMINATION There are no formal ethics approvals needed for this protocol. The findings of this systematic review will be shared with academic, governmental, community-based, institutes and NA (tribal) entities via a published peer-reviewed article, informational brief, poster and oral presentations. PROSPERO REGISTRATION NUMBER CRD42022363405.
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Affiliation(s)
- Martín F Celaya
- Bureau of Assessment and Evaluation, Arizona Department of Health Services, Phoenix, Arizona, USA
- Health Promotion Sciences, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Purnima Madhivanan
- Health Promotion Sciences, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Jean McClelland
- Health Sciences Library, The University of Arizona, Tucson, Arizona, USA
| | - Alaa Zahlan
- Health Promotion Sciences, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | | | | | - Aishwarya Acharya
- Health Promotion Sciences, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
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Okusanya BO, Lott BE, Ehiri J, McClelland J, Rosales C. Medical Cannabis for the Treatment of Migraine in Adults: A Review of the Evidence. Front Neurol 2022; 13:871187. [PMID: 35711271 PMCID: PMC9197380 DOI: 10.3389/fneur.2022.871187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Medical cannabis (MC) has been hypothesized as an alternative therapy for migraines, given the undesirable side effects of current migraine medications. The objective of this review was to assess the effectiveness and safety of MC in the treatment of migraine in adults. Methods We searched PubMed, EMBASE, PsycINFO, CINAHL, and Web of Science for eligible studies in adults aged 18 years and older. Two reviewers independently screened studies for eligibility. A narrative synthesis of the included studies was conducted. Results A total of 12 publications involving 1,980 participants in Italy and the United States of America were included. Medical cannabis significantly reduced nausea and vomiting associated with migraine attacks after 6 months of use. Also, MC reduced the number of days of migraine after 30 days, and the frequency of migraine headaches per month. MC was 51% more effective in reducing migraines than non-cannabis products. Compared to amitriptyline, MC aborted migraine headaches in some (11.6%) users and reduced migraine frequency. While the use of MC for migraines was associated with the occurrence of medication overuse headaches (MOH), and the adverse events were mostly mild and occurred in 43.75% of patients who used oral cannabinoid preparations. Conclusions There is promising evidence that MC may have a beneficial effect on the onset and duration of migraine headaches in adults. However, well-designed experimental studies that assess MC's effectiveness and safety for treating migraine in adults are needed to support this hypothesis.
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Affiliation(s)
- Babasola O Okusanya
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Breanne E Lott
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jean McClelland
- Health Sciences Library, University of Arizona, Tucson, AZ, United States
| | - Cecilia Rosales
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, United States
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Nikou P, Nisbet A, Thompson A, Gulliford S, McClelland J. PO-1492 Characterising anatomical changes of head and neck cancer patients during radiotherapy treatment. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03456-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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4
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Jackson C, Allington L, Chang Y, McClelland J, Gulliford S. PO-1976 Has the Covid-19 Pandemic increased willingness to engage with remote collection of outcome data? Radiother Oncol 2021. [PMCID: PMC8629146 DOI: 10.1016/s0167-8140(21)08427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Hermanski A, McClelland J, Pearce-Walker J, Ruiz J, Verhougstraete M. The effects of blue spaces on mental health and associated biomarkers. International Journal of Mental Health 2021. [DOI: 10.1080/00207411.2021.1910173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Andrew Hermanski
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jean McClelland
- Health Promotion Sciences Department, University of Arizona Health Sciences, Tucson, Arizona, USA
| | - Jennifer Pearce-Walker
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - John Ruiz
- College of Science, University of Arizona, Tucson, Arizona, USA
| | - Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
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6
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Dong Y, Kumar H, Tawhai M, Veiga C, Szmul A, Landau D, McClelland J, Lao L, Burrowes KS. In Silico Ventilation Within the Dose-Volume is Predictive of Lung Function Post-radiation Therapy in Patients with Lung Cancer. Ann Biomed Eng 2020; 49:1416-1431. [PMID: 33258090 PMCID: PMC8058012 DOI: 10.1007/s10439-020-02697-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022]
Abstract
Lung cancer is a leading cause of death worldwide. Radiation therapy (RT) is one method to treat this disease. A common side effect of RT for lung cancer is radiation-induced lung damage (RILD) which leads to loss of lung function. RILD often compounds pre-existing smoking-related regional lung function impairment. It is difficult to predict patient outcomes due to large variability in individual response to RT. In this study, the capability of image-based modelling of regional ventilation in lung cancer patients to predict lung function post-RT was investigated. Twenty-five patient-based models were created using CT images to define the airway geometry, size and location of tumour, and distribution of emphysema. Simulated ventilation within the 20 Gy isodose volume showed a statistically significant negative correlation with the change in forced expiratory volume in 1 s 12-months post-RT (p = 0.001, R = - 0.61). Patients with higher simulated ventilation within the 20 Gy isodose volume had a greater loss in lung function post-RT and vice versa. This relationship was only evident with the combined impact of tumour and emphysema, with the location of the emphysema relative to the dose-volume being important. Our results suggest that model-based ventilation measures can be used in the prediction of patient lung function post-RT.
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Affiliation(s)
- Yu Dong
- Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand
| | - H Kumar
- Auckland Bioengineering Institute, Level 6, 70 Symonds Street, Auckland, 1010, New Zealand
| | - M Tawhai
- Auckland Bioengineering Institute, Level 6, 70 Symonds Street, Auckland, 1010, New Zealand
| | - C Veiga
- Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering, University College London, London, UK
| | - A Szmul
- Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering, University College London, London, UK
| | - D Landau
- Department of Oncology, University College London Hospital, London, UK
| | - J McClelland
- Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering, University College London, London, UK
| | - L Lao
- Auckland District Health Board, Auckland, New Zealand
| | - K S Burrowes
- Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand. .,Auckland Bioengineering Institute, Level 6, 70 Symonds Street, Auckland, 1010, New Zealand.
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Hussein M, McClelland J, Speight R, Clark C. PO-1635: How do UK centres clinically use, commission, and QA deformable image registration? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01653-4] [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: 11/28/2022]
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Palmer K, Rivers P, Melton F, McClelland J, Hatcher J, Marrero DG, Thomson C, Garcia DO. Protocol for a systematic review of health promotion interventions for African Americans delivered in US barbershops and hair salons. BMJ Open 2020; 10:e035940. [PMID: 32341046 PMCID: PMC7204845 DOI: 10.1136/bmjopen-2019-035940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION African American adults are disproportionately burdened by chronic diseases, particularly at younger ages. Developing culturally appropriate interventions is paramount to closing the gap in these health inequities. The purpose of this systematic review is to critically evaluate health promotion interventions for African Americans delivered in two environments that are frequented by this population: barbershops and hair salons. Characteristics of effective interventions will be identified and evidence for the effectiveness of these interventions will be provided. Results of this review will inform future health promotion efforts for African Americans particularly focused on the leading health inequities in obesity-related chronic diseases: cardiovascular disease, cancer and type 2 diabetes. METHODS AND ANALYSIS Subject headings and keywords will be used to search for synonyms of 'barbershops,' 'hair salons' and 'African Americans' to identify all relevant articles (from inception onwards) in the following databases: Academic Search Ultimate, Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO, PubMed, Web of Science (Science Citation Index and Social Sciences Citation Index) and ProQuest Dissertations. Experimental and quasi-experimental studies for adult (>18 years) African Americans delivered in barbershops and hair salons will be included. Eligible interventions will include risk reduction/management of obesity-related chronic disease: cardiovascular disease, cancer and type 2 diabetes. Two reviewers will independently screen, select and extract data and a third will mediate disagreements. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. Quality and content of the evidence will be narratively synthesised. ETHICS AND DISSEMINATION Since this is a protocol for a systematic review, ethical approval is not required. Findings from the review will be widely disseminated through conference presentations, peer-reviewed publications and traditional and social media outlets.
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Affiliation(s)
- Kelly Palmer
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Patrick Rivers
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Forest Melton
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jean McClelland
- Health Sciences Library, University of Arizona Arizona Health Sciences Center, Tucson, Arizona, USA
| | - Jennifer Hatcher
- Division of Public Health Practice and Translational Research, University of Arizona, Phoenix, Arizona, USA
| | - David G Marrero
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Cynthia Thomson
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - David O Garcia
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, Arizona, USA
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Green B, Lin M, McClelland J, Semciw A, Schache A, Rotstein A, Cook J, Pizzari T. Which factors are predictive of return to play and re-injury following calf muscle strain injury? J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Johnston P, Feller J, McClelland J, Webster K. Comparison of quadriceps and hamstring tendon grafts for anterior cruciate ligament reconstruction surgery. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
INTRODUCTION Victims of intimate partner violence (IPV), or those individuals susceptible to IPV victimisation or perpetration, may benefit from participation in primary, secondary or tertiary interventions to address or mitigate exposure to violence despite mixed evidence of IPV intervention effectiveness. However, participation in such programmes is limited by poor access, sociocultural barriers and programme cost. As the world fast approaches universal access to the internet, web-based technologies and low-cost smartphones, new avenues to provide preventive health services including mobile health (mHealth) tools, platforms and services have emerged. The objective of this systematic review is to assess current web-based and mHealth interventions, which include web-based or mobile-based delivery methods for IPV prevention. Interpersonal violence is defined as perpetration or victimisation of a physical, psychological or sexual nature among adults. Interventions may be at the primary, secondary or tertiary level of the public health model. METHODS AND ANALYSIS This systematic review will incorporate studies focused on any empirical prevention intervention intended for IPV victims or perpetrators of any gender where one or more components is web based or mobile based. Articles will be retrieved from the following academic databases: MEDLINE/PubMed, Embase, CINAHL, PsycInfo and Open Grey, as well Google Scholar. Results will be limited to articles reporting primary data, published since 1998, and in English, Spanish, Portuguese or French. Data extraction procedures will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. The Mixed Methods Appraisal Tool, a critical appraisal tool, will be used to record ratings of quality and risk of bias among studies selected for inclusion. Content analysis and between-study comparisons will be used to answer the objectives of this review. ETHICS AND DISSEMINATION Results from this review will be published in an open access format for the benefit of both academic and non-academic audiences, including community organisations and individuals seeking mHealth strategies to reduce and prevent IPV. TRIAL REGISTRATION NUMBER CRD42019123006.
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Affiliation(s)
| | - Jean McClelland
- Arizona Health Sciences Center, University of Arizona, Tucson, Arizona, USA
| | | | - Keegan C Krause
- College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - David O Garcia
- College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Mary P Koss
- College of Public Health, University of Arizona, Tucson, Arizona, USA
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Green R, Pizzari T, McClelland J, Zacharias A, Huynh P, Weerakkody N, Semciw A. Between session reliability of intramuscular electromyography for segments of gluteus medius and minimus during gait and stepping tasks. J Electromyogr Kinesiol 2019; 47:96-104. [DOI: 10.1016/j.jelekin.2019.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 11/17/2022] Open
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13
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Dong Y, Tawhai M, Veiga C, Doel T, Landau D, McClelland J, Burrowes K. PO-0948 Predicting lung function post-RT in lung cancer using multivariate and principal component analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31368-4] [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: 10/26/2022]
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14
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Akintonde A, Grimes H, Moinuddin S, Sharma R, McClelland J, Thielemans K. EP-2067 Data driven region of interest respiratory surrogate signal extraction from CBCT data. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32487-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Hunt S, Thomas S, McClelland J, Harrison K, Rose C, Scaife J, Sutcliffe M, Burnet N, Jena R. EP-2038 Use of deformable image registration for automatic outlining of the rectum. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32458-2] [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: 10/26/2022]
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16
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Paganelli C, Whelan B, Peroni M, Summers P, Fast M, van de Lindt T, McClelland J, Eiben B, Keall P, Lomax T, Riboldi M, Baroni G. MRI-guidance for motion management in external beam radiotherapy: current status and future challenges. Phys Med Biol 2018; 63:22TR03. [PMID: 30457121 DOI: 10.1088/1361-6560/aaebcf] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
High precision conformal radiotherapy requires sophisticated imaging techniques to aid in target localisation for planning and treatment, particularly when organ motion due to respiration is involved. X-ray based imaging is a well-established standard for radiotherapy treatments. Over the last few years, the ability of magnetic resonance imaging (MRI) to provide radiation-free images with high-resolution and superb soft tissue contrast has highlighted the potential of this imaging modality for radiotherapy treatment planning and motion management. In addition, these advantageous properties motivated several recent developments towards combined MRI radiation therapy treatment units, enabling in-room MRI-guidance and treatment adaptation. The aim of this review is to provide an overview of the state-of-the-art in MRI-based image guidance for organ motion management in external beam radiotherapy. Methodological aspects of MRI for organ motion management are reviewed and their application in treatment planning, in-room guidance and adaptive radiotherapy described. Finally, a roadmap for an optimal use of MRI-guidance is highlighted and future challenges are discussed.
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Affiliation(s)
- C Paganelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy. Author to whom any correspondence should be addressed. www.cartcas.polimi.it
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Green B, McClelland J, Semciw A, Pizzari T. Calf strain injuries in elite Australian rules football: Epidemiological features, muscles injured and return to play. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Veiga C, Landau D, Devaraj A, Doel T, Ngai Y, Hawkes D, McClelland J. Objective CT-Based Imaging Biomarkers of Radiation-Induced Lung Damage. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Rabusin C, Menz H, McClelland J, Evans A, Landorf K, Malliaris P, Docking S, Munteanu S. Efficacy of heel lifts in the treatment of mid-portion Achilles tendinopathy: A randomised trial. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chuang C, Xu R, Li X, Royle G, McClelland J. OC-0525: An evaluation of vocal instruction for external respiratory motion using kernel density estimation. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30835-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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21
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Pizzari T, McClelland J, Semciw A. Inducing slight hip discomfort reduces hip extension in gait. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.09.291] [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]
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22
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Veiga C, Landau D, Devaraj A, Doel T, Hawkes D, McClelland J. Quantification of Radiation Therapy-Induced Diaphragmatic Changes Using Serial CT Imaging. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.045] [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: 10/18/2022]
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23
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Guerreiro F, Burgos N, Dunlop A, Wong K, Petkar I, Nutting C, Harrington K, Bhide S, Newbold K, Dearnaley D, deSouza NM, Morgan VA, McClelland J, Nill S, Cardoso MJ, Ourselin S, Oelfke U, Knopf AC. Evaluation of a multi-atlas CT synthesis approach for MRI-only radiotherapy treatment planning. Phys Med 2017; 35:7-17. [PMID: 28242137 PMCID: PMC5368286 DOI: 10.1016/j.ejmp.2017.02.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/27/2017] [Accepted: 02/14/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Computed tomography (CT) imaging is the current gold standard for radiotherapy treatment planning (RTP). The establishment of a magnetic resonance imaging (MRI) only RTP workflow requires the generation of a synthetic CT (sCT) for dose calculation. This study evaluates the feasibility of using a multi-atlas sCT synthesis approach (sCTa) for head and neck and prostate patients. MATERIAL AND METHODS The multi-atlas method was based on pairs of non-rigidly aligned MR and CT images. The sCTa was obtained by registering the MRI atlases to the patient's MRI and by fusing the mapped atlases according to morphological similarity to the patient. For comparison, a bulk density assignment approach (sCTbda) was also evaluated. The sCTbda was obtained by assigning density values to MRI tissue classes (air, bone and soft-tissue). After evaluating the synthesis accuracy of the sCTs (mean absolute error), sCT-based delineations were geometrically compared to the CT-based delineations. Clinical plans were re-calculated on both sCTs and a dose-volume histogram and a gamma analysis was performed using the CT dose as ground truth. RESULTS Results showed that both sCTs were suitable to perform clinical dose calculations with mean dose differences less than 1% for both the planning target volume and the organs at risk. However, only the sCTa provided an accurate and automatic delineation of bone. CONCLUSIONS Combining MR delineations with our multi-atlas CT synthesis method could enable MRI-only treatment planning and thus improve the dosimetric and geometric accuracy of the treatment, and reduce the number of imaging procedures.
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Affiliation(s)
- F Guerreiro
- Faculty of Sciences, University of Lisbon, Campo Grande, Portugal; Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom.
| | - N Burgos
- Translational Imaging Group, Centre for Medical Imaging Computing, University College London, London, United Kingdom.
| | - A Dunlop
- Royal Marsden Hospital, London, United Kingdom
| | - K Wong
- Royal Marsden Hospital, London, United Kingdom
| | - I Petkar
- Royal Marsden Hospital, London, United Kingdom
| | - C Nutting
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - K Harrington
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - S Bhide
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - K Newbold
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - D Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - N M deSouza
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - V A Morgan
- Royal Marsden Hospital, London, United Kingdom
| | - J McClelland
- Centre for Medical Image Computing, Dept. Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - S Nill
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - M J Cardoso
- Translational Imaging Group, Centre for Medical Imaging Computing, University College London, London, United Kingdom
| | - S Ourselin
- Translational Imaging Group, Centre for Medical Imaging Computing, University College London, London, United Kingdom
| | - U Oelfke
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - A C Knopf
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
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McClelland J, Maes M, Feller J, Webster K. Single limb landing from different directions in young athletes after anterior cruciate ligament reconstruction. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Johnston P, McClelland J, Feller J, Webster K. Hip and knee kinematics during successful and failed single leg landings in anterior cruciate ligament reconstructed subjects. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2016.12.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McClelland J, Webster K, Whitehead T, Feller J. Altered trunk movements during landing in people with anterior cruciate ligament reconstruction. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Giles L, McClelland J, Webster K, Cook J. Atrophy of the quadriceps is not isolated to vastus medialis oblique in patellofemoral pain. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Alves Da Rocha P, McClelland J, Morris ME. Complementary physical therapies for movement disorders in Parkinson's disease: a systematic review. Eur J Phys Rehabil Med 2015; 51:693-704. [PMID: 26138090] [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: 06/04/2023]
Abstract
BACKGROUND The growth and popularity of complementary physical therapies for Parkinson's disease (PD) attempt to fill the gap left by conventional exercises, which does not always directly target wellbeing, enjoyment and social participation. AIM To evaluate the effects of complementary physical therapies on motor performance, quality of life and falls in people living with PD. DESIGN Systematic review with meta-analysis. POPULATION Outpatients--adults diagnosed with idiopathic PD, male or female, modified Hoehn and Yahr scale I-IV, any duration of PD, any duration of physical treatment or exercise. METHODS Randomized controlled trials, non-randomized controlled trials and case series studies were identified by systematic searching of health and rehabilitation electronic databases. A standardized form was used to extract key data from studies by two independent researchers. RESULTS 1210 participants from 20 randomized controlled trials, two non-randomized controlled trials and 13 case series studies were included. Most studies had moderately strong methodological quality. Dancing, water exercises and robotic gait training were an effective adjunct to medical management for some people living with PD. Virtual reality training, mental practice, aerobic training, boxing and Nordic walking training had a small amount of evidence supporting their use in PD. CONCLUSION On balance, alternative physical therapies are worthy of consideration when selecting treatment options for people with this common chronic disease. CLINICAL REHABILITATION IMPACT Complementary physical therapies such as dancing, hydrotherapy and robotic gait training appear to afford therapeutic benefits, increasing mobility and quality of life, in some people living with PD.
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Affiliation(s)
- P Alves Da Rocha
- Department of Physiotherapy, College Science Health and Engineering, School Allied Health, La Trobe University, Bundoora, Australia -
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McClelland J, Modat M, Champion B, Kaza E, Collins D, Leach M, Hawkes D. EP-1492: A framework combining image registration, respiratory motion models, and motion compensated image reconstruction. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41484-7] [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: 10/23/2022]
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Veiga C, McClelland J, Moinuddin S, Ricketts K, Modat M, Ourselin S, D'Souza D, Royle G. Towards adaptive radiotherapy for head and neck patients: validation of an in-house deformable registration algorithm. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/1742-6596/489/1/012083] [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: 11/12/2022]
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Giles L, Webster K, McClelland J, Cook J. Can diagnostic ultrasound measure quadriceps size and vastus medialis to vastus lateralis ratio in patellofemoral pain syndrome? J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Veiga C, McClelland J, Moinuddin S, Ricketts K, D'Souza D, Royle G. EP-1274: Calculation of the dose of the day using an in-house validated deformable registration algorithm. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33580-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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33
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McClelland J, Suh Y, Ahmad S, Hawkes D. TH-E-218-04: Study of Deformable Registration Based 4DCT Ventilation Imaging Methods. Med Phys 2012. [DOI: 10.1118/1.4736390] [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: 11/07/2022] Open
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34
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Roth H, McClelland J, Modat M, Hampshire T, Boone D, Hu M, Ourselin S, Halligan S, Hawkes D. WE-E-213CD-03: Inverse-Consistent Symmetric Registration of Inner Colon Surfaces Derived from Prone and Supine CT Colonography. Med Phys 2012; 39:3959-3960. [PMID: 28519970 DOI: 10.1118/1.4736159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Robust registration of prone and supine colonie surfaces acquired during CT colonography may lead to faster and more accurate detection of colorectal cancer and polyps. Any directional bias when registering one surface to the other could precipitate incorrect anatomical correspondence and engender reader error. Despite this, non-rigid registration methods are often implemented asymmetrically, which could negatively influence the registration. We aimed to reduce directional bias and so increase robustness by adapting a cylindrical registration algorithm to be both symmetric and inverse-consistent. METHODS The registration task can be simplified by mapping both prone and supine colonie surfaces onto regular cylinders. Spatial correspondence can then be established in cylindrical space using the original surfaces' local shape indices. We implemented a symmetric formulation of the popular non-rigid B-spline image registration method in cylindrical space. A symmetric similarity measure computes the sum of squared differences between both cylindrical representations of prone-to-supine and supine-to-prone directions simultaneously. Inverse consistency of the transformation is enforced by adding an appropriately weighted penalty term to the optimisation function. RESULTS We selected 8 CT colonography patient cases with marked variation in luminal distension and surface morphology. We randomly allocated 4 of these for tuning an optimal set of registration parameters and 4 for validation. The mean inverse-consistency error was reduced by 32% from 4.8mm to 3.2mm by the new symmetric formulation. The mean registration error improved from 8.2mm to 7.3mm for 330 manually chosen reference points on the 4 validation sets. CONCLUSIONS A symmetric formulation of prone and supine surface registration improves the quality of registration. Information from both prone-to-supine and supine-to-prone directions helps enforce convergence towards a more accurate solution due to reduced directional bias. A more robust and accurate registration will facilitate interpretation of CT colonography and has the potential to improve existing computer-aided detection methods. The authors gratefully acknowledge financial support for this work from the NIHR program: “Imaging diagnosis of colorectal cancer: Interventions for efficient and acceptable diagnosis in symptomatic and screening populationsâ€.
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Affiliation(s)
- H Roth
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - J McClelland
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - M Modat
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - T Hampshire
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - D Boone
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - M Hu
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - S Ourselin
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - S Halligan
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
| | - D Hawkes
- Centre for Medical Image Computing.,Centre for Medical Imaging, University College London, London, United Kingdom
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Martin J, McClelland J, Hawkes D. 1214 poster DETERMINATION OF TUMOUR-CENTRE MOTION DURING A CONE-BEAM CT ACQUISITION – A FEASIBILITY STUDY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71336-6] [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]
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37
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Webster K, Santamaria L, McClelland J, Feller J. Effect of fatigue on landing biomechanics following anterior cruciate ligament reconstruction surgery. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2010.10.515] [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]
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38
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Hughes S, Boutland J, Adams M, McClelland J, Deehan C, Hawkes D, Landau D. A study to find a suitable fiducial marker to validate the use of non-rigid registration (NRR) algorithms and 4D-CT motion modelling in lung cancer radiotherapy. Lung Cancer 2009. [DOI: 10.1016/s0169-5002(09)70103-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Colgan R, McClelland J, McQuaid D, Evans PM, Hawkes D, Brock J, Landau D, Webb S. Planning lung radiotherapy using 4D CT data and a motion model. Phys Med Biol 2008; 53:5815-30. [DOI: 10.1088/0031-9155/53/20/017] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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McClelland J, Gao G, Tarte S, Blackall J, Hughes S, Ahmad S, Landau D, Hawkes D. TH-D-332-07: Removing Artifacts From 4DCT Volumes Acquired in Cine Mode Using B-Spline Non-Rigid Registrations. Med Phys 2008. [DOI: 10.1118/1.2962936] [Citation(s) in RCA: 5] [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: 11/07/2022] Open
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41
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Hughes S, McClelland J, Chandler A, Adams M, Boutland J, Withers D, Ahmad S, Blackall J, Tarte S, Hawkes D, Landau D. A Comparison of Internal Target Volume Definition by Limited Four-dimensional Computed Tomography, the Addition of Patient-specific Margins, or the Addition of Generic Margins when Planning Radical Radiotherapy for Lymph Node-positive Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2008; 20:293-300. [DOI: 10.1016/j.clon.2007.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 11/20/2007] [Accepted: 12/03/2007] [Indexed: 10/22/2022]
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42
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Kashani R, Balter J, Kessler M, Hub M, Dong L, Zhang L, Xing L, Xie Y, Hawkes D, Schnabel J, McClelland J, Joshi S. TU-C-M100J-03: Objective Assessment of Deformable Image Registration in Radiotherapy - a Multi-Institution Study. Med Phys 2007. [DOI: 10.1118/1.2761334] [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: 11/07/2022] Open
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43
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McClelland J, Blackall J, Tarte S, Hughes S, Hawkes D. MO-D-L100J-04: Non-Rigid Registration Based Respiratory Motion Models of the Lung Using Two Parameters. Med Phys 2007. [DOI: 10.1118/1.2761214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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44
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McClelland J, Blackall J, Hughes S, Ahmad S, Landau D, Hawkes D. 186 4D models of respiratory motion for use in RT planning and their advantages over 4DCT techniques. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81163-6] [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: 10/23/2022]
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45
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Ahmad S, McClelland J, Chandler A, Blackall J, Hughes S, Hawkes D. 238 Movement of tumour and mediastinal lymph nodes with respiration in patients with non small cell lung cancer (NSCLC). Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81215-0] [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: 10/23/2022]
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Abstract
We discuss laser cooling opportunities in atomic erbium, identifying five J ? J + 1 transitions from the 4f126s2 3H6 ground state that are accessible to common visible and near-infrared continuous-wave tunable lasers. We present lifetime measurements for the 4f11(4Io 15/2)5d5/26s2 (15/2, 5/2)7o state at 11888 cm-1 and the 4f11(4Io 13/2)5d3/26s2 (13/2, 5/2)7o state at 15847 cm-1, showing values of 20 +/- 4 micros and 5.6 +/- 1.4 micros, respectively. We also present a calculated value of 13 +/- 7 s-1 for the transition rate from the 4f11(4Io 15/2)5d3/26s2 (15/2, 3/2)7 o state at 7697 cm-1 to the ground state, based on scaled Hartree-Fock energy parameters. Laser cooling on these transitions in combination with a strong, fast (5.8 ns) laser cooling transition at 401 nm, suggest new opportunities for narrowband laser cooling of a large-magnetic moment atom, with possible applications in quantum information processing, high-precision atomic clocks, quantum degenerate gases, and deterministic single-atom doping of materials.
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Hawkes DJ, Barratt D, Blackall JM, Chan C, Edwards PJ, Rhode K, Penney GP, McClelland J, Hill DLG. Tissue deformation and shape models in image-guided interventions: a discussion paper. Med Image Anal 2004; 9:163-75. [PMID: 15721231 DOI: 10.1016/j.media.2004.11.007] [Citation(s) in RCA: 35] [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] [Indexed: 01/27/2023]
Abstract
This paper promotes the concept of active models in image-guided interventions. We outline the limitations of the rigid body assumption in image-guided interventions and describe how intraoperative imaging provides a rich source of information on spatial location of anatomical structures and therapy devices, allowing a preoperative plan to be updated during an intervention. Soft tissue deformation and variation from an atlas to a particular individual can both be determined using non-rigid registration. Established methods using free-form deformations have a very large number of degrees of freedom. Three examples of deformable models--motion models, biomechanical models and statistical shape models--are used to illustrate how prior information can be used to restrict the number of degrees of freedom of the registration algorithm and thus provide active models for image-guided interventions. We provide preliminary results from applications for each type of model.
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Affiliation(s)
- D J Hawkes
- Division of Imaging Sciences, GKT School of Medicine, King's College London, UK.
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Shaw T, McEvoy M, McClelland J. An Australian survey of in-patient protocols for quadriceps exercises following anterior cruciate ligament reconstruction. J Sci Med Sport 2002; 5:291-6. [PMID: 12585612 DOI: 10.1016/s1440-2440(02)80017-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 10/25/2022]
Abstract
Current practices regarding in-patient strengthening exercise prescription following anterior cruclate ligament (ACL) reconstruction are scarcely addressed in the literature and remain unreported for Australian hospitals. An observational, questionnaire-based study was used to Investigate in-patient quadriceps strengthening practices in Australian hospitals after ACL reconstruction. Questionnaires were returned by 248 hospitals (76% response rate) and of these 88 hospitals reported performing ACL reconstructions. These hospitals were surveyed to determine the types of quadriceps strengthening exercises prescribed during the in-patient period. Information was sought regarding routine management strengthening practices. A variety of quadriceps exercises such as static quadriceps contractions (SQC), straight leg raises (SLR) and inner range quadriceps (IRQ) were frequently prescribed, although no standard practice currently exists. Static quadriceps exercises were prescribed by 91% of hospitals surveyed, IRQ exercises were used by 30%, and 49% reported using SLR exercises. Current literature tends to support the performance of SQC and SLR exercises during the early postoperative period following ACL reconstruction. Conversely, current clinical practice is incongruent with regard to the scientific recommendations for IRQ performance.
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Affiliation(s)
- T Shaw
- School of Physiotherapy, University of South Australia, New South Wales, Australia
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50
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Lal MK, McClelland J, Phillips J, Taub NA, Beattie RM. Comparison of EMLA cream versus placebo in children receiving distraction therapy for venepuncture. Acta Paediatr 2001; 90:154-9. [PMID: 11236044 DOI: 10.1080/080352501300049307] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
UNLABELLED Eutectic mixture of local anaesthetics (EMLA) cream is used routinely as a local anaesthetic prior to venepuncture in children. Despite this, however, a significant proportion of children will still be distressed. Cognitive-behavioural interventions, such as distraction by breathing and blowing exercises, have been used and found to be helpful as alternative coping strategies. There is, however, a paucity of data regarding effectiveness. We have evaluated the efficacy of distraction therapy as a coping strategy before and during venepuncture, and in these children evaluated the need for EMLA using a prospective, randomized, double-blind, placebo-controlled clinical trial. Twenty-eight children attending for venepuncture were recruited, median age 6 y (range 4-8 y), and randomly allocated to receive either EMLA or a placebo cream. All were given distraction therapy prior to and during the procedure by a play specialist. Venepuncture was carried out by one investigator. A modified paediatric pain assessment chart was used for objective pain score at the end of the procedure. After one exclusion, the treatment group (17 children) and the placebo group (10 children) were similar: median age of 6 and 7 y (range 4-8), median baseline and post-procedure heart rate and oxygen saturation. The median (interquartile range) for total pain score in the treatment group was 1 (0 to 4.5) and in the control group 1 (0 to 2.3). There was no significant difference in pain score between the two groups (Mann-Whitney test, p = 0.7). The 95% confidence interval for the difference in pain score was -1.0 to +3.0. CONCLUSIONS The low pain score in both groups suggests the effectiveness of distraction therapy, although factors such as skill of the operator and previous experience of the patient group are of relevance. There was no significant difference in the pain score between the EMLA and placebo groups, suggesting that in this age group if carefully selected children receive distraction during venepuncture EMLA may not be necessary.
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Affiliation(s)
- M K Lal
- Department of Paediatrics, Peterborough District Hospital, UK
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