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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Bolnick J, Roubin S, Burr M, Byrne S. Assessing awareness and compliance with fish consumption advisories on the upper Hudson River: Implications for risk management of the Hudson River Superfund site. Environ Pollut 2023; 334:122125. [PMID: 37390914 DOI: 10.1016/j.envpol.2023.122125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/07/2023] [Accepted: 06/27/2023] [Indexed: 07/02/2023]
Abstract
Polychlorinated biphenyls (PCBs) are a common environmental contaminant. The NYS Department of Health (DOH) issues fish consumption advisories to limit consumption of PCB-contaminated fish. Fish consumption advisories are utilized as institutional controls within the Hudson River Superfund site to limit exposure to PCBs. There is a "Do Not Eat" advisory for all species caught in the upper Hudson River, from Glens Falls, NY to Troy, NY. The section of the river below Bakers Falls also has a catch-and-release regulation issued by the NYS Department of Environmental Conservation. There is limited research on the effectiveness of these advisories in preventing consumption of contaminated fish in the context of Superfund site risk management. We surveyed individuals actively fishing on the upper Hudson River in the area with a "Do Not Eat" advisory, specifically between Hudson Falls and the Federal Dam in Troy, NY. The goal of the survey was to assess knowledge of the consumption guidelines, and if the guidelines are effectively preventing exposure to PCBs. A subset of individuals continue to consume fish caught from the upper Hudson River Superfund site. Awareness of advisories was inversely related to fish consumption from the Superfund site. Age, race, and possession of a fishing license were associated with overall awareness of fish consumption guidelines; age and possession of a license were associated with awareness of the "Do Not Eat" advisory. While institutional controls appear to have a beneficial impact, there is incomplete awareness and compliance with advisories and regulations aimed at preventing exposure to PCBs from fish consumption. Risk assessment and management strategies for contaminated fisheries should consider imperfect adherence to fish consumption guidelines.
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Affiliation(s)
- Jeffrey Bolnick
- Middlebury College, 14 Old Chapel Rd, Middlebury, VT, 05753, USA.
| | - Sam Roubin
- Middlebury College, 14 Old Chapel Rd, Middlebury, VT, 05753, USA
| | - Makenna Burr
- St. Lawrence University, 23 Ramoda Dr, Canton, NY, 13617, USA
| | - Sam Byrne
- Middlebury College, 14 Old Chapel Rd, Middlebury, VT, 05753, USA.
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Byrne S, Cobham V, Richardson M, Imuta K. Do Parents Enhance Cognitive Behavior Therapy for Youth Anxiety? An Overview of Systematic Reviews Over Time. Clin Child Fam Psychol Rev 2023; 26:773-788. [PMID: 37217646 PMCID: PMC10465628 DOI: 10.1007/s10567-023-00436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/24/2023]
Abstract
The last 20 years has seen debate regarding the merits of involving parents in cognitive behavior therapy (CBT) for youth anxiety played out across systematic reviews which have high impact. These reviews examined varying treatment formats in relation to parent involvement, including youth only CBT (Y-CBT), parent only CBT (P-CBT) and family CBT (youth and parent; F-CBT). This is a novel overview of systematic reviews examining evidence for parental involvement in CBT for youth anxiety over the period this was studied. Two independent coders systematically searched for studies in medical and psychological databases using the categories "Review", "Youth", "Anxiety", "Cognitive Behavior Therapy" and "Parent/Family". Of the 2,189 unique articles identified, there were 25 systematic reviews since 2005 which compared the effects of CBT for youth anxiety with varying parent involvement. Despite systematically studying the same phenomenon, the reviews were heterogeneous in outcome, design, inclusion criteria and often had methodological limitations. Of the 25 reviews, 21 found no difference between formats and 22 reviews were considered inconclusive. Yet while there were typically no statistical differences, consistent patterns in the direction of effects were detected over time. P-CBT was less effective than other formats, suggesting the importance of directly treating anxious youths. Early reviews favored F-CBT over Y-CBT, however, later reviews did not show this trend. We consider the effects of moderators including exposure therapy, long-term outcomes and the child's age. We consider how to manage heterogeneity in primary studies and reviews to better detect treatment differences where they exist.Trial registration This protocol is registered with the Open Science Framework: osf.io/2u58t.
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Affiliation(s)
- S Byrne
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.
| | - V Cobham
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
- Parenting and Family Support Centre, University of Queensland, Brisbane, QLD, Australia
| | - M Richardson
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
| | - K Imuta
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
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Stein C, Nassereldine H, Sorensen RJD, Amlag JO, Bisignano C, Byrne S, Castro E, Coberly K, Collins JK, Dalos J, Daoud F, Deen A, Gakidou E, Giles JR, Hulland EN, Huntley BM, Kinzel KE, Lozano R, Mokdad AH, Pham T, Pigott DM, Reiner Jr. RC, Vos T, Hay SI, Murray CJL, Lim SS. Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis. Lancet 2023; 401:833-842. [PMID: 36930674 PMCID: PMC9998097 DOI: 10.1016/s0140-6736(22)02465-5] [Citation(s) in RCA: 113] [Impact Index Per Article: 113.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 02/18/2023]
Abstract
BACKGROUND Understanding the level and characteristics of protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease is essential for predicting future potential disease burden, for designing policies that restrict travel or access to venues where there is a high risk of transmission, and for informing choices about when to receive vaccine doses. We aimed to systematically synthesise studies to estimate protection from past infection by variant, and where data allow, by time since infection. METHODS In this systematic review and meta-analysis, we identified, reviewed, and extracted from the scientific literature retrospective and prospective cohort studies and test-negative case-control studies published from inception up to Sept 31, 2022, that estimated the reduction in risk of COVID-19 among individuals with a past SARS-CoV-2 infection in comparison to those without a previous infection. We meta-analysed the effectiveness of past infection by outcome (infection, symptomatic disease, and severe disease), variant, and time since infection. We ran a Bayesian meta-regression to estimate the pooled estimates of protection. Risk-of-bias assessment was evaluated using the National Institutes of Health quality-assessment tools. The systematic review was PRISMA compliant and was registered with PROSPERO (number CRD42022303850). FINDINGS We identified a total of 65 studies from 19 different countries. Our meta-analyses showed that protection from past infection and any symptomatic disease was high for ancestral, alpha, beta, and delta variants, but was substantially lower for the omicron BA.1 variant. Pooled effectiveness against re-infection by the omicron BA.1 variant was 45·3% (95% uncertainty interval [UI] 17·3-76·1) and 44·0% (26·5-65·0) against omicron BA.1 symptomatic disease. Mean pooled effectiveness was greater than 78% against severe disease (hospitalisation and death) for all variants, including omicron BA.1. Protection from re-infection from ancestral, alpha, and delta variants declined over time but remained at 78·6% (49·8-93·6) at 40 weeks. Protection against re-infection by the omicron BA.1 variant declined more rapidly and was estimated at 36·1% (24·4-51·3) at 40 weeks. On the other hand, protection against severe disease remained high for all variants, with 90·2% (69·7-97·5) for ancestral, alpha, and delta variants, and 88·9% (84·7-90·9) for omicron BA.1 at 40 weeks. INTERPRETATION Protection from past infection against re-infection from pre-omicron variants was very high and remained high even after 40 weeks. Protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants. The immunity conferred by past infection should be weighed alongside protection from vaccination when assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access, on the basis of immune status, to settings where the risk of transmission is high, such as travel and high-occupancy indoor settings. FUNDING Bill & Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.
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L Gleeson L, O'Brien GL, O'Mahony D, Byrne S. Interprofessional communication in the hospital setting : a systematic review of the qualitative literature. J Interprof Care 2023; 37:203-213. [PMID: 35109753 DOI: 10.1080/13561820.2022.2028746] [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: 02/06/2023]
Abstract
Communication plays a key role in the provision of safe patient care, and miscommunication in healthcare can lead to avoidable patient harm or mortality. Interprofessional communication (IPCom) can be challenging due to differences in training, education and roles between healthcare professions. The aim of this systematic review was to synthesize the qualitative evidence regarding healthcare providers' perceptions of interprofessional communication in the hospital setting. Four databases (PubMed, CINAHL, Web of Science, and Embase) were searched for studies that met the inclusion criteria. Eighteen studies were identified as suitable for inclusion in the review and were examined using thematic synthesis. Thematic synthesis led to the development of five descriptive themes: 1) 'Hierarchy", 2) "Interprofessional Ethos," 3) "Healthcare Environment," 4) "Personal Factors" and 5) "Methods of Communication," and two overarching analytical themes: "Barriers to Communication" and "Facilitators to Communication." Personal factors, such as strong interprofessional relationships, were found to be important facilitators to IPCom, while organizational factors, such as challenging and hierarchical working environments, were found to pose barriers to IPCom.
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Affiliation(s)
- Laura L Gleeson
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - G L O'Brien
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - D O'Mahony
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland.,Department of Medicine, School of Medicine, University College Cork, Cork, Ireland
| | - S Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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Gleeson L, McNamara J, Donworth E, Crowley E, Delaney A, Sahm L, O'Mahony D, Russell N, Byrne S. Healthcare provider perceptions of safety culture: A multi-site study using the safety attitudes questionnaire. Explor Res Clin Soc Pharm 2023; 9:100228. [PMID: 36793798 PMCID: PMC9922969 DOI: 10.1016/j.rcsop.2023.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Introduction Patient safety culture, the way in which members of a healthcare organisation think about and prioritise safety, has been linked to positive patient outcomes. The aim of this study was to use the Safety Attitudes Questionnaire (SAQ) to measure the safety culture in a variety of healthcare settings located in the province of Munster of Ireland. Methods The SAQ was applied in six healthcare settings in the Munster province of Ireland between December 2017 and November 2019. The attitudes of healthcare staff towards six domains of safety culture were assessed over 32 Likert-scaled items. The mean, median, interquartile range and percent positive scores for each domain were calculated for the study population, and subgroup analyses were carried out between study sites and professions. Results for each setting were compared to international benchmarking data. Chi-Squared tests were used to determine whether study site or profession were related to domain scores. Reliability analysis was carried out using Cronbach's alpha. Results Study participants (n = 1749) comprising doctors, pharmacists, nurses, and healthcare assistants, were found to have positive attitudes towards patient safety culture but scored poorly in the domains Working Conditions and Perceptions of Management. Perceptions of safety culture were more positive in smaller healthcare settings, and amongst nurses and HCAs. The survey had acceptable internal consistency. Conclusions In this study investigating the safety culture of healthcare organisations in Ireland, study participants had generally positive attitudes towards the safety culture in their organisation, however working conditions, perceptions of management, and medication incident reporting were identified as key areas for improvement.
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Affiliation(s)
- L.L. Gleeson
- School of Pharmacy, University College Cork, Ireland,Corresponding author.
| | - J. McNamara
- School of Pharmacy, University College Cork, Ireland
| | - E. Donworth
- School of Pharmacy, University College Cork, Ireland
| | - E.K. Crowley
- School of Pharmacy, University College Cork, Ireland
| | | | - L. Sahm
- School of Pharmacy, University College Cork, Ireland
| | | | | | - S. Byrne
- School of Pharmacy, University College Cork, Ireland
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Byrne S, Seguinot-Medina S, Waghiyi V, Apatiki E, Immingan T, Miller P, von Hippel FA, Buck CL, Carpenter DO. PFAS and PBDEs in traditional subsistence foods from Sivuqaq, Alaska. Environ Sci Pollut Res Int 2022; 29:77145-77156. [PMID: 35672645 PMCID: PMC9588546 DOI: 10.1007/s11356-022-20757-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
The Arctic is a hemispheric sink for both legacy and current use persistent organic pollutants (POPs). Once in the Arctic, POPs biomagnify in food webs, potentially reaching concentrations in high trophic level animals that pose a health concern for people who subsist on those animals. Indigenous Peoples of the Arctic may be highly exposed to POPs through their traditional diets. The objective of this study was to assess concentrations of polybrominated diphenyl ethers (PBDEs) and per- and polyfluoroalkyl substances (PFAS) in tissues of traditionally harvested foods from Sivuqaq (St. Lawrence Island), Alaska. Community health researchers identified volunteer households and local hunters to donate tissues from traditionally harvested animals. Target species included bowhead whale (Balaena mysticetus), Pacific walrus (Odobenus rosmarus), ringed seal (Pusa hispida), bearded seal (Erignathus barbatus), ribbon seal (Histriophoca fasciata), spotted seal (Phoca largha), and reindeer (Rangifer tarandus). PBDEs were frequently detected in all species and tissues. PBDE concentrations tended to be highest in lipid-rich tissues of seals. PFAS were infrequently detected and did not show obvious patterns among species or tissues. This and other studies demonstrate that POPs such as PBDEs are present in tissues of traditional food animals from Sivuqaq, as they are throughout the Arctic, and consumption of these animals likely contributes to exposure among Arctic Indigenous Peoples.
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Affiliation(s)
- Sam Byrne
- Department of Biology, Global Health Program, Middlebury College, Bicentennial Hall, Bicentennial Way, VT, 05753, Middlebury, USA.
| | | | - Vi Waghiyi
- Alaska Community Action on Toxics, Anchorage, AK, USA
| | | | | | - Pamela Miller
- Alaska Community Action on Toxics, Anchorage, AK, USA
| | - Frank A von Hippel
- Department of Community, Environment & Policy, University of Arizona, Tucson, AZ, USA
| | - Charles Loren Buck
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - David O Carpenter
- Institute for Health and the Environment, University at Albany, Albany, NY, USA
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Coen M, Murphy R, Connolly A, O'Connor A, Doyle E, Byrne S, Carty J, Breen C, Canavan M, Waters R, Robinson S. 225 OLDER PERSONS REHAB AT HOME (OPRAH) INDICATES AN EFFECTIVE ALTERNATIVE PATHWAY TO INPATIENT REHABILITATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Older adults have longer hospital stays, higher incidence of nosocomial complications and higher readmissions rates. Older persons rehabilitation at home (OPRaH) is a novel service developed to provide patients with intensive domiciliary based therapy to regain function, mobility and social care goals. OPRaH offers a comprehensive geriatric and interdisciplinary approach. The model enables a safe and accelerated discharge from acute care to home.
Methods
Patients are identified and screened by a team coordinator. On Discharge to OPRaH the following measures were collected; basic demographics, referral source, clinical frailty score and Functional Independence Measures (FIM). Outcomes evaluated are the FIM change, readmission rates, length of inpatient stay savings and time on the service. Data from the first year of operation was analysed using descriptive statistics.
Results
109 patients have undergone rehabilitation with the service with a median age of 82 years (63-103 range). Over two thirds (68%) were classified as frail, with 44% living alone. An injurious fall was the most common reason for index hospitalisation (50%). Referral source was inpatient acute medical team in 50% of cases, with 21% from acute geriatrics , 13 % ortho geriatrics, 13% surgical. Average functional independence measure scores improved from 89 to 102 (p = 0.007). There was no difference in the magnitude of improvement by frailty status (13 vs 14, p = 0.85). The average length of stay saving was 7 days per case, with a total of 757 days saved in one year. Readmission rate within 30 days was 9.3 %. Participants highly rated the service through structured evaluation.
Conclusion
This novel service provides a valuable intervention to a wide case-mix of older adults with evidence of improvements in formal markers of functional impairment after intervention. Referral was based on definable rehabilitation goals and not just on frailty status, age, or gender.
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Affiliation(s)
- M Coen
- Galway University Hospital , Galway, Ireland
| | - R Murphy
- Galway University Hospital , Galway, Ireland
- National University of Ireland , Galway, Ireland
| | - A Connolly
- Galway University Hospital , Galway, Ireland
| | - A O'Connor
- Galway University Hospital , Galway, Ireland
| | - E Doyle
- Galway University Hospital , Galway, Ireland
| | - S Byrne
- Galway University Hospital , Galway, Ireland
| | - J Carty
- Galway University Hospital , Galway, Ireland
- National University of Ireland , Galway, Ireland
| | - C Breen
- Galway University Hospital , Galway, Ireland
| | - M Canavan
- Galway University Hospital , Galway, Ireland
- National University of Ireland , Galway, Ireland
| | - R Waters
- Galway University Hospital , Galway, Ireland
- National University of Ireland , Galway, Ireland
| | - S Robinson
- Galway University Hospital , Galway, Ireland
- National University of Ireland , Galway, Ireland
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Victorasso Jardim Perassi B, Abrahams D, Irrera P, Whelan C, Beatty M, Byrne S, Longo D, Gaspar K, Pilon-Thomas S, Ibrahim Hashim A, Böhler C, Gillies R. Targeting acidosis to improve immunotherapy in a pancreatic ductal adenocarcinoma model. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01038-3] [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: 11/17/2022]
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Siltari A, Lönnerbro R, Pang K, Shiranov K, Asiimwe A, Evans-Axelsson S, Franks B, Kiran A, Murtola TJ, Schalken J, Steinbeisser C, Bjartell A, Auvinen A, Smith E, N'Dow J, Plass K, Ribal M, Mottet N, Moris L, Lardas M, Van den Broeck T, Willemse PP, Gandaglia G, Campi R, Greco I, Gacci M, Serni S, Briganti A, Crosti D, Meoni M, Garzonio R, Bangma R, Roobol M, Remmers S, Tilki D, Visakorpi T, Talala K, Tammela T, van Hemelrijck M, Bayer K, Lejeune S, Taxiarchopoulou G, van Diggelen F, Senthilkumar K, Schutte S, Byrne S, Fialho L, Cardone A, Gono P, De Vetter M, Ceke K, De Meulder B, Auffray C, Balaur IA, Taibi N, Power S, Kermani NZ, van Bochove K, Cavelaars M, Moinat M, Voss E, Bernini C, Horgan D, Fullwood L, Holtorf M, Lancet D, Bernstein G, Omar I, MacLennan S, Maclennan S, Healey J, Huber J, Wirth M, Froehner M, Brenner B, Borkowetz A, Thomas C, Horn F, Reiche K, Kreux M, Josefsson A, Tandefekt DG, Hugosson J, Huisman H, Hofmacher T, Lindgren P, Andersson E, Fridhammar A, Vizcaya D, Verholen F, Zong J, Butler-Ransohoff JE, Williamson T, Chandrawansa K, Dlamini D, waldeck R, Molnar M, Bruno A, Herrera R, Jiang S, Nevedomskaya E, Fatoba S, Constantinovici N, Maass M, Torremante P, Voss M, Devecseri Z, Cuperus G, Abott T, Dau C, Papineni K, Wang-Silvanto J, Hass S, Snijder R, Doye V, Wang X, Garnham A, Lambrecht M, Wolfinger R, Rogiers S, Servan A, Lefresne F, Caseriego J, Samir M, Lawson J, Pacoe K, Robinson P, Jaton B, Bakkard D, Turunen H, Kilkku O, Pohjanjousi P, Voima O, Nevalaita L, Reich C, Araujo S, Longden-Chapman E, Burke D, Agapow P, Derkits S, Licour M, McCrea C, Payne S, Yong A, Thompson L, Lujan F, Bussmann M, Köhler I. How well do polygenic risk scores identify men at high risk for prostate cancer? Systematic review and meta-analysis. Clin Genitourin Cancer 2022; 21:316.e1-316.e11. [PMID: 36243664 DOI: 10.1016/j.clgc.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Genome-wide association studies have revealed over 200 genetic susceptibility loci for prostate cancer (PCa). By combining them, polygenic risk scores (PRS) can be generated to predict risk of PCa. We summarize the published evidence and conduct meta-analyses of PRS as a predictor of PCa risk in Caucasian men. PATIENTS AND METHODS Data were extracted from 59 studies, with 16 studies including 17 separate analyses used in the main meta-analysis with a total of 20,786 cases and 69,106 controls identified through a systematic search of ten databases. Random effects meta-analysis was used to obtain pooled estimates of area under the receiver-operating characteristic curve (AUC). Meta-regression was used to assess the impact of number of single-nucleotide polymorphisms (SNPs) incorporated in PRS on AUC. Heterogeneity is expressed as I2 scores. Publication bias was evaluated using funnel plots and Egger tests. RESULTS The ability of PRS to identify men with PCa was modest (pooled AUC 0.63, 95% CI 0.62-0.64) with moderate consistency (I2 64%). Combining PRS with clinical variables increased the pooled AUC to 0.74 (0.68-0.81). Meta-regression showed only negligible increase in AUC for adding incremental SNPs. Despite moderate heterogeneity, publication bias was not evident. CONCLUSION Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone.
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Auliffe CM, Hayden D, Kenny J, Byrne S. 153 DIFFERENCES IN POTENTIALLY INAPPROPRIATE PRESCRIBING (PIP) AT DISCHARGE ACCORDING TO FRAILTY STATUS. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Frailty is a key concept in healthcare service planning development for our ageing population. Guidelines recommend that older patients requiring acute hospital care should be routinely assessed for frailty (NCPOP). Potentially Inappropriate Prescribing (PIP) encompasses both over- and under-prescribing and is associated with adverse health outcomes for older persons. The objective of this study was to investigate differences in PIP at discharge of older patients according to frailty status (robust, pre-frail and frail).
Methods: In this retrospective single-centre cohort study, a random sample of older patients (≥75 years) assessed for frailty on admission, was selected. The discharge prescriptions of 150 patients were reviewed using STOPP and START criteria to identify Potentially Inappropriate Medications (PIMs and Potential Prescribing Omissions (PPOs). Drg Burden Index (DBI) scores, a measure of anticholinergic and sedative burden, were calculated for each patient. Data was analysed using descriptive statistics.
Results
There was a significant difference in the mean number of medications between the groups (F = 12.335,p < 0.001), with frailer patients prescribed more medications. Significantly more hyperpolypharmacy (≥10 regular medications) was identified in the frail group (χ2 = 17.378,p < 0.001).
A high prevalence of both PIMs(72%) and PPOs (63.3%) was found, as was a significant difference in the proportion of patients with PPOs according to frailty status (χ2 = 6.507,p = 0.039). The median number of PPOs increased significantly from the robust to pre-frail and frail groups (χ2 = 8.194,p = 0.017).
DBI scores increased significantly from the robust to pre-frail and frail groups (χ2 = 7.389, p = 0.025) and there was a significant difference in the proportion of patients with high DBI exposure (scores≥1) across the groups (χ2 = 6.497,p = 0.039).
Conclusion
Frail patients were on more medications, had more instances of PPOs and a higher anticholinergic and sedative burden than their non-frail counterparts. The results of this study support the use of frailty assessments in identifying patients for targeted medication reviews aimed at reducing PIP.
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Affiliation(s)
- C M Auliffe
- Department of Pharmacy, Tallaght University Hospital , Dublin, Ireland
| | - D Hayden
- Department of Age Related Healthcare, Tallaght University Hospital , Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin , Dublin, Ireland
| | - J Kenny
- Department of Pharmacy, Tallaght University Hospital , Dublin, Ireland
| | - S Byrne
- Pharmaceutical Care Research Group , School of Pharmacy, , Cork, Ireland
- University College Cork , School of Pharmacy, , Cork, Ireland
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O'Riordan F, Shiely F, Byrne S, O'Brien D, Ronayne A, Fleming A. Antimicrobial use and antimicrobial resistance in Enterobacterales and Enterococcus faecium: a time series analysis. J Hosp Infect 2021; 120:57-64. [PMID: 34780809 DOI: 10.1016/j.jhin.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Irish and European antimicrobial resistance (AMR) surveillance data have highlighted increasing AMR in Enterobacterales and vancomycin resistance in Enterococcus faecium (VRE). Antimicrobial consumption (AC) in Irish hospital settings is also increasing. METHODS A retrospective time series analysis (TSA) was conducted to evaluate the trends and possible relationship between AC of selected antimicrobials and AMR in Enterobacterales and vancomycin resistance in E. faecium, from January 2017 to December 2020. RESULTS Increased AC was seen with ceftriaxone (p= 0.0006), piperacillin/tazobactam (p = 0.03) and meropenem (p = 0.05), while ciprofloxacin and gentamicin use trended downwards. AMR rates in E. coli, K. pneumoniae and other Enterobacterales were largely stable, an increase in ertapenem resistance in the latter from 0.58% in 2017 to 5.19% in 2020 (p= 0.003) being the main concern. The proportion of E. faecium that was VRE did not changed significantly (64% in 2017; 53% in 2020, p = 0.1). TSA identified a correlation between piperacillin/tazobactam use and the decreasing rate of ceftriaxone resistance in E. coli. CONCLUSION Our data suggest that hospital antimicrobial stewardship programme is largely containing, but not reducing AMR in key nosocomial pathogens. An increase in AC following the COVID-19 pandemic appears as yet to have had no impact on AMR rates.
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Affiliation(s)
- F O'Riordan
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland; Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
| | - F Shiely
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland; School of Public Health, University College Cork, Cork, Ireland
| | - S Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - D O'Brien
- Department of Microbiology, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - A Ronayne
- Department of Microbiology, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - A Fleming
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland; Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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Hayes-Ryan D, Meaney S, Byrne S, Ramphul M, O'Dwyer V, Cooley S. Womens experience of Manual Vacuum Aspiration: An Irish perspective. Eur J Obstet Gynecol Reprod Biol 2021; 266:114-118. [PMID: 34624739 DOI: 10.1016/j.ejogrb.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Manual Vacuum Aspiration (MVA) is a well-established management option for early pregnancy loss or early termination of pregnancy. MVA is performed as out-patient surgical procedure using local anaesthetic whereby aspiration of uterine contents is achieved through use of a hand-held negative pressure syringe. Ireland's first MVA service was established at the Rotunda Hospital Dublin in April 2020,. The purpose of this study was to gather feedback from women who had undergone MVA in the unit. STUDY DESIGN Prospective mixed methods study of women attending for uterine aspiration under local anaesthetic from July to October 2020 in the unit. Consenting women were contacted one week following MVA via telephone. The survey conducted consisted of structured closed questions along with open-ended questions, to assess womens satisfaction in relation to all aspects of the MVA service. RESULTS Nineteen women took part in the study, a response rate of 86.4%. Participants reported feeling well informed prior to attending for MVA. Prior to the procedure, pain expectation scores were high but actual reported pain scores were much lower. Although some participants did find MVA uncomfortable, the fact the procedure was very quick and the side effects so minimal generally negated this. The location and set up of the clinic scored highly among participants as did the staff of the clinic. Overall satisfaction with the MVA service was high with 84.2% of participants reporting they would opt again for MVA in the future. CONCLUSIONS Women living in Ireland are interested and agreeable with having Manual Vacuum Aspiration as an available option for management of early pregnancy complications. Consideration should be given to expansion of MVA services nationally.
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Affiliation(s)
- D Hayes-Ryan
- Obstetrics & Gynaecology Department, The Rotunda Maternity Hospital, Dublin, Ireland.
| | - S Meaney
- National Perinatal Epidemiology Centre, University College Cork, Ireland
| | - S Byrne
- Obstetrics & Gynaecology Department, The Rotunda Maternity Hospital, Dublin, Ireland
| | - M Ramphul
- Obstetrics & Gynaecology Department, The Rotunda Maternity Hospital, Dublin, Ireland
| | - V O'Dwyer
- Obstetrics & Gynaecology Department, The Rotunda Maternity Hospital, Dublin, Ireland
| | - S Cooley
- Obstetrics & Gynaecology Department, The Rotunda Maternity Hospital, Dublin, Ireland
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O'Riordan F, Shiely F, Byrne S, Fleming A. Quality indicators for hospital antimicrobial stewardship programmes: a systematic review. J Antimicrob Chemother 2021; 76:1406-1419. [PMID: 33787876 DOI: 10.1093/jac/dkab034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/18/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Measuring the quality and effectiveness of antimicrobial stewardship (AMS) programmes with quality indicators (QIs) is an area of increasing interest. We conducted a systematic review to identify QIs of AMS programmes in the hospital setting and critically appraise their methodological quality. METHODS We searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CINAHL, Scopus/web of science databases and the grey literature for studies that defined and/or described the development process and characteristics of the QIs developed. The Appraisal of Indicators through Research and Evaluation (AIRE) instrument was used to critically appraise the methodological quality of the QI sets. RESULTS We identified 16 studies of QI sets consisting of 229 QIs. The QI sets addressed a broad range of areas of AMS in the hospital setting and consisted of 75% process indicators, 24% structural indicators and 1% outcome indicators. There was a wide variation in the information and level of detail presented describing the methodological characteristics of the QI sets identified. CONCLUSIONS The QIs identified in this study focused on process and structural indicators with few outcome indicators developed-a major deficiency in this area. Future research should focus on the development of outcome indicators or the use of process or structural indicators linked to outcomes to assess AMS. Testing of the QIs in practice is an essential methodological element of the QI development process and should be included in the QI development study or as planned validation work.
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Affiliation(s)
- F O'Riordan
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - F Shiely
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - S Byrne
- Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - A Fleming
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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Gleeson L, O’Brien GL, O’Mahony D, Byrne S. Interdisciplinary Communication in the Hospital Setting: A Systematic Review and Thematic Synthesis of the Qualitative Literature. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Communication is widely recognised to play a key role in patient care. The US Institute of Medicine’s 2002 report, ‘Crossing the Quality Chasm’, stated that ‘effective methods of communication, both among caregivers and between caregivers and patients, are critical to providing high-quality care’.(1) Interdisciplinary communication (IDC) can be challenging due to differences in training, education and roles between healthcare professions. Due to the nature of IDC, the majority of research on this subject has been qualitative, exploring the views of healthcare professionals on IPC. To date, however, the qualitative evidence on IDC has not been synthesised in a systematic manner. Therefore, a systematic review of the qualitative literature on healthcare providers’ experiences of interprofessional communication was conducted and registered with PROSPERO (registration number CRD42020177967).
Aim
The primary aim of this systematic review was to synthesise the qualitative evidence regarding healthcare providers’ perceptions of IDC in the hospital setting. A secondary aim was to identify the barriers and facilitators to IDC in the hospital setting.
Methods
Studies were eligible for inclusion in the review if they met the following criteria: 1) studies examining healthcare professionals’ experiences of IDC, 2) studies conducted in the hospital setting, and 3) studies conducted using qualitative research methods. Four databases (PubMed, CINAHL, Web of Science and Embase) were searched from inception until May 2020. Quality appraisal of the identified studies was conducted using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. Data from the results sections of eligible studies were synthesised using thematic synthesis as described by Thomas and Harden.(2) Thematic synthesis consists of three stages: 1) line-by-line coding of all text relevant labelled ‘results’ or ‘findings’ in the included studies, 2) organisation of codes into descriptive themes that reflect the results of the included studies, and 3) development of descriptive themes into analytical themes that address the review question.
Results
Eighteen studies were identified as being eligible for inclusion in this review (Figure 1). Five descriptive themes emerged during thematic synthesis: 1) ‘Hierarchy’, 2) ‘Interprofessional Ethos’, 3) ‘Healthcare Environment’, 4) ‘Personal Factors’ and 5) ‘Methods of Communication’, which were developed into two analytical themes: ‘Barriers to IDC’ and ‘Facilitators to IDC’. Personal factors, such as strong interprofessional relationships, were found to facilitate IDC, while organisational factors, such as challenging and hierarchical working environments, were found to pose barriers to IPC.
Conclusion
We believe that this review makes a significant contribution to the literature. To our knowledge, it is the first study to synthesis the qualitative evidence on healthcare providers’ perceptions of IDC in hospitals. Maintaining an interprofessional ethos and building positive working relationships were identified as facilitators to IDC, while hierarchy and challenging working conditions were identified as barriers. A key finding is the significance that healthcare providers associate with personal aspects of IDC, such as mutual respect and understanding among healthcare professionals. Future research should involve the theory- and evidence-driven design of interventions to improve personal aspects of IDC, such as interprofessional education and engagement.
References
1. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century - Institute of Medicine. Institute of Medicine. 2001.
2. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8(45).
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Affiliation(s)
- L Gleeson
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland
| | - G L O’Brien
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland
| | - D O’Mahony
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
- Department of Medicine, School of Medicine, University College Cork, Ireland
| | - S Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland
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Solmi M, Wade TD, Byrne S, Del Giovane C, Fairburn CG, Ostinelli EG, De Crescenzo F, Johnson C, Schmidt U, Treasure J, Favaro A, Zipfel S, Cipriani A. Comparative efficacy and acceptability of psychological interventions for the treatment of adult outpatients with anorexia nervosa: a systematic review and network meta-analysis. Lancet Psychiatry 2021; 8:215-224. [PMID: 33600749 DOI: 10.1016/s2215-0366(20)30566-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/25/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND No consistent first-option psychological interventions for adult outpatients with anorexia nervosa emerges from guidelines. We aimed to compare stand-alone psychological interventions for adult outpatients with anorexia nervosa with a specific focus on body-mass index, eating disorder symptoms, and all-cause dropout rate. METHODS In this systematic review and network meta-analysis, we assessed randomised controlled trials about stand-alone pharmacological or non-pharmacological treatments of adult outpatients with anorexia nervosa, defined according to standardised criteria, with data for at least two timepoints relating to either body-mass index or global eating disorder psychopathology. We searched Cochrane CENTRAL, CINAHL, MEDLINE, and PsychINFO for published and unpublished literature from inception until March 20, 2020. The primary outcomes were the change in body mass index and clinical symptoms, and the secondary outcome was all-cause dropout rate, which were all assessed for treatment as usual, cognitive behavioural therapy (CBT), Maudsley anorexia treatment for adults, family-based treatment, psychodynamic-oriented psychotherapies, a form of CBT targeting compulsive exercise, and cognitive remediation therapy followed by CBT. Global and local inconsistencies for the network meta-analysis were measured, and CINeMA was used to assess the confidence in evidence for primary outcomes. The protocol is registered in PROSPERO (CRD42017064429). FINDINGS Of 14 003 studies assessed for their title and abstract, 16 (0·1%) randomised controlled trials for psychological treatments were included in the systematic review, of which 13 (0·1%) contributed to the network meta-analysis, with 1047 patients in total (of whom 1020 [97·4%] were female). None of the interventions outperformed treatment as usual in our primary outcomes, but the all-cause dropout rate was lower for CBT than for psychodynamic-oriented psychotherapies (OR 0·54, 95% CI 0·31-0·93). Heterogeneity or inconsistency emerged only for a few comparisons. Confidence in the evidence was low to very low. INTERPRETATION Compared with treatment as usual, specific psychological treatments for adult outpatients with anorexia nervosa can be associated with modest improvements in terms of clinical course and quality of life, but no reliable evidence supports clear superiority or inferiority of the specific treatments that are recommended by clinical guidelines internationally. Our analysis is based on the best data from existing clinical studies, but these findings should not be seen as definitive or universally applicable. There is an urgent need to fund new research to develop and improve therapies for adults with anorexia nervosa. Meanwhile, to better understand the effects of available treatments, participant-level data should be made freely accessible to researchers to eventually identify whether specific subgroups of patients are more likely to respond to specific treatments. FUNDING Flinders University, National Institute for Health Research Oxford Health Biomedical Research Centre.
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Affiliation(s)
- M Solmi
- Neurosciences Department and Neuroscience Centre, University of Padua, Padua, Italy
| | - T D Wade
- Discipline of Psychology, Flinders University, Adelaide, SA, Australia
| | - S Byrne
- School of Psychological Sciences, The University of Western Australia, Perth, WA, Australia
| | - C Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - C G Fairburn
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - E G Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, UK
| | - F De Crescenzo
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - C Johnson
- Discipline of Psychology, Flinders University, Adelaide, SA, Australia
| | - U Schmidt
- Department of Psychological Medicine, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | - J Treasure
- Department of Psychological Medicine, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | - A Favaro
- Neurosciences Department and Neuroscience Centre, University of Padua, Padua, Italy
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - A Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, UK.
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Affiliation(s)
- S Byrne
- By email, Melbourne, Australia
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O'Riordan F, Shiely F, Byrne S, Fleming A. A qualitative process evaluation of the introduction of procalcitonin testing as an antimicrobial stewardship intervention. Int J Clin Pharm 2020; 43:532-540. [PMID: 33001314 DOI: 10.1007/s11096-020-01159-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
Background Successful antimicrobial stewardship interventions are imperative in today's environment of antimicrobial resistance. New antimicrobial stewardship interventions should include qualitative analysis such as a process evaluation to determine which elements within an intervention are effective and provide insight into the context in which the intervention is introduced. Objective To assess the implementation process and explore the contextual factors which influenced implementation. Setting An academic teaching hospital in Cork, Ireland. Methods A process evaluation was conducted on completion of a feasibility study of the introduction of a procalcitonin antimicrobial stewardship intervention. The process evaluation consisted of semi-structured face-to-face interviews of key stakeholders including participating (senior) doctors (5), medical laboratory scientists (3) and a hospital administrator. The Consolidated Framework for Implementation Research was used to guide data collection, analysis, and interpretation. Main outcome measures Qualitative assessment of the intervention implementation process, the contextual factors which influenced implementation and identification of improvements to the intervention and its implementation and determine if proceeding to a randomised controlled trial would be appropriate. Results Analysis of the interviews identified three main themes. (1) The procalcitonin intervention and implementation process was viewed positively to support prescribing decisions. Participants identified modifications to procalcitonin processing and availability to improve implementation and allow procalcitonin to be "more of a clinical influence". (2) In the antimicrobial stewardship context the concept of fear of missing an infection and risks of potentially serious outcomes for patients emerged. (3) The hospital context consisted of barriers such as available resources and facilitators including the hospital culture of quality improvement. Conclusion This process evaluation provides a detailed analysis of the implementation of procalcitonin testing as an antimicrobial stewardship intervention. The positive findings of this process evaluation and feasibility study should be built upon and a full randomised controlled trial and economic evaluation should be conducted in a variety of hospital settings to confirm the effectiveness of procalcitonin as an antimicrobial stewardship intervention.
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Affiliation(s)
- F O'Riordan
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland. .,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
| | - F Shiely
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - S Byrne
- Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - A Fleming
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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20
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O'Riordan F, Shiely F, Byrne S, O'Brien D, Palmer B, Dahly D, O'Connor TM, Curran D, Fleming A. An investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility study. J Antimicrob Chemother 2020; 74:3352-3361. [PMID: 31325313 DOI: 10.1093/jac/dkz313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diagnostic uncertainty and a high prevalence of viral infections present unique challenges for antimicrobial prescribing for respiratory tract infections (RTIs). Procalcitonin (PCT) has been shown to support prescribing decisions and reduce antimicrobial use safely in patients with RTIs, but recent study results have been variable. METHODS We conducted a feasibility study of the introduction of PCT testing in patients admitted to hospital with a lower RTI to determine if PCT testing is an effective and worthwhile intervention to introduce to support the existing antimicrobial stewardship (AMS) programme and safely decrease antimicrobial prescribing in patients admitted with RTIs. RESULTS A total of 79 patients were randomized to the intervention PCT-guided treatment group and 40 patients to the standard care respiratory control group. The addition of PCT testing led to a significant decrease in duration of antimicrobial prescriptions (mean 6.8 versus 8.9 days, P = 0.012) and decreased length of hospital stay (median 7 versus 8 days, P = 0.009) between the PCT and respiratory control group. PCT did not demonstrate a significant reduction in antimicrobial consumption when measured as DDDs and days of therapy. CONCLUSIONS PCT testing had a positive effect on antimicrobial prescribing during this feasibility study. The successful implementation of PCT testing in a randomized controlled trial requires an ongoing comprehensive education programme, greater integration into the AMS programme and delivery of PCT results in a timely manner. This feasibility study has shown that a larger randomized controlled trial would be beneficial to further explore the positive aspects of these findings.
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Affiliation(s)
- F O'Riordan
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - F Shiely
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - S Byrne
- Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - D O'Brien
- Department of Microbiology, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - B Palmer
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - D Dahly
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - T M O'Connor
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - D Curran
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - A Fleming
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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21
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Duarte KD, Schmidt BE, Chilton HT, Hughson KHG, Sizemore HG, Ferrier KL, Buffo JJ, Scully JEC, Nathues A, Platz T, Landis M, Byrne S, Bland M, Russell CT, Raymond CA. Landslides on Ceres: Diversity and Geologic Context. J Geophys Res Planets 2019; 124:3329-3343. [PMID: 32355585 PMCID: PMC7185231 DOI: 10.1029/2018je005673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 08/20/2019] [Accepted: 08/30/2019] [Indexed: 06/11/2023]
Abstract
Landslides are among the most widespread geologic features on Ceres. Using data from Dawn's Framing Camera, landslides were previously classified based upon geomorphologic characteristics into one of three archetypal categories, Type 1(T1), Type 2 (T2), and Type 3 (T3). Due to their geologic context, variation in age, and physical characteristics, most landslides on Ceres are, however, intermediate in their morphology and physical properties between the archetypes of each landslide class. Here we describe the varied morphology of individual intermediate landslides, identify geologic controls that contribute to this variation, and provide first-order quantification of the physical properties of the continuum of Ceres's surface flows. These intermediate flows appear in varied settings and show a range of characteristics, including those found at contacts between craters, those having multiple trunks or lobes; showing characteristics of both T2 and T3 landslides; material slumping on crater rims; very small, ejecta-like flows; and those appearing inside of catenae. We suggest that while their morphologies can vary, the distribution and mechanical properties of intermediate landslides do not differ significantly from that of archetypal landslides, confirming a link between landslides and subsurface ice. We also find that most intermediate landslides are similar to Type 2 landslides and formed by shallow failure. Clusters of these features suggest ice enhancement near Juling, Kupalo and Urvara craters. Since the majority of Ceres's landslides fall in the intermediate landslide category, placing their attributes in context contributes to a better understanding of Ceres's shallow subsurface and the nature of ground ice.
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Affiliation(s)
- K. D. Duarte
- School of Earth and Atmospheric SciencesGeorgia Institute of TechnologyAtlantaGAUSA
| | - B. E. Schmidt
- School of Earth and Atmospheric SciencesGeorgia Institute of TechnologyAtlantaGAUSA
| | - H. T. Chilton
- School of Earth and Atmospheric SciencesGeorgia Institute of TechnologyAtlantaGAUSA
| | - K. H. G. Hughson
- School of Earth and Atmospheric SciencesGeorgia Institute of TechnologyAtlantaGAUSA
- Institute of Geophysics and Planetary PhysicsUniversity of CaliforniaLos AngelesCAUSA
| | | | - K. L. Ferrier
- School of Earth and Atmospheric SciencesGeorgia Institute of TechnologyAtlantaGAUSA
| | - J. J. Buffo
- School of Earth and Atmospheric SciencesGeorgia Institute of TechnologyAtlantaGAUSA
| | - J. E. C. Scully
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - A. Nathues
- Max‐Planck Institute for Solar System ResearchKatlenburg‐LindauGermany
| | - T. Platz
- Max‐Planck Institute for Solar System ResearchKatlenburg‐LindauGermany
| | - M. Landis
- Lunar and Planetary LaboratoryUniversity of ArizonaTucsonAZUSA
- USGSFlagstaffAZUSA
| | - S. Byrne
- Lunar and Planetary LaboratoryUniversity of ArizonaTucsonAZUSA
| | - M. Bland
- Now at Boulder Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| | - C. T. Russell
- Institute of Geophysics and Planetary PhysicsUniversity of CaliforniaLos AngelesCAUSA
| | - C. A. Raymond
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
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22
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Harper J, De Vega J, Swain S, Heavens D, Gasior D, Thomas A, Evans C, Lovatt A, Lister S, Thorogood D, Skøt L, Hegarty M, Blackmore T, Kudrna D, Byrne S, Asp T, Powell W, Fernandez-Fuentes N, Armstead I. Integrating a newly developed BAC-based physical mapping resource for Lolium perenne with a genome-wide association study across a L. perenne European ecotype collection identifies genomic contexts associated with agriculturally important traits. Ann Bot 2019; 123:977-992. [PMID: 30715119 PMCID: PMC6589518 DOI: 10.1093/aob/mcy230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/28/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND AIMS Lolium perenne (perennial ryegrass) is the most widely cultivated forage and amenity grass species in temperate areas worldwide and there is a need to understand the genetic architectures of key agricultural traits and crop characteristics that deliver wider environmental services. Our aim was to identify genomic regions associated with agriculturally important traits by integrating a bacterial artificial chromosome (BAC)-based physical map with a genome-wide association study (GWAS). METHODS BAC-based physical maps for L. perenne were constructed from ~212 000 high-information-content fingerprints using Fingerprint Contig and Linear Topology Contig software. BAC clones were associated with both BAC-end sequences and a partial minimum tiling path sequence. A panel of 716 L. perenne diploid genotypes from 90 European accessions was assessed in the field over 2 years, and genotyped using a Lolium Infinium SNP array. The GWAS was carried out using a linear mixed model implemented in TASSEL, and extended genomic regions associated with significant markers were identified through integration with the physical map. KEY RESULTS Between ~3600 and 7500 physical map contigs were derived, depending on the software and probability thresholds used, and integrated with ~35 k sequenced BAC clones to develop a resource predicted to span the majority of the L. perenne genome. From the GWAS, eight different loci were significantly associated with heading date, plant width, plant biomass and water-soluble carbohydrate accumulation, seven of which could be associated with physical map contigs. This allowed the identification of a number of candidate genes. CONCLUSIONS Combining the physical mapping resource with the GWAS has allowed us to extend the search for candidate genes across larger regions of the L. perenne genome and identified a number of interesting gene model annotations. These physical maps will aid in validating future sequence-based assemblies of the L. perenne genome.
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Affiliation(s)
- J Harper
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - J De Vega
- Earlham Institute, Norwich Research Park, Norwich, UK
| | - S Swain
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - D Heavens
- Earlham Institute, Norwich Research Park, Norwich, UK
| | - D Gasior
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - A Thomas
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - C Evans
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - A Lovatt
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - S Lister
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - D Thorogood
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - L Skøt
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - M Hegarty
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - T Blackmore
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - D Kudrna
- Arizona Genomics Institute, School of Plant Sciences, University of Arizona, Tucson, AZ, USA
| | - S Byrne
- Teagasc, Department of Crop Science, Carlow, Ireland
| | - T Asp
- Department of Molecular Biology and Genetics, Crop Genetics and Biotechnology, Aarhus University, Slagelse, Denmark
| | - W Powell
- Scotland’s Rural College, Edinburgh, UK
| | - N Fernandez-Fuentes
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - I Armstead
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
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23
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Niederdeppe J, Kemp D, Jesch E, Scolere L, Greiner Safi A, Porticella N, Avery RJ, Dorf MC, Mathios AD, Byrne S. Using graphic warning labels to counter effects of social cues and brand imagery in cigarette advertising. Health Educ Res 2019; 34:38-49. [PMID: 30358853 PMCID: PMC6315110 DOI: 10.1093/her/cyy039] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 06/08/2023]
Abstract
Exposure to cigarette advertising can increase the likelihood of youth smoking initiation and may encourage people who already smoke to continue. Requiring prominent, graphic warning labels could reduce these effects. We test whether graphic versus text-only warning labels in cigarette advertisements influence cognitive and emotional factors associated with youth susceptibility to smoking and adult intentions to quit. We conducted two randomized, between-subjects experiments with middle-school youth (n = 474) and adult smokers (n = 451). Both studies employed a two (graphic or text-only warnings) by two (advertisements with social cues or brand imagery) factorial design with a fifth, offset control group (social cue advertisements with the current US Surgeon General's Warning). Graphic warnings outperformed text-only warnings in reducing visual attention to the advertisement, generating visual attention to the warning and arousing more negative affect. Graphic warnings also reduced the appeal of cigarette brands among youth relative to social cue advertisements with the Surgeon General's warnings. None of the warnings (graphic or textual) influenced health risk beliefs. Graphic warning labels on cigarette advertisements appear to have effects similar to those observed on cigarette packs in previous work, with an added benefit of reducing cigarette brand appeal among youth.
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Affiliation(s)
- J Niederdeppe
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - D Kemp
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - E Jesch
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - L Scolere
- Department of Design and Merchandising, Colorado State University, Fort Collins, CO, USA
| | - A Greiner Safi
- Department of Communication, Cornell University, Ithaca, NY, USA
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | - N Porticella
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - R J Avery
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
| | - M C Dorf
- Cornell Law School, Ithaca, NY, USA
| | - A D Mathios
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
| | - S Byrne
- Department of Communication, Cornell University, Ithaca, NY, USA
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24
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Vallières F, Ceannt R, Daccache F, Abou Daher R, Sleiman J, Gilmore B, Byrne S, Shevlin M, Murphy J, Hyland P. ICD-11 PTSD and complex PTSD amongst Syrian refugees in Lebanon: the factor structure and the clinical utility of the International Trauma Questionnaire. Acta Psychiatr Scand 2018; 138:547-557. [PMID: 30357808 DOI: 10.1111/acps.12973] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Support for ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) is growing; however, few studies include refugees or examine the clinical utility of PTSD/CPTSD classifications. This study sought to provide the first evaluations of (i) the factor structure of ICD-11 PTSD/CPTSD amongst refugees in the Middle East; and (ii) the clinical utility of the International Trauma Questionnaire (ITQ) to identify PTSD/CPTSD in a humanitarian context. METHOD Participants were 112 treatment-seeking Syrian refugees living in Lebanon. Factorial validity was assessed using confirmatory factor analysis (CFA) based on responses to the ITQ. Clinical utility of the ITQ was assessed through semi-structured interviews with six Lebanese psychotherapists. RESULTS Complex PTSD (36.1%) was more common than PTSD (25.2%), and no sex or age differences were observed at the prevalence or symptomatic levels. CFA results supported a two-factor higher-order model consistent with ICD-11 PTSD/CPTSD. Qualitative findings indicated that the ITQ is generally positively regarded, with some limitations and suggested modifications noted. CONCLUSION This is the first study to support the ICD-11 PTSD/CPTSD amongst refugees in the Middle East and the clinical utility of the ITQ in a humanitarian context. Findings support the growing evidence for the cross-cultural applicability of ICD-11 PTSD/CPTSD.
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Affiliation(s)
- F Vallières
- Centre for Global Health, University of Dublin, Trinity College, Dublin 2.,School of Psychology, University of Dublin, Trinity College, Dublin 2, Ireland
| | - R Ceannt
- Centre for Global Health, University of Dublin, Trinity College, Dublin 2
| | - F Daccache
- International Medical Corps Lebanon, Beirut, Lebanon
| | - R Abou Daher
- International Medical Corps Lebanon, Beirut, Lebanon
| | - J Sleiman
- International Medical Corps Lebanon, Beirut, Lebanon
| | - B Gilmore
- Centre for Global Health, University of Dublin, Trinity College, Dublin 2.,School of Psychology, University of Dublin, Trinity College, Dublin 2, Ireland
| | - S Byrne
- School of Psychology, University of Dublin, Trinity College, Dublin 2, Ireland
| | - M Shevlin
- Psychology Research Institute, Ulster University, Londonderry, UK
| | - J Murphy
- Psychology Research Institute, Ulster University, Londonderry, UK
| | - P Hyland
- Centre for Global Health, University of Dublin, Trinity College, Dublin 2.,School of Business, International Financial Services Centre, National College of Ireland, Dublin 1, Ireland
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25
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Vujovic N, Barr D, Bowen JJ, Byrne S, Chaloka V, Chellappa S, Heng S, Kelly LM, Kerlin K, Mistretta J, Nedeltcheva A, Qian J, Rahman N, Van Zee C, Scheer FA. 0118 Endogenous Circadian Rhythm In Diet-induced Thermogenesis In Humans. Sleep 2018. [DOI: 10.1093/sleep/zsy061.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Vujovic
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - D Barr
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - J J Bowen
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - S Byrne
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - V Chaloka
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - S Chellappa
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - S Heng
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - L M Kelly
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - K Kerlin
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - J Mistretta
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - A Nedeltcheva
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - J Qian
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - N Rahman
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - C Van Zee
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
| | - F A Scheer
- Harvard Medical School/Brigham and Women’s Hospital, Boston, MA
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26
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Byrne S, Wade T, Hay P, Touyz S, Fairburn CG, Treasure J, Schmidt U, McIntosh V, Allen K, Fursland A, Crosby RD. A randomised controlled trial of three psychological treatments for anorexia nervosa. Psychol Med 2017; 47:2823-2833. [PMID: 28552083 DOI: 10.1017/s0033291717001349] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy. METHOD A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25-40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment. RESULTS Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up. CONCLUSION The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/.
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Affiliation(s)
- S Byrne
- School of Psychology, The University of Western Australia,Perth,Australia
| | - T Wade
- School of Psychology, Flinders University,Adelaide,Australia
| | - P Hay
- School of Medicine & Centre for Health Research, Western Sydney University,Sydney,Australia
| | - S Touyz
- School of Psychology, Sydney University,Sydney,Australia
| | - C G Fairburn
- Department of Psychiatry,Oxford University,Oxford,UK
| | - J Treasure
- Department of Psychological Medicine,Kings College London,London,UK
| | - U Schmidt
- Department of Psychological Medicine,Kings College London,London,UK
| | - V McIntosh
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - K Allen
- School of Psychology, The University of Western Australia,Perth,Australia
| | - A Fursland
- Centre for Clinical Interventions,Perth,Australia
| | - R D Crosby
- Department of Psychiatry and Behavioral Sciences,University of North Dakota School of Medicine and Health Sciences,Fargo, ND,USA
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27
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Affiliation(s)
- S. Byrne
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology , Brisbane, Australia
| | - K. M. Mullen
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology , Brisbane, Australia
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28
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Dalton K, O’Sullivan D, O’Connor M, Byrne S, O’Mahony D. PREVENTION OF ADVERSE DRUG REACTIONS IN HOSPITALIZED OLDER PATIENTS: PHYSICIAN VERSUS PHARMACIST. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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)
- K. Dalton
- University College Cork, Cork, Ireland,
| | | | | | - S. Byrne
- University College Cork, Cork, Ireland,
| | - D. O’Mahony
- University College Cork, Cork, Ireland,
- Cork University Hospital, Cork, Ireland
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29
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Lopez R, Byrne S, Vukcevic M, Sekulic-Jablanovic M, Xu L, Brink M, Alamelu J, Voermans N, Snoeck M, Clement E, Muntoni F, Zhou H, Radunovic A, Mohammed S, Wraige E, Zorzato F, Treves S, Jungbluth H. A novel bleeding disorder associated with RYR1 mutations. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.019] [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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30
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Ruesch O, Platz T, Schenk P, McFadden LA, Castillo-Rogez JC, Quick LC, Byrne S, Preusker F, O’Brien DP, Schmedemann N, Williams DA, Li JY, Bland MT, Hiesinger H, Kneissl T, Neesemann A, Schaefer M, Pasckert JH, Schmidt BE, Buczkowski DL, Sykes MV, Nathues A, Roatsch T, Hoffmann M, Raymond CA, Russell CT. Cryovolcanism on Ceres. Science 2016; 353:353/6303/aaf4286. [DOI: 10.1126/science.aaf4286] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 07/20/2016] [Indexed: 11/02/2022]
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31
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Buczkowski DL, Schmidt BE, Williams DA, Mest SC, Scully JEC, Ermakov AI, Preusker F, Schenk P, Otto KA, Hiesinger H, O'Brien D, Marchi S, Sizemore H, Hughson K, Chilton H, Bland M, Byrne S, Schorghofer N, Platz T, Jaumann R, Roatsch T, Sykes MV, Nathues A, De Sanctis MC, Raymond CA, Russell CT. The geomorphology of Ceres. Science 2016; 353:353/6303/aaf4332. [PMID: 27701088 DOI: 10.1126/science.aaf4332] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 07/22/2016] [Indexed: 11/02/2022]
Abstract
Analysis of Dawn spacecraft Framing Camera image data allows evaluation of the topography and geomorphology of features on the surface of Ceres. The dwarf planet is dominated by numerous craters, but other features are also common. Linear structures include both those associated with impact craters and those that do not appear to have any correlation to an impact event. Abundant lobate flows are identified, and numerous domical features are found at a range of scales. Features suggestive of near-surface ice, cryomagmatism, and cryovolcanism have been identified. Although spectroscopic analysis has currently detected surface water ice at only one location on Ceres, the identification of these potentially ice-related features suggests that there may be at least some ice in localized regions in the crust.
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Affiliation(s)
- D L Buczkowski
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA.
| | - B E Schmidt
- Georgia Institute of Technology, Atlanta, GA 30332, USA
| | | | - S C Mest
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - J E C Scully
- NASA Jet Propulsion Laboratory, La Cañada Flintridge, CA 91011, USA
| | - A I Ermakov
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - F Preusker
- German Aerospace Center (DLR), Berlin 12489, Germany
| | - P Schenk
- Lunar and Planetary Institute, Houston, TX 77058, USA
| | - K A Otto
- German Aerospace Center (DLR), Berlin 12489, Germany
| | - H Hiesinger
- Westfälische Wilhelms-Universität Münster, Münster 48149, Germany
| | - D O'Brien
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - S Marchi
- Southwest Research Institute, Boulder, CO 80302, USA
| | - H Sizemore
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - K Hughson
- University of California, Los Angeles, CA 90095, USA
| | - H Chilton
- Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - M Bland
- United States Geological Survey, Flagstaff, AZ 86001, USA
| | - S Byrne
- Lunar and Planetary Laboratory, Tucson, AZ 85721, USA
| | - N Schorghofer
- University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - T Platz
- Max Planck Institute for Solar System Research, Göttingen 37077, Germany
| | - R Jaumann
- German Aerospace Center (DLR), Berlin 12489, Germany
| | - T Roatsch
- German Aerospace Center (DLR), Berlin 12489, Germany
| | - M V Sykes
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - A Nathues
- Max Planck Institute for Solar System Research, Göttingen 37077, Germany
| | - M C De Sanctis
- Istituto di Astrofisica e Planetologia Spaziale INAF, Rome 00133, Italy
| | - C A Raymond
- NASA Jet Propulsion Laboratory, La Cañada Flintridge, CA 91011, USA
| | - C T Russell
- University of California, Los Angeles, CA 90095, USA
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Hill-Taylor B, Walsh KA, Stewart S, Hayden J, Byrne S, Sketris IS. Effectiveness of the STOPP/START (Screening Tool of Older Persons' potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment) criteria: systematic review and meta-analysis of randomized controlled studies. J Clin Pharm Ther 2016; 41:158-69. [PMID: 26990017 DOI: 10.1111/jcpt.12372] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/08/2016] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE STOPP/START are explicit screening tools that identify potentially inappropriate prescribing in older adults. Our objective was to update our 2013 systematic review that showed limited evidence of impact, using new evidence from randomized controlled trials (RCTs) assessing clinical, humanistic and economic outcomes in older adults. METHODS We performed a search of PubMed, EMBASE, CINAHL, Web of Science and grey literature for RCTs published in English since the previous review through June 2014. The Cochrane Risk of Bias Tool was used. We performed a meta-analysis on the effect of STOPP on potentially inappropriate medication (PIM) rates and a narrative synthesis on other outcomes. RESULTS AND DISCUSSION Four RCTs (n = 1925 adults) from four countries were included, reporting both acute (n = 2) and long-term care (n = 2) patients. Studies differed in implementation. Two studies were judged to have low risk, and two to have moderate-to-high risk of bias in key domains. Meta-analysis found that the STOPP criteria reduced PIM rates in all four studies, but study heterogeneity (I(2) = 86·7%) prevented the calculation of a meaningful statistical summary. We found evidence that use of the criteria reduces falls, delirium episodes, hospital length-of-stay, care visits (primary and emergency) and medication costs, but no evidence of improvements in quality of life or mortality. WHAT IS NEW AND CONCLUSION STOPP/START may be effective in improving prescribing quality, clinical, humanistic and economic outcomes. Additional research investigating these tools is needed, especially in frail elderly and community-living patients receiving primary care.
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Affiliation(s)
- B Hill-Taylor
- College of Pharmacy, Faculty of Health Professions, Dalhousie University, Halifax, NS, Canada
| | - K A Walsh
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.,Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - S Stewart
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - J Hayden
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - S Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - I S Sketris
- College of Pharmacy, Faculty of Health Professions, Dalhousie University, Halifax, NS, Canada
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Abstract
Herein we report the development of a new series of surface bound triazolium based anion sensors. Differences in the chemical reactivity and anion binding properties were observed; highlighting the need for good surface characterisation techniques such as HR MAS NMR.
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Affiliation(s)
- S. Byrne
- School of Chemistry, Physics and Mechanical Engineering
- Queensland University of Technology
- Brisbane
- Australia
| | - K. M. Mullen
- School of Chemistry, Physics and Mechanical Engineering
- Queensland University of Technology
- Brisbane
- Australia
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O’Caoimh R, Sweeney C, Hynes H, McGlade C, Cornally N, Daly E, Weathers E, Coffey A, FitzGerald C, Healy E, O’Connell E, O’Keeffe G, O'Sullivan R, Timmons S, Foley T, Creed E, Hynes M, Twomey A, Sammon M, Cullen D, Mullan E, Orfila F, Paúl C, Clarnette R, Campbell S, Lupari M, McCarthy S, Sahm L, Byrne S, O’Leary C, O'Shea S, O’Donoghue J, McAdoo J, Kearney P, Galvin P, O’Byrne-Maguire I, Browne J, Kenny R, O’Herlihy E, O’Toole P, McFarlane A, Deery M, Bond R, Martin J, Shorten G, Molloy W. COLLaboration on AGEing-COLLAGE: Ireland's three star reference site for the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2015.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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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Worsley A, Wang WC, Yeatman H, Byrne S, Wijayaratne P. Does school health and home economics education influence adults' food knowledge? Health Promot Int 2015; 31:925-935. [PMID: 26289322 DOI: 10.1093/heapro/dav078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 11/12/2022] Open
Abstract
Home economics and health teachers are to be found in many parts of the world. They teach students about food in relation to its nutritional, safety and environmental properties. The effects of such teaching might be expected to be reflected in the food knowledge of adults who have undertaken school education in these areas. This study examined the food knowledge associations of school home economics and health education among Australian adults. Two separate online surveys were conducted nationwide among 2022 (November 2011) and 2146 Australian adults (November-December 2012). True/false and multiple choice questions in both surveys were used to assess nutrition, food safety and environmental knowledge. Knowledge scores were constructed and compared against respondents' experience of school health or home economics education via multiple regression analyses. The results from both studies showed that home economics (and similar) education was associated with higher levels of food knowledge among several age groups. The associations of home economics education with food knowledge differed across several Australian states and recall of home economics themes differed across the age groups. These findings suggest that home economics education may bring about long-lasting learning of food knowledge. Further research is required, however, to confirm the findings and to test the causal influence of home economics education on adults' food knowledge.
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Affiliation(s)
- A Worsley
- School of Exercise and Nutrition Sciences, Deakin University, Building J, 221 Burwood Highway, Burwood, VIC, Australia
| | - W C Wang
- School of Exercise and Nutrition Sciences, Deakin University, Building J, 221 Burwood Highway, Burwood, VIC, Australia
| | - H Yeatman
- School of Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - S Byrne
- School of Exercise and Nutrition Sciences, Deakin University, Building J, 221 Burwood Highway, Burwood, VIC, Australia
| | - P Wijayaratne
- School of Exercise and Nutrition Sciences, Deakin University, Building J, 221 Burwood Highway, Burwood, VIC, Australia
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Bede P, Elamin M, Byrne S, McLaughlin RL, Kenna K, Vajda A, Fagan A, Bradley DG, Hardiman O. Patterns of cerebral and cerebellar white matter degeneration in ALS. J Neurol Neurosurg Psychiatry 2015; 86:468-70. [PMID: 25053771 PMCID: PMC4392231 DOI: 10.1136/jnnp-2014-308172] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- P Bede
- Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - M Elamin
- Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - S Byrne
- Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - R L McLaughlin
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - K Kenna
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - A Vajda
- Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - A Fagan
- Centre for Advanced Medical Imaging, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - D G Bradley
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - O Hardiman
- Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Gallagher J, Mc Carthy S, Woods N, Ryan F, O' Shea S, Byrne S. Economic evaluation of a randomized controlled trial of pharmacist-supervized patient self-testing of warfarin therapy. J Clin Pharm Ther 2014; 40:14-9. [DOI: 10.1111/jcpt.12215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 09/10/2014] [Indexed: 12/19/2022]
Affiliation(s)
- J. Gallagher
- Clinical Pharmacy Research Group; School of Pharmacy; University College Cork; Cork Ireland
| | - S. Mc Carthy
- Clinical Pharmacy Research Group; School of Pharmacy; University College Cork; Cork Ireland
| | - N. Woods
- Centre for Policy Studies; University College Cork; Cork Ireland
| | - F. Ryan
- McGee Pharma International; Dublin UK
| | - S. O' Shea
- Department of Haematology; Cork University Hospital; Cork UK
| | - S. Byrne
- Clinical Pharmacy Research Group; School of Pharmacy; University College Cork; Cork Ireland
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Almarsdóttir A, Cullinan S, Masdottir B, Byrne S. Pharmacist expertise in designing a decision support tool for optimization of drug therapy in older persons. Res Social Adm Pharm 2014. [DOI: 10.1016/j.sapharm.2014.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sinnott SJ, Woods N, Byrne S, Whelton H. OP60 The impact of two consecutive prescription charges on adherence to chronic medications in the Irish General Medical Services population. Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Choi H, Byrne S, Larsen LS, Sigsgaard T, Thorne PS, Larsson L, Sebastian A, Bornehag CG. Residential culturable fungi, (1-3, 1-6)-β-d-glucan, and ergosterol concentrations in dust are not associated with asthma, rhinitis, or eczema diagnoses in children. Indoor Air 2014; 24:158-70. [PMID: 24016225 PMCID: PMC3992620 DOI: 10.1111/ina.12068] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 09/02/2013] [Indexed: 05/06/2023]
Abstract
Qualitative reporting of home indoor moisture problems predicts respiratory diseases. However, causal agents underlying such qualitative markers remain unknown. In the homes of 198 multiple allergic case children and 202 controls in Sweden, we cultivated culturable fungi by directly plating dust, and quantified (1-3, 1-6)-β-D-glucan and ergosterol in dust samples from the child's bedroom. We examined the relationship between these fungal agents and degree of parent or inspector-reported home indoor dampness, and microbiological laboratory's mold index. We also compared the concentrations of these agents between multiple allergic cases and healthy controls, as well as IgE-sensitization among cases. The concentrations of culturable fungal agents were comparable between houses with parent and inspector-reported mold issues and those without. There were no differences in concentrations of the individual or the total summed culturable fungi, (1-3, 1-6)-β-D-glucan, and ergosterol between the controls and the multiple allergic case children, or individual diagnosis of asthma, rhinitis, or eczema. Culturable fungi, (1-3, 1-6)-β-D-glucan, and ergosterol in dust were not associated with qualitative markers of indoor dampness or mold or indoor humidity. Furthermore, these agents in dust samples were not associated with any health outcomes in the children.
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Affiliation(s)
- Hyunok Choi
- Department of Environmental Health Sciences, University at Albany, School of Public Health, 1 University Place, Rensselaer, NY USA 12144
- Corresponding:
| | - Sam Byrne
- Department of Environmental Health Sciences, University at Albany, School of Public Health, 1 University Place, Rensselaer, NY USA 12144
| | - Lisbeth Suldrup Larsen
- Mycological Laboratory, Danish Technological Institute, Gregersensvej 1, DK-2630 Taastrup, Denmark; phone +72202336
| | - Torben Sigsgaard
- Department of Public Health – Section of Environment, Occupation and Health, Aarhus University, University Bartholin Allé 2 DK-8000 Aarhus C Denmark
| | - Peter S. Thorne
- Department of Occupational and Environmental Health, University of Iowa, 105 River Street, S-341A CPHB, Iowa City, IA USA 52242
| | - Lennart Larsson
- Lund University, Laboratory Medicine/Medical Microbiology Sölvegatan 23 223 62 Lund Sweden; phone +46 46177298SP
| | - Aleksandra Sebastian
- Lund University, Laboratory Medicine/Medical Microbiology Sölvegatan 23 223 62 Lund Sweden; phone +46 46177298SP
| | - Carl-Gustaf Bornehag
- Technical Research Institute of Sweden, Sweden
- Department of Public Health Sciences, Karlstad University, SE-651 88 Karlstad, Sweden
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O’Connor S, Byrne S, Stack C, Leahy M, Finnegan K, Fleming A. CP-060 An investigation into the impact of a Clinical Ward Pharmacist on medicines returned to Pharmacy for re-use or destruction. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Fleming A, Byrne S, Stewart D, O’Connor S, Tonna A. CP-061 A cross-sectional survey of the profile and activities of Antimicrobial Management Teams in Irish hospitals. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Byrne S, Rodrigo MJ, Máiquez ML. Patterns of individual change in a parenting program for child maltreatment and their relation to family and professional environments. Child Abuse Negl 2014; 38:457-467. [PMID: 24518441 DOI: 10.1016/j.chiabu.2013.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 12/18/2013] [Accepted: 12/27/2013] [Indexed: 06/03/2023]
Abstract
In the area of child maltreatment prevention, little is known about the typology of changes that individuals undergo in response to parent-training interventions. In this study, we examined the patterns of change observed in parents immediately after their completion of the Apoyo Personal y Familiar (APF, Personal and Family Support) parenting program. We identified five clusters and classified 496 parents according to two criteria: (a) the amount of pre-post changes (total or partial) as reflected in their self-reports on implicit theories, parental agency and childrearing practices, and (b) the positive, negative or mixed character of these changes. The study also included a follow-up of a subset of 95 participants intended to examine the extent to which the patterns of change identified in the first part of the study might predict the quality of the childrearing environment at home and the successful integration of the APF program into social services structures one year on. In this follow-up study, external evaluators observed families' home environments and collected the parenting program facilitators' self-reports on changes to their work environment. The evaluators found higher-quality childrearing environments and more positive appraisals of the changes to the teams' work with families in those cases where participants had experienced partial or total positive changes as a result of the APF. This approach offers insights into processes of individual change that have practical implications for the successful implementation of parenting programs in child maltreatment prevention services.
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Affiliation(s)
- S Byrne
- Facultad de Psicología, Universidad de La Laguna, Campus de Guajara, 38071 La Laguna, Santa Cruz de Tenerife, Spain
| | - M J Rodrigo
- Facultad de Psicología, Universidad de La Laguna, Campus de Guajara, 38071 La Laguna, Santa Cruz de Tenerife, Spain
| | - M L Máiquez
- Facultad de Psicología, Universidad de La Laguna, Campus de Guajara, 38071 La Laguna, Santa Cruz de Tenerife, Spain
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Murphy M, Brodie G, Byrne S, Bradley C. An observational study of public and private general practitioner consultations in the Republic of Ireland. Ir J Med Sci 2014; 184:147-52. [PMID: 24554205 DOI: 10.1007/s11845-014-1078-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 02/03/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The reasons why patients visit their general practitioner (GP) is vital information for fund holders and policy makers. GP consultations in the Republic of Ireland are either paid by the patient on a fee-per-service basis (private patients) or by the state [general medical service (GMS) card holders], and information related to primary care consultations is limited. OBJECTIVES The aim of this study was to conduct an observational study of GMS and private consultations within general practice in Ireland. DESIGN This is a cross-sectional study of general practitioner consultations. METHODS GPs within existing Continued Medical Education (CME) groups were invited to participate. Participating GPs gathered data on 100 consecutive consultations between September 2008 and April 2010. RESULTS There were 16,899 consultations recorded; 53.8 % (9,095) were GMS patients. Patients ≥65 years accounted for 23.69 % of consultations (n = 3,822). Respiratory illnesses accounted for the highest proportion of consultations (3,886, 23.0 %), followed by routine check-ups (15.4 %). GMS patients were more likely to consult for a repeat prescription (OR = 4.04, 95 % CI 2.93-5.57) and were also more likely to consult to review their treatment (OR = 2.33, 95 % CI 1.68-3.22) compared to private patients. CONCLUSION This study displays the consultation behaviour of patients in Ireland. It suggests that inequalities may exist in access to primary care services in ROI; however, more research is required to examine this further. There is insufficient information available on primary healthcare utilisation. Key issues such as the lack of unique patient identifiers and the lack of extractable data from GP practices in ROI need to be addressed.
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Affiliation(s)
- M Murphy
- Department of General Practice, School of Medicine, University College Cork, Cork, Ireland,
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Bede P, Elamin M, Byrne S, McLaughlin RL, Kenna K, Vajda A, Pender N, Bradley DG, Hardiman O. Basal ganglia involvement in amyotrophic lateral sclerosis. Neurology 2013; 81:2107-15. [DOI: 10.1212/01.wnl.0000437313.80913.2c] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Elamin M, Bede P, Byrne S, Jordan N, Gallagher L, Wynne B, O'Brien C, Phukan J, Lynch C, Pender N, Hardiman O. Cognitive changes predict functional decline in ALS: A population-based longitudinal study. Neurology 2013; 80:1590-7. [DOI: 10.1212/wnl.0b013e31828f18ac] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hill-Taylor B, Sketris I, Hayden J, Byrne S, O'Sullivan D, Christie R. Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact. J Clin Pharm Ther 2013; 38:360-72. [PMID: 23550814 DOI: 10.1111/jcpt.12059] [Citation(s) in RCA: 253] [Impact Index Per Article: 23.0] [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: 12/18/2012] [Accepted: 03/04/2013] [Indexed: 02/06/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Potentially inappropriate prescribing (PIP) has significant clinical, humanistic and economic impacts. Identifying PIP in older adults may reduce their burden of adverse drug events. Tools with explicit criteria are being developed to screen for PIP in this population. These tools vary in their ability to identify PIP in specific care settings and jurisdictions due to such factors as local prescribing practices and formularies. One promising set of screening tools are the STOPP (Screening Tool of Older Person's potentially inappropriate Prescriptions) and START (Screening Tool of Alert doctors to the Right Treatment) criteria. We conducted a systematic review of research studies that describe the application of the STOPP/START criteria and examined the evidence of the impact of STOPP/START on clinical, humanistic and economic outcomes in older adults. METHODS We performed a systematic review of studies from relevant biomedical databases and grey literature sources published from January 2007 to January 2012. We searched citation and reference lists and contacted content experts to identify additional studies. Two authors independently selected studies using a predefined protocol. We did not restrict selection to particular study designs; however, non-English studies were excluded during the selection process. Independent extraction of articles by two authors used predefined data fields. For randomized controlled trials and observational studies comparing STOPP/START to other explicit criteria, we assessed risk of bias using an adapted tool. RESULTS AND DISCUSSION We included 13 studies: a single randomized controlled trial and 12 observational studies. We performed a descriptive analysis as heterogeneity of study populations, interventions and study design precluded meta-analysis. All observational studies reported the prevalence of PIP; however, the application of the criteria was not consistent across all studies. Seven of the observational studies compared STOPP/START with other explicit criteria. The STOPP/START criteria were reported to be more sensitive than the more-frequently-cited Beers criteria in six studies, but less sensitive than a set of criteria developed in Australia. The STOPP criteria identified more medications associated with adverse drug events than the 2002 version of the Beers criteria. Patients with PIP, as identified by STOPP, had an 85% increased risk of adverse drug events in one study (OR = 1·85, 95% CI: 1·51-2·26; P < 0·001). There was limited evidence that the application of STOPP/START criteria optimized prescribing. Research involving the application of STOPP/START on the impact on the quality of life was not found. The direct costs of PIP were documented in three studies from Ireland, but more extensive analyses on the economic impact or studies from other jurisdictions were not found. WHAT IS NEW AND CONCLUSION The STOPP/START criteria have been used to review the medication profiles of community-dwelling, acute care and long-term care older patients in Europe, Asia and North America. Observational studies have reported the prevalence and predictors of PIP. The STOPP/START criteria appear to be more sensitive than the 2002 version of the Beers criteria. Limited evidence was found related to the clinical and economic impact of the STOPP/START criteria.
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Affiliation(s)
- B Hill-Taylor
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada.
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O’Connor M, O'Sullivan D, Gallagher P, Byrne S, Eustace J, O’Mahony D. Prevention of adverse drug events in hospitalized older patients: A randomised controlled trial using STOPP/START criteria. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.07.328] [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: 10/27/2022]
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