1
|
Toye F, Dixon S, Izett-Kay M, Keating S, McNiven A. Exploring the experiences of people with urogynaecology conditions in the UK: a reflexive thematic analysis and conceptual model. BMC Womens Health 2023; 23:431. [PMID: 37580761 PMCID: PMC10426194 DOI: 10.1186/s12905-023-02592-w] [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] [Received: 03/07/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Urogynaecological conditions, such as pelvic organ prolapse, urinary incontinence, and urinary tract infection, can have a profound impact on people's lives. The Independent Medicines and Medical Devices Safety Review highlights missed opportunities to prevent harm when patient voices are not incorporated into healthcare policy and practice. This resonates with the Women's Health Strategy for England. The National Institute for Health and Care Research (NIHR) Policy Research Programme funded this in-depth qualitative exploration of people's experiences of living with urogynaecological conditions, and of seeking healthcare treatment, to inform health and social care improvements in the UK. METHODS We conducted in-depth interviews online or by telephone (April 2021-December 2021) and used reflexive thematic analysis to develop themes that cut across urogynaecological conditions. RESULTS We spoke to seventy-four adults aged 22-84 across a range of backgrounds and lived experiences of urogynaecological conditions, including pelvic organ prolapse, urinary incontinence and persistent or recurring urinary tract infection. Eight themes were developed: [1] I get no respite from my own body; [2] I feel confined and separated; [3] I can no longer be 'me'; [4] I am constrained by stigma, shame and silence; [5] I feel fragmented and lost in the healthcare system; [6] I need to be heard, believed, and valued; [7] I need respect as an equal partner in healthcare; and [8] (Re)connected to a more open community. CONCLUSIONS High quality care focuses on the whole person rather than their body parts. Openness and candour support a shared decision-making model of care. A culture of shame can have a negative impact on access to health care and recovery.
Collapse
Affiliation(s)
- F Toye
- Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX37HE, UK.
| | - S Dixon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - M Izett-Kay
- Department of Urogynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - S Keating
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - A McNiven
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| |
Collapse
|
2
|
Gibbs NK, Angus C, Dixon S, Parry CDH, Meier PS. Stakeholder Engagement in the Development of Public Health Economic Models: An Application to Modelling of Minimum Unit Pricing of Alcohol in South Africa. Appl Health Econ Health Policy 2023; 21:395-403. [PMID: 36894828 PMCID: PMC9998014 DOI: 10.1007/s40258-023-00789-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Health economic models aim to provide decision makers with information that is contextually relevant, understandable and credible. This requires ongoing engagement throughout the research project between the modeller and end-users. OBJECTIVES We aim to reflect on how a public health economic model of minimum unit pricing of alcohol in South Africa benefited from, and was shaped by, stakeholders. We outline how engagement activities were used during the development, validation and communication phases of the research with input gathered at each stage to inform future priorities. METHODS A stakeholder mapping exercise was completed to identify stakeholders with the required knowledge, for example academics with expertise in modelling alcohol harm in South Africa, members of civil society organisations with lived experience of informal alcohol outlets, and policy professionals working at the forefront of alcohol policy development in South Africa. The stakeholder engagement consisted of four phases: developing a detailed understanding of the local policy context; co-producing model focus and structure; scrutinising model development and communication planning; and communicating research evidence to end-users. The first phase utilised 12 individual semi-structured interviews. Phases two to four centred around face-to-face workshops (two online) with both individual and group-based exercises employed to achieve required outputs. RESULTS Phase one provided key learning on policy context and initiated working relationships. Phases two to four provided a conceptualisation of the problem of alcohol harm in South Africa and the choice of policy to model. Stakeholders chose population subgroups of interest and advised on both economic and health outcomes. They provided input on critical assumptions, data sources, priorities for future work, and communication strategies. The final workshop provided a platform to communicate the results of the model to a largely policy audience. These activities led to the production of highly contextualised research methods and findings that were able to be communicated widely beyond academia. CONCLUSIONS Our programme of stakeholder engagement was fully integrated into the research programme. It resulted in a number of benefits including creating positive working relationships, guiding modelling decisions, tailoring the research to the context, and providing ongoing opportunities for communication.
Collapse
Affiliation(s)
- N K Gibbs
- Centre for Health Economics, University of York, York, UK.
| | - C Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - S Dixon
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- Priority Cost Effective Lessons for Systems Strengethening, South Africa (PRICELESS SA), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - C D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - P S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| |
Collapse
|
3
|
Dixon S, Benson A, Kalaiselvan R, Kanwar S, Samad A, Pritchard-Jones R, West C, Scott M. OC-022 MAINTAINING AN ELECTIVE ABDOMINAL WALL RECONSTRUCTION SERVICE DURING THE COVID 19 PANDEMIC. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Elective surgery services suffered significantly due to the COVID-19 pandemic. The aim of this study was to analyse the impact and outcomes of abdominal wall reconstruction (AWR) performed during the COVID-19 pandemic, assessing safety and sustainability.
Material and Methods
A retrospective review of all patients undergoing AWR in a single NHS trust, multiple surgeons, between 23rd March 2020 and 22rd March 2022, the 2 years following U.K. Government imposed lockdown, was undertaken and compared with the pre-pandemic AWR activity. Procedures were initially undertaken at a cold site and when demonstrated to be safe, main site operating restarted. The primary outcome was 90 day mortality, secondary outcomes of COVID-19 infection within 7 days, length of stay, critical care requirement, and complication rate.
Results
In the study period, 173 patients underwent AWR, compared with 99 cases in a single year preceding lockdown. 90 day mortality rate was zero. No patients returned positive COVID tests to the trust within 7 days of AWR, and no patients were readmitted for COVID related symptoms. Critical care admission was required in 7 patients, 3 of these were planned admissions pre-operatively. The surgical site occurrence rate was 9.8% (17), infection 5.8% (10), seroma 2.3% (4) and haematoma 1.7% (3). There were no recurrences reported, with follow up ranging between 1 and 18 months.
Conclusion
Continuing AWR services during the COVID pandemic is feasible and safe. Peri-operative COVID infection rates are low, critical care requirements minimal, and there is no impact on patient morbidity or mortality.
Collapse
Affiliation(s)
- S Dixon
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - A Benson
- Plastic Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - R Kalaiselvan
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - S Kanwar
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - A Samad
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - R Pritchard-Jones
- Plastic Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - C West
- Plastic Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - M Scott
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| |
Collapse
|
4
|
Dixon S, Benson A, Kalaiselvan R, Kanwar S, Samad A, Pritchard-Jones R, West C, Scott M. P-135 FIRST EXPERIENCE WITH A NEW CLOSED INCISION NEGATIVE PRESSURE WOUND THERAPY, PREVENA™, IN ABDOMINAL WALL RECONSTRUCTION PATIENTS. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.232] [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: 11/14/2022]
Abstract
Abstract
Aim
Surgical site infection (SSI) contributes a significant proportion of post operative morbidity in patients undergoing abdominal wall reconstruction (AWR). Prevena™ closed incision negative pressure wound therapy (ciNPT) has been demonstrated to reduce SSI rates in the elective and emergency laparotomy setting. However, there is no evidence for Prevena™ use in AWR patients. The aim of this study was to assess the safety and feasibility of Prevena™ in AWR patients.
Materials and Method
Patients undergoing AWR at a single trust were selected at random to receive Prevena™. This was applied to the incision under sterile conditions, a continuous pressure of -125mmHg was applied for 7 days. The primary outcome measure was SSI, with secondary outcomes of 90 day mortality, complications and length of stay.
Results
10 patients received ciNPT in the study period, 8 female 2 male, mean BMI was 34.5. All patients had a Rives-Stoppa repair, with 2 patients also requiring bilateral transversus abdominal release (TAR). A vertical panniculectomy with umboplasty was used in 7 cases, fleur-de-lys panniculectomy with umboplasty in 2 cases, and a single case approached via transverse panniculectomy. There were no deaths within 90 days, median length of stay was 4 days. There was a single SSI managed with oral antibiotics, not requiring admission.
Conclusion
Prevena™ has been shown to reduce SSI rates in other patient cohorts and this small series demonstrates it is feasible and safe to use in the AWR setting. Larger studies are required to demonstrate SSI rate reduction in AWR patients.
Collapse
Affiliation(s)
- S Dixon
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - A Benson
- Plastic Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - R Kalaiselvan
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - S Kanwar
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - A Samad
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - R Pritchard-Jones
- Plastic Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - C West
- Plastic Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| | - M Scott
- General Surgery, St Helens and Knowsley Trust , Liverpool , United Kingdom
| |
Collapse
|
5
|
Estepp JH, Kalpatthi R, Woods G, Trompeter S, Liem RI, Sims K, Inati A, Inusa BPD, Campbell A, Piccone C, Abboud MR, Smith-Whitley K, Dixon S, Tonda M, Washington C, Griffin NM, Brown C. Safety and efficacy of voxelotor in pediatric patients with sickle cell disease aged 4 to 11 years. Pediatr Blood Cancer 2022; 69:e29716. [PMID: 35451176 DOI: 10.1002/pbc.29716] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/02/2022] [Accepted: 03/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) is a devastating, multisystemic disorder that affects millions of people worldwide. The earliest clinical manifestations of SCD can affect infants as young as 6 months of age, and pediatric patients are at risk for acute and life-threatening complications. Early intervention with treatments that target the underlying pathophysiological mechanism of SCD, sickle hemoglobin (HbS) polymerization, are expected to slow disease progression and circumvent disease-associated morbidity and mortality. PROCEDURE The HOPE-KIDS 1 trial (NCT02850406) is an ongoing four-part, phase 2a, open-label, single- and multiple-dose study to evaluate the pharmacokinetics, efficacy, and safety of voxelotor-a first-in-class HbS polymerization inhibitor-in patients aged 6 months to 17 years with SCD. Initial findings from a cohort of 45 patients aged 4 to 11 years who received voxelotor treatment for up to 48 weeks are reported. RESULTS Hemoglobin (Hb) response, defined as a >1.0 g/dl increase from baseline, was achieved at week 24 by 47% (n = 16/34) of patients with Hb measurements at baseline and week 24. At week 24, 35% (n = 12/34) and 21% (n = 7/34) of patients had a >1.5 g/dl increase and a >2.0 g/dl increase from baseline in Hb concentration, respectively. Concurrent improvements in hemolytic markers were observed. Voxelotor was well tolerated in this young cohort, with no newly emerging safety signals. CONCLUSIONS Based on its mechanism as an HbS polymerization inhibitor, voxelotor improves Hb levels and markers of hemolysis and has the potential to mitigate SCD-related complications; these results support its use in patients aged ≥4 years.
Collapse
Affiliation(s)
| | - Ram Kalpatthi
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gerald Woods
- Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Sara Trompeter
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Robert I Liem
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Kacie Sims
- St. Jude Affiliate Clinic Baton Rouge, Baton Rouge, Los Angeles, USA
| | - Adlette Inati
- School of Medicine, Byblos and Nini Hospital, Lebanese American University, Tripoli, Lebanon
| | - Baba P D Inusa
- Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Andrew Campbell
- Division of Hematology, Children's National Hospital, Washington, District of Columbia, USA
| | - Connie Piccone
- Department of Pediatric Hematology, Carle Foundation Hospital, Urbana, Illinois, USA
| | - Miguel R Abboud
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Kim Smith-Whitley
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sandra Dixon
- Global Blood Therapeutics, South San Francisco, California, USA
| | - Margaret Tonda
- Global Blood Therapeutics, South San Francisco, California, USA
| | | | | | - Clark Brown
- Emory + Children's Pediatric Institute, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Hazy A, Saadat S, Krauss D, Dilworth J, Stevens C, Dixon S, Safian R, Lee K. Clinical Outcomes in Patients Undergoing Coronary Brachytherapy for Restenosis of Coronary Vessels Previously Treated With Drug Eluting Stents. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
7
|
Abdel-Fattah M, Chapple C, Guerrero K, Dixon S, Cotterill N, Ward K, Hashim H, Monga A, Brown K, Drake MJ, Gammie A, Mostafa A, Bladder Health UK, Breeman S, Cooper D, MacLennan G, Norrie J. Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study): a superiority randomised clinical trial to evaluate the effectiveness and cost-effectiveness of invasive urodynamic investigations in management of women with refractory overactive bladder symptoms. Trials 2021; 22:745. [PMID: 34702331 PMCID: PMC8546752 DOI: 10.1186/s13063-021-05661-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Overactive bladder (OAB) syndrome is a symptom complex affecting 12-14% of the UK adult female population. Symptoms include urinary urgency, with or without urgency incontinence, increased daytime urinary frequency and nocturia. OAB has a negative impact on women's social, physical, and psychological wellbeing. Initial treatment includes lifestyle modifications, bladder retraining, pelvic floor exercises and pharmacological therapy. However, these measures are unsuccessful in 25-40% of women (refractory OAB). Before considering invasive treatments, such as Botulinum toxin injection or sacral neuromodulation, most guidelines recommend urodynamics to confirm diagnosis of detrusor overactivity (DO). However, urodynamics may fail to show evidence of DO in up to 45% of cases, hence the need to evaluate its effectiveness and cost-effectiveness. FUTURE (Female Urgency, Trial of Urodynamics as Routine Evaluation) aims to test the hypothesis that, in women with refractory OAB, urodynamics and comprehensive clinical assessment is associated with superior patient-reported outcomes following treatment and is more cost-effective, compared to comprehensive clinical assessment only. METHODS FUTURE is a pragmatic, multi-centre, superiority randomised controlled trial. Women aged ≥ 18 years with refractory OAB or urgency predominant mixed urinary incontinence, and who have failed/not tolerated conservative and medical treatment, are considered for trial entry. We aim to recruit 1096 women from approximately 60 secondary/tertiary care hospitals across the UK. All consenting women will complete questionnaires at baseline, 3 months, 6 months and 15 months post-randomisation. The primary outcome is participant-reported success at 15 months post-randomisation measured using the Patient Global Impression of Improvement. The primary economic outcome is incremental cost per quality-adjusted life year gained at 15 months. The secondary outcomes include adverse events, impact on other urinary symptoms and health-related quality of life. Qualitative interviews with participants and clinicians and a health economic evaluation will also be conducted. The statistical analysis of the primary outcome will be by intention-to-treat. Results will be presented as estimates and 95% CIs. DISCUSSION The FUTURE study will inform patients, clinicians and policy makers whether routine urodynamics improves treatment outcomes in women with refractory OAB and whether it is cost-effective. TRIAL REGISTRATION ISRCTN63268739 . Registered on 14 September 2017.
Collapse
Affiliation(s)
- M Abdel-Fattah
- Aberdeen Centre for Women's Health Research, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
| | - C Chapple
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - K Guerrero
- Department of Urogynaecology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - S Dixon
- Health Economics and Decision Science, University of Sheffield, Sheffield, UK
| | - N Cotterill
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - K Ward
- Warrell Unit, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - H Hashim
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
- Bristol Urological Institute, University of Bristol, Bristol, UK
| | - A Monga
- Department of Gynaecology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K Brown
- Department of Gynaecology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - M J Drake
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
- Bristol Urological Institute, University of Bristol, Bristol, UK
| | - A Gammie
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - A Mostafa
- Aberdeen Centre for Women's Health Research, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - S Breeman
- Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, UK
| | - D Cooper
- Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, UK
| | - G MacLennan
- Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, UK
| | - J Norrie
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
8
|
Anumba DOC, Stern V, Healey JT, Dixon S, Brown BH. Value of cervical electrical impedance spectroscopy to predict spontaneous preterm delivery in asymptomatic women: the ECCLIPPx prospective cohort study. Ultrasound Obstet Gynecol 2021; 58:293-302. [PMID: 32798253 DOI: 10.1002/uog.22180] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 05/10/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Preterm birth (PTB) accounts for two-thirds of deaths of structurally normal babies and is associated with substantial lifetime healthcare costs. Prevention of PTB remains limited by the modest accuracy of prediction methods, namely transvaginal ultrasound (TVS) cervical length (CL) measurement and quantitative cervicovaginal fetal fibronectin (FFN) estimation. We report the first substantive study detailing the predictive performance of a cervical probe device based on electrical impedance spectroscopy (EIS) for PTB - the EleCtriCaL Impedance Prediction of Preterm birth by spectroscopy of the cervix (ECCLIPPx) study. We aimed to compare the accuracy of cervical EIS-based prediction of spontaneous PTB with that of prediction using TVS-CL and FFN in asymptomatic women in the mid-trimester. METHODS We studied asymptomatic women with a singleton pregnancy at 20-22 weeks' and 26-28 weeks' gestation. EIS was performed using a Sheffield Mark 5.0 device that makes measurements in the frequency range 76 Hz to 625 kHz using a small probe housing tetrapolar electrodes. TVS-CL and FFN were also measured. The associations of cervical EIS, TVS-CL and FFN with spontaneous delivery before 37 weeks and before 32 weeks were determined by multivariate linear and non-linear logistic regression analysis. Areas under the receiver-operating-characteristics curves (AUC) plots of sensitivity against specificity were used to compare the predictive performance of all parameters, both in isolation and in combination. RESULTS Of the 365 asymptomatic women studied at 20-22 weeks who were not receiving treatment, 29 had spontaneous PTB, 14 had indicated PTB and 322 had term birth. At the higher frequencies assessed, cervical EIS predicted spontaneous PTB before 37 weeks with an AUC of 0.76 (95% CI, 0.71-0.81), compared with AUCs of 0.72 (95% CI, 0.66-0.76) for TVS-CL and 0.62 (95% CI, 0.56-0.72) for FFN. Combining all three assessments improved the prediction of spontaneous PTB before 37 weeks (AUC, 0.79 (95% CI, 0.74-0.83)) compared with TVS-CL and FFN alone. Incorporating a history of spontaneous PTB (defined as previous mid-trimester miscarriage or spontaneous PTB (14 to < 37 weeks)) into the cervical EIS prediction model improved the accuracy of prediction of spontaneous PTB before 37 weeks (AUC, 0.83 (95% CI, 0.78-0.87)) and before 32 weeks (AUC, 0.86 (95% CI, 0.82-0.90)). CONCLUSIONS Mid-trimester cervical EIS assessment predicts spontaneous PTB. Larger confirmatory studies investigating its potential clinical utility and to inform effective preventive interventions are required. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- D O C Anumba
- Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - V Stern
- Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - J T Healey
- Medical Physics and Clinical Engineering, University of Sheffield, Sheffield, UK
| | - S Dixon
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - B H Brown
- Medical Physics and Clinical Engineering, University of Sheffield, Sheffield, UK
| |
Collapse
|
9
|
Evans CD, Peacock M, Baird AJ, Artz RRE, Burden A, Callaghan N, Chapman PJ, Cooper HM, Coyle M, Craig E, Cumming A, Dixon S, Gauci V, Grayson RP, Helfter C, Heppell CM, Holden J, Jones DL, Kaduk J, Levy P, Matthews R, McNamara NP, Misselbrook T, Oakley S, Page SE, Rayment M, Ridley LM, Stanley KM, Williamson JL, Worrall F, Morrison R. Overriding water table control on managed peatland greenhouse gas emissions. Nature 2021; 593:548-552. [PMID: 33882562 DOI: 10.1038/s41586-021-03523-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/08/2021] [Indexed: 02/02/2023]
Abstract
Global peatlands store more carbon than is naturally present in the atmosphere1,2. However, many peatlands are under pressure from drainage-based agriculture, plantation development and fire, with the equivalent of around 3 per cent of all anthropogenic greenhouse gases emitted from drained peatland3-5. Efforts to curb such emissions are intensifying through the conservation of undrained peatlands and re-wetting of drained systems6. Here we report eddy covariance data for carbon dioxide from 16 locations and static chamber measurements for methane from 41 locations in the UK and Ireland. We combine these with published data from sites across all major peatland biomes. We find that the mean annual effective water table depth (WTDe; that is, the average depth of the aerated peat layer) overrides all other ecosystem- and management-related controls on greenhouse gas fluxes. We estimate that every 10 centimetres of reduction in WTDe could reduce the net warming impact of CO2 and CH4 emissions (100-year global warming potentials) by the equivalent of at least 3 tonnes of CO2 per hectare per year, until WTDe is less than 30 centimetres. Raising water levels further would continue to have a net cooling effect until WTDe is within 10 centimetres of the surface. Our results suggest that greenhouse gas emissions from peatlands drained for agriculture could be greatly reduced without necessarily halting their productive use. Halving WTDe in all drained agricultural peatlands, for example, could reduce emissions by the equivalent of over 1 per cent of global anthropogenic emissions.
Collapse
Affiliation(s)
- C D Evans
- UK Centre for Ecology and Hydrology, Bangor, UK. .,Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - M Peacock
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - A J Baird
- School of Geography, University of Leeds, Leeds, UK
| | - R R E Artz
- The James Hutton Institute, Aberdeen, UK
| | - A Burden
- UK Centre for Ecology and Hydrology, Bangor, UK
| | - N Callaghan
- UK Centre for Ecology and Hydrology, Bangor, UK
| | - P J Chapman
- School of Geography, University of Leeds, Leeds, UK
| | - H M Cooper
- UK Centre for Ecology and Hydrology, Wallingford, UK
| | - M Coyle
- The James Hutton Institute, Aberdeen, UK.,UK Centre for Ecology and Hydrology, Penicuik, UK
| | - E Craig
- UK Centre for Ecology and Hydrology, Bangor, UK.,School of Natural Sciences, Bangor University, Bangor, UK
| | - A Cumming
- UK Centre for Ecology and Hydrology, Wallingford, UK
| | - S Dixon
- Department of Earth Sciences, Durham University, Durham, UK
| | - V Gauci
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - R P Grayson
- School of Geography, University of Leeds, Leeds, UK
| | - C Helfter
- UK Centre for Ecology and Hydrology, Penicuik, UK
| | - C M Heppell
- School of Geography, Queen Mary University of London, London, UK
| | - J Holden
- School of Geography, University of Leeds, Leeds, UK
| | - D L Jones
- School of Natural Sciences, Bangor University, Bangor, UK.,SoilsWest, Centre for Sustainable Farming Systems, Food Futures Institute, Murdoch University, Murdoch, Western Australia, Australia.,UWA School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - J Kaduk
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - P Levy
- UK Centre for Ecology and Hydrology, Penicuik, UK
| | - R Matthews
- Rothamsted Research, North Wyke, Okehampton, UK
| | - N P McNamara
- UK Centre for Ecology and Hydrology, Lancaster, UK
| | | | - S Oakley
- UK Centre for Ecology and Hydrology, Lancaster, UK
| | - S E Page
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - M Rayment
- School of Natural Sciences, Bangor University, Bangor, UK
| | - L M Ridley
- School of Natural Sciences, Bangor University, Bangor, UK
| | - K M Stanley
- Institut für Atmosphäre und Umwelt, Goethe Universität Frankfurt, Frankfurt am Main, Germany
| | | | - F Worrall
- Department of Earth Sciences, Durham University, Durham, UK
| | - R Morrison
- UK Centre for Ecology and Hydrology, Wallingford, UK
| |
Collapse
|
10
|
Readnour RS, Coleman MR, Leadbetter MG, Armstrong F, Campbell H, Cleveland C, Dixon S, Massom L, Nandihalli U, Pritts K, Smallidge R, Steed M, Wallace M. Liquid Chromatographic Determination of Tilmicosin in Swine Feed at 200–400 mg/kg Level: Interlaboratory Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.6.1156] [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] [Indexed: 11/13/2022]
Abstract
Abstract
An analytical method for the determination of tilmicosin at 200–400 mg/kg, the intended use concentration range, was evaluated in an interlaboratory study involving 5 laboratories, including the sponsor. The interlaboratory study evaluated the intra- and interlaboratory precision and accuracy of a tilmicosin feed method. The method procedure involved extracting tilmicosin from feed by adding 200 mL extractant to 20 g feed and shaking for 1 h. The extract is filtered and analyzed by gradient liquid chromatography which separates tilmicosin from feed matrix in 30 min. Each laboratory assayed 5 replicates of fortified feed at concentrations of 0,100, 200, 400, and 600 mg/kg. The mean recovery among fortified samples ranged from 81.4 to 98.8%, with a percent coefficient of variation (%CV) ranging from 0.3 to 4.0%. For all blank control feed samples no significant interferences were observed. In addition, each laboratory assayed 5 replicates of medicated feed samples prepared at 2 levels (200 and 400 mg/kg) with either a horizontal or vertical mixer. Along with the medicated feed samples were included 5 replicates of a blank control feed. The identities of the medicated and blank control feed samples were blinded to the analysts. The results for the medicated feed samples ranged from 95.8 to 106% of label claim, with a %CV ranging from 2.1 to 6.7%.
Collapse
Affiliation(s)
- Robin S Readnour
- Elanco Animal Health, A Division of Eli Lilly and Co., 2001 W. Main St, Greenfield, IN 46140
| | - Mark R Coleman
- Elanco Animal Health, A Division of Eli Lilly and Co., 2001 W. Main St, Greenfield, IN 46140
| | - Mary G Leadbetter
- U.S. Food and Drug Administration, Center for Veterinary Medicine, New Animal Drug Evaluation, Division of Chemistry, Chemotherapeutics Branch, HFV-143, 7500 Standish Place, Rockville, MD 20855
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Thring CB, Hill SJ, Dixon S, Edwards RS. The effect of EMAT coil geometry on the Rayleigh wave frequency behaviour. Ultrasonics 2019; 99:105945. [PMID: 31279961 DOI: 10.1016/j.ultras.2019.06.007] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/02/2019] [Accepted: 06/10/2019] [Indexed: 06/09/2023]
Abstract
Understanding of optimal signal generation and frequency content for electromagnetic acoustic transducers (EMATs) is key to improving their design and signal to noise ratio. Linear and meander coil designs are fairly well understood, but other designs such as racetrack or focused coils have recently been proposed. Multiple transmission racetrack coil EMATs, with focused and unfocused designs, were constructed. The optimum driving frequency for maximum detected signal was found to range between 1.1 and 1.4 MHz on aluminium for a 1.5 mm width coil. A simple analytical model based on the instantaneous velocity of a wave predicts a maximum signal at 1.44 MHz. Modelling the detection coil as a spatial square wave agrees with this, and predicts a general relation of fP=0.761v/L between the optimum frequency fP, the wave velocity v, and the coil width L. A time domain model of the detection coil predicts a 1.4-1.5 MHz peak for continuous wave excitation, with a frequency that decreases as the length of the wavepacket is decreased, consistent with the experimental data. Linear coil modelling using the same technique is shown to be consistent with previous work, with improving detection at lower wave frequencies, and signal minima at every integer multiple of the wavelength. Finite Element Analysis (FEA) is used to model the effects of the spatial width of the racetrack generation coil and focused geometry, and no significant difference is found between the focused and the unfocused EMAT response. This highlights the importance of designing the EMAT coil for the correct lift-off and desired frequency of operation.
Collapse
Affiliation(s)
- C B Thring
- Department of Physics, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - S J Hill
- Department of Physics, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - S Dixon
- Department of Physics, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - R S Edwards
- Department of Physics, University of Warwick, Coventry CV4 7AL, United Kingdom.
| |
Collapse
|
12
|
Rembacken BJ, Dixon S, Albuquerque A, Fairbrass K, Pana M. Barriers and bias standing in the way of female trainees wanting to learn advanced endoscopy. United European Gastroenterol J 2019; 7:1141-1145. [PMID: 31662873 PMCID: PMC6794690 DOI: 10.1177/2050640619877603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- B J Rembacken
- Leeds Teaching Hospitals NHS Trust Corresponding author: Bjorn Rembacken
| | - S Dixon
- Leeds Teaching Hospitals NHS Trust Corresponding author: Bjorn Rembacken
| | - A Albuquerque
- Leeds Teaching Hospitals NHS Trust Corresponding author: Bjorn Rembacken
| | - K Fairbrass
- Leeds Teaching Hospitals NHS Trust Corresponding author: Bjorn Rembacken
| | - M Pana
- Leeds Teaching Hospitals NHS Trust Corresponding author: Bjorn Rembacken
| |
Collapse
|
13
|
Rice H, Fallowfield J, Allsopp A, Dixon S. Altered forefoot function following a military training activity. Gait Posture 2019; 74:182-186. [PMID: 31539799 DOI: 10.1016/j.gaitpost.2019.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 10/16/2018] [Revised: 08/30/2019] [Accepted: 09/09/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Injury rates are high in populations that regularly undertake weight-bearing physical activity, particularly military populations. Military training activities, that often include load carriage, have been associated with lower limb injury occurrence, specifically stress fractures. RESEARCH QUESTION Recent work identified plantar loading variables as risk factors for lower limb stress fractures in Royal Marines recruits that were assessed during barefoot running. This study aimed to quantify how those plantar loading variables changed in Royal Marines recruits following a prolonged military load carriage activity, to further understand potential mechanisms for lower limb stress fractures. METHODS Bilateral, synchronised plantar pressure and lower limb kinematic data were recorded during barefoot running at 3.6 m s-1 (±5%) pre- and post- a 12.8-km training activity (∼150 min). The training activity was completed with an average speed typical of walking (1.4 m.s-1), and 35.5 kg of additional load was carried throughout. Data were collected from 32 male Royal Marines recruits who completed the training activity in week-21 of the 32-week training programme. Plantar pressure variables and ankle dorsiflexion were compared between pre- and post-activity. RESULTS Post-activity there was reduced loading under the forefoot and increased loading under the rearfoot and midfoot. There was no change in dorsiflexion touchdown angle, but an increase in peak dorsiflexion and range of motion post-activity. SIGNIFICANCE The increased rearfoot loading, reduced forefoot loading and increased ankle dorsiflexion following a prolonged military load carriage activity suggest a reduced transfer of loading from the rearfoot to the forefoot during stance, which may have implications for the development of stress fractures, particularly of the metatarsals.
Collapse
Affiliation(s)
- H Rice
- Sport and Health Sciences, University of Exeter, Exeter, UK.
| | - J Fallowfield
- Institute of Naval Medicine, Alverstoke, Gosport, PO12, UK
| | - A Allsopp
- Institute of Naval Medicine, Alverstoke, Gosport, PO12, UK
| | - S Dixon
- Sport and Health Sciences, University of Exeter, Exeter, UK
| |
Collapse
|
14
|
King M, Kerr A, Dixon S, Taylor S, Smith A, Merriman C, Mitchell J, Canavan J, Hunter V. Multicentre review of readmission rates within 30 days of discharge following lung cancer surgery. Br J Nurs 2019; 28:S16-S22. [PMID: 31556737 DOI: 10.12968/bjon.2019.28.17.s16] [Citation(s) in RCA: 2] [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] [Indexed: 11/11/2022]
Abstract
Postoperative complications following curative lung cancer surgery are well recognised, but there is limited data on 30-day readmission rates. The UK Thoracic Surgery Group conducted a multicentre review over a 3-month period to assess readmission rates. Overall readmission among the 268 patients who had undergone primary lung cancer surgery was 30 (11%); 14/30 of readmissions occurred within 7 days of discharge, with 13/30 patients readmitted to a hospital that had not performed the surgery. The causes of readmission were mainly pulmonary related (16/30). Readmission was associated with being discharged with a pleural drain 11/30 (P<0.01), having two or more postoperative complications 11/30 (P<0.01) and a patient's readiness for discharge 9/30 (P=0.001). There was a trend toward an association with smoking 13/30 (P=0.18). The authors suggest that a greater focus on patients presenting with characteristics associated with readmission, and incorporating a patient's readiness for discharge, may reduce readmission, although more studies are needed.
Collapse
Affiliation(s)
- Maureen King
- Thoracic Oncology Clinical Nurse Specialist, Royal Papworth Hospital, Cambridge
| | - Amy Kerr
- Senior Thoracic Surgery Research Nurse, Heart of England NHS Foundation Trust, Birmingham
| | - Sandra Dixon
- Macmillan Thoracic Surgical Nurse Specialist, Leeds General Infirmary, Leeds
| | - Sarah Taylor
- Thoracic Nurse Specialist, Glenfield Hospital, Leicester
| | - Alison Smith
- Advanced Practitioner in Cardiothoracic Surgery, Harefield Hospital, Uxbridge
| | - Charlotte Merriman
- Macmillan Advanced Nurse Practitioner, Oxford University Hospitals NHS Trust, Oxford
| | - Jenny Mitchell
- Advanced Nurse Practitioner, Thoracic Surgery, Oxford University Hospitals NHS Trust, Oxford
| | - Jane Canavan
- Macmillan Advanced Therapist Practitioner, Oxford University Hospital, Oxford
| | - Verity Hunter
- Clinical Audit and Effectiveness Supervisor, Royal Papworth Hospital, Cambridge
| |
Collapse
|
15
|
Dixon S. Intersectionality of Cultural Identities in Health Psychology: Key Recommendations for Working With African-Caribbean Immigrant Women. Front Sociol 2019; 4:51. [PMID: 33869374 PMCID: PMC8022647 DOI: 10.3389/fsoc.2019.00051] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 06/03/2019] [Indexed: 06/12/2023]
Abstract
While the field of health psychology has progressed over the years, much work still needs to be done when considering immigrants' health care and well-being. Particularly, for African-Caribbean immigrants, the intersectionality of their cultural identities in the health care system require much attention moving forward. Therefore, this article is particularly relevant for Canada's multicultural society; it describes cultural identity reconstruction within health psychology as a common issue for diverse groups, particularly African-Caribbean immigrant women. The article speaks to the holistic worldview that is required in a paradigm shift which engages a pluralistic society that is Canada. The author presents a key cultural identity model and assessment tool that should be integrated into the health care system to ensure culturally-sensitive and inclusive care for immigrants, especially women. As is argued in the article, contemporary research, advocacy, and social movements speak to invoking alternative ways to complement the prevailing downstream approach to health psychology. In a growing multicultural society that should strive on honoring and respecting the pluralistic cultural worldviews of all people in the health care system, many immigrant women struggle to cope with the social determinants of health post-migration. Their concerns are often pushed to the margins of health care services, with several individuals relying on their faith for coping strategies. This article concludes with culturally-informed and socially-just recommendations for health care professionals working with immigrant populations, particularly African Caribbean immigrant women.
Collapse
Affiliation(s)
- Sandra Dixon
- Faculty of Education, University of Lethbridge, Lethbridge, AB, Canada
| |
Collapse
|
16
|
Lee M, Dixon S, Hind D, Bradburn M. Could early total parenteral nutrition in small bowel obstruction be cost effective? Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.043] [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: 10/27/2022]
|
17
|
Dixon S, Horgan LF. The elusive spleen. Ann R Coll Surg Engl 2019; 101:176-179. [PMID: 30602286 DOI: 10.1308/rcsann.2018.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this study was to review the experience of general surgeons performing splenectomy in a district general hospital. The outcomes are discussed together with potential reasons for the increasing rarity of the procedure. METHODS A retrospective cohort study was carried out of all patients undergoing splenectomy (as identified by a single trust pathology department on receipt of splenic samples) between 1 January 2000 and 1 May 2017. Case notes and computer systems were interrogated for data on operating surgeon, patient demographics, diagnosis, surgical approach (laparoscopic/open/converted to open), critical care admission and 30-day mortality. RESULTS During the study period, 170 consecutive splenectomies were undertaken by 24 different operating surgeons. There were on average 5.8 planned and 4.2 unplanned splenectomies per year. The 30-day mortality rate for all splenectomies was 8.8%, with an elective 30-day mortality rate of 2.0%. Only 3 of the current consultant surgeons had undertaken more than 6 cases over the 17-year study period. Some senior consultants had not performed any splenectomies (either planned or unplanned) during the 17-year study period. CONCLUSIONS Splenectomy is required ever more rarely and experience as a district general hospital consultant is limited. Possible reasons for this include improvements in medical management of haematological diseases, the increasing use of conservative and radiological management for traumatic splenic injury, and a reduction in trauma cases and diversion of such cases to major trauma centres. Trainees and consultants must seek experience during specialty training or via cadaveric training in order to demonstrate competence.
Collapse
Affiliation(s)
- S Dixon
- Health Education England - North East , UK
| | - L F Horgan
- Northumbria Healthcare NHS Foundation Trust , UK
| |
Collapse
|
18
|
Dixon S, Karrow N, Cánovas A, Borkowski E, Menzies P, Boareki M, Fonseca P, Suárez-Vega A, Kennedy D, Peregrine A, Mallard B. PSI-30 Identifying key regulator genes associated with parasite resistance and their link with climate conditions in sheep. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.407] [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)
- S Dixon
- University of Guelph,Waterloo, ON, Canada
| | - N Karrow
- University of Guelph,Guelph, ON, Canada
| | - A Cánovas
- Department of Animal Biosciences, Centre for Genetic Improvement of Livestock, University of Guelph,Guelph, ON, Canada
| | - E Borkowski
- Ontario Veterinary College,Guelph, ON, Canada
| | - P Menzies
- Ontario Veterinary College,Guelph, ON, Canada
| | - M Boareki
- University of Guelph,Guelph, ON, Canada
| | - P Fonseca
- Universidade Federal de Minas Gerais,Pampulha, Belo Horizonte, Brazil
| | | | - D Kennedy
- Ontario Ministry of Agricultural, Food and Rural Affairs,Simcoe, ON, Canada
| | - A Peregrine
- Ontario Veterinary College,Guelph, ON, Canada
| | - B Mallard
- University of Guelph - Ontario Veterinary College - Department of Pathobiology,Guelph, ON, Canada
| |
Collapse
|
19
|
Gallagher KE, Kelly H, Cocks N, Dixon S, Mounier-Jack S, Howard N, Watson-Jones D. Vaccine programme stakeholder perspectives on a hypothetical single-dose human papillomavirus (HPV) vaccine schedule in low and middle-income countries. Papillomavirus Res 2018; 6:33-40. [PMID: 30352297 PMCID: PMC6218645 DOI: 10.1016/j.pvr.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/03/2018] [Accepted: 10/16/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommends a 2-dose HPV vaccine schedule for girls aged 9-14 years. As randomised controlled trials assessing the immunogenicity and efficacy of a 1-dose schedule are ongoing, we interviewed immunisation programme managers and advisors in low and middle-income countries (LMIC) about a hypothetical, future reduction in the HPV vaccine schedule. METHODS We conducted semi-structured interviews with LMIC immunisation programme managers and national immunisation technical advisory group members (key informants; KIs) in 2017, recruited for their knowledge/experience in national HPV vaccine policy and provision. Data were analysed thematically. RESULTS We conducted 30 interviews with KIs from 18 countries. Perceived advantages of a 1-dose schedule included reduced logistical and financial resources needed for vaccine delivery, fewer cold chain requirements and easier integration into routine immunisation services. Perceived challenges included health worker hesitancy, resources needed to re-mobilise communities and re-train health workers, potential misrepresentation of schedule changes by anti-vaccine groups or the media. Half of interviewees suggested a WHO recommendation would be necessary prior to policy change. CONCLUSIONS We found wide-ranging support among LMIC immunisation managers and advisors for a 1-dose vaccine schedule if research demonstrated immunological and clinical evidence of efficacy, and WHO provided a formal recommendation.
Collapse
Affiliation(s)
- Katherine E Gallagher
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, Keppel St, London WC1E 7HT, United Kingdom.
| | - Helen Kelly
- London School of Hygiene and Tropical Medicine, Clinical Research Department, Keppel St, London WC1E 7HT, United Kingdom.
| | - Naomi Cocks
- London School of Hygiene and Tropical Medicine, Clinical Research Department, Keppel St, London WC1E 7HT, United Kingdom.
| | - Sandra Dixon
- London School of Hygiene and Tropical Medicine, Clinical Research Department, Keppel St, London WC1E 7HT, United Kingdom.
| | - Sandra Mounier-Jack
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, Keppel St, London WC1E 7HT, United Kingdom.
| | - Natasha Howard
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, Keppel St, London WC1E 7HT, United Kingdom.
| | - Deborah Watson-Jones
- London School of Hygiene and Tropical Medicine, Clinical Research Department, Keppel St, London WC1E 7HT, United Kingdom; Mwanza Intervention Trials Unit, National Institute for Medical Research, PO Box 11936, Mwanza, Tanzania.
| |
Collapse
|
20
|
King M, Kerr A, Dixon S, Taylor S, Smith A, Merriman C, Mitchell J, Hunter V. MA17.11 Multi-Centred, Prospective, Audit to Identify Readmission Causes and Complications Within 30 of Primary Lung Cancer Surgery. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
21
|
Dixon S, Agha K, Ali F, El-Hindi L, Kelly B, Locock L, Otoo-Oyortey N, Penny S, Plugge E, Hinton L. Female genital mutilation in the UK- where are we, where do we go next? Involving communities in setting the research agenda. Res Involv Engagem 2018; 4:29. [PMID: 30237901 PMCID: PMC6139895 DOI: 10.1186/s40900-018-0103-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Female Genital Mutilation (FGM) is all practices involving cutting, alteration or injury to the female genitalia for non-medical reasons. It is a form of violence against women and children, with no benefits and many harms. In 2014, the UK Government committed to working to eliminate FGM. Steps taken towards this aim included creation of educational and safeguarding resources for professionals, and legislative changes including a mandatory reporting duty for professionals in England and Wales (where if a girl under 18 discloses or is found on examination to have FGM then the professional is mandated to report this to the police), and an FGM Enhanced Dataset applicable to NHS organisations in England requiring the submission of personal data about women and girls who have had FGM to NHS Digital. To date, compliance with dataset returns from primary care services have been low. This report describes using patient and public involvement (PPI) to identify research and service priorities to support communities affected by FGM. METHODS We held a series of PPI events (4 focus groups, and a multi-agency seminar) in 2015-2016, following the introduction of these legislative changes, speaking to community members, and professionals involved in their care. We asked participants to consider what they identified as research, knowledge and service priorities to support communities affected by FGM. RESULTS The impact of these legislative and reporting requirements on the trust needed for community members to seek to consult health services was identified as important for further research. Priorities for service development were holistic services, that met a woman's needs throughout her lifecourse. Participants emphasised the importance of understanding how to listen, involve and utilise community voices in developing education for professionals, designing services, and developing policy. CONCLUSIONS There was a desire for change to develop from within affected communities; any learning and resources need to be co-created and constructed in such a way that they can be effectively shared between women, communities, and professionals. Questions remain about how to define community consultation, how to recognise when it was adequate, and how to hear beyond community activists to hear a wider range of voices.
Collapse
Affiliation(s)
- S. Dixon
- Nuffield department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - K. Agha
- Oxford Against Cutting, Oxford, UK
| | - F. Ali
- Midaye Somali Development Network, London, UK
| | | | - B. Kelly
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - L. Locock
- Nuffield department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - S. Penny
- English Creative Writing Department, Brunel University, London, UK
| | - E. Plugge
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - L. Hinton
- Nuffield department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
22
|
Dixon S, Fazel M, Kelly B, Andersson M, Al-Hourani K, Dwivedi K, O'Higgins A, Reeves M. 1.10-P2The Oxford (UK) Refugee Health Initiative project: medical students supporting refugee families to provide healthcare advocacy and develop skills to care for vulnerable groups of patients. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.002] [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)
- S Dixon
- Nuffield Department Of Primary Health Care Sciences, University Of Oxford, United Kingdom
| | - M Fazel
- Department of Psychiatry, Medical Sciences Division, University of Oxford, United Kingdom
| | - B Kelly
- Nuffield Department of Obstetrics and Gynaecology, Medical Sciences Division, University of Oxford, United Kingdom
| | - M Andersson
- Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, United Kingdom
| | - K Al-Hourani
- Oxford University Medical School, United Kingdom
| | - K Dwivedi
- Oxford University Medical School, United Kingdom
| | - A O'Higgins
- Department of Education, University of Oxford, United Kingdom
| | - M Reeves
- Cowley Road Medical Practice, Oxford, United Kingdom
| |
Collapse
|
23
|
Dixon S, Hinton L, Locock L. 4.11-P7Exploring community and professional priorities for research and resource development for supporting women and communities in the UK affected by female genital mutilation: report from a PPI project. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.172] [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)
- S Dixon
- Health Experiences Research Group, Nuffield Department of Primary Health Care Sciences, University of Oxford, United Kingdom
| | - L Hinton
- Health Experiences Research Group, Nuffield Department of Primary Health Care Sciences, University of Oxford, United Kingdom
| | - L Locock
- Health Services Research Unit, University of Aberdeen, United Kingdom
| |
Collapse
|
24
|
Arundel C, Fairhurst C, Corbacho-Martin B, Buckley H, Clarke E, Cullum N, Dixon S, Dumville J, Firth A, Henderson E, Lamb K, McGinnis E, Oswald A, Saramago Goncalves P, Soares MO, Stubbs N, Chetter I. Pilot feasibility randomized clinical trial of negative-pressure wound therapy versus usual care in patients with surgical wounds healing by secondary intention. BJS Open 2018; 2:99-111. [PMID: 29951633 PMCID: PMC5989956 DOI: 10.1002/bjs5.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/13/2017] [Indexed: 01/09/2023] Open
Abstract
Background Surgical wounds healing by secondary intention (SWHSI) are increasingly being treated with negative-pressure wound therapy (NPWT) despite a lack of high-quality research evidence regarding its clinical and cost-effectiveness. This pilot feasibility RCT aimed to assess the methods for and feasibility of conducting a future definitive RCT of NPWT for the treatment of SWHSI. Methods Eligible consenting adult patients receiving care at the study sites (2 acute and 1 community) and with a SWHSI appropriate for NPWT or wound dressing treatment were randomized 1 : 1 centrally to receive NPWT or usual care (no NPWT). Participants were followed up every 1-2 weeks for 3 months. Feasibility (recruitment rate, time to intervention delivery) and clinical (time to wound healing) outcomes were assessed. Results A total of 248 participants were screened for eligibility; 40 (16·1 per cent) were randomized, 19 to NPWT and 21 to usual care. Twenty-four of the 40 wounds were located on the foot. Participants received NPWT for a median of 18 (range 0-72) days. Two participants in the NPWT group never received the intervention and 14 received NPWT within 48 h of randomization. Five participants in the usual care group received NPWT during the study. Ten of the 40 wounds were deemed to have healed during the study. Conclusion A full-scale RCT to investigate the clinical and cost-effectiveness of NPWT for SWHSI is feasible. This study identified crucial information on recruitment rates and data collection methods to consider during the design of a definitive RCT. Registration number: ISRCTN12761776 (http://www.iscrtn.com).
Collapse
Affiliation(s)
- C Arundel
- York Trials Unit, Department of Health Sciences University of York York UK
| | - C Fairhurst
- York Trials Unit, Department of Health Sciences University of York York UK
| | - B Corbacho-Martin
- York Trials Unit, Department of Health Sciences University of York York UK
| | - H Buckley
- York Trials Unit, Department of Health Sciences University of York York UK
| | - E Clarke
- Academic Vascular Surgical Unit Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | - N Cullum
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK.,Research and Innovation Division, Central Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK
| | - S Dixon
- Patient and Public Involvement Group Hull UK
| | - J Dumville
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - A Firth
- Academic Vascular Surgical Unit Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | - E Henderson
- Outpatient Services Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | - K Lamb
- Leeds Wound Research Unit Leeds Community Healthcare NHS Trust Leeds UK
| | - E McGinnis
- Department for Tissue Viability Leeds Teaching Hospitals NHS Trust Leeds UK
| | - A Oswald
- Academic Vascular Surgical Unit Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | | | - M O Soares
- Centre for Health Economics University of York York UK
| | - N Stubbs
- Leeds Wound Research Unit Leeds Community Healthcare NHS Trust Leeds UK
| | - I Chetter
- Centre for Health Economics University of York York UK.,Research Office Hull York Medical School Hull UK
| |
Collapse
|
25
|
Gaukroger A, Evans J, Dixon S. Does Skin Prep Alter Suture Strength Characteristics? Assessing the Effect of Chlorhexidine and Isopropyl Alcohol on Common Skin Closure Suture Material. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
26
|
Pompili C, Velikova G, White J, Callister M, Robson J, Dixon S, Franks K, Brunelli A. Poor preoperative patient-reported quality of life is associated with complications following pulmonary lobectomy for lung cancer. Eur J Cardiothorac Surg 2017; 51:526-531. [PMID: 28082473 DOI: 10.1093/ejcts/ezw363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Received: 07/29/2016] [Accepted: 09/05/2016] [Indexed: 12/20/2022] Open
Abstract
Objectives To assess whether quality of life (QOL) was associated with cardiopulmonary complications following pulmonary lobectomy for lung cancer. Methods Retrospective analysis of 200 consecutive patients who had pulmonary lobectomy for lung cancer (September 2014-October 2015). QOL was assessed by the self-administration of the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire within 2 weeks before the operation. The individual QOL scales were tested for a possible association with cardiopulmonary complications along with other objective baseline and surgical parameters by univariable and multivariable analyses. Results Forty-three patients (21.5%) developed postoperative cardiopulmonary complications; 4 of them died within 30 days (2%). Univariable analysis showed that, compared to patients without complications, those with complications reported a lower global health status (GHS) [59.1; standard deviation (SD) 27.2 vs 69.6; SD 20.6, P = 0.02], were older (71.2; SD 8.4 vs 67.7; SD 9.4, P = 0.03), had lower values of forced expiratory volume in one second (FEV1) (83.9; SD 27.2 vs 91.4; SD 20.9), P = 0.06) and carbon monoxide lung diffusion capacity (DLCO) (67.9; SD 20.9 vs 74.2; SD 17.6, P = 0.02) and higher performance score (0.76; SD 0.63 vs 0.53; SD 0.64, P = 0.02). Stepwise logistic regression analysis showed that factors independently associated with cardiopulmonary complications were age [odds ratio (OR) 1.04, 95% CI 1.0-1.09, P = 0.02] and patient-reported GHS [OR 0.98, 95% confidence interval (CI) 0.96-0.99, P = 0.006], whereas other objective parameters (i.e. FEV1, DLCO) were not. The best cut-off value for GHS to discriminate patients with complications after surgery was 50 (c-index 0.65, 95% CI 0.58-0.72). Conclusions A poor GHS perceived by the patient was associated with postoperative cardiopulmonary morbidity. Patient perceptions and values should be included in the risk stratification process to tailor cancer treatment.
Collapse
Affiliation(s)
- Cecilia Pompili
- Leeds Institute of Cancer and Pathology, Section of Patient Centered Outcomes Research, Leeds, UK
| | - Galina Velikova
- Leeds Institute of Cancer and Pathology, Section of Patient Centered Outcomes Research, Leeds, UK
| | - John White
- Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Matthew Callister
- Department of Respiratory Medicine, St. James's University Hospital, Leeds, UK
| | - Jonathan Robson
- Department of Respiratory Medicine, St. James's University Hospital, Leeds, UK
| | - Sandra Dixon
- Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Kevin Franks
- Department of Clinical Oncology, St. James's University Hospital, Leeds, UK
| | | |
Collapse
|
27
|
Dixon S. 100: Guideline for smoking cessation prior to lung cancer treatment. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
28
|
Roberts A, Roscoe D, Hulse D, Bennett A, Dixon S. BIOMECHANICAL DIFFERENCES BETWEEN CASES WITH CECS AND ASYMPTOMATIC CONTROLS DURING WALKING AND MARCHING. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096952.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
29
|
Roberts A, Roscoe D, Hulse D, Bennett A, Dixon S. BIOMECHANICAL DIFFERENCES BETWEEN CASES WITH CECS AND ASYMPTOMATIC CONTROLS DURING RUNNING. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096952.32] [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]
|
30
|
Lopes JC, Harper MT, Giallongo F, Oh J, Smith LG, Ortega-Perez AM, Dixon S, Kniffen DM, Fabin RA, Hristov AN. 1310 Effect of high-oleic acid whole, heated soybeans or extruded soybean meal on production performance, milk fatty acid composition, and enteric methane emission in dairy cows. J Anim Sci 2016. [DOI: 10.2527/jam2016-1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
31
|
Pompili C, White J, Velikova G, O'Connor T, Ying JM, Dixon S, Kefaloyannis E, Brunelli A. O-025POOR PREOPERATIVE PATIENT-REPORTED QUALITY OF LIFE IS ASSOCIATED WITH COMPLICATIONS FOLLOWING PULMONARY LOBECTOMY FOR LUNG CANCER. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.25] [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: 11/12/2022] Open
|
32
|
McCallum IJD, McLean RC, Dixon S, O'Loughlin P. Retrospective analysis of 30-day mortality for emergency general surgery admissions evaluating the weekend effect. Br J Surg 2016; 103:1557-65. [DOI: 10.1002/bjs.10261] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 02/05/2016] [Accepted: 06/06/2016] [Indexed: 11/09/2022]
Abstract
Abstract
Background
The weekend effect describes excess mortality associated with hospital admission on Saturday or Sunday. This study assessed whether a weekend effect exists for patients admitted for emergency general surgery.
Methods
Data for emergency general surgical admissions to National Health Service hospitals in the Northern Deanery in England between 2000 and 2014 were collected, including demographics, co-morbidities, diagnoses, operations undertaken and outcomes. The primary outcome of interest was in-hospital death within 30 days of admission. Cox regression analysis was undertaken with adjustment for co-variables.
Results
There were 12 100 in-hospital deaths within 30 days of admission (3·3 per cent). The overall 30-day mortality rate reduced significantly during the 15-year interval studied, from 5·4 per cent (2000–2004) to 4·0 per cent (2005–2009) and 2·9 per cent during 2010–2014 (P < 0·001). There was no significant mortality difference for patients admitted at the weekend in adjusted Cox models (hazard ratio (HR) 1·00 for Saturday and 0·90 for Sunday, versus Wednesday). There was a significantly higher mortality for operations undertaken at the weekend (HR 1·15 for Saturday and 1·40 for Sunday; P = 0·021 and P < 0·001 respectively). The significantly increased mortality that was evident for emergency surgery at the weekend compared with weekdays in 2000–2004 (HR 1·46 for Saturday and 1·55 for Sunday; both P < 0·001); had reduced by 2010–2014, when the adjusted mortality risk was not significant (HR 1·18 for Saturday and 1·12 for Sunday).
Conclusion
During the past 15 years there has been a weekend effect in patients undergoing emergency general surgery based on day of operation, but not day of admission. Overall mortality for emergency general surgery has improved significantly, and in the past 5 years the increased mortality risk of weekend surgery has reduced.
Collapse
Affiliation(s)
- I J D McCallum
- Department of Colorectal Surgery, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK
| | - R C McLean
- Department of Colorectal Surgery, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK
| | - S Dixon
- Department of Colorectal Surgery, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK
| | - P O'Loughlin
- Department of Colorectal Surgery, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK
| |
Collapse
|
33
|
Schultz C, Dixon S. SU-F-I-77: Radiation Dose in Cardiac Catheterization Procedures: Impact of a Systematic Reduction in Pulsed Fluoroscopy Frame Rate. Med Phys 2016. [DOI: 10.1118/1.4955905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
34
|
|
35
|
Adamson P, Ader C, Andrews M, Anfimov N, Anghel I, Arms K, Arrieta-Diaz E, Aurisano A, Ayres DS, Backhouse C, Baird M, Bambah BA, Bays K, Bernstein R, Betancourt M, Bhatnagar V, Bhuyan B, Bian J, Biery K, Blackburn T, Bocean V, Bogert D, Bolshakova A, Bowden M, Bower C, Broemmelsiek D, Bromberg C, Brunetti G, Bu X, Butkevich A, Capista D, Catano-Mur E, Chase TR, Childress S, Choudhary BC, Chowdhury B, Coan TE, Coelho JAB, Colo M, Cooper J, Corwin L, Cronin-Hennessy D, Cunningham A, Davies GS, Davies JP, Del Tutto M, Derwent PF, Deepthi KN, Demuth D, Desai S, Deuerling G, Devan A, Dey J, Dharmapalan R, Ding P, Dixon S, Djurcic Z, Dukes EC, Duyang H, Ehrlich R, Feldman GJ, Felt N, Fenyves EJ, Flumerfelt E, Foulkes S, Frank MJ, Freeman W, Gabrielyan M, Gallagher HR, Gebhard M, Ghosh T, Gilbert W, Giri A, Goadhouse S, Gomes RA, Goodenough L, Goodman MC, Grichine V, Grossman N, Group R, Grudzinski J, Guarino V, Guo B, Habig A, Handler T, Hartnell J, Hatcher R, Hatzikoutelis A, Heller K, Howcroft C, Huang J, Huang X, Hylen J, Ishitsuka M, Jediny F, Jensen C, Jensen D, Johnson C, Jostlein H, Kafka GK, Kamyshkov Y, Kasahara SMS, Kasetti S, Kephart K, Koizumi G, Kotelnikov S, Kourbanis I, Krahn Z, Kravtsov V, Kreymer A, Kulenberg C, Kumar A, Kutnink T, Kwarciancy R, Kwong J, Lang K, Lee A, Lee WM, Lee K, Lein S, Liu J, Lokajicek M, Lozier J, Lu Q, Lucas P, Luchuk S, Lukens P, Lukhanin G, Magill S, Maan K, Mann WA, Marshak ML, Martens M, Martincik J, Mason P, Matera K, Mathis M, Matveev V, Mayer N, McCluskey E, Mehdiyev R, Merritt H, Messier MD, Meyer H, Miao T, Michael D, Mikheyev SP, Miller WH, Mishra SR, Mohanta R, Moren A, Mualem L, Muether M, Mufson S, Musser J, Newman HB, Nelson JK, Niner E, Norman A, Nowak J, Oksuzian Y, Olshevskiy A, Oliver J, Olson T, Paley J, Pandey P, Para A, Patterson RB, Pawloski G, Pearson N, Perevalov D, Pershey D, Peterson E, Petti R, Phan-Budd S, Piccoli L, Pla-Dalmau A, Plunkett RK, Poling R, Potukuchi B, Psihas F, Pushka D, Qiu X, Raddatz N, Radovic A, Rameika RA, Ray R, Rebel B, Rechenmacher R, Reed B, Reilly R, Rocco D, Rodkin D, Ruddick K, Rusack R, Ryabov V, Sachdev K, Sahijpal S, Sahoo H, Samoylov O, Sanchez MC, Saoulidou N, Schlabach P, Schneps J, Schroeter R, Sepulveda-Quiroz J, Shanahan P, Sherwood B, Sheshukov A, Singh J, Singh V, Smith A, Smith D, Smolik J, Solomey N, Sotnikov A, Sousa A, Soustruznik K, Stenkin Y, Strait M, Suter L, Talaga RL, Tamsett MC, Tariq S, Tas P, Tesarek RJ, Thayyullathil RB, Thomsen K, Tian X, Tognini SC, Toner R, Trevor J, Tzanakos G, Urheim J, Vahle P, Valerio L, Vinton L, Vrba T, Waldron AV, Wang B, Wang Z, Weber A, Wehmann A, Whittington D, Wilcer N, Wildberger R, Wildman D, Williams K, Wojcicki SG, Wood K, Xiao M, Xin T, Yadav N, Yang S, Zadorozhnyy S, Zalesak J, Zamorano B, Zhao A, Zirnstein J, Zwaska R. First Measurement of Electron Neutrino Appearance in NOvA. Phys Rev Lett 2016; 116:151806. [PMID: 27127961 DOI: 10.1103/physrevlett.116.151806] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Indexed: 06/05/2023]
Abstract
We report results from the first search for ν_{μ}→ν_{e} transitions by the NOvA experiment. In an exposure equivalent to 2.74×10^{20} protons on target in the upgraded NuMI beam at Fermilab, we observe 6 events in the Far Detector, compared to a background expectation of 0.99±0.11(syst) events based on the Near Detector measurement. A secondary analysis observes 11 events with a background of 1.07±0.14(syst). The 3.3σ excess of events observed in the primary analysis disfavors 0.1π<δ_{CP}<0.5π in the inverted mass hierarchy at the 90% C.L.
Collapse
Affiliation(s)
- P Adamson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Ader
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Andrews
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - N Anfimov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - I Anghel
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - K Arms
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - E Arrieta-Diaz
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Aurisano
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - D S Ayres
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - C Backhouse
- California Institute of Technology, Pasadena, California 91125, USA
| | - M Baird
- Indiana University, Bloomington, Indiana 47405, USA
| | - B A Bambah
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - K Bays
- California Institute of Technology, Pasadena, California 91125, USA
| | - R Bernstein
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Betancourt
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Bhatnagar
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - B Bhuyan
- Department of Physics, IIT Guwahati, Guwahati 781 039, India
| | - J Bian
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - K Biery
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Blackburn
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - V Bocean
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Bogert
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Bolshakova
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - M Bowden
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Bower
- Indiana University, Bloomington, Indiana 47405, USA
| | - D Broemmelsiek
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Bromberg
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Brunetti
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - X Bu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Butkevich
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - D Capista
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - E Catano-Mur
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - T R Chase
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Childress
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B C Choudhary
- Department of Physics & Astrophysics, University of Delhi, Delhi 110007, India
| | - B Chowdhury
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - T E Coan
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J A B Coelho
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M Colo
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - J Cooper
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Corwin
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - D Cronin-Hennessy
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Cunningham
- Physics Department, University of Texas at Dallas, 800 W. Campbell Road, Richardson, Texas 75083-0688, USA
| | - G S Davies
- Indiana University, Bloomington, Indiana 47405, USA
| | - J P Davies
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - M Del Tutto
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P F Derwent
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K N Deepthi
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - D Demuth
- Math, Science and Technology Department, University of Minnesota-Crookston, Crookston, Minnesota 56716, USA
| | - S Desai
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - G Deuerling
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Devan
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - J Dey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Dharmapalan
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - P Ding
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Dixon
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Djurcic
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E C Dukes
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - H Duyang
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Ehrlich
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - G J Feldman
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - N Felt
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - E J Fenyves
- Physics Department, University of Texas at Dallas, 800 W. Campbell Road, Richardson, Texas 75083-0688, USA
| | - E Flumerfelt
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - S Foulkes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M J Frank
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - W Freeman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Gabrielyan
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - H R Gallagher
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M Gebhard
- Indiana University, Bloomington, Indiana 47405, USA
| | - T Ghosh
- Instituto de Física, Universidade Federal de Goiás, Goiánia, Goiás 74690-900, Brazil
| | - W Gilbert
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Giri
- Department of Physics, IIT Hyderabad, Hyderabad 502 205, India
| | - S Goadhouse
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - R A Gomes
- Instituto de Física, Universidade Federal de Goiás, Goiánia, Goiás 74690-900, Brazil
| | - L Goodenough
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M C Goodman
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Grichine
- Nuclear Physics Department, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - N Grossman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Group
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - J Grudzinski
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Guarino
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - B Guo
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A Habig
- Department of Physics and Astronomy, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - T Handler
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - J Hartnell
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - R Hatcher
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Hatzikoutelis
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - K Heller
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - C Howcroft
- California Institute of Technology, Pasadena, California 91125, USA
| | - J Huang
- Department of Physics, University of Texas at Austin, 1 University Station C1600, Austin, Texas 78712, USA
| | - X Huang
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Hylen
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Ishitsuka
- Indiana University, Bloomington, Indiana 47405, USA
| | - F Jediny
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - C Jensen
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Jensen
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Johnson
- Indiana University, Bloomington, Indiana 47405, USA
| | - H Jostlein
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G K Kafka
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - Y Kamyshkov
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - S M S Kasahara
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Kasetti
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - K Kephart
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Koizumi
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Kotelnikov
- Nuclear Physics Department, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - I Kourbanis
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Krahn
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Kravtsov
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Kreymer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Ch Kulenberg
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - A Kumar
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - T Kutnink
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - R Kwarciancy
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Kwong
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - K Lang
- Department of Physics, University of Texas at Austin, 1 University Station C1600, Austin, Texas 78712, USA
| | - A Lee
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - W M Lee
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Lee
- Physics and Astronomy Department, UCLA, Box 951547, Los Angeles, California 90095-1547, USA
| | - S Lein
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - J Liu
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - M Lokajicek
- Institute of Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - J Lozier
- California Institute of Technology, Pasadena, California 91125, USA
| | - Q Lu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Lucas
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Luchuk
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Lukhanin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Magill
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - K Maan
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - W A Mann
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M L Marshak
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - M Martens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Martincik
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - P Mason
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - K Matera
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Mathis
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - V Matveev
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - N Mayer
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - E McCluskey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Mehdiyev
- Department of Physics, University of Texas at Austin, 1 University Station C1600, Austin, Texas 78712, USA
| | - H Merritt
- Indiana University, Bloomington, Indiana 47405, USA
| | - M D Messier
- Indiana University, Bloomington, Indiana 47405, USA
| | - H Meyer
- Physics Division, Wichita State University, 1845 Fairmout Street, Wichita, Kansas 67220, USA
| | - T Miao
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Michael
- California Institute of Technology, Pasadena, California 91125, USA
| | - S P Mikheyev
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - W H Miller
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S R Mishra
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Mohanta
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - A Moren
- Department of Physics and Astronomy, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - L Mualem
- California Institute of Technology, Pasadena, California 91125, USA
| | - M Muether
- Physics Division, Wichita State University, 1845 Fairmout Street, Wichita, Kansas 67220, USA
| | - S Mufson
- Indiana University, Bloomington, Indiana 47405, USA
| | - J Musser
- Indiana University, Bloomington, Indiana 47405, USA
| | - H B Newman
- California Institute of Technology, Pasadena, California 91125, USA
| | - J K Nelson
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - E Niner
- Indiana University, Bloomington, Indiana 47405, USA
| | - A Norman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Nowak
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - Y Oksuzian
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - A Olshevskiy
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - J Oliver
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - T Olson
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - J Paley
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Pandey
- Department of Physics & Astrophysics, University of Delhi, Delhi 110007, India
| | - A Para
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R B Patterson
- California Institute of Technology, Pasadena, California 91125, USA
| | - G Pawloski
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - N Pearson
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Perevalov
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Pershey
- California Institute of Technology, Pasadena, California 91125, USA
| | - E Peterson
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Petti
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Phan-Budd
- Department of Physics, Winona State University, P.O. Box 5838, Winona, Minnesota 55987, USA
| | - L Piccoli
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Pla-Dalmau
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R K Plunkett
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Poling
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - B Potukuchi
- Department of Physics and Electronics, University of Jammu, Jammu Tawi, 180 006 Jammu & Kashmir, India
| | - F Psihas
- Indiana University, Bloomington, Indiana 47405, USA
| | - D Pushka
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - X Qiu
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - N Raddatz
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Radovic
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - R A Rameika
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Ray
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Rebel
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Rechenmacher
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Reed
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - R Reilly
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Rocco
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Rodkin
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - K Ruddick
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Rusack
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Ryabov
- Nuclear Physics Department, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - K Sachdev
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Sahijpal
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - H Sahoo
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - O Samoylov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - M C Sanchez
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - N Saoulidou
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Schlabach
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Schneps
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - R Schroeter
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - J Sepulveda-Quiroz
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - P Shanahan
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Sherwood
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Sheshukov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - J Singh
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221 005, India
| | - A Smith
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Smith
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - J Smolik
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - N Solomey
- Physics Division, Wichita State University, 1845 Fairmout Street, Wichita, Kansas 67220, USA
| | - A Sotnikov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - A Sousa
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - K Soustruznik
- Charles University in Prague, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - Y Stenkin
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - M Strait
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - L Suter
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - R L Talaga
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M C Tamsett
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - S Tariq
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Tas
- Charles University in Prague, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - R J Tesarek
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R B Thayyullathil
- Department of Physics, Cochin University of Science and Technology, Kochi 682 022, India
| | - K Thomsen
- Department of Physics and Astronomy, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - X Tian
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - S C Tognini
- Instituto de Física, Universidade Federal de Goiás, Goiánia, Goiás 74690-900, Brazil
| | - R Toner
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - J Trevor
- California Institute of Technology, Pasadena, California 91125, USA
| | - G Tzanakos
- Department of Physics, University of Athens, Athens 15771, Greece
| | - J Urheim
- Indiana University, Bloomington, Indiana 47405, USA
| | - P Vahle
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - L Valerio
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Vinton
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - T Vrba
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - A V Waldron
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - B Wang
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - Z Wang
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - A Weber
- Subdepartment of Particle Physics, University of Oxford, Oxford OX1 3RH, United Kingdom
- Rutherford Appleton Laboratory, Science and Technology Facilities Council, Didcot OX11 0QX, United Kingdom
| | - A Wehmann
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - N Wilcer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Wildberger
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Wildman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Williams
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S G Wojcicki
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - K Wood
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Xiao
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Xin
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - N Yadav
- Department of Physics, IIT Guwahati, Guwahati 781 039, India
| | - S Yang
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - S Zadorozhnyy
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - J Zalesak
- Institute of Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - B Zamorano
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - A Zhao
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Zirnstein
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Zwaska
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| |
Collapse
|
36
|
Prada C, Shain K, Voorhees P, Gabrail N, Abidi M, Zonder J, Boccia R, Richardson P, Neuman L, Wong H, Dixon S, Hari P. Oprozomib (OPZ) and Dexamethasone (DEX) in Patients (Pts) With Relapsed and/or Refractory Multiple Myeloma (RRMM): Updated Results From a Phase 1b/2, Multicenter, Open-Label Study. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Berenson JR, Cartmell A, Bessudo A, Lyons RM, Harb WA, Tzachanis D, Coleman M, Boccia RV, Rifkin RM, Patel P, Dixon S, Berdeja JG. Updated results from CHAMPION-1, a phase I/II study investigating weekly carfilzomib with dexamethasone for patients (Pts) with relapsed or refractory multiple myeloma (RRMM). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Alan Cartmell
- Comprehensive Blood and Cancer Center, Bakersfield, CA
| | - Alberto Bessudo
- Cancer Care Associates for Research and Excellence, Encinitas, CA
| | - Roger M. Lyons
- US Oncology Research and Cancer Care Centers of South Texas, San Antonio, TX
| | | | | | | | | | | | - Priti Patel
- Onyx Pharmaceuticals, Inc., South San Francisco, CA
| | - Sandra Dixon
- Onyx Pharmaceuticals, Inc., South San Francisco, CA
| | | |
Collapse
|
38
|
White J, Dixon S. Nurse led Patient Education Programme for patients undergoing a lung resection for primary lung cancer. J Thorac Dis 2015; 7:S131-7. [PMID: 25984358 DOI: 10.3978/j.issn.2072-1439.2015.03.11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/05/2015] [Indexed: 11/14/2022]
Abstract
There has been an increase in the number of patients undergoing lung resection for primary or suspected primary lung cancer in the UK due to improved staging techniques, dedicated thoracic surgeons and other initiatives such as preoperative pulmonary rehabilitation. This has had an impact on local healthcare resources requiring new ways of delivering thoracic surgical services. When considering service changes, patient reported outcomes are pivotal in terms of ensuring that the experience of care is enhanced and may include elements such as involving patients in their care, reducing the length of inpatient stay and reducing postoperative complications. The implementation of a thoracic surgical Patient Education Programme (PEP) has the potential to address these measures and improve the psychological and physical wellbeing of patients who require a lung resection. It may also assist in their care as an inpatient and to enhance recovery after surgery both in the short and long term.
Collapse
Affiliation(s)
- John White
- 1 Lead Macmillan Lung Cancer Nurse Specialist, 2 Macmillan Thoracic Surgical Nurse Specialist, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sandra Dixon
- 1 Lead Macmillan Lung Cancer Nurse Specialist, 2 Macmillan Thoracic Surgical Nurse Specialist, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| |
Collapse
|
39
|
Elliott J, Rankin D, Jacques RM, Lawton J, Emery CJ, Campbell MJ, Dixon S, Heller SR. A cluster randomized controlled non-inferiority trial of 5-day Dose Adjustment for Normal Eating (DAFNE) training delivered over 1 week versus 5-day DAFNE training delivered over 5 weeks: the DAFNE 5 × 1-day trial. Diabet Med 2015; 32:391-8. [PMID: 25363466 DOI: 10.1111/dme.12621] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 09/04/2014] [Accepted: 10/28/2014] [Indexed: 12/24/2022]
Abstract
AIMS To compare, in a randomized controlled non-inferiority trial, the outcomes of the traditional format for Dose Adjustment for Normal Eating structured education courses; that is, one delivered over 5 consecutive days (1-week course) with a variant of this format delivered 1 day a week for 5 consecutive weeks (5-week course). METHODS Adults with Type 1 diabetes, from seven UK Dose Adjustment For Normal Eating training centres, were individually randomized, stratified by centre, to receive either a 1-week or 5-week course. A qualitative study was embedded within the trial to explore patients' experiences. RESULTS In total, 213 patients were randomized and 160 completed the study procedures. In the per-protocol analysis, the difference in HbA1c levels (95% CI) between the arms at 6 months was 0.4 mmol/mol (-2.4, 3.1) or 0.03% (-0.22, 0.28) and -0.9 mmol/mol (-3.9, 2.2) or -0.08% (-0.36, 0.20) at 12 months. All confidence limits were within the non-inferiority margin of ± 5.5 mmol/mol (0.5%) for HbA1c %. For those patients with a baseline HbA1c of ≥ 58 mmol/mol (≥ 7.5%) the mean change (95% CI) in HbA1c was -2.2 mmol/mol (-4.0, -0.4) or -0.20% (-0.37, -0.04) at 6 months (P = 0.016), and -2.0 mmol/mol (-4.1, 0.04) or -0.18% (-0.37 to 0.004) at 12 months (P = 0.055). Episodes of severe hypoglycaemia were decreased by 82% [relative risk 0.18 (95% CI 0.03-0.936); P = 0.042], psychosocial outcomes improved significantly, and the difference between arms was not significant. Qualitative interviews showed that patients overwhelmingly favoured the format of course that they attended. CONCLUSIONS In summary, 5-week and 1-week Dose Adjustment for Normal Eating courses are equivalent in terms of biomedical and psychosocial outcomes, and we were persuaded that both course formats should be made available in routine care.
Collapse
Affiliation(s)
- J Elliott
- Academic Unit of Diabetes, Endocrinology and Metabolism, Department of Human Metabolism, University of Sheffield, Sheffield, UK
| | | | | | | | | | | | | | | |
Collapse
|
40
|
White J, Ashcroft A, Callister M, Dixon S, Adams M, Sajjad B, Robson J, Brunelli A. 25: Lung cancer survivorship clinic. Lung Cancer 2015. [DOI: 10.1016/s0169-5002(15)50025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
41
|
|
42
|
Berenson JR, Klein LM, Rifkin RM, Patel P, Dixon S, Ou Y, Cartmell A. Results of the dose-escalation portion of a phase 1/2 study (CHAMPION-1) investigating weekly carfilzomib in combination with dexamethasone for patients with relapsed or refractory multiple myeloma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8594] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Priti Patel
- Onyx Pharmaceuticals, Inc, South San Francisco, CA
| | - Sandra Dixon
- Onyx Pharmaceuticals, Inc, South San Francisco, CA
| | - Ying Ou
- Onyx Pharmaceuticals, Inc, South San Francisco, CA
| | - Alan Cartmell
- Comprehensive Blood and Cancer Center, Bakersfield, CA
| |
Collapse
|
43
|
Petcher PA, Burrows SE, Dixon S. Shear horizontal (SH) ultrasound wave propagation around smooth corners. Ultrasonics 2014; 54:997-1004. [PMID: 24360814 DOI: 10.1016/j.ultras.2013.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/15/2013] [Accepted: 11/25/2013] [Indexed: 06/03/2023]
Abstract
Shear horizontal (SH) ultrasound guided waves are being used in an increasing number of non-destructive testing (NDT) applications. One advantage SH waves have over some wave types, is their ability to propagate around curved surfaces with little energy loss; to understand the geometries around which they could propagate, the wave reflection must be quantified. A 0.83mm thick aluminium sheet was placed in a bending machine, and a shallow bend was introduced. Periodically-poled magnet (PPM) electromagnetic acoustic transducers (EMATs), for emission and reception of SH waves, were placed on the same side of the bend, so that reflected waves were received. Additional bending of the sheet demonstrated a clear relationship between bend angles and the reflected signal. Models suggest that the reflection is a linear superposition of the reflections from each bend segment, such that sharp turns lead to a larger peak-to-peak amplitude, in part due to increased phase coherence.
Collapse
Affiliation(s)
- P A Petcher
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK.
| | - S E Burrows
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK.
| | - S Dixon
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK.
| |
Collapse
|
44
|
Abstract
INTRODUCTION The Triathlon® (Stryker, Kalamazoo, MI, US) total knee replacement was designed to improve patient function and survivorship. The aim of this study was to determine whether the Triathlon® prosthesis produces better patient reported outcomes than a previous design by the same manufacturer, the Kinemax Plus. METHODS The outcome of 233 knees of patients with a mean age of 68 years (range: 40–80 years) who received the Kinemax Plus prosthesis were compared with the outcomes of 220 knees of patients with a mean age of 70 years (range: 42–90 years) who received the Triathlon® prosthesis. Data were collected via postal questionnaire prior to surgery as well as at 8–12 weeks and at 1 year following surgery. Validated questionnaires were used including the WOMAC® (Western Ontario and McMaster Universities) pain and function scales, the Knee injury and Osteoarthritis Outcome Score quality of life scale and the self-administered patient satisfaction scale. RESULTS This study found that patients who had the Triathlon® prosthesis had significantly better pain relief (p<0.0001), function (p=0.028), knee related quality of life (p<0.0001) and satisfaction (p=0.0003) at three months after surgery than those who received the Kinemax Plus prosthesis. In addition, knee related quality of life (p=0.002) and satisfaction (p=0.021) were significantly higher at one year after surgery in Triathlon® patients. CONCLUSIONS The findings suggest that return to function and reduction in pain may occur more quickly in patients with a Triathlon® prosthesis than in those with the Kinemax Plus.
Collapse
Affiliation(s)
- S Dixon
- North Bristol NHS Trust, UK.
| | | | | | | |
Collapse
|
45
|
Tosh J, Dixon S, Carter A, Daley A, Petty J, Roalfe A, Sharrack B, Saxton JM. Cost effectiveness of a pragmatic exercise intervention (EXIMS) for people with multiple sclerosis: economic evaluation of a randomised controlled trial. Mult Scler 2014; 20:1123-30. [DOI: 10.1177/1352458513515958] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/12/2013] [Indexed: 11/16/2022]
Abstract
Background: Exercise is a safe, non-pharmacological adjunctive treatment for people with multiple sclerosis but cost-effective approaches to implementing exercise within health care settings are needed. Objective: The objective of this paper is to assess the cost effectiveness of a pragmatic exercise intervention in conjunction with usual care compared to usual care only in people with mild to moderate multiple sclerosis. Methods: A cost-utility analysis of a pragmatic randomised controlled trial over nine months of follow-up was conducted. A total of 120 people with multiple sclerosis were randomised (1:1) to the intervention or usual care. Exercising participants received 18 supervised and 18 home exercise sessions over 12 weeks. The primary outcome for the cost utility analysis was the incremental cost per quality-adjusted life year (QALY) gained, calculated using utilities measured by the EQ-5D questionnaire. Results: The incremental cost per QALY of the intervention was £10,137 per QALY gained compared to usual care. The probability of being cost effective at a £20,000 per QALY threshold was 0.75, rising to 0.78 at a £30,000 per QALY threshold. Conclusion: The pragmatic exercise intervention is highly likely to be cost effective at current established thresholds, and there is scope for it to be tailored to particular sub-groups of patients or services to reduce its cost impact.
Collapse
Affiliation(s)
- J Tosh
- School of Health and Related Research, University of Sheffield, UK
| | - S Dixon
- School of Health and Related Research, University of Sheffield, UK
| | - A Carter
- Centre for Sport and Exercise Science, Sheffield Hallam University, UK
| | - A Daley
- Primary Care Clinical Sciences, University of Birmingham, UK
| | - J Petty
- Multiple Sclerosis Society, UK
| | - A Roalfe
- Primary Care Clinical Sciences, University of Birmingham, UK
| | - B Sharrack
- Neurology Department, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - JM Saxton
- School of Rehabilitation Sciences, University of East Anglia, UK
| |
Collapse
|
46
|
Dhillon A, Farid SG, Dixon S, Evans J. Right salpingo-ovarian and distal ileal entrapment within a paracaecal hernia presenting as acute appendicits. Int J Surg Case Rep 2013; 4:1127-9. [PMID: 24246293 PMCID: PMC3860031 DOI: 10.1016/j.ijscr.2013.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 09/03/2013] [Accepted: 10/10/2013] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Pericaecal hernias are a rare subgroup of internal abdominal hernias that present with abdominal pain and occasionally with features of bowel obstruction. PRESENTATION OF CASE A 72 year old female presented with a 24-h history of sharp, localised right iliac fossa pain, and no other symptoms. Clinical examination confirmed localised peritonism in the right iliac fossa. A tentative diagnosis of acute appendicitis was considered but in view of age a CT scan was performed. An area of abnormality in the right iliac fossa region was noted. At laparoscopy a macroscopically normal appendix and caecum was found. A smooth non-indentable mass in the lateral right iliac fossa contained loops of distal ileum, passing through a retro-caecal mesenteric defect consistent with a paraceacal hernia, with entrapment of the right ovary and fallopian tube. A right salpingectomy as performed and subsequent histopathological examination confirmed infarction of the fallopian tube. DISCUSSION Internal abdominal hernias are reported to have a post mortem incidence ranging between 0.2 and 0.9% of which only 10-15% are accounted for by pericaecal hernias. Types of pericaecal hernias include: ileocolic, retrocaecal, ileocaecal and paracaecal. These hernias are predisposed by the embryological development of the caecum retracting to the posterior abdominal wall and forming potential fossae. CONCLUSION This case highlights the need to consider a pericaecal hernia as a differential cause of right iliac fossa peritonism, and an indication for radiological imaging such as CT scan when the history is atypical for acute appendicitis.
Collapse
Affiliation(s)
- A Dhillon
- Department of General Surgery, Northampton General Hospital, United Kingdom.
| | | | | | | |
Collapse
|
47
|
Archer DT, Berry L, Dixon S, Hogg R. ASSESSMENT OF TECHNICAL CHANGES DURING SWIMMING PERFORMANCE IN TRAINED JUNIOR SWIMMERS: Table 1. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.46] [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]
|
48
|
Tapping CR, Little MW, Briggs JH, Woodhouse JB, Dixon S, Anthony S, Uberoi R, Bratby MJ. Prospective study evaluating technical and clinical outcomes from the use of low profile angioplasty (LOPA) systems. Clin Radiol 2013; 68:562-7. [PMID: 23312672 DOI: 10.1016/j.crad.2012.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 10/26/2012] [Accepted: 11/12/2012] [Indexed: 11/26/2022]
Abstract
AIM To compare the success and complication associated with 4 and 5 F access systems prospectively in the treatment of infra-inguinal vascular disease. MATERIALS AND METHODS One hundred and twenty consecutive patients were treated for lower limb vascular disease via a 4 F (n = 60) or 5 F (n = 60) access sheath over a 12 month period. All common femoral arteries were punctured in an antegrade direction with ultrasound guidance. Seven minutes of manual compression was applied and the groin assessed with ultrasound to document complications. Repeated manual compression was applied until haemostasis was achieved in all cases. Time to haemostasis, equipment used, patient biochemical data, and demographics were recorded. Patients were followed-up at a mean of 12 weeks post-procedure. RESULTS Antegrade access and sheath insertion was achieved in all cases. The technical success of the procedure was 56/60 (93%) cases using 4 F access and 57 (95%) cases using 5 F access. The time to haemostasis was reduced to a mean of 8.2 min (range 7-12 min) with a 4 F system compared to a mean of 12 min (range 7-30 minutes) with a 5 F system (p = 0.045). Overall there were 12 complications (10%; 11 <2 cm haematomas and one pseudoaneurysm) noted on ultrasound post-haemostasis, although there was no statistically significance difference between the two groups. Hypertension and renal dysfunction were associated with complications (p < 0.05). A 4 F system used an additional average of 5.1 (range 3-8) wires and catheters compared to an additional average of 3.5 (range 2-6) wires and catheters when using a 5 F system (p = 0.002). A 4 F technique cost three-times that of a 5 F technique. CONCLUSION Four and 5 F access sheaths allow safe and successful infra-inguinal angioplasty with a low complication rate. Hypertensive patients and those with impaired renal function are at increased risk of complications. There are increasing costs using a 4 F system offset by a decrease in time to haemostasis following manual compression but no reduction in complication rate.
Collapse
Affiliation(s)
- C R Tapping
- Department of Radiology, John Radcliffe Hospital, Oxford University Hospitals, Headington, Oxford, UK
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Dixon S, White J. 120 Patient journey interviews. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70120-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
50
|
Dixon S, Tapping C, Walker J, Bratby M, Anthony S, Boardman P, Phillips-Hughes J, Uberoi R. The role of interventional radiology and imaging in pancreatic islet cell transplantation. Clin Radiol 2012; 67:923-31. [DOI: 10.1016/j.crad.2012.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 01/26/2012] [Accepted: 02/06/2012] [Indexed: 11/29/2022]
|