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van der Wardt V, Conroy S, Tomas W, Logan P, Harrison J, Taggar J, Gladman J. P-088: Recruitment of people with dementia in primary care –experiences from the HIND study. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Booth V, Logan P, Masud T, Hood V, Van Der Wardt V, Taylor R, Harwood R. P-272: Falls, gait and dual-tasking in older adults with mild cognitive impairment: A cross-sectional study. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30370-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Woods JA, Ferguson JS, Kalra S, Degabriele A, Gardner J, Logan P, Ferguson J. The phototoxicity of vemurafenib: An investigation of clinical monochromator phototesting and in vitro phototoxicity testing. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 151:233-8. [PMID: 26318280 DOI: 10.1016/j.jphotobiol.2015.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/26/2015] [Accepted: 08/11/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vemurafenib is a targeted therapy approved for the treatment of patients with metastatic melanoma harbouring the BRAF V600E mutation. Photosensitivity has been reported in over 50% of patients and has been demonstrated to involve at least the broadband UVA spectrum in most patients. Erythrocyte protoporphyrin levels have also been reported as elevated in some patients. OBJECTIVES We report the results of monochromator phototesting in one patient recorded before and while taking vemurafenib. Analysis of porphyrin levels was also conducted. RESULTS After one month of vemurafenib therapy the patient demonstrated markedly increased light sensitivity in the UVA spectrum between 335 ± 27 nm, 365 ± 27 nm and 400 ± 27 nm. However responses in the UVB (305 ± 5 nm) and blue light (430 ± 27 nm) regions were normal. There was no abnormal immediate erythemal response. Pre-vemurafenib baseline phototesting was normal, as was repeat testing two months later when the patient was taking high doses of systemic steroid. No abnormal porphyrins were detected and the antinuclear antibody test was normal. In parallel studies, HaCaT keratinocytes incubated with vemurafenib were killed by UVA but not by visible (blue) light and did not show evidence of detectable intracellular porphyrin in the presence of the drug. CONCLUSION These data confirm vemurafenib induced UVA photosensitivity with a probable phototoxic mechanism not mediated via enhanced porphyrin.
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Walker GM, Logan P, Gordon AL, Conroy S, Armstrong S, Robertson K, Ward M, Frowd N, Darby J, Arnold G, Gladman JRF. 45 * ARE ACCELEROMETERS A USEFUL WAY TO MEASURE ACTIVITY IN CARE HOME RESIDENTS? Age Ageing 2015. [DOI: 10.1093/ageing/afv032.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Watson A, Charlesworth L, Jacob R, Kendrick D, Logan P, Marshall F, Montgomery A, Sach T, Tan W, Walker M, Waring J, Whitham D, Sahota O. The Community In-Reach and Care Transition (CIRACT) clinical and cost-effectiveness study: study protocol for a randomised controlled trial. Trials 2015; 16:41. [PMID: 25886822 PMCID: PMC4327808 DOI: 10.1186/s13063-015-0551-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 01/06/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Older people represent a significant proportion of patients admitted to hospital. Their care compared to younger patients is more challenging, length of stay is longer, risk of hospital-acquired problems higher and the risk of being re-admitted within 28 days greater. This study aims to compare a Community In-Reach and Care Transition (CIRACT) service with Traditional Hospital Based rehabilitation (THB-Rehab) provided to the older person. The CIRACT service differs from the THB-rehab service in that they are able to provide more intensive hospital rehabilitation, visiting patients daily, and are able to continue with the patient's rehabilitation following discharge allowing a seamless, integrated discharge working alongside community providers. A pilot comparing the two services showed that the CIRACT service demonstrated reduced length of stay and reduced re-admission rates when analysed over a four-month period. METHODS/DESIGN This trial will evaluate the clinical and cost-effectiveness of the CIRACT service, conducted as a randomised controlled trial (RCT) with an integral qualitative mechanism and action study designed to provide the explanatory and theoretical components on how the CIRACT service compares to current practice. The RCT element consists of 240 patients over 70 years of age, being randomised to either the THB therapy group or the CIRACT service following an unplanned hospital admission. The primary outcome will be hospital length of stay from admission to discharge from the general medical elderly care ward. Additional outcome measures including the Barthel Index, Charlson Co-morbidity Scale, EuroQoL-5D and the modified Client Service Receipt Inventory will be assessed at the time of recruitment and repeated at 91 days post-discharge. The qualitative mechanism and action study will involve a systematic programme of organisational profiling, observations of work processes, interviews with key informants and care providers and tracking of participants. In addition, a within-trial economic evaluation will be undertaken comparing the CIRACT and THB-rehab services to determine cost-effectiveness. DISCUSSION The outcome of the study will inform clinical decision-making, with respect to allocation of resources linked to hospital discharge planning and re-admissions, in a resource intensive and growing group of patients. TRIAL REGISTRATION Registered with the ISRCTN registry ( ISCRCTN94393315 ) on 25 April 2013 (version 3.1, 11 September 2014).
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Schultz A, Blackburn M, Logan P, White D, Taaffe D, Lockie R. Musculoskeletal screening as a predictor of seasonal low back pain in Olympic class sailors. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Robinson K, Anthony K, Leighton P, Gladman JR, Gordon A, Harwood RH, Logan P, Masud T. 72 * DEVELOPING A CHAIR BASED EXERCISE PROGRAMME FOR OLDER PEOPLE: A DELPHI STUDY. Age Ageing 2014. [DOI: 10.1093/ageing/afu133.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Van der Wardt V, Patel D, Gondek D, Pollock K, Logan P, Das Nair R, Harwood R. P492: Systematic review into motivational strategies that support adherence to exercise for people with mild cognitive impairment (MCI) or dementia. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70657-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Anand V, Ong T, Bicker A, Walker G, Logan P, Sahota O. P247: PHYsical activity Study of older people In hospital: a Cross-sectional analysis using AcceLerometers (PHYSICAL). Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70419-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Van der Wardt V, Logan P, Masud T, Harwood R. P495: The relationship between executive function and falls risk in people with mild cognitive impairment (MCI) and early stage dementia. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70660-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Robinson KR, Leighton P, Logan P, Gordon AL, Anthony K, Harwood RH, Gladman JRF, Masud T. Developing the principles of chair based exercise for older people: a modified Delphi study. BMC Geriatr 2014; 14:65. [PMID: 24884392 PMCID: PMC4039312 DOI: 10.1186/1471-2318-14-65] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chair based exercise (CBE) is suggested to engage older people with compromised health and mobility in an accessible form of exercise. A systematic review looking at the benefits of CBE for older people identified a lack of clarity regarding a definition, delivery, purpose and benefits. This study aimed to utilise expert consensus to define CBE for older people and develop a core set of principles to guide practice and future research. METHODS The framework for consensus was constructed through a team workshop identifying 42 statements within 7 domains. A four round electronic Delphi study with multi-disciplinary health care experts was undertaken. Statements were rated using a 5 point Likert scale of agreement and free text responses. A threshold of 70% agreement was used to determine consensus. Free text responses were analysed thematically. Between rounds a number of strategies (e.g., amended wording of statements, generation and removal of statements) were used to move towards consensus. RESULTS 16 experts agreed on 46 statements over four rounds of consultation (Round 1: 22 accepted, 3 removed, 5 new and 17 modified; Round 2: 16 accepted, 0 removed, 4 new and 6 modified; Round 3: 4 accepted, 2 removed, 0 new and 4 modified; Round 4: 4 accepted, 0 removed, 0 new, 0 modified).Statements were accepted in all seven domains: the definition of CBE (5), intended users (3), potential benefits (8), structure (12), format (8), risk management (7) and evaluation (3).The agreed definition of CBE had five components: 1. CBE is primarily a seated exercise programme; 2. The purpose of using a chair is to promote stability in both sitting and standing; 3. CBE should be considered as part of a continuum of exercise for frail older people where progression is encouraged; 4. CBE should be used flexibly to respond to the changing needs of frail older people; and 5. Where possible CBE should be used as a starting point to progress to standing programmes. CONCLUSIONS Consensus has been reached on a definition and a set of principles governing CBE for older people; this provides clarity for implementation and future research about CBE.
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Vlachopoulou M, Coughlin D, Forrow D, Kirk S, Logan P, Voulvoulis N. The potential of using the Ecosystem Approach in the implementation of the EU Water Framework Directive. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 470-471:684-94. [PMID: 24176715 DOI: 10.1016/j.scitotenv.2013.09.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/24/2013] [Accepted: 09/24/2013] [Indexed: 05/16/2023]
Abstract
The Ecosystem Approach provides a framework for looking at whole ecosystems in decision making to ensure that society can maintain a healthy and resilient natural environment now and for future generations. Although not explicitly mentioned in the Water Framework Directive, the Ecosystem Approach appears to be a promising concept to help its implementation, on the basis that there is a connection between the aims and objectives of the Directive (including good ecological status) and the provision of ecosystem services. In this paper, methodological linkages between the Ecosystem Approach and the Water Framework Directive have been reviewed and a framework is proposed that links its implementation to the Ecosystem Approach taking into consideration all ecosystem services and water management objectives. Individual River Basin Management Plan objectives are qualitatively assessed as to how strong their link is with individual ecosystem services. The benefits of using this approach to provide a preliminary assessment of how it could support future implementation of the Directive have been identified and discussed. Findings also demonstrate its potential to encourage more systematic and systemic thinking as it can provide a consistent framework for identifying shared aims and evaluating alternative water management scenarios and options in decision making. Allowing for a broad consideration of the benefits, costs and tradeoffs that occur in each case, this approach can further improve the economic case for certain measures, and can also help restore the shift in focus from strict legislative compliance towards a more holistic implementation that can deliver the wider aims and intentions of the Directive.
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Darby J, Edmans J, Logan P, Gladman J. The acute medical unit: Narratives of older people and their carers about the hospital stay and resettlement experience. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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McGhee DJM, Royle PL, Counsell CE, Abbas A, Sethi P, Manku L, Narayan A, Clegg K, Bardai A, Brown SHM, Hafeez U, Abdelhafiz AH, McGovern A, Breckenridge A, Seenan P, Samani A, Das S, Khan S, Puffett AJ, Morgan J, Ross G, Cantlay A, Khan N, Bhalla A, Sweeting M, Nimmo CAMD, Fleet J, Igbedioh C, Harari D, Downey CL, Handforth C, Stothard C, Cracknell A, Barnes C, Shaw L, Bainbridge L, Crabtree L, Clark T, Root S, Aitken E, Haroon K, Sudlow M, Hanley K, Welsh S, Hill E, Falconer A, Miller H, Martin B, Tidy E, Pendlebury S, Thompson S, Burnett E, Taylor H, Lonan J, Adler B, McCallion J, Sykes E, Bancroft R, Tullo ES, Young TJ, Clift E, Flavin B, Roberts HC, Sayer AA, Belludi G, Aithal S, Verma A, Singh I, Barne M, Wilkinson I, Sakoane R, Singh N, Wilkinson I, Cottee M, Irani TS, Martinovic O, Abdulla AJJ, Irani TS, Abdulla AJJ, Riglin J, Husk J, Lowe D, Treml J, Vasilakis JN, Buttery A, Reid J, Healy P, Grant-Casey J, Pendry K, Richards J, Singh A, Jarrett D, Hewitt J, Slevin J, Barwell G, Youde J, Kennedy C, Romero-Ortuno R, O'Shea D, Robinson D, O'Shea D, Kenny RA, O'Connell J, Kennedy C, Romero-Ortuno R, O'Shea D, Robinson D, O'Shea D, Robinson D, O'Connell J, Topp JD, Topp JD, Warburton K, Simpson L, Bryce K, Suntharalingam S, Grosser K, D'Silva A, Southern L, Bielawski C, Cook L, Sutton GM, Flanagan L, Storr A, Charlton L, Kerr S, Robinson L, Shaw F, Finch LK, Weerasuriya N, Walker M, Sahota O, Logan P, Brown F, Rossiter F, Baxter M, Mucci E, Brown A, Jackson SHD, de Savary N, Hasan S, Jones H, Birrell J, Hockley J, Hensey N, Meiring R, Athavale N, Simms J, Brown S, West A, Diem P, Simms J, Brown S, West A, Diem P, Davies R, Kings R, Coleman H, Stevens D, Campbell C, Hope S, Morris A, Ong T, Harwood R, Dasgupta D, Mitchell S, Dimmock V, Collin F, Wood E, Green V, Hendrickse-Welsh N, Singh N, Cracknell A, Eccles J, Beezer J, Garside M, Baxter J. Clinical effectiveness. Age Ageing 2013. [DOI: 10.1093/ageing/aft016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Robbins I, Gordon A, Dyas J, Logan P, Gladman J. Explaining the barriers to and tensions in delivering effective healthcare in UK care homes: a qualitative study. BMJ Open 2013; 3:e003178. [PMID: 23872297 PMCID: PMC3717448 DOI: 10.1136/bmjopen-2013-003178] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To explain the current delivery of healthcare to residents living in UK care homes. DESIGN Qualitative interview study using a grounded theory approach. SETTING 6 UK care homes and primary care professionals serving the homes. PARTICIPANTS Of the 32 participants, there were 7 care home managers, 2 care home nurses, 9 care home assistants, 6 general practitioners (GPs), 3 dementia outreach nurses, 2 district nurses, 2 advanced nurse practitioners and 1 occupational therapist. RESULTS 5 themes were identified: complex health needs and the intrinsic nature of residents' illness trajectories; a mismatch between healthcare requirements and GP time; reactive or anticipatory healthcare?; a dissonance in healthcare knowledge and ethos; and tensions in the responsibility for the healthcare of residents. Care home managers and staff were pivotal to healthcare delivery for residents despite their perceived role in social care provision. Formal healthcare for residents was primarily provided via one or more GPs, often organised to provide a reactive service that did not meet residents' complex needs. Deficiencies were identified in training required to meet residents' needs for both care home staff as well as GPs. Misunderstandings, ambiguities and boundaries around roles and responsibilities of health and social care staff limited the development of constructive relationships. CONCLUSIONS Healthcare of care home residents is difficult because their needs are complex and unpredictable. Neither GPs nor care home staff have enough time to meet these needs and many lack the prerequisite skills and training. Anticipatory care is generally held to be preferable to reactive care. Attempts to structure care to make it more anticipatory are dependent on effective relationships between GPs and care home staff and their ability to establish common goals. Roles and responsibilities for many aspects of healthcare are not made explicit and this risks poor outcomes for residents.
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Edmans J, Conroy S, Harwood R, Lewis S, Elliott RA, Logan P, Bradshaw L, Franklin M, Gladman J. Acute medical unit comprehensive geriatric assessment intervention study (AMIGOS). Trials 2011; 12:200. [PMID: 21864399 PMCID: PMC3184060 DOI: 10.1186/1745-6215-12-200] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 08/24/2011] [Indexed: 11/12/2022] Open
Abstract
Background Many older people presenting to Acute Medical Units (AMU) are discharged after only a short stay (< 72 hours), yet many re-present to hospital or die within 1 year. Comprehensive Geriatric Assessment may improve patient outcomes for this group. Method Trial Registration ISRCTN: ISRCTN21800480
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Falzon K, Galea M, Guerin M, Logan P. Unusual complications associated with maxillary herpes zoster. IRISH MEDICAL JOURNAL 2011; 104:58-59. [PMID: 21469268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Murphy A, Logan P. An analysis of the East Kent Outcome System for use in intermediate care. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2009. [DOI: 10.12968/ijtr.2009.16.9.43766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Fitzsimon JS, Toland J, Phillips J, Logan P, Eustace P. Trends and Developments: Giant Aneurysms in the Cavernous Sinus. Neuroophthalmology 2009. [DOI: 10.3109/01658109509009644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Murphy D, O'Mahony M, Logan P, Costello R, McElvaney N. Bilateral Pneumothoraces following a Bungee Jump in a Patient with Cystic Fibrosis. Respiration 2006; 73:113. [PMID: 16131787 DOI: 10.1159/000087948] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Walker MF, Leonardi-Bee J, Bath P, Langhorne P, Dewey M, Corr S, Drummond A, Gilbertson L, Gladman JRF, Jongbloed L, Logan P, Parker C. Individual Patient Data Meta-Analysis of Randomized Controlled Trials of Community Occupational Therapy for Stroke Patients. Stroke 2004; 35:2226-32. [PMID: 15272129 DOI: 10.1161/01.str.0000137766.17092.fb] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Trials of occupational therapy for stroke patients living in the community have varied in their findings. It is unclear why these discrepancies have occurred. METHODS Trials were identified from searches of the Cochrane Library and other sources. The primary outcome measure was the Nottingham Extended Activities of Daily Living (NEADL) score at the end of intervention. Secondary outcome measures included the Barthel Index or the Rivermead ADL (Personal ADL), General Health Questionnaire (GHQ), Nottingham Leisure Questionnaire (NLQ), and death. Data were analyzed using linear or logistic regression with a random effect for trial and adjustment for age, gender, baseline dependency, and method of follow-up. Subgroup analyses compared any occupational therapy intervention with control. RESULTS We included 8 single-blind randomized controlled trials incorporating 1143 patients. Occupational therapy was associated with higher NEADL scores at the end of intervention (weighted mean difference [WMD], 1.30 points, 95% confidence intervals [CI], 0.47 to 2.13) and higher leisure scores at the end of intervention (WMD, 1.51 points; 95% CI, 0.24 to 2.79). Occupational therapy emphasizing activities of daily living (ADL) was associated with improved end of intervention NEADL (WMD, 1.61 points; 95% CI, 0.72 to 2.49) and personal activities of daily living (odds ratio [OR], 0.65; 95% CI, 0.46 to 0.91), but not NLQ. Leisure-based occupational therapy improved end of intervention NLQ (WMD, 1.96 points; 95% CI, 0.27 to 3.66) but not NEADL or PADL. CONCLUSIONS Community occupational therapy significantly improved personal and extended activities of daily living and leisure activity in patients with stroke. Better outcomes were found with targeted interventions.
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Simpson T, Spivey C, Logan P, Oh MK. 161 ADOLESCENTS' EXPERIENCES WITH PREVENTIVE CARE. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Fahey DK, Fenton S, Mohamed Q, Logan P. Cystinosis, cataract surgery, and corneal erosions. J Cataract Refract Surg 2001; 27:2041-3. [PMID: 11738923 DOI: 10.1016/s0886-3350(01)00882-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 21-year-old man presented with severe corneal cystinosis and steroid-related cataract bilaterally. Rather than combined cataract surgery and penetrating keratoplasty, the patient had uneventful phacoemulsification and intraocular lens implantation after which visual acuity improved to 66 in both eyes. The outcome indicates that conventional phacoemulsification is sufficient in these cases. A guarded prognosis is advised in patients with cystinosis having cataract surgery as the fundal view is often impaired and there may be associated maculopathy.
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Ashenden MJ, Hahn AG, Martin DT, Logan P, Parisotto R, Gore CJ. A comparison of the physiological response to simulated altitude exposure and r-HuEpo administration. J Sports Sci 2001; 19:831-7. [PMID: 11695504 DOI: 10.1080/026404101753113778] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Concerns have been raised about the morality of using simulated altitude facilities in an attempt to improve athletic performance. One assumption that has been influential in this debate is the belief that altitude houses simply mimic the physiological effects of illegal recombinant human erythropoietin (r-HuEpo) doping. To test the validity of this assumption, the haematological and physiological responses of 23 well-trained athletes exposed to a simulated altitude of 2650-3000 m for 11-23 nights were contrasted with those of healthy volunteers receiving a low dose (150 IU x kg(-1) per week) of r-HuEpo for 25 days. Serial blood samples were analysed for serum erythropoietin and percent reticulocytes; maximal oxygen uptake (VO2max) was assessed before and after r-HuEpo administration or simulated altitude exposure. The group mean increase in serum erythropoietin (422% for r-HuEpo vs 59% for simulated altitude), percent reticulocytes (89% vs 30%) and VO2max (6.6% vs -2.0%) indicated that simulated altitude did not induce the changes obtained with r-HuEpo administration. Based on the disparity of these responses, we conclude that simulated altitude facilities should not be considered unethical based solely on the tenet that they provide an alternative means of obtaining the benefits sought by illegal r-HuEpo doping.
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Slater G, Jenkins D, Logan P, Lee H, Vukovich M, Rathmacher JA, Hahn AG. Beta-hydroxy-beta-methylbutyrate (HMB) supplementation does not affect changes in strength or body composition during resistance training in trained men. Int J Sport Nutr Exerc Metab 2001; 11:384-96. [PMID: 11599506 DOI: 10.1123/ijsnem.11.3.384] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This investigation evaluated the effects of oral beta-hydroxy-beta-methylbutyrate (HMB) supplementation on training responses in resistance-trained male athletes who were randomly administered HMB in standard encapsulation (SH), HMB in time release capsule (TRH), or placebo (P) in a double-blind fashion. Subjects ingested 3 g x day(-1) of HMB or placebo for 6 weeks. Tests were conducted pre-supplementation and following 3 and 6 weeks of supplementation. The testing battery assessed body mass, body composition (using dual energy x-ray absorptiometry), and 3-repetition maximum isoinertial strength, plus biochemical parameters, including markers of muscle damage and muscle protein turnover. While the training and dietary intervention of the investigation resulted in significant strength gains (p < .001) and an increase in total lean mass (p = .01), HMB administration had no influence on these variables. Likewise, biochemical markers of muscle protein turnover and muscle damage were also unaffected by HMB supplementation. The data indicate that 6 weeks of HMB supplementation in either SH or TRH form does not influence changes in strength and body composition in response to resistance training in strength-trained athletes.
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