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Avey JP, Wark K, Andrews P, Donadio J, Bradbury T, Outten B. Acceptability and feasibility of an intervention for Alaska Native and American Indian couples. Fam Relat 2024; 73:298-317. [PMID: 38576473 PMCID: PMC10989934 DOI: 10.1111/fare.12986] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 11/30/2023] [Indexed: 04/06/2024]
Abstract
Objective This acceptability and feasibility study assessed a previously tested movie discussion intervention culturally adapted for a tribal health setting. Background Despite family and relationships being important in Alaska Native and American Indian (ANAI) cultures, social health interventions supporting committed ANAI couples have not been investigated. Couples watching and discussing movies can promote and sustain relationship health as effectively as intensive skill-building classes. Method This study culturally adapted a movie discussion intervention. Multiple stakeholders guided adaptations, including changes to intervention duration, recommended movies, discussion guide, and study measures. Eligible participants were cohabitating adults in a committed relationship, with at least one person in the couple being ANAI. Participants watched and discussed movies over 4 weeks at home or in person. Study measures assessed demographics, relationship characteristics, and intervention acceptability and feasibility. Results Twenty-three couples participated: 87% chose at-home participation, 70% completed the intervention. Almost 90% of couples felt comfortable discussing the movies, felt the discussion guide improved communication, and would recommend the intervention to other couples, but 26% were mildly stressed by the discussions. Conclusion This intervention was a feasible and acceptable way to help ANAI couples maintain positive relationship features. Implications This intervention could support ANAI couples in regions with limited access to behavioral health services.
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Affiliation(s)
- Jaedon P. Avey
- Research Department, Southcentral Foundation, Anchorage, AK
| | - Kyle Wark
- Research Department, Southcentral Foundation, Anchorage, AK
| | - Polly Andrews
- Family Wellness Warriors, Southcentral Foundation, Anchorage, AK
| | - James Donadio
- Family Wellness Warriors, Southcentral Foundation, Anchorage, AK
| | - Thomas Bradbury
- Department of Psychology, University of California, Los Angeles, CA
| | - Bobbi Outten
- Family Wellness Warriors, Southcentral Foundation, Anchorage, AK
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Mathioudakis AG, Abroug F, Agusti A, Ananth S, Bakke P, Bartziokas K, Beghe B, Bikov A, Bradbury T, Brusselle G, Cadus C, Coleman C, Contoli M, Corlateanu A, Corlateanu O, Criner GJ, Csoma B, Emelyanov A, Faner R, Fernandez Romero G, Hammouda Z, Horváth P, Huerta Garcia A, Jacobs M, Jenkins C, Joos G, Kharevich O, Kostikas K, Lapteva E, Lazar Z, Leuppi JD, Liddle C, Linnell J, López-Giraldo A, McDonald VM, Nielsen R, Papi A, Saraiva I, Sergeeva G, Sioutkou A, Sivapalan P, Stovold E, Wang H, Wen F, Yorke J, Williamson PR, Vestbo J, Jensen JU. ERS statement: a core outcome set for clinical trials evaluating the management of COPD exacerbations. Eur Respir J 2022; 59:2102006. [PMID: 34649975 DOI: 10.1183/13993003.02006-2021] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/03/2021] [Indexed: 02/05/2023]
Abstract
Clinical trials evaluating the management of acute exacerbations of COPD assess heterogeneous outcomes, often omitting those that are clinically relevant or more important to patients. We have developed a core outcome set, a consensus-based minimum set of important outcomes that we recommend are evaluated in all future clinical trials on exacerbations management, to improve their quality and comparability. COPD exacerbations outcomes were identified through methodological systematic reviews and qualitative interviews with 86 patients from 11 countries globally. The most critical outcomes were prioritised for inclusion in the core outcome set through a two-round Delphi survey completed by 1063 participants (256 patients, 488 health professionals and 319 clinical academics) from 88 countries in five continents. Two global, multi-stakeholder, virtual consensus meetings were conducted to 1) finalise the core outcome set and 2) prioritise a single measurement instrument to be used for evaluating each of the prioritised outcomes. Consensus was informed by rigorous methodological systematic reviews. The views of patients with COPD were accounted for at all stages of the project. Survival, treatment success, breathlessness, quality of life, activities of daily living, the need for a higher level of care, arterial blood gases, disease progression, future exacerbations and hospital admissions, treatment safety and adherence were all included in the core outcome set. Focused methodological research was recommended to further validate and optimise some of the selected measurement instruments. The panel did not consider the prioritised set of outcomes and associated measurement instruments to be burdensome for patients and health professionals to use.
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Affiliation(s)
- Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- A.G. Mathioudakis and J-U. Jensen are the co-chairs of the COS-AECOPD ERS task force
| | | | - Alvar Agusti
- Respiratory Institute, Hospital Clinic and Catedra de Salud Respiratoria, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain
| | | | - Per Bakke
- Dept of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Bianca Beghe
- Section of Respiratory Diseases, Dept of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Andras Bikov
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Thomas Bradbury
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Guy Brusselle
- Depts of Epidemiology and Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Cordula Cadus
- University Department of Medicine, Cantonal Hospital Basell and Liestal, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | | | - Marco Contoli
- Research Center on Asthma and COPD, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alexandru Corlateanu
- Dept of Respiratory Medicine, State University of Medicine and Pharmacy 'Nicolae Testemitanu', Chisinau, Moldova
| | - Olga Corlateanu
- Dept of Internal Medicine, State University of Medicine and Pharmacy 'Nicolae Testemitanu', Chisinau, Moldova
| | - Gerard J Criner
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Balazs Csoma
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Alexander Emelyanov
- Dept of Respiratory Medicine and Allergy, North-Western Medical University St Petersburg, St Petersburg, Russian Federation
| | - Rosa Faner
- Respiratory Institute, Hospital Clinic and Catedra de Salud Respiratoria, University of Barcelona, Barcelona, Spain
| | - Gustavo Fernandez Romero
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | | | - Peter Horváth
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Arturo Huerta Garcia
- Respiratory Institute, Hospital Clinic and Catedra de Salud Respiratoria, University of Barcelona, Barcelona, Spain
- Respiratory Intensive Care Division, Clinica Sagrada Familia, Barcelona, Spain
| | - Michael Jacobs
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Christine Jenkins
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Guy Joos
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Olga Kharevich
- Dept of Pulmonology and Tuberculosis, Belarusian Medical Academy of Postgraduate Education, Minsk Belarus
| | - Konstantinos Kostikas
- Respiratory Medicine Dept, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elena Lapteva
- Dept of Pulmonology and Tuberculosis, Belarusian Medical Academy of Postgraduate Education, Minsk Belarus
| | - Zsofia Lazar
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Joerg D Leuppi
- University Department of Medicine, Cantonal Hospital Basell and Liestal, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | | | | | - Alejandra López-Giraldo
- Respiratory Institute, Hospital Clinic and Catedra de Salud Respiratoria, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain
| | - Vanessa M McDonald
- Dept of Respiratory and Sleep Medicine, Medical and Interventional Services, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, Australia
- Priority Research Centre for Healthy Lungs, University of Newcastle, Callaghan, Australia
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
| | - Rune Nielsen
- Dept of Clinical Science, University of Bergen, Bergen, Norway
- Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Alberto Papi
- Research Center on Asthma and COPD, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Galina Sergeeva
- Dept of Respiratory Medicine and Allergy, North-Western Medical University St Petersburg, St Petersburg, Russian Federation
| | - Agni Sioutkou
- Respiratory Medicine Dept, University of Ioannina School of Medicine, Ioannina, Greece
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Dept of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
- Dept of Internal Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Elizabeth Stovold
- Cochrane Airways Group, Population Health Research Institute, St George's University of London, London, UK
| | - Hao Wang
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Fuqiang Wen
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Janelle Yorke
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - Paula R Williamson
- MRC/NIHR Trials Methodology Research Partnership, Dept of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), Liverpool, UK
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jens-Ulrik Jensen
- Section of Respiratory Medicine, Dept of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- A.G. Mathioudakis and J-U. Jensen are the co-chairs of the COS-AECOPD ERS task force
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3
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Bradbury T, Di Tanna GL, Scaria A, Martin A, Wen FQ, Zhong NS, Zheng JP, Barnes PJ, Celli B, Berend N, Jenkins CR. Blood Eosinophils in Chinese COPD Participants and Response to Treatment with Combination Low-Dose Theophylline and Prednisone: A Post-Hoc Analysis of the TASCS Trial. Int J Chron Obstruct Pulmon Dis 2022; 17:273-282. [PMID: 35153479 PMCID: PMC8827641 DOI: 10.2147/copd.s339889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives The burden of chronic obstructive pulmonary disease (COPD) disproportionately affects patients in low to middle-income countries. Although the Theophylline and Steroids in COPD Study (TASCS) showed no clinical benefit from administering low-dose theophylline and prednisone in COPD patients compared to placebo, it was hypothesized that those with elevated blood eosinophil counts would receive clinical benefit from the intervention. Methods This was a post-hoc analysis of the TASCS dataset – a double-blinded, placebo-controlled trial conducted in patients with moderate–severe COPD in China. Participants were allocated 1:1:1 to low-dose oral theophylline (100mg bd) and prednisone (5mg qd; PrT), theophylline (100mg bd) and prednisone-matched placebo (TP), or double-matched placebo (DP) groups and followed-up for 48 weeks. A baseline count of ≥300 eosinophils/µL blood was categorized as elevated/eosinophilic, and the primary outcome was the annualized moderate-severe exacerbation rate. Results Of 1487 participants eligible for analysis, 325 (22%) were eosinophilic. These participants were predominantly male (82%), had a mean (SD) age of 64 (±8) years and a predicted forced expiratory volume in 1s (FEV1) of 43% (±16). The annualized moderate–severe exacerbation rate was significantly higher in the PrT group compared to the pooled results of the TP and DP groups (incidence rate ratio = 1.6; ([95% CI 1.06–1.76]) p = 0.016). Changes in spirometry values and reported disease impact scores (St. George’s Respiratory Questionnaire and COPD Assessment Test) at week 48 were not significantly different between groups. Conclusion Combination low-dose theophylline and prednisone was associated with a significant increase in the annual moderate-severe exacerbation rate in participants with a blood eosinophil count ≥300 cells/µL compared to placebo.
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Affiliation(s)
- Thomas Bradbury
- Respiratory Group, The George Institute for Global Health, Sydney, NSW 2042, Australia
- Correspondence: Thomas Bradbury, Respiratory Group, The George Institute for Global Health, Level 5, 1 King St, Newtown, Sydney, NSW 2042, Australia, Tel +61 2 8052 4413, Email
| | - Gian Luca Di Tanna
- Respiratory Group, The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Anish Scaria
- Respiratory Group, The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Allison Martin
- Respiratory Group, The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Fu-Qiang Wen
- West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Jin-Ping Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Peter J Barnes
- National Heart & Lung Institute, Imperial College, London, UK
| | - Bartolome Celli
- Pulmonary and Critical Care Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Norbert Berend
- Respiratory Group, The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Christine R Jenkins
- Respiratory Group, The George Institute for Global Health, Sydney, NSW 2042, Australia
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4
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Mathioudakis AG, Ananth S, Bradbury T, Csoma B, Sivapalan P, Stovold E, Fernandez-Romero G, Lazar Z, Criner GJ, Jenkins C, Papi A, Jensen JU, Vestbo J. Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study. Biomedicines 2021; 9:biomedicines9121837. [PMID: 34944653 PMCID: PMC8698292 DOI: 10.3390/biomedicines9121837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022] Open
Abstract
A recently published ERS core outcome set recommends that all trials of COPD exacerbation management should assess the treatment success (or “cure” of the exacerbation), defined as a dichotomous measure of the overall outcome of an exacerbation. This methodological systematic review describes and compares the instruments that were used to assess treatment success or failure in 54 such RCTs, published between 2006–2020. Twenty-three RCTs used composite measures consisting of several undesirable outcomes of an exacerbation, together defining an overall unfavourable outcome, to define treatment failure. Thirty-four RCTs used descriptive instruments that used qualitative or semi-quantitative descriptions to define cure, marked improvement, improvement of the exacerbation, or treatment failure. Treatment success and failure rates among patients receiving guidelines-directed treatments at different settings and timepoints are described and could be used to inform power calculations in future trials. Descriptive instruments appeared more sensitive to treatment effects compared to composite instruments. Further methodological studies are needed to optimise the evaluation of treatment success/failure. In the meantime, based on the findings of this systematic review, the ERS core outcome set recommends that cure should be defined as sufficient improvement of the signs and symptoms of the exacerbation such that no additional systemic treatments are required.
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Affiliation(s)
- Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester M23 9LT, UK;
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M23 9LT, UK
- Correspondence:
| | - Sachin Ananth
- West Hertfordshire Hospital NHS Trust, Watford WD18 0HB, UK;
| | - Thomas Bradbury
- The George Institute for Global Health, University of New South Wales, Sydney 1466, Australia; (T.B.); (C.J.)
| | - Balazs Csoma
- Department of Pulmonology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary; (B.C.); (Z.L.)
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Department of Internal Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.-U.J.)
- Department of Internal Medicine, Zealand University Hospital, 4000 Roskilde, Denmark
| | - Elizabeth Stovold
- Cochrane Airways Group, Population Health Research Institute, St George’s University of London, London SW17 0RE, UK;
| | - Gustavo Fernandez-Romero
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (G.F.-R.); (G.J.C.)
| | - Zsofia Lazar
- Department of Pulmonology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary; (B.C.); (Z.L.)
| | - Gerard J. Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (G.F.-R.); (G.J.C.)
| | - Christine Jenkins
- The George Institute for Global Health, University of New South Wales, Sydney 1466, Australia; (T.B.); (C.J.)
| | - Alberto Papi
- Research Center on Asthma and COPD, Faculty of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Jens-Ulrik Jensen
- Section of Respiratory Medicine, Department of Internal Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.-U.J.)
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester M23 9LT, UK;
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M23 9LT, UK
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5
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Mathioudakis AG, Abroug F, Agusti A, Ananth S, Bakke P, Bartziokas K, Beghe B, Bikov A, Bradbury T, Brusselle G, Cadus C, Coleman C, Contoli M, Corlateanu A, Corlateanu O, Criner GJ, Csoma B, Emelyanov A, Faner R, Fernandez Romero G, Hammouda Z, Horváth P, Huerta Garcia A, Jacobs M, Jenkins C, Joos G, Kharevich O, Kostikas K, Lapteva E, Lazar Z, Leuppi JD, Liddle C, Linnell J, López-Giraldo A, McDonald VM, Nielsen R, Papi A, Saraiva I, Sergeeva G, Sioutkou A, Sivapalan P, Stovold E, Wang H, Wen F, Yorke J, Williamson PR, Vestbo J, Jensen JU. ERS Statement: A core outcome set for clinical trials evaluating the management of chronic obstructive pulmonary disease (COPD) exacerbations. Eur Respir J 2021. [DOI: doi.org/10.1183/13993003.02006-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Clinical trials evaluating the management of acute exacerbations of COPD assess heterogeneous outcomes, often omitting those that are clinically relevant or more important to patients. We have developed a core outcome set, a consensus-based minimum set of important outcomes that we recommend are evaluated in all future clinical trials on exacerbations management, to improve their quality and comparability. COPD exacerbations outcomes were identified through methodological systematic reviews and qualitative interviews with 86 patients from 11 countries globally. The most critical outcomes were prioritized for inclusion in the core outcome set through a two-round Delphi survey that was completed by 1,063 participants (256 patients, 488 health professionals and 319 clinical academics) from 88 countries in 5 continents. Two global, multi-stakeholder, virtual consensus meetings were conducted to (i) finalize the core outcome set and (ii) prioritize a single measurement instrument to be used for evaluating each of the prioritized outcomes. Consensus was informed by rigorous methodological systematic reviews. The views of patients with COPD were accounted for in all stages of the project. Survival, treatment success, breathlessness, quality of life, activities of daily living, need for higher level of care, arterial blood gases, disease progression, future exacerbations and hospital admissions, treatment safety and adherence were all included in the core outcome set. Focused methodological research was recommended to further validate and optimize some of the selected measurement instruments. The panel did not consider the prioritized set of outcomes and associated measurement instruments burdensome for patients and health professionals to use.
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6
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Kang A, Arnold R, Gallagher M, Snelling P, Green J, Fernando M, Kiernan MC, Hand S, Grimley K, Burman J, Heath A, Rogers K, Bhattacharya A, Smyth B, Bradbury T, Hawley C, Perkovic V, Krishnan AV, Jardine MJ. Effect of Hemodiafiltration on the Progression of Neuropathy with Kidney Failure: A Randomized Controlled Trial. Clin J Am Soc Nephrol 2021; 16:1365-1375. [PMID: 34233923 PMCID: PMC8729572 DOI: 10.2215/cjn.17151120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/23/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Neuropathy is a common complication of kidney disease that lacks proven disease-modifying treatments. Hemodiafiltration improves clearance of uremic toxins and is associated with better nerve function than hemodialysis. We aimed to determine whether hemodiafiltration reduces the progression of neuropathy in people receiving hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The Filtration in the Neuropathy of End-Stage Kidney Disease Symptom Evolution (FINESSE) study was an open-label, blinded end point assessment, controlled trial that randomized maintenance hemodialysis recipients to hemodiafiltration or high-flux hemodialysis for 48 months or until death or cessation of dialysis at four study centers. The primary outcome was the mean change in the yearly modified total neuropathy score from baseline, with time points weighted equally. RESULTS A total of 124 participants were randomized and followed for a mean of 41 months. At baseline, neuropathy was present in 91 (73%) participants (modified total neuropathy score greater than or equal to two), and 38 (31%) had moderate to severe neuropathy (modified total neuropathy score 9-28). Convection volume in the hemodiafiltration arm was a median of 24.7 (interquartile range, 22.4-26.5) L. The mean modified total neuropathy score (SEM) worsened by 1.7 (0.4)/28 and 1.2 (0.4)/28 in the hemodiafiltration and hemodialysis groups, respectively, with a mean difference of 0.5 (95% confidence interval, -0.7 to 1.7; P=0.37). There was no difference in survival (hazard ratio, 1.24; 95% confidence interval, 0.61 to 2.51; log rank P=0.55) or any of the prespecified adverse events. There was no difference between groups in the number of participants who suffered an adverse event adjusted by follow-up time (relative risk, 1.05; 95% confidence interval, 0.83 to 1.32; P=0.68). CONCLUSIONS Neuropathy is still a common complication of kidney disease without disease-altering therapy. Hemodiafiltration did not affect neuropathy progression compared with hemodialysis. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Filtration in the Neuropathy of End-Stage Kidney Disease Symptom Evolution (FINESSE), ACTRN12609000615280.
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Affiliation(s)
- Amy Kang
- Renal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Department of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia.,Department of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Ria Arnold
- Department of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Martin Gallagher
- Renal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Department of Renal Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Paul Snelling
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Julianne Green
- Department of Renal Medicine, Sydney Adventist Hospital, Sydney, New South Wales, Australia
| | - Mangalee Fernando
- Department of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia.,Department of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Matthew C Kiernan
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Samantha Hand
- Department of Renal Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Kim Grimley
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Jenny Burman
- Department of Renal Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Anne Heath
- Department of Renal Medicine, Sydney Adventist Hospital, Sydney, New South Wales, Australia
| | - Kris Rogers
- Statistics Division, The George Institute The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Department of Statistics, University of Technology, Sydney, New South Wales, Australia
| | - Amritendu Bhattacharya
- Statistics Division, The George Institute The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Brendan Smyth
- Renal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Kidney Health Division, National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.,Department of Renal Medicine, St. George Hospital, Sydney, New South Wales, Australia
| | - Thomas Bradbury
- Renal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Carmel Hawley
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia
| | - Vlado Perkovic
- Renal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Department of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Arun V Krishnan
- Department of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Department of Neurology, Prince of Wales Hospital, Sydney, New South Wales, Australia
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7
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Jenkins CR, Wen FQ, Martin A, Barnes PJ, Celli B, Zhong NS, Zheng JP, Scaria A, Di Tanna GL, Bradbury T, Berend N. The effect of low-dose corticosteroids and theophylline on the risk of acute exacerbations of COPD: the TASCS randomised controlled trial. Eur Respir J 2021; 57:13993003.03338-2020. [PMID: 33334939 DOI: 10.1183/13993003.03338-2020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/21/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The highest burden of chronic obstructive pulmonary disease (COPD) occurs in low- and middle-income countries. Low-cost oral medications, if effective, could enable affordable, accessible COPD treatment. METHODS In this randomised, three-arm, double-blind, double-dummy, placebo-controlled study conducted in 37 centres in China, symptomatic patients with moderate to very severe COPD were randomised 1:1:1 to placebo twice daily plus placebo once daily, low-dose theophylline 100 mg twice daily plus placebo once daily or low-dose theophylline 100 mg twice daily plus low-dose oral prednisone 5 mg once daily for 48 weeks. The primary end-point was annualised exacerbation rate. RESULTS 1670 subjects were randomised and 1242 completed the study (1142 with acceptable data at week 48). Subjects (75.7% male) had a mean age of 64.4 years, with mean±sd baseline post-bronchodilator forced expiratory volume in 1 s (FEV1) 1.1±0.4 L (42.2% predicted) and St George's Respiratory Questionnaire (SGRQ) score 45.8±20.1. There were negligible differences between annualised exacerbation rates across the three treatments: 0.89 (95% CI 0.78-1.02) on theophylline plus prednisone, 0.86 (95% CI 0.75-0.99) on theophylline plus placebo and 1.00 (95% CI 0.87-1.14) on placebo. The rate ratio for theophylline plus prednisone versus pooled theophylline plus placebo and placebo was 0.96 (95% CI 0.83-1.12), for theophylline plus placebo versus placebo was 0.87 (95% CI 0.73-1.03; p=0.101) and for theophylline plus prednisone versus placebo was 0.90 (95% CI 0.76-1.06; p=0.201). Secondary outcomes of hospitalisations, FEV1, SGRQ and COPD Assessment Test score showed no statistically significant difference between treatment arms. Serious adverse events other than exacerbations were <2% and did not differ between treatment arms. CONCLUSIONS Low-dose theophylline alone or in combination with prednisone did not reduce exacerbation rates or clinically important secondary end-points compared with placebo.
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Affiliation(s)
- Christine R Jenkins
- The George Institute for Global Health, Sydney, Australia .,Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Fu-Qiang Wen
- West China Hospital, Sichuan University, Chengdu, China
| | - Allison Martin
- The George Institute for Global Health, Sydney, Australia.,Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Peter J Barnes
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Bartolome Celli
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jin-Ping Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Anish Scaria
- The George Institute for Global Health, Sydney, Australia.,Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Gian-Luca Di Tanna
- The George Institute for Global Health, Sydney, Australia.,Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Thomas Bradbury
- The George Institute for Global Health, Sydney, Australia.,Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Norbert Berend
- The George Institute for Global Health, Sydney, Australia.,Faculty of Medicine, UNSW Sydney, Sydney, Australia
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Mathioudakis AG, Abroug F, Agusti A, Bakke P, Bartziokas K, Beghe B, Bikov A, Bradbury T, Brusselle G, Cadus C, Coleman C, Contoli M, Corlateanu A, Corlateanu O, Criner G, Csoma B, Emelyanov A, Faner R, Romero GF, Hammouda Z, Horváth P, Huerta AG, Jacobs M, Jenkins C, Joos G, Kharevich O, Kostikas K, Lapteva E, Lazar Z, Leuppi JD, Liddle C, López-Giraldo A, McDonald VM, Nielsen R, Papi A, Saraiva I, Sergeeva G, Sioutkou A, Sivapalan P, Stovold E, Wang H, Wen F, Yorke J, Williamson PR, Vestbo J, Jensen JU. Core outcome set for the management of acute exacerbations of chronic obstructive pulmonary disease: the COS-AECOPD ERS Task Force study protocol. ERJ Open Res 2020; 6:00193-2020. [PMID: 32964006 PMCID: PMC7487360 DOI: 10.1183/23120541.00193-2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/17/2020] [Accepted: 06/15/2020] [Indexed: 02/05/2023] Open
Abstract
Randomised controlled trials (RCTs) on the management of COPD exacerbations evaluate heterogeneous outcomes, often omitting those that are clinically important and patient relevant. This limits their usability and comparability. A core outcome set (COS) is a consensus-based minimum set of clinically important outcomes that should be evaluated in all RCTs in specific areas of health care. We present the study protocol of the COS-AECOPD ERS Task Force, aiming to develop a COS for COPD exacerbation management, that could remedy these limitations. For the development of this COS we follow standard methodology recommended by the COMET initiative. A comprehensive list of outcomes is assembled through a methodological systematic review of the outcomes reported in relevant RCTs. Qualitative research with patients with COPD will also be conducted, aiming to identify additional outcomes that may be important to patients, but are not currently addressed in clinical research studies. Prioritisation of the core outcomes will be facilitated through an extensive, multi-stakeholder Delphi survey with a global reach. Selection will be finalised in an international, multi-stakeholder meeting. For every core outcome, we will recommend a specific measurement instrument and standardised time points for evaluation. Selection of instruments will be based on evidence-informed consensus. Our work will improve the quality, usability and comparability of future RCTs on the management of COPD exacerbations and, ultimately, the care of patients with COPD. Multi-stakeholder engagement and societal support by the European Respiratory Society will raise awareness and promote implementation of the COS.
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Affiliation(s)
- Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Co-chairs of the COS-AECOPD ERS Task Force
| | | | - Alvar Agusti
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain.,Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Per Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Bianca Beghe
- Section of Respiratory Diseases, Dept of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Andras Bikov
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Thomas Bradbury
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Guy Brusselle
- Depts of Epidemiology and Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Cordula Cadus
- University Department of Medicine, Cantonal Hospital Basell and Liestal, Basell, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland
| | | | - Marco Contoli
- Research Center on Asthma and COPD, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alexandru Corlateanu
- Dept of Respiratory Medicine, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Moldova
| | - Olga Corlateanu
- Department of Internal Medicine, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Moldova
| | - Gerard Criner
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Balazs Csoma
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Alexander Emelyanov
- Dept of Respiratory Medicine and Allergy, North-Western Medical University, St Petersburg, Russian Federation
| | - Rosa Faner
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain
| | - Gustavo Fernandez Romero
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | | | - Peter Horváth
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Arturo Garcia Huerta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain.,Respiratory Intensive Care Division, Clinica Sagrada Familia, Barcelona, Spain
| | - Michael Jacobs
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Christine Jenkins
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Guy Joos
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Olga Kharevich
- Dept of Pulmonology and Tuberculosis, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
| | - Konstantinos Kostikas
- Respiratory Medicine Dept, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elena Lapteva
- Dept of Pulmonology and Tuberculosis, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
| | - Zsofia Lazar
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Joerg D Leuppi
- University Department of Medicine, Cantonal Hospital Basell and Liestal, Basell, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland
| | | | - Alejandra López-Giraldo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), National Spanish Network for Respiratory Research (CIBERES), Barcelona, Spain.,Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Vanessa M McDonald
- Dept of Respiratory and Sleep Medicine, Medical and Interventional Services, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, Australia.,Priority Research Centre for Healthy Lungs, University of Newcastle, Callaghan, Australia.,School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
| | - Rune Nielsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Alberto Papi
- Research Center on Asthma and COPD, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Galina Sergeeva
- Dept of Respiratory Medicine and Allergy, North-Western Medical University, St Petersburg, Russian Federation
| | - Agni Sioutkou
- Respiratory Medicine Dept, University of Ioannina School of Medicine, Ioannina, Greece
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Dept of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark.,Dept of Internal Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Elizabeth Stovold
- Cochrane Airways Group, Population Health Research Institute, St George's University of London, London, UK
| | - Hao Wang
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Fuqiang Wen
- Dept of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Janelle Yorke
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - Paula R Williamson
- Liverpool Clinical Trials Centre, Dept of Biostatistics, University of Liverpool, Liverpool, UK.,MRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jens-Ulrik Jensen
- Section of Respiratory Medicine, Dept of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark.,CHIP and PERSIMUNE, Dept of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Co-chairs of the COS-AECOPD ERS Task Force
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Bradbury T, Hutchinson S, Jay N, West N. P117 Evaluation of drug allergy recording in the clinical records of children with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Alaee F, Angerame M, Bradbury T, Blackwell R, Booth RE, Brekke AC, Courtney PM, Frenkel T, Grieco Silva FR, Heller S, Hube R, Ismaily S, Jennings J, Lee M, Noble PC, Ponzio D, Saxena A, Simpson H, Smith BM, Smith EB, Stephens S, Vasarhelyi E, Wang Q, Yeo SJ. General Assembly, Prevention, Operating Room - Surgical Technique: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S139-S146. [PMID: 30348556 DOI: 10.1016/j.arth.2018.09.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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11
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Shau D, Shenvi N, Easley K, Smith M, Bradbury T, Guild G. Medicaid Payer Status Is Associated with Increased 90-Day Morbidity and Resource Utilization Following Primary Total Hip Arthroplasty: A Propensity-Score-Matched Analysis. J Bone Joint Surg Am 2018; 100:2041-2049. [PMID: 30516627 DOI: 10.2106/jbjs.17.00834] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Medicaid payer status has been shown to affect risk-adjusted outcomes and resource utilization across multiple medical specialties. The purpose of this study was to examine resource utilization via readmission rates, length of stay, and total cost specific to Medicaid payer status following primary total hip arthroplasty. METHODS The Nationwide Readmissions Database (NRD) was utilized to identify patients who underwent total hip arthroplasty in 2013 as well as corresponding "Medicaid" or "non-Medicaid" payer status. Demographic data, 14 individual comorbidities, readmission rates, length of stay, and direct cost were evaluated. A propensity-score-based matching model was utilized to control for baseline confounding variables between payer groups. Following propensity-score matching, the chi-square test was used to compare readmission rates between the 2 payer groups. The relative risk (RR) with 95% confidence interval (CI) was estimated to quantify readmission risk. Length of stay and total cost comparisons were evaluated using the Wilcoxon signed-rank test. RESULTS A total of 5,311 Medicaid and 144,814 non-Medicaid patients managed with total hip arthroplasty were identified from the 2013 NRD. A propensity score was estimated for each patient on the basis of the available baseline demographics, and 5,311 non-Medicaid patients were matched by propensity score to the 5,311 Medicaid patients. Medicaid versus non-Medicaid payer status yielded significant differences in overall readmission rates of 28.8% versus 21.0% (p < 0.001; RR = 1.37 [95% CI, 1.28 to 1.46]) and 90-day hip-specific readmission rates of 2.5% versus 1.8% (p = 0.01; RR = 1.38 [95% CI, 1.07 to 1.78]). Mean length of stay was greater in the Medicaid group than in the non-Medicaid group at 4.5 versus 3.3 days (p < 0.0001), as was the mean total cost at $71,110 versus $65,309 (p < 0.0001). CONCLUSIONS This study demonstrates that Medicaid payer status is independently associated with increased resource utilization, including readmission rates, length of stay, and total cost following primary total hip arthroplasty. Providers may have a disincentive to treat patient populations who require increased resource utilization following surgery. Risk adjustment models accounting for Medicaid payer status are necessary to avoid decreased access to care for this patient population and to avoid financial penalty for physicians and hospitals alike. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- David Shau
- Department of Orthopaedics and Sports Medicine, Emory University, Atlanta, Georgia
| | - Neeta Shenvi
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Kirk Easley
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Melissa Smith
- Department of Orthopaedics and Sports Medicine, Emory University, Atlanta, Georgia
| | - Thomas Bradbury
- Department of Orthopaedics and Sports Medicine, Emory University, Atlanta, Georgia
| | - George Guild
- Department of Orthopaedics and Sports Medicine, Emory University, Atlanta, Georgia
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Bradbury T. Years of service: Full circle. Br Dent J 2017; 222:746. [DOI: 10.1038/sj.bdj.2017.436] [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: 11/09/2022]
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Burgers PTPW, Poolman RW, Van Bakel TMJ, Tuinebreijer WE, Zielinski SM, Bhandari M, Patka P, Van Lieshout EMM, Devereaux PJ, Guyatt GH, Einhorn TA, Thabane L, Schemitsch EH, Koval KJ, Frihagen F, Poolman RW, Tetsworth K, Guerra-Farfan E, Walter SD, Sprague S, Swinton M, Scott T, McKay P, Madden K, Heels-Ansdell D, Buckingham L, Duraikannan A, Silva H, Heetveld MJ, Van Lieshout EMM, Burgers PT, Zura RD, Avram V, Manjoo A, Williams D, Antoniou J, Ramsay T, Bogoch ER, Trenholm A, Lyman S, Mazumdar M, Bozic KJ, Luborsky M, Goodman S, Muray S, Korley R, Buckley R, Duffy P, Puloski S, Carcary K, Lorenzo M, McKee MD, Hall JA, Nauth A, Whelan D, Daniels TR, Waddell JP, Ahn H, Vicente MR, Hidy JT, MacNevin MT, Kreder H, Axelrod T, Jenkinson R, Nousiainen M, Stephen D, Wadey V, Kunz M, Milner K, Cagaanan R, MacNevin M, O’Brien PJ, Blachut PA, Broekhuyse HM, Guy P, Lefaivre KA, Slobogean GP, Johal R, Leung I, Coles C, Leighton R, Richardson CG, Biddulph M, Gross M, Dunbar M, Amirault JD, Alexander D, Coady C, Glazebrook M, Johnston D, Oxner W, Reardon G, Wong I, Trask K, MacDonald S, Furey A, Stone C, Parsons M, Stone T, Zomar M, McCormack R, Apostle K, Boyer D, Moola F, Perey B, Viskontas D, Moon K, Moon R, Laflamme Y, Benoit B, Ranger P, Malo M, Fernandes J, Tardif K, Fournier J, Vendittoli PA, Massé V, Roy AG, Lavigne M, Lusignan D, Davis C, Stull P, Weinerman S, Weingarten P, Lindenbaum S, Hewitt M, Danielwicz R, Baker J, Mont M, Delanois DE, Kapadia B, Issa K, Mullen M, Sems A, Foreman B, Parvizi J, Morrison T, Lewis C, Caminiti S, Tornetta P, Creevy WR, Lespasio MJ, Carlisle H, Marcantonio A, Kain M, Specht L, Tilzey J, Garfi J, Mehta S, Esterhai JL, Ahn J, Donegan D, Horan A, McGinnis K, Roberson J, Bradbury T, Erens G, Webb K, Mullis B, Shively K, Parr A, Ertl J, Worman R, Webster M, Cummings J, Frizzell V, Moore M, Jones CB, Ringler JR, Sietsema DL, Walker JE, Kanlic E, Abdelgawad A, Shunia J, DePaolo C, Sutherland S, Alosky R, Zura R, Manson M, Strathy G, Peter K, Johnson P, Morton M, Shaer J, Schrickel T, Hileman B, Hanes M, Chance E, Heinrich EM, Dodgin D, LaBadie M, Zamorano D, Tynan M, Schwarzkopf R, Scolaro JA, Gupta R, Bederman S, Bhatia N, Hoang B, Kiester D, Jones N, Rafijah G, Alavekios D, Lee J, Mehta A, Schroder S, Chao T, Colin V, Dang P(P, Heng SK, Lopez G, Galle S, Pahlavan S, Phan DL, Tapadia M, Bui C, Jain N, Moore T, Moroski N, Pourmand D, Kubiak EN, Gililland J, Rothberg D, Peters C, Pelt C, Stuart AR, Corbey K, Shuler FD, Day J, Garabekyan T, Cheung F, Oliashirazi A, Salava J, Morgan L, Wilson-Byrne T, Cordle MB, Elmans LH, van den Hout JA, Joosten AJP, van Beurden AFA, Bolder SBT, Eygendaal D, Moonen AF, van Geenen RCI, Hoebink EA, Wagenmakers R, van Helden W, van Jonbergen HPW, Roerdink H, Reuver JM, Barnaart AFW, Flikweert ER, Krips R, Mullers JB, Schüller H, Falke MLM, Kurek FJ, Slingerland ACH, van Dijk JP, van Helden WH, Bolhuis HW, Bullens PHJ, Hogervorst M, de Kroon KE, Jansen RH, Steenstra F, Raven EEJ, Fontijne WPJ, Wiersma SC, Boetes B, ten Holder EJT, van der Heide HJL, Nagels J, van der Linden-van der Zwaag EH, Keizer SB, Swen JWA, den Hollander PHC, Thomassen BJW, Molekamp WJK, de Meulemeester FR, Kleipool AEB, Haverlag R, Simons MP, Mutsaerts EL, Kooijman R, Postema RR, Bleker RJ, Lampe HIH, Schuman L, Cheung J, van Bommel F, Winia WP, Haverkamp D, van der Vis H, Nolte PA, van den Bekerom MPJ, de Jong T, van Noort A, Vergroesen DA, Schutte BG, van der Vis HM, Beimers L, de Vries J, Zurcher AW, Albers GR, Rademakers M, Breugem S, van der Haven I, Jan Damen P, Bulstra GH, Campo MM, Somford MP, Haverkamp D, Liew S, Bedi H, Carr A, Chia A, Csongvay S, Donohue C, Doig S, Edwards E, Esser M, Freeman R, Gong A, Li D, Miller R, Ton L, Wang O, Young I, Dowrick A, Murdoch Z, Sage C, Page R, Bainbridge D, Angliss R, Miller B, Thomson A, Brown G, Williams S, Eng K, Bowyer D, Skelley J, Goyal C, Beattie S, Guerado E, Cruz E, Cano JR, Froufe MA, Serra LM, Al-dirra S, Martinez C, Tarazona Santabalbina FJ, Serra JT, Hernandez JT, Garcia MA, Garcia VM, Barrera S, Garrido M, Nordsletten L, Clarke-Jenssen J, Hjorthaug G, Brekke AC, Vesterhus EB, Skaugrud I, Tripathi P, Katiyar S, Shukla P, Swiontkowski M, Guyatt G, Jeray K, Walter S, Viveiros H, Truong V, Koo K, Zhou Q, Maddock D, Simunovic N, Agel J, Zielinski SM, Rangan A, Hanusch BC, Kottam L, Clarkson R, Della Rocca GJ, Slobogean G, Katz J, Gillespie B, Greendale GA, Hartman C, Rubin C, Waddell J, Lemke HM, Oatt A, Buckley RE, Korley R, Johnston K, Powell J, Sanders D, Lawendy A, Tieszer C, Murnaghan J, Nam D, Yee A, Whelan DB, Wild LM, Khan RM, Coady C, Amirault D, Richardson G, Dobbin G, Bicknell R, Yach J, Bardana D, Wood G, Harrison M, Yen D, Lambert S, Howells F, Ward A, Zalzal P, Brien H, Naumetz V, Weening B, Wai EK, Papp S, Gofton WT, Kingwell SP, Johnson G, O’Neil J, Roffey DM, Borsella V, Oliver TM, Jones V, Endres TJ, Agnew SG, Jeray KJ, Broderick JS, Goetz DR, Pace TB, Schaller TM, Porter SE, Tanner SL, Snider RG, Nastoff LA, Bielby SA, Switzer JA, Cole PA, Anderson SA, Lafferty PM, Li M, Ly TV, Marston SB, Foley AL, Vang S, Wright DM, Marcantonio AJ, Kain MSH, Iorio R, Specht LM, Tilzey JF, Lobo MJ, Garfi JS, Vallier HA, Dolenc A, Robinson C, Prayson MJ, Laughlin R, Rubino LJ, May J, Rieser GR, Dulaney-Cripe L, Gayton C, Gorczyca JT, Gross JM, Humphrey CA, Kates S, Noble K, McIntyre AW, Pecorella K, Davis CA, Lindenbaum S, Schwappach J, Baker JK, Rutherford T, Newman H, Lieberman S, Finn E, Robbins K, Hurley M, Lyle L, Mitchell K, Browner K, Whatley E, Payton K, Reeves C, Cannada LK, Karges D, Hill L, Esterhai J, Horan AD, Kaminski CA, Kowalski BN, Keeve JP, Anderson CG, McDonald MD, Hoffman JM, Tarkin I, Siska P, Gruen G, Evans A, Farrell DJ, Irrgang J, Luther A, Cross WW, Cass JR, Sems SA, Torchia ME, Scrabeck T, Jenkins M, Dumais J, Romero AW, Sagebien CA, Butler MS, Monica JT, Seuffert P, Hsu JR, Ficke J, Charlton M, Napierala M, Fan M, Tannoury C, Archdeacon M, Finnan R, Le T, Wyrick J, Hess S, Brennan ML, Probe R, Kile E, Mills K, Clipper L, Yu M, Erwin K, Horwitz D, Strohecker K, Swenson TK, Schmidt AH, Westberg JR, Aurang K, Zohman G, Peterson B, Huff RB, Baele J, Weber T, Edison M, McBeth J, Ertl JP, Parr JA, Moore MM, Tobias E, Thomas E, DePaolo CJ, Shell LE, Hampton L, Shepard S, Nanney T, Cuento C, Cantu RV, Henderson ER, Eickhoff LS, Hammerberg EM, Stahel P, Hak D, Mauffrey C, Gibula D, Gissel H, Henderson C, Zamorano DP, Tynan MC, Lawson D, Crist BD, Murtha YM, Anderson LK, Linehan C, Pilling L, Lewis CG, Sullivan RJ, Roper E, Obremskey W, Kregor P, Richards JE, Stringfellow K, Dohm MP, Zellar A, Segers MJM, Zijl JAC, Verhoeven B, Smits AB, de Vries JPPM, Fioole B, van der Hoeven H, Theunissen EBM, de Vries Reilingh TS, Govaert L, Wittich P, de Brauw M, Wille J, Go PM, Ritchie ED, Wessel RN, Hammacher ER, Visser GA, Stockmann H, Silvis R, Snellen JP, Rijbroek B, Scheepers JJG, Vermeulen EGJ, Siroen MPC, Vuylsteke R, Brom HLF, Rijna H, de Rijcke PAR, Koppert CL, Buijk SE, Groenendijk RPR, Dawson I, Tetteroo GWM, Bruijninckx MMM, Doornebosch PG, de Graaf EJR, van der Elst M, van der Pol CC, van’t Riet M, Karsten TM, de Vries MR, Stassen LPS, Schep NWL, Ben Schmidt G, Hoffman WH, van der Heijden FH, Willems WJ, van der Hart CP, Turckan K, Festen S, de Nies F, Out NJM, Bosma J, van Kampen A, Biert J, van Vugt AB, Edwards MJR, Blokhuis TJ, Frölke JPM, Geeraedts LMG, Gardeniers JWM, Tan ET, Poelhekke LM, de Waal Malefijt MC, Schreurs B, Roukema GR, Josaputra HA, Keller P, de Rooij PD, Kuiken H, Boxma H, Cleffken BI, Liem R, Rhemrev SJ, Bosman CHR, de Mol van Otterloo A, Hoogendoorn J, de Vries AC, Meylaerts SAG, Verhofstad MHJ, Meijer J, van Egmond T, van der Brand I, Patka P, Eversdijk MG, Peters R, Den Hartog D, Van Waes OJF, Oprel P, Campo M, Verhagen R, Albers GR, Simmermacher RKJ, van Mulken J, van Wessem K, van Gaalen SM, Leenen LPH, Bronkhorst MW, Guicherit OR, Goslings JC, Ponsen KJ, Bhatia M, Arora V, Tyagi V, Gupta A, Jain N, Khan F, Sharma A, Sanghavi A, Trivedi M, Rai A, Subash, Rai K, Yadav V, Singh S, Prasad AS, Mishra V, Sundaresh DC, Khanna A, Cherian JJ, Olakkengil DJ, Sharma G, Dadi A, Palla N, Ganguly U, Rai BS, Rajakumar J, Hull P, Lewis S, Evans S, Nanda R, Logishetty R, Anand S, Bowler C, Jennings A, Chuter G, Rose G, Horner G, Clark C, Eke K, Reed M, Herriott C, Dobb C, Curry H, Etherington G, Jain A, Moaveni A, Russ M, Donald G, Weinrauch P, Pincus P, Yang S, Halliday B, Gervais T, Holt M, Flynn A, Pirpiris M, Love D, Bucknill A, Farrugia RJ, Ianssen T, Amundsen A, Brattgjerd JE, Borch T, Bøe B, Flatøy B, Hasselund S, Haug KJ, Hemlock K, Hoseth TM, Jomaas G, Kibsgård T, Lona T, Moatshe G, Müller O, Molund M, Nicolaisen T, Nilsen F, Rydinge J, Smedsrud M, Stødle A, Trommer A, Ugland S, Karlsten A, Ekås G, Pape HC, Knobe M, Pfeifer R. Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for elderly patients with a femoral neck fracture. J Bone Joint Surg Am 2015; 97:751-7. [PMID: 25948522 DOI: 10.2106/jbjs.n.00542] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. METHODS Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. RESULTS The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). CONCLUSIONS The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations. CLINICAL RELEVANCE The results are based on two clinical trials. The questionnaires used concern pure, clinically relevant issues (ability to walk, climb stairs, etc.). Moreover, the results can be used for future research comparing clinical outcomes (or treatments) for populations with a femoral neck fracture.
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Affiliation(s)
- Paul T P W Burgers
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Rudolf W Poolman
- Joint Research, Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM Amsterdam, the Netherlands. E-mail address:
| | - Theodorus M J Van Bakel
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Wim E Tuinebreijer
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Stephanie M Zielinski
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Mohit Bhandari
- Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC 2C, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada. E-mail address:
| | - Peter Patka
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address:
| | - Esther M M Van Lieshout
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
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Falconier MK, Nussbeck F, Bodenmann G, Schneider H, Bradbury T. Stress from daily hassles in couples: its effects on intradyadic stress, relationship satisfaction, and physical and psychological well-being. J Marital Fam Ther 2015; 41:221-35. [PMID: 24807831 DOI: 10.1111/jmft.12073] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
According to the systemic-transactional stress model (STM; G. Bodenmann, European Review of Applied Psychology, 1997; 47: 137), extradyadic stress from daily hassles can have a negative impact on the individual psychological and physical health and the couple's relationship. This study is the first one to test the STM propositions in a model that includes both partners' individual and relational outcomes simultaneously. The model also includes actor and partner effects as well as the interdependence between partners' processes. Cross-sectional, self-report data were collected from 110 community couples in Switzerland. Consistent with STM predictions, results from the path model analysis indicate that for actor effects extradyadic stress from daily hassles relates directly to lower psychological (increase in anxiety symptoms) and physical well-being and only indirectly to lower relationship satisfaction through increased intradyadic stress from relationship problems and also through more depressive symptomatology in men. The female extradyadic stress and intradyadic stress had partner effects on the male intradyadic stress and the male relationship satisfaction, respectively. Limitations as well as research and clinical implications for marriage and family therapists are discussed.
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Aggarwal VK, Tischler EH, Lautenbach C, Williams GR, Abboud JA, Altena M, Bradbury T, Calhoun J, Dennis D, Del Gaizo DJ, Font-Vizcarra L, Huotari K, Kates S, Koo KH, Mabry TM, Moucha CS, Palacio JC, Peel TN, Poolman RW, Robb WJ, Salvagno R, Seyler T, Skaliczki G, Vasarhelyi EM, Watters WC. Mitigation and education. J Orthop Res 2014; 32 Suppl 1:S16-25. [PMID: 24464892 DOI: 10.1002/jor.22547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Campos B, Graesch AP, Repetti R, Bradbury T, Ochs E. Opportunity for interaction? A naturalistic observation study of dual-earner families after work and school. J Fam Psychol 2009; 23:798-807. [PMID: 20001138 DOI: 10.1037/a0015824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Everyday patterns of interaction can strengthen or undermine bonds between family members. This naturalistic observation study focused on an understudied facet of family life: opportunities for interaction among dual-earner family members after work and family members' responses to these opportunities. Thirty dual-earner couples and their children were observed and video-recorded in their homes throughout two weekday afternoons and evenings. Two interaction opportunities were analyzed: (1) the behavior of family members toward a parent returning home from work and (2) the physical proximity of family members throughout the evening. Three main findings emerged. Women, who tended to return home before men, were greeted with positive behavior and reports of the day's information from family members. Men, in contrast, returned home later in the day and received positive behavior or no acknowledgment from family members distracted by other activities. Throughout the evening, mothers spent more time with children whereas fathers spent more time alone. Couples were seldom together without their children. The implications of observed interaction patterns and the contribution of naturalistic observation methods to the study of family relationships are discussed.
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Affiliation(s)
- Belinda Campos
- Department of Chicano/Latino Studies, University of California, Irvine, Irvine, CA 92697-5100, USA.
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Bradbury T, Fehring TK, Taunton M, Hanssen A, Azzam K, Parvizi J, Odum SM. The fate of acute methicillin-resistant Staphylococcus aureus periprosthetic knee infections treated by open debridement and retention of components. J Arthroplasty 2009; 24:101-4. [PMID: 19553077 DOI: 10.1016/j.arth.2009.04.028] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 04/21/2009] [Indexed: 02/01/2023] Open
Abstract
The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and virulence of the infecting organism have been shown to influence outcome. This multicenter, retrospective study identified 19 cases of acute periprosthetic methicillin-resistant Staphylococcus aureus (MRSA) knee infections managed by ODCR and at least 4 weeks of postoperative intravenous vancomycin therapy. At minimum follow-up of 2 years, the treatment failed to eradicate the infection in 16 cases (84% failure rate). Of those 16 failures, 13 patients required a 2-stage exchange arthroplasty, 2 patients required repeat incision and debridement with antibiotic suppression, and 1 patient died of MRSA sepsis. In addition, a systematic review of the literature revealed failure to eradicate infection in 10 of 13 patients managed with a similar protocol. The total success rate of ODCR in acute periprosthetic MRSA knee infection was 18%.
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Affiliation(s)
- Thomas Bradbury
- The Emory Orthopaedics Center, 59 Executive Park South, Atlanta, Georgia, USA
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Bradbury T, Dunn WR, Kuhn JE. Preventing the popeye deformity after release of the long head of the biceps tendon: an alternative technique and biomechanical evaluation. Arthroscopy 2008; 24:1099-102. [PMID: 19028160 DOI: 10.1016/j.arthro.2008.06.002] [Citation(s) in RCA: 26] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Revised: 05/30/2008] [Accepted: 06/03/2008] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this biomechanical study is to compare the pullout strength of a traditional biceps release with an alternative method of releasing the biceps in which a portion of the superior labrum is included in the release. METHODS Five pairs of shoulders were arbitrarily separated into 2 groups: biceps tendons to be released "without labrum" or "with labrum." The biceps tendons of shoulders in the without-labrum group were released at the tendon-labrum junction. In the shoulders in the with-labrum group, the biceps was released with a portion of the superior labrum equal to twice the width of the biceps tendon and half the height of the superior labrum. The force required to pull the biceps tendon through the bicipital groove was then measured with a servohydraulic frame (858 Bionix; MTS Systems, Minneapolis, MN). The mean force required to pull the tendon out of the groove was compared by use of parametric and nonparametric statistical tests. RESULTS The mean force required to pull the tendon through the bicipital groove was 25.0 N (95% confidence interval, 8.8 to 41.1) in the without-labrum group and 73.2 N (95% confidence interval, 57.1 to 89.3) in the with-labrum group (P = .001 by paired t test and P = .042 by Wilcoxon signed-rank test). CONCLUSIONS Release of the biceps tendon with a portion of the superior labrum significantly increases the force required to pull the biceps tendon through the bicipital tunnel. CLINICAL RELEVANCE The described method of releasing the biceps tendon with some of the superior labrum may prevent complete biceps retraction and may result in fewer Popeye deformities after biceps release.
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Affiliation(s)
- Thomas Bradbury
- Department of Orthopaedics and Rehabilitation, Vanderbilt Sports Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37212, USA
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Abstract
The current work investigates how personality and interpersonal processes combine to predict change in relationship quality. Measures of personality and emotion similarity were collected during laboratory interactions from a cross-sectional sample of dating couples (Study 1) and a 1-year longitudinal study of newlywed married couples (Study 2). Results showed that emotion similarity mediated the association between personality similarity and relationship quality (Studies 1 and 2) and that emotion convergence mediated the association between personality convergence and relationship satisfaction (Study 2). These results indicate that similarity and convergence in personality may benefit relationships by promoting similarity and convergence in partners' shared emotional experiences. Findings also lend support to models that integrate partners' enduring traits and couples' adaptive processes as antecedents of relationship outcomes.
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Marvaldi AE, Oberprieler RG, Lyal CHC, Bradbury T, Anderson RS. Phylogeny of the Oxycoryninae sensu lato (Coleoptera:Belidae) and evolution of host-plant associations. INVERTEBR SYST 2006. [DOI: 10.1071/is05059] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Phylogenetic relationships among the genera of the subfamily Oxycoryninae and other belids (Curculionoidea) were reconstructed by cladistic analysis using 21 terminals and 98 characters: 62 from imaginal morphology, 33 from larval morphology and three biological characters relating to host plants and larval feeding habits. Terminal taxa represent all extant genera of Oxycoryninae, two genera of each of the three tribes of Belinae plus two outgroup taxa used to root the tree. New information on the larvae and biology of the metrioxenines is used in phylogenetic reconstruction. In accord with the single optimal cladogram obtained, a revised classification of the Oxycoryninae is proposed. The subfamily is classified into three tribes (Oxycorynini, Metrioxenini and Aglycyderini), with the tribe Oxycorynini further classified into three subtribes (Oxycraspedina Marvaldi & Oberprieler, subtr. nov., Oxycorynina and Allocorynina) and the tribe Metrioxenini into two subtribes (Metrioxenina and Afrocorynina ( = Hispodini, syn. nov.)). Larval and adult unambiguous synapomorphies defining each clade are identified. Tracing the evolution of biological traits from the phylogenetic estimate indicates that drastic shifts to phylogenetically distant host plants occurred from the ancestral belid association with conifers. Structural, chemical and/or ecological similarities of the plant organs consumed apparently had a major influence in the colonisation of different plant taxa by this group of weevils.
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