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Quinn KM, Chen X, Griffiths C, Chen G, Osayi S, Husain S. Skill transference and learning curves in novice learners: a randomized comparison of robotic and laparoscopic platforms. Surg Endosc 2023; 37:8483-8488. [PMID: 37759146 DOI: 10.1007/s00464-023-10486-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND While well-established protocols direct laparoscopic training, there remains a relative paucity of guidelines for robotic education. Furthermore, it is unknown how exposure to one platform influences trainees' proficiency in the other. This study aimed to compare and quantify (1) learning curves and (2) transference of skill between the two modalities in novice learners. METHODS Thirty pre-clinical medical students were randomized into two groups. One group performed the peg-transfer task using the robot first, followed by laparoscopy, while the other group performed the same task laparoscopically first. Participants completed five repetitions with each methodology. Participants were timed and errors were recorded. We hypothesized that laparoscopic experience with the peg-transfer task would assist in completing the task robotically, and there would be a higher degree of skill transference from the laparoscopic to robotic platform. RESULTS Peg-transfer task completion was consistently faster and more accurate with the robot compared to laparoscopy (p < 0.01). We observed a positive transference of skill from the laparoscopic to robotic platform. However, exposure to the robot-hindered students' ability to perform the task laparoscopically, evidenced by significantly increased time and errors when compared with baseline laparoscopic performance (p < 0.01). CONCLUSION These findings encourage surgical residency programs to treat robotic and laparoscopic training as discrete entities and consider their unique learning curves and skill transference when designing an efficient curriculum. While these effects are observed in novices, future directions include uncovering the trends among resident trainees and practicing surgeons.
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Affiliation(s)
- Kristen M Quinn
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
- Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA.
| | - Xiaodong Chen
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Claire Griffiths
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Grace Chen
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sylvester Osayi
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Syed Husain
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Griffiths C, Radley D, Gately P, South J, Sanders G, Morris MA, Clare K, Martin A, Heppenstall A, McCann M, Rodgers J, Nobles J, Coggins A, Cooper N, Cooke C, Gilthorpe MS, Ells L. A complex systems approach to obesity: a transdisciplinary framework for action. Perspect Public Health 2023; 143:305-309. [PMID: 37395317 PMCID: PMC10683338 DOI: 10.1177/17579139231180761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- C Griffiths
- Obesity Institute, School of Sport, Leeds Beckett University, Headingly Campus, Leeds LS6 3QS, Yorkshire, UK
| | - D Radley
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - P Gately
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - J South
- Centre for Health Promotion Research, School of health, Leeds Beckett University, UK
| | - G Sanders
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - MA Morris
- Leeds Institute for Data Analytics and Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - K Clare
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - A Martin
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - A Heppenstall
- School of Political and Social Sciences, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - M McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - J Rodgers
- International Business School, Teesside University, Middlesbrough, UK
| | - J Nobles
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - A Coggins
- Essex County Council, Chelmsford, UK
| | - N Cooper
- Suffolk County Council, Ipswich, UK
| | - C Cooke
- Obesity Institute, School of Sport, Leeds Beckett University, UK
| | - MS Gilthorpe
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - L Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
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Griffiths C, Scott WE, Ali S, Fisher AJ. Maximizing organs for donation: the potential for ex situ normothermic machine perfusion. QJM 2023; 116:650-657. [PMID: 31943119 DOI: 10.1093/qjmed/hcz321] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/13/2022] Open
Abstract
Currently, there is a shortfall in the number of suitable organs available for transplant resulting in a high number of patients on the active transplant waiting lists worldwide. To address this shortfall and increase the utilization of donor organs, the acceptance criteria for donor organs is gradually expanding including increased use of organs from donation after circulatory death. Use of such extended criteria donors and exposure of organs to more prolonged periods of warm or cold ischaemia also increases the risk of primary graft dysfunction occurring. Normothermic machine perfusion (NMP) offers a unique opportunity to objectively assess donor organ function outside the donor body and potentially recondition those deemed unsuitable on initial evaluation prior to implantation in the recipient. Furthermore, NMP provides a platform to support the use of established and novel therapeutics delivered directly to the organ, without the need to worry about potential deleterious 'off-target' side effects typically considered when treating the whole patient. This review will explore some of the novel therapeutics currently being added to perfusion platforms during NMP experimentally in an attempt to improve organ function and post-transplant outcomes.
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Affiliation(s)
- C Griffiths
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - W E Scott
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - S Ali
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - A J Fisher
- From the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
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Greatwood HC, McGregor S, Duckworth LC, Griffiths C. Socio-ecological influences on adolescent dietary typologies. Nutr Health 2023:2601060231186297. [PMID: 37428136 DOI: 10.1177/02601060231186297] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background: Dietary behaviours of adolescence are concerning, and this may impact long-term well-being. Aim: This study examined the socio-ecological determinants of dietary behaviours in a national prospective cohort study of English adolescents. Methods: Latent class analysis was used to identify the typologies of eight dietary behaviours: fruit, vegetable, breakfast, sugar-sweetened beverages, artificial-sweetened beverages, fast-food, bread, and milk from 7402 adolescents aged 13-15 years (mean 13.8 ± 0.45 years) (50.3% female and 71.3% white ethnicity) participating in the U.K. Millennium Cohort Study (sixth survey). Multinomial logistic regression and path analysis predicted associations between personal characteristics, individual, influential others, social environment and physical environment determinants and three distinct diet typologies: (1) healthy, (2) less-healthy and (3) mixed, (reference category = mixed). Results: Within Path analysis, the magnitudes of coefficients were small to moderate suggesting a relatively weak relationship between the variables. Model 1 reported adolescents within the less-healthy compared to mixed typology had lower levels of physical activity (β = 0.074, 95% CI = -0.115, -0.033), and have siblings (β = 0.246, 95% CI = 0.105, 0.387). Model 2 reported adolescents within the healthy compared to mixed typology had lower screen time (β = 0.104, 95% CI = 0.067, 0.141), and lower social media usage (β = 0.035, 95% CI = 0.024, 0.046). Conclusion: This study highlights the importance of considering multiple dietary determinants. These findings are likely to be useful in supporting the development of multi-faceted interventions. They emphasise the need to move away from investigating silo behaviours on individual diet components and a step towards more systems thinking to improve adolescent eating behaviours.
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Pusateri A, Litzenberg K, Griffiths C, Hayes C, Gnyawali B, Manious M, Kelly SG, Conteh LF, Jalil S, Nagaraja HN, Mumtaz K. Randomized intervention and outpatient follow-up lowers 30-d readmissions for patients with hepatic encephalopathy, decompensated cirrhosis. World J Hepatol 2023; 15:826-840. [PMID: 37397939 PMCID: PMC10308285 DOI: 10.4254/wjh.v15.i6.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/23/2023] [Accepted: 04/14/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND We previously reported national 30-d readmission rates of 27% in patients with decompensated cirrhosis (DC).
AIM To study prospective interventions to reduce early readmissions in DC at our tertiary center.
METHODS Adults with DC admitted July 2019 to December 2020 were enrolled and randomized into the intervention (INT) or standard of care (SOC) arms. Weekly phone calls for a month were completed. In the INT arm, case managers ensured outpatient follow-up, paracentesis, and medication compliance. Thirty-day readmission rates and reasons were compared.
RESULTS Calculated sample size was not achieved due to coronavirus disease 2019; 240 patients were randomized into INT and SOC arms. 30-d readmission rate was 33.75%, 35.83% in the INT vs 31.67% in the SOC arm (P = 0.59). The top reason for 30-d readmission was hepatic encephalopathy (HE, 32.10%). There was a lower rate of 30-d readmissions for HE in the INT (21%) vs SOC arm (45%, P = 0.03). There were fewer 30-d readmissions in patients who attended early outpatient follow-up (n = 17, 23.61% vs n = 55, 76.39%, P = 0.04).
CONCLUSION Our 30-d readmission rate was higher than the national rate but reduced by interventions in patients with DC with HE and early outpatient follow-up. Development of interventions to reduce early readmission in patients with DC is needed.
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Affiliation(s)
- Antoinette Pusateri
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Kevin Litzenberg
- Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Claire Griffiths
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Caitlin Hayes
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Bipul Gnyawali
- The Ohio State University College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Michelle Manious
- Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Sean G Kelly
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Lanla F Conteh
- Division of Gastroenterology and Hepatology, The Ohio State Wexner Medical Center, Columbus, OH 43210, United States
| | - Sajid Jalil
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Haikady N Nagaraja
- Division of Biostatistics, The Ohio State University, Columbus, OH 43210, United States
| | - Khalid Mumtaz
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
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Christensen A, Griffiths C, Hobbs M, Gorse C, Radley D. Investigating where adolescents engage in moderate to vigorous physical activity and sedentary behaviour: An exploratory study. PLoS One 2022; 17:e0276934. [PMID: 36472978 PMCID: PMC9725162 DOI: 10.1371/journal.pone.0276934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is a persistent lack of understanding on the influence of the environment on behaviour and health. While the environment is considered an important modifiable determinant of health behaviour, past research assessing environments often relies on static, researcher-defined buffers of arbitrary distance. This likely leads to misrepresentation of true environmental exposures. This exploratory study aims to compare researcher-defined and self-drawn buffers in reflecting the spaces and time adolescents engage in physical activity (PA) and sedentary behaviour. It also investigates if adolescent's access the PA facility and greenspace nearest their home or school for PA, as well as examine how much time adolescents spent in PA at any PA facilities and greenspaces. METHODS Adolescents (aged 14-18 years; n = 34) were recruited from schools in West Yorkshire, England. Seven consecutive days of global positioning system (GPS) and accelerometer data were collected at 15 second intervals. Using ArcGIS, we compared 30 different researcher-defined buffers including: radial, network and ellipse buffers at 400m, 800m, 1000m, 1600m and 3000m and participant-defined self-drawn neighbourhoods to objectively measured PA and sedentary space and PA time. Location of PA was also compared to Points of Interest data to determine if adolescents use the nearest PA facility or greenspace to their home or school and to examine how much PA was undertaken within these locations. RESULTS Our exploratory findings show the inadequacy of researcher-defined buffer size in assessing MVPA space or sedentary space. Furthermore, less than 35% of adolescents used the greenspaces or PA facilities nearest to their home or school. Approximately 50% of time spent in PA did not occur within the home, school, PA facility, or greenspace environments. CONCLUSION Our exploratory findings help to begin to quantify the inadequacy of researcher-defined, and self-drawn buffers in capturing adolescent MVPA and sedentary space, as well as time spent in PA. Adolescents often do not use PA facilities and greenspaces nearest their home and school and a large proportion of PA is achieved outside PA facilities and greenspaces. Further research with larger samples are needed to confirm the findings of this exploratory study.
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Affiliation(s)
- Alex Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- * E-mail:
| | - Claire Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Matthew Hobbs
- Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Chris Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, United Kingdom
| | - Duncan Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
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7
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Al-Janabi A, Eyre S, Foulkes A, Khan A, Dand N, Smith C, Griffiths C, Morris A, Warren R. 269 Atopic polygenic risk score is associated with paradoxical eczema developing in psoriasis patients treated with biologics. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.281] [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: 11/19/2022]
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8
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kiss O, Griffiths C, Wang R, Chien A, Kang S, O’Connor C, Watson R, Langton A. 515 Topical retinoids for the treatment of photoageing in skin of colour. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.530] [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: 11/19/2022]
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9
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Hardman-Smart J, Ejarque RA, Solanky S, Tosi I, Grys K, Barker J, Griffiths C, Reynolds N, Smith C, Warren R, Di Meglio P, Consortium P. 115 The frequency of intermediate monocytes before treatment is a candidate biomarker of clinical response to secukinumab in of psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.125] [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: 11/19/2022]
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10
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Ells LJ, Ashton M, Li R, Logue J, Griffiths C, Torbahn G, Marwood J, Stubbs J, Clare K, Gately PJ, Campbell-Scherer D. Can We Deliver Person-Centred Obesity Care Across the Globe? Curr Obes Rep 2022; 11:350-355. [PMID: 36272056 PMCID: PMC9589792 DOI: 10.1007/s13679-022-00489-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW This article discusses what person-centred care is; why it is critically important in providing effective care of a chronic, complex disease like obesity; and what can be learnt from international best practice to inform global implementation. RECENT FINDINGS There are four key principles to providing person-centred obesity care: providing care that is coordinated, personalised, enabling and delivered with dignity, compassion and respect. The Canadian 5AsT framework provides a co-developed person-centred obesity care approach that addresses complexity and is being tested internationally. Embedding person-centred obesity care across the globe will require a complex system approach to provide a framework for healthcare system redesign, advances in people-driven discovery and advocacy for policy change. Additional training, tools and resources are required to support local implementation, delivery and evaluation. Delivering high-quality, effective person-centred care across the globe will be critical in addressing the current obesity epidemic.
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Affiliation(s)
- Louisa J Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK.
| | | | - Rui Li
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Jennifer Logue
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Claire Griffiths
- Obesity Institute, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik Der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
| | - Jordan Marwood
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - James Stubbs
- School of Psychology, University of Leeds, Leeds, UK
| | - Ken Clare
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
- , Obesity UK, Leeds, UK
| | - Paul J Gately
- , Obesity UK, Leeds, UK
- Obesity Institute, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- MoreLife UK Ltd, Leeds, UK
| | - Denise Campbell-Scherer
- Physician Learning Program, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
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11
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Christensen A, Radley D, Hobbs M, Gorse C, Griffiths C. Investigating how researcher-defined buffers and self-drawn neighbourhoods capture adolescent availability to physical activity facilities and greenspaces: An exploratory study. Spat Spatiotemporal Epidemiol 2022; 43:100538. [PMID: 36460456 DOI: 10.1016/j.sste.2022.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/16/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Modifying the environment is considered an effective population-level approach for increasing healthy behaviours, but associations remain ambiguous. This exploratory study aims to compare researcher-defined buffers and self-drawn neighbourhoods (SDN) to objectively measured availability of physical activity (PA) facilities and greenspaces in adolescents. METHODS Seven consecutive days of GPS data were collected in an adolescent sample of 14-18 year olds (n = 69). Using Points of Interest and greenspace data, availability of PA opportunities within activity spaces were determined. We compared 30 different definitions of researcher-defined neighbourhoods and SDNs to objectively measured availability. RESULTS Findings showed low agreement for all researcher-defined buffers in measuring the availability of PA facilities in activity spaces. However, results were less clear for greenspace. SDNs also demonstrate low agreement for capturing availability to the PA environment. CONCLUSION This exploratory study highlights the inadequacy of researcher-defined buffers and SDNs to define availability to environmental features.
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Affiliation(s)
- A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK.
| | - D Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK
| | - M Hobbs
- Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK
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Quinn KM, Chen X, Runge LT, Pieper H, Renton D, Meara M, Collins C, Griffiths C, Husain S. The robot doesn't lie: real-life validation of robotic performance metrics. Surg Endosc 2022:10.1007/s00464-022-09707-8. [PMID: 36266482 DOI: 10.1007/s00464-022-09707-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Degree of resident participation in a case is often used as a surrogate marker for operative autonomy, an essential element of surgical resident training. Previous studies have demonstrated a considerable disagreement between the perceptions of attending surgeons and trainees when it comes to estimating operative participation. The Da Vinci Surgical System dual console interface allows machine generated measurements of trainee's active participation, which has the potential to obviate the need for labor intensive direct observation of surgical procedures. However, the robotic metrics require validation. We present a comparison of operative participation as perceived by the resident, faculty, trained research staff observer (gold standard), and robotic machine generated data. METHODS A total of 28 consecutive robotic inguinal hernia repair procedures were observed by research staff. Operative time, percent active time for the resident, and number of handoffs between the resident and attending were recorded by trained research staff in the operating room and the Da Vinci Surgical System. Attending and resident evaluations of operative performance and perceptions of percent active time for the resident were collected using standardized forms and compared with the research staff observed values and the robot-generated console data. Wilcoxon two-sample tests and Pearson Correlation coefficients statistical analysis were performed. RESULTS Robotic inguinal hernia repair cases had a mean operative time of 91.3 (30) minutes and an attending-rated mean difficulty of 3.1 (1.26) out of 5. Residents were recorded to be the active surgeon 71.8% (17.7) of the total case time by research staff. There was a strong correlation (r = 0.77) in number of handoffs between faculty and trainee as recorded by the research staff and robot (4.28 (2.01) vs. 5.8 (3.04) respectively). The robotic machine generated data demonstrated the highest degree of association when compared to the gold standard (research staff observed data), with r = 0.98, p < 0.0001. Lower levels of association were seen with resident reported (r = 0.66) perceptions and faculty-reported (r = 0.55) perceptions of resident active operative time. CONCLUSIONS Our findings suggest that robot-generated performance metrics are an extremely accurate and reliable measure of intraoperative resident participation indicated by a very strong correlation with the data recorded by research staff's direct observation of the case. Residents demonstrated a more accurate awareness of their degree of participation compared with faculty surgeons. With high accuracy and ease of use, robotic surgical system performance metrics have the potential to be a valuable tool in surgical training and skill assessment.
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Affiliation(s)
- Kristen M Quinn
- Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas St. Room CSB 417, Charleston, SC, 29425, USA.
| | - Xiaodong Chen
- Division of Gastrointestinal Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Louis T Runge
- Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas St. Room CSB 417, Charleston, SC, 29425, USA
| | - Heidi Pieper
- Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - David Renton
- Division of Gastrointestinal Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Michael Meara
- Division of Gastrointestinal Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Courtney Collins
- Division of Gastrointestinal Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Claire Griffiths
- Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Syed Husain
- Division of Colorectal Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
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13
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Rutkowski D, Warren R, Griffiths C, Paus R. 861 EGFR/MEK inhibitor therapy induces partial hair follicle immune privilege collapse in vivo and ex vivo. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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14
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Gajaweera HS, Griffiths C, Everitt LH, Evans HJ. Medical management of severe obstructive sleep apnoea in two cases during the coronavirus disease 2019 pandemic. J Laryngol Otol 2022; 136:1-2. [PMID: 35307044 DOI: 10.1017/s0022215121004230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Severe paediatric obstructive sleep apnoea in typically developing children with adenotonsillar hypertrophy is primarily managed surgically. Non-emergency ENT surgery was paused early in the coronavirus disease 2019 pandemic and children were offered medical management for obstructive sleep apnoea. METHODS A service evaluation was performed to assess the impact of continuous positive airway pressure alongside medical management for severe obstructive sleep apnoea. RESULTS Over 5 months during 2020, in a tertiary care setting, two children (one boy and one girl), aged 2.7 years and 4.1 years, were offered continuous positive airway pressure and medical treatments for severe obstructive sleep apnoea whilst surgery was paused during the coronavirus disease 2019 pandemic. Both children failed to establish continuous positive airway pressure therapy because of ongoing disturbed sleep on ventilation, and they proceeded to adenotonsillectomy. Sleep-Related Breathing Disorder scale scores improved following surgical intervention. CONCLUSION Continuous positive airway pressure therapy is poorly tolerated in children with severe obstructive sleep apnoea secondary to adenotonsillar hypertrophy. Surgery remains the most appropriate treatment.
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Affiliation(s)
- H S Gajaweera
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
| | - C Griffiths
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
| | - L H Everitt
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
| | - H J Evans
- Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
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15
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Ellison C, Griffiths C, Thompson J, Arapi I, Martens M, Gore E. P40.07 Immunotherapy Toxicity in Lung Cancer & the Impact of Thoracic Radiation Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Langton A, Chien A, Kang S, Rhodes L, O’Connor C, Bell M, Griffiths C, Watson R. 148 Fibrillin-rich microfibrils: Key components of dermal-epidermal junction architecture? J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Griffiths C, Connelly J, Chaudhary LN. Sudden Paralysis in a 39-Year-Old Woman With Metastatic Breast Cancer. JAMA Oncol 2021; 7:1239-1240. [PMID: 34042938 DOI: 10.1001/jamaoncol.2021.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Claire Griffiths
- Division of Hematology and Oncology, Froedtert and Medical College of Wisconsin, Milwaukee
| | | | - Lubna N Chaudhary
- Division of Hematology and Oncology, Froedtert and Medical College of Wisconsin, Milwaukee
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18
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Marwa WL, Radley D, Davis S, McKenna J, Griffiths C. Exploring factors affecting individual GPS-based activity space and how researcher-defined food environments represent activity space, exposure and use of food outlets. Int J Health Geogr 2021; 20:34. [PMID: 34320996 PMCID: PMC8316713 DOI: 10.1186/s12942-021-00287-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Obesity remains one of the most challenging public health issues of our modern time. Despite the face validity of claims for influence, studies on the causes of obesity have reported the influence of the food environment to be inconsistent. This inconsistency has been attributed to the variability of measures used by researchers to represent the food environments—Researcher-Defined Food Environments (RDFE) like circular, street-network buffers, and others. This study (i.) determined an individual’s Activity Space (AS) (ii.) explored the accuracy of the RDFE in representing the AS, (iii.) investigated the accuracy of the RDFE in representing actual exposure, and (iv.) explored whether exposure to food outlet reflects the use of food outlets. Methods Data were collected between June and December 2018. A total of 65 participants collected Global Positioning System (GPS) data, kept receipt of all their food purchases, completed a questionnaire about their personal information and had their weight and height measured. A buffer was created around the GPS points and merged to form an AS (GPS-based AS). Results Statistical and geospatial analyses found that the AS size of participants working away from home was positively related to the Euclidean distance from home to workplace; the orientation (shape) of AS was also influenced by the direction of workplace from home and individual characteristics were not predictive of the size of AS. Consistent with some previous studies, all types and sizes of RDFE variably misrepresented individual exposure in the food environments. Importantly, the accuracy of the RDFE was significantly improved by including both the home and workplace domains. The study also found no correlation between exposure and use of food outlets. Conclusions Home and workplace are key activity nodes in modelling AS or food environments and the relationship between exposure and use is more complex than is currently suggested in both empirical and policy literature.
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Affiliation(s)
| | | | - Samantha Davis
- Leeds Beckett University, City Campus, Leeds, LS1 3HE, UK
| | - James McKenna
- Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK
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19
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Christensen A, Griffiths C, Hobbs M, Gorse C, Radley D. Accuracy of buffers and self-drawn neighbourhoods in representing adolescent GPS measured activity spaces: An exploratory study. Health Place 2021; 69:102569. [PMID: 33882372 DOI: 10.1016/j.healthplace.2021.102569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There continues to be a lack of understanding as to the geographical area at which the environment exerts influence on behaviour and health. This exploratory study compares different potential methods of both researcher- and participant-defined definitions of neighbourhood reflect an adolescent's activity space. METHODS Seven consecutive days of global positioning system (GPS) tracking data were collected at 15 s intervals using a small exploratory adolescent sample of 14-18 year olds (n = 69) in West Yorkshire, England. A total of 304,581 GPS tracking points were collected and compared 30 different definitions of researcher-defined neighbourhoods including radial, network and ellipse buffers at 400 m, 800 m, 1000 m, 1600 m and 3000 m, as well as participant-defined self-drawn neighbourhoods. RESULTS This exploratory study supports emerging evidence cautioning against the use of static neighbourhood definitions for defining exposure. Traditional buffers (network and radial) capture at most 67% of activity space (home radial), and at worst they captured only 3.5% (school network) and range from capturing between 3 and 88% of total time. Similarly, self-drawn neighbourhoods captured only 10% of actual daily movement. Interestingly, 40% of an adolescent's self-drawn neighbourhood was not used. We also demonstrate that buffers capture a range of space (22-95%) where adolescents do not go, thus misclassifying the exposure. CONCLUSION Our exploratory findings demonstrate that neither researcher- nor participant-defined definition of neighbourhood adequately captures adolescent activity space. Further research with larger samples are needed to confirm the findings of this exploratory study.
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Affiliation(s)
- A Christensen
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK; School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK.
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - D Radley
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
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20
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Sanders GJ, Griffiths C, Flint S, Christensen A, Gately P. Implementation fidelity of an Integrated Healthy Lifestyle Service: a process evaluation. Perspect Public Health 2021; 142:278-286. [PMID: 33779407 PMCID: PMC9483679 DOI: 10.1177/1757913920986205] [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] [Indexed: 11/24/2022]
Abstract
Aims: The current study aimed to evaluate implementation fidelity of an
Integrated Healthy Lifestyle Service (IHLS). Methods: A pragmatic sample of 28 individual interviews and 11 focus groups
were conducted. This resulted in a total of 81 (22 male)
individuals comprising key stakeholders (n = 18), as well as
intervention staff across senior management (n = 4), team lead
(n = 14) and practitioner (n = 11) roles, and intervention
clients (n = 34). Results: A mixed degree of implementation fidelity was demonstrated
throughout the five a priori fidelity domains of study design,
provider training, intervention delivery, intervention receipt,
and enactment. Stakeholders, staff and clients alike noted a
high degree of intervention receipt across all services offered.
Contrastingly, practitioners noted that they received minimal
formal operational, data systems, clinical, and curriculum
training as well as a lack of personal development
opportunities. Consequently, practitioners reported low
confidence in delivering sessions and collecting and analysing
any data. A top-down approach to information dissemination
within the service was also noted among practitioners which
affected motivation and overall team morale. Conclusion: Results can be used to conceptualise best practices as a process to
further strengthen the design, delivery and recruitment
strategies of the IHLS.
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Affiliation(s)
- G J Sanders
- Carnegie School of Sport, Leeds Beckett University, Fairfax Hall Rm 230, Headingley Campus, Leeds LS6 3QS, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - S Flint
- School of Psychology, University of Leeds, Leeds, UK.,Scaled Insights, Nexus, University of Leeds, Leeds, UK
| | - A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - P Gately
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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21
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Hobbs M, Moltchanova E, Wicks C, Pringle A, Griffiths C, Radley D, Zwolinsky S. Investigating the environmental, behavioural, and sociodemographic determinants of attendance at a city-wide public health physical activity intervention: Longitudinal evidence over one year from 185,245 visits. Prev Med 2021; 143:106334. [PMID: 33227345 DOI: 10.1016/j.ypmed.2020.106334] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/23/2020] [Accepted: 11/18/2020] [Indexed: 10/23/2022]
Abstract
Understanding the determinants of attendance at public health interventions is critical for effective policy development. Most research focuses on individual-level determinants of attendance, while less is known about environmental-level determinants. Data were obtained from the Leeds Let's Get Active public health intervention in Leeds, England. Longitudinal data (April 2015-March 2016) on attendance were obtained for n = 25,745 individuals (n = 185,245 total visits) with baseline data on sociodemographic determinants and lifestyle practices obtained for n = 3621 individuals. This resulted in a total of n = 744,468 days of attendance and non-attendance. Random forests were used to explore the relative importance of the determinants on attendance, while generalised linear models were applied to examine specific associations (n = 3621). The probability that a person will attend more than once, the number of return visits, and the probability that a person will attend on a particular day were investigated. When considering if a person returned to the same leisure centre after one visit, the most influential determinant was the distance from their home. When considering number of return visits overall however, age group was the most influential. While distance to a leisure centre was less important for predicting the number of return visits, the difference between estimates for 300 m and 15,000 m was 7-10 visits per year. Finally, calendar month was the most important determinant of daily attendance. This longitudinal study highlights the importance of both individual and environmental determinants in predicting various aspects of attendance. It has implications for strategies aiming to increase attendance at public health interventions.
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Affiliation(s)
- M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand; Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - E Moltchanova
- School of Mathematics & Statistics, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - C Wicks
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
| | - A Pringle
- Sport, Outdoor & Exercise Sciences, University of Derby, Derby, United Kingdom
| | - C Griffiths
- Leeds Beckett University, Leeds, United Kingdom
| | - D Radley
- Leeds Beckett University, Leeds, United Kingdom
| | - S Zwolinsky
- West Yorkshire & Harrogate Cancer Alliance, Wakefield, United Kingdom
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22
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Guest E, Paraskeva N, Griffiths C, Hansen E, Clarke A, Baker E, Harcourt D. The nature and importance of women's goals for immediate and delayed breast reconstruction. J Plast Reconstr Aesthet Surg 2021; 74:2169-2175. [PMID: 33495140 DOI: 10.1016/j.bjps.2020.12.085] [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: 10/14/2019] [Revised: 11/11/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Increasingly, women undergo breast reconstruction (BR) surgery to restore health-related and psychosocial quality of life after mastectomy. Most research focuses on BR outcomes rather than women's pre-surgical expectations of, and goals for, immediate (IBR) or delayed (DBR) procedures, yet such information could support women's decision-making. This study aimed to investigate women's BR goals, whether they differed according surgery timing (IBR or DBR), and the importance women placed on them. METHODS Seventy-six women considering DBR (n = 50) or IBR (n = 26) at a UK hospital were encouraged to clarify their BR goals and rate the importance of achieving each one. Content analysis categorised and counted the frequency of the goals they reported. RESULTS Fifteen goal categories (7 surgical, e.g. scarring; 8 psychosocial/lifestyle, e.g. feeling feminine) were identified. Many (e.g. scarring, intimacy) were reported by a similar percentage of women in each surgical group, however, differences were identified (e.g. breast sensation was not mentioned by women considering IBR). Women reported more psychosocial (n = 206) than surgical goals (n = 160). Further, an independent t-tests revealed that women in both groups placed significantly more importance on the psychosocial (M = 9.4) than surgical goals (M = 8.5). CONCLUSIONS This study highlights the variety of goals women have for BR, the importance they attach to them, and differences and similarities between those seeking IBR and DBR. Future research should consider whether BR goals are met, how goal achievement influences satisfaction with outcome over time and how best to incorporate goals into pre-surgical treatment decision-making.
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Affiliation(s)
- E Guest
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom.
| | - N Paraskeva
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - C Griffiths
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - E Hansen
- Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| | - A Clarke
- Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| | - E Baker
- Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| | - D Harcourt
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
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23
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Lansing SS, Abdel-Rasoul M, Griffiths C, Diaz K, Arnold MW, Eldon Harzman A, Huang ES, Linnell Traugott A, Husain S. Reducing Colorectal Operation Readmissions Through Patient Engagement During Transitions of Care: Results of a Randomized Prospective Trial. J Am Coll Surg 2020. [DOI: 10.1016/j.jamcollsurg.2020.07.115] [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: 11/25/2022]
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24
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Yiu Z, Parisi R, Lunt M, Warren R, Griffiths C, Langan S, Ashcroft D. 399 Risk of hospitalization due to infection in patients with psoriasis: A population-based cohort study using the UK Clinical Practice Research Datalink. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Mellody K, Bradley E, Bell M, Halai P, Cotterell L, Griffiths C, Watson R. 238 Retinol at a concentration of 0.3% restores fibrillin-rich microfibrils and modifies the epidermis in photoaged human skin in vivo in a manner similar to 1% retinol. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Annunzio K, Griffiths C, Arapi I, Lasowski M, Singavi AK, Dua K, Khan AH, Ritch PS, Kamgar M, Thomas JP, Hall WA, Erickson B, Tsai S, Christians KK, Evans DB, Urrutia R, Szabo A, George B. Impact of CDKN2A/b status in pancreatic cancer (PC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
759 Background: PC is a lethal disease with limited treatment options. We utilized Comprehensive Genomic Profiling (CGP) to identify putative prognostic and/or predictive biomarkers. Methods: We retrospectively reviewed PC patients (pts) at our institution who underwent CGP utilizing the Foundation One assay. CGP was performed on hybrid-capture, adaptor ligation-based libraries for up to 315 genes plus 47 introns from 19 genes frequently rearranged in cancer. PC pts were categorized by clinical stage – localized (resectable and borderline resectable PC; LPC), locally advanced (LAPC) and metastatic (mPC). Effect of gene alterations (GAs) with at least 10% prevalence were analyzed. The marginal effect of each gene on radiographic response and survival outcomes was estimated using proportional odds and multivariate Cox regression analysis, respectively, adjusting for stage. Results: Ninety-three pts were identified - median age was 63, 55% were male, and 50% were smokers. Clinical stage at diagnosis was LPC, LAPC and mPC in 42 (45%), 23 (25%) and 28 (30%) pts, respectively. The most commonly altered genes were KRAS (94%), TP53 (75%), CDKN2A (41.2%) and SMAD4 (32.9%). All patients were microsatellite stable and the median tumor mutational burden was 1.7. 5-FU (52%) or Gemcitabine (46%) based chemotherapy combinations were utilized as the first systemic therapy. Median overall survival for patients with LPC, LAPC and mPC were 30.7, 28.8 and 9.6 months respectively. Thirty-eight (91%) pts with LPC underwent curative intent surgery compared to 15 (65%) pts with LAPC (p = 0.019). Thirty-five (95%) pts with wild type (WT) CDKN2A and 47 (94%) pts with WT CDKN2B underwent curative intent surgery compared to 13 (65%) and 1(14%) pt(s) with GAs in CDKN2A and CDKN2B respectively (p = 0.003 and p < 0.0001 respectively). The response to chemotherapy was statistically significantly higher in pts with WT CDKN2A (53%) and CDKN2B (48%) compared to pts with GAs in CDKN2A (19%) and CDKN2B (12%) (p = 0.03 and p = 0.05, respectively). Conclusions: GAs in CDKN2A/B may have a predictive and possibly a prognostic impact. The clinical validity and biological relevance of these findings need to be further explored in larger studies.
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Affiliation(s)
| | | | - Igli Arapi
- Medical College of Wisconsin, Milwaukee, WI
| | | | | | | | | | | | | | | | | | | | - Susan Tsai
- Medical College of Wisconsin and Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
| | | | | | | | | | - Ben George
- Froedtert & the Medical College of Wisconsin, Milwaukee, WI
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27
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Wilkins E, Aravani A, Downing A, Drewnowski A, Griffiths C, Zwolinsky S, Birkin M, Alvanides S, Morris MA. Evidence from big data in obesity research: international case studies. Int J Obes (Lond) 2020; 44:1028-1040. [PMID: 31988482 DOI: 10.1038/s41366-020-0532-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/20/2019] [Accepted: 01/07/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVE Obesity is thought to be the product of over 100 different factors, interacting as a complex system over multiple levels. Understanding the drivers of obesity requires considerable data, which are challenging, costly and time-consuming to collect through traditional means. Use of 'big data' presents a potential solution to this challenge. Big data is defined by Delphi consensus as: always digital, has a large sample size, and a large volume or variety or velocity of variables that require additional computing power (Vogel et al. Int J Obes. 2019). 'Additional computing power' introduces the concept of big data analytics. The aim of this paper is to showcase international research case studies presented during a seminar series held by the Economic and Social Research Council (ESRC) Strategic Network for Obesity in the UK. These are intended to provide an in-depth view of how big data can be used in obesity research, and the specific benefits, limitations and challenges encountered. METHODS AND RESULTS Three case studies are presented. The first investigated the influence of the built environment on physical activity. It used spatial data on green spaces and exercise facilities alongside individual-level data on physical activity and swipe card entry to leisure centres, collected as part of a local authority exercise class initiative. The second used a variety of linked electronic health datasets to investigate associations between obesity surgery and the risk of developing cancer. The third used data on tax parcel values alongside data from the Seattle Obesity Study to investigate sociodemographic determinants of obesity in Seattle. CONCLUSIONS The case studies demonstrated how big data could be used to augment traditional data to capture a broader range of variables in the obesity system. They also showed that big data can present improvements over traditional data in relation to size, coverage, temporality, and objectivity of measures. However, the case studies also encountered challenges or limitations; particularly in relation to hidden/unforeseen biases and lack of contextual information. Overall, despite challenges, big data presents a relatively untapped resource that shows promise in helping to understand drivers of obesity.
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Affiliation(s)
- Emma Wilkins
- Leeds Institute for Data Analytics and School of Medicine, University of Leeds, Leeds, UK
| | - Ariadni Aravani
- Leeds Institute for Data Analytics and School of Medicine, University of Leeds, Leeds, UK
| | - Amy Downing
- Leeds Institute for Data Analytics and School of Medicine, University of Leeds, Leeds, UK
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, USA
| | | | | | - Mark Birkin
- Leeds Institute for Data Analytics and School of Geography, University of Leeds, Leeds, UK
| | - Seraphim Alvanides
- Engineering and Environment, Northumbria University, Newcastle, UK.,GESIS-Leibniz Institute for the Social Sciences, Cologne, Germany
| | - Michelle A Morris
- Leeds Institute for Data Analytics and School of Medicine, University of Leeds, Leeds, UK.
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28
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de Bruin-Weller M, Griffiths C, Prens E, Szepietowski J, Etoh T, Rossi A, Gadkari A, Chen Z, Eckert L. Le dupilumab améliore les signes, les symptômes et la qualité de vie chez des patients adultes atteints de dermatite atopique non parvenus à un score IGA de 0/1. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Burman M, Copas A, Zenner D, Hickson V, Gosce L, Trathen D, Ashcroft R, Martineau AR, Abubakar I, Griffiths C, Kunst H. Protocol for a cluster randomised control trial evaluating the efficacy and safety of treatment for latent tuberculosis infection in recent migrants within primary care: the CATAPuLT trial. BMC Public Health 2019; 19:1598. [PMID: 31783742 PMCID: PMC6884916 DOI: 10.1186/s12889-019-7983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background The identification and treatment of LTBI is a key component of the WHO’s strategy to eliminate TB. Recent migrants from high TB-incidence countries are recognised to be at risk TB reactivation, and many high-income countries have focused on LTBI screening and treatment programmes for this group. However, migrants are the group least likely to complete the LTBI cascade-of-care. This pragmatic cluster-randomised, parallel group, superiority trial investigates whether a model of care based entirely within a community setting (primary care) will improve treatment completion compared with treatment in specialist TB services (secondary care). Methods The CATAPuLT trial (Completion and Acceptability of Treatment Across Primary Care and the community for Latent Tuberculosis) randomised 34 general practices in London, England, to evaluate the efficacy and safety of treatment for LBTI in recent migrants within primary care. GP practices were randomised to either provide management for LTBI entirely within primary care (GPs and community pharmacists) or to refer patients to secondary care. The target recruitment number for individuals is 576. The primary outcome is treatment completion (defined as taking at least 90% of antibiotic doses). The secondary outcomes assess adherence, acceptance of treatment, the incidence of adverse effects including drug-induced liver injury, the rates of active TB, patient satisfaction and cost-effectiveness of LTBI treatment. This protocol adheres to the SPIRIT Checklist. Discussion The CATAPuLT trial seeks to provide implementation research evidence for a patient-centred intervention to improve treatment completion for LTBI amongst recent migrants to the UK. Trial registration NCT03069807, March 2017, registered retrospectively.
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Affiliation(s)
- M Burman
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
| | - A Copas
- Institute for Global Health, University College London, London, UK
| | - D Zenner
- Institute for Global Health, University College London, London, UK
| | - V Hickson
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - L Gosce
- Institute for Global Health, University College London, London, UK
| | - D Trathen
- Newham Clinical Commissioning Group, London, UK
| | - R Ashcroft
- School of Law, Queen Mary University of London, London, UK
| | - A R Martineau
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - I Abubakar
- Institute for Global Health, University College London, London, UK
| | - C Griffiths
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - H Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Barts Health NHS Trust, London, UK
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30
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Rutkowski D, Hardman J, Warren R, Griffiths C, Paus R. 422 Human hair follicles express PD-L1, whose expression is down-regulated by EGFR and MEK inhibitors ex vivo. A potential mechanism for EGFR inhibitor induced sterile folliculitis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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31
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Langton A, Chien A, Kang S, Griffiths C, Watson R. 098 Retinoids in the treatment of skin photoageing: A histological study of topical all-trans retinoic acid efficacy in black skin. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pilkington S, Langton A, Costello P, Newton V, Griffiths C, Watson R. 148 Increased skin viscoelastic creep following menopause is not driven by changes to the dermal elastic fibre network. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.152] [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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Earnshaw C, Nagore E, Roeck K, Schneider S, Budden T, Craig S, Griffiths C, Furney S, Krutmann J, Viros A. 554 Skin ageing continues long after ultraviolet radiation damage. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.469] [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: 11/27/2022]
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Mellody K, Bradley E, Halai P, Cotterell L, Horn J, Griffiths C, Bell M, Watson R. 610 Hibiscus abelmoschus seed extract induces remodelling of the papillary dermal fibrillin-rich microfibrils. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.614] [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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Hobbs M, Green MA, Wilkins E, Lamb KE, McKenna J, Griffiths C. Associations between food environment typologies and body mass index: Evidence from Yorkshire, England. Soc Sci Med 2019; 239:112528. [PMID: 31499332 DOI: 10.1016/j.socscimed.2019.112528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/29/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
International research linking food outlets and body mass index (BMI) is largely cross-sectional, yielding inconsistent findings. However, addressing the exposure of food outlets is increasingly considered as an important adult obesity prevention strategy. Our study investigates associations between baseline food environment types and change in BMI over time. Survey data were used from the Yorkshire Health Study (n=8,864; wave one: 2010-2012, wave two: 2013-2015) for adults aged 18-86. BMI was calculated using self-reported height (cm) and weight (kg). Restaurants, cafés, fast-food, speciality, convenience and large supermarkets were identified from the Ordnance Survey Point of Interest database within 1600m radial buffer of home postcodes. K-means cluster analysis developed food environment typologies based on food outlets and population density. Large supermarkets, restaurants, cafés, fast-food, speciality and convenience food outlets all clustered together to some extent. Three neighbourhood typologies were identified. However, multilevel models revealed that relative to cluster one all were unrelated to change in BMI (cluster 2, b= -0.146 [-0.274, 0.566]; cluster 3, b= 0.065 [-0.224, 0.356]). There was also little evidence of gender-based differences in these associations when examined in a three-way interaction. Policymakers may need to begin to consider multiple types of food outlet clusters, while further research is needed to confirm how these relate to changed BMI.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand.
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - E Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - K E Lamb
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
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Griffiths C, Valant R, Elvin J, Gay L, Murray M, Almog N, Jimenez E, Chalas E. Bridging the actionability gap: Virtual molecular tumor board impact on integrating comprehensive genomic profiling in management of gynecologic malignancies. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hobbs M, Green M, Roberts K, Griffiths C, McKenna J. Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach. J Epidemiol Community Health 2019; 73:861-866. [PMID: 31171581 DOI: 10.1136/jech-2018-211798] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/14/2019] [Accepted: 04/21/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Internationally, the prevalence of adults with obesity is a major public health concern. Few studies investigate the explanatory pathways between fast-food outlets and body mass index (BMI). We use structural equation modelling to explore an alternative hypothesis to existing research using area-level deprivation as the predictor of BMI and fast-food outlets and diet quality as mediators. METHODS Adults (n=7544) from wave II of the Yorkshire Health Study provided self-reported diet, height and weight (used to calculate BMI). Diet quality was based on sugary drinks, wholemeal (wholegrain) bread and portions of fruit and vegetables. Fast-food outlets were mapped using the Ordnance Survey Points of Interest within 2 km radial buffers around home postcode which were summed to indicate availability. Age (years), gender (female/male) and long-standing health conditions (yes/no) were included as covariates. RESULTS There was little evidence linking fast-food outlets to diet or BMI. An independent association between fast-food outlet availability and BMI operated counterintuitively and was small in effect. There was also little evidence of mediation between fast-food outlet availability and BMI. However, there was more evidence that area-level deprivation was associated with increased BMI, both as an independent effect and through poorer diet quality. CONCLUSION This exploratory study offers a first step for considering complexity and pathways linking fast-food outlets, area-level deprivation, diet quality and BMI. Research should respond to and build on the hypothesised pathways and our simple framework presented within our study.
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Affiliation(s)
- Matthew Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand .,Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Mark Green
- Geography and Planning, University of Liverpool, Liverpool, UK
| | - Kath Roberts
- Public Health Section, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Wilkins E, Morris M, Radley D, Griffiths C. Methods of measuring associations between the Retail Food Environment and weight status: Importance of classifications and metrics. SSM Popul Health 2019; 8:100404. [PMID: 31245526 PMCID: PMC6582068 DOI: 10.1016/j.ssmph.2019.100404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/26/2019] [Accepted: 04/24/2019] [Indexed: 12/29/2022] Open
Abstract
Despite considerable research, evidence supporting associations between the 'Retail Food Environment' (RFE) and obesity remains mixed. Differences in the methods used to measure the RFE may explain this heterogeneity. Using data on a large (n = 10,111) sample of adults from the Yorkshire Health Study (UK), we modelled cross-sectional associations between the RFE and weight status using (i) multiple definitions of 'Fast Food', 'Convenience' and 'Supermarkets' and (ii) multiple RFE metrics, identified in a prior systematic review to be common in the literature. Both the choice of outlet definition and the choice of RFE metric substantively impacted observed associations with weight status. Findings differed in relation to statistical significance, effect sizes, and directions of association. This study provides novel evidence that the diversity of RFE measurement methods is contributing to heterogeneous study findings and conflicting policy messages. Greater attention is needed when selecting and communicating RFE measures in research.
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Affiliation(s)
- Emma Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Michelle Morris
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - Duncan Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Wilkins E, Radley D, Morris M, Hobbs M, Christensen A, Marwa WL, Morrin A, Griffiths C. A systematic review employing the GeoFERN framework to examine methods, reporting quality and associations between the retail food environment and obesity. Health Place 2019; 57:186-199. [PMID: 31060018 DOI: 10.1016/j.healthplace.2019.02.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/24/2019] [Accepted: 02/26/2019] [Indexed: 11/17/2022]
Abstract
This systematic review quantifies methods used to measure the 'retail food environment' (RFE), appraises the quality of methodological reporting, and examines associations with obesity, accounting for differences in methods. Only spatial measures of the RFE, such as food outlet proximity were included. Across the 113 included studies, methods for measuring the RFE were extremely diverse, yet reporting of methods was poor (average reporting quality score: 58.6%). Null associations dominated across all measurement methods, comprising 76.0% of 1937 associations in total. Outcomes varied across measurement methods (e.g. narrow definitions of 'supermarket': 20.7% negative associations vs 1.7% positive; broad definitions of 'supermarket': 9.0% negative associations vs 10.4% positive). Researchers should report methods more clearly, and should articulate findings in the context of the measurement methods employed.
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Affiliation(s)
- Emma Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
| | - Duncan Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Michelle Morris
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - Matthew Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand
| | | | | | - Adele Morrin
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Griffiths C, Charlton C, Scott W, Ali S, Fisher A. Evaluating the immunomodulatory potential of human amniotic epithelial cells as a therapeutic in ex vivo donor lung reconditioning. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hobbs M, Griffiths C, Green M, Christensen A, McKenna J. Examining longitudinal associations between the recreational physical activity environment, change in body mass index, and obesity by age in 8864 Yorkshire Health Study participants. Soc Sci Med 2019; 227:76-83. [DOI: 10.1016/j.socscimed.2018.06.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/14/2018] [Accepted: 06/23/2018] [Indexed: 11/16/2022]
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Colby J, Bradley J, Durran-Dyer D, Read G, Griffiths C, Burch N. A model of an effective supportive Community Nursing Service for Tube fed patients. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.029] [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: 11/25/2022]
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, Christensen A, McKenna J. Fast-food outlet availability and obesity: Considering variation by age and methodological diversity in 22,889 Yorkshire Health Study participants. Spat Spatiotemporal Epidemiol 2018; 28:43-53. [PMID: 30739654 DOI: 10.1016/j.sste.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/17/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
This study investigated if the relationship between residential fast-food outlet availability and obesity varied due to methodological diversity or by age. Cross-sectional data (n = 22,889) from the Yorkshire Health Study, England were used. Obesity was defined using self-reported height and weight (BMI ≥ 30). Food outlets ("fast-food", "large supermarkets", and "convenience or other food retail outlets") were mapped using Ordnance Survey Points of Interest (PoI) database. Logistic regression was used for all analyses. Methodological diversity included adjustment for other food outlets as covariates and continuous count vs. quartile. The association between residential fast-food outlets and obesity was inconsistent and effects remained substantively the same when considering methodological diversity. This study contributes to evidence by proposing the use of a more comprehensive conceptual model adjusting for wider markers of the food environment. This study offers tentative evidence that the association between fast-food outlets and obesity varies by age.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Ernest Rutherford Building, Christchurch, New Zealand.
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Leeds Beckett University formerly Public Health Team, Rotherham Borough Council, UK
| | - A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
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Griffiths C, Valant R, Ebling D, Haas J, Fazzari M, Villella J, Chalas E, Jimenez E. Cyberknife therapy for locally recurrent gynecologic cancers after external-beam radiation therapy. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Griffiths C, Valant R, Ebling D, Haas J, Fazzari M, Villella J, Chalas E, Jimenez E. Cyberknife therapy for locally recurrent gynecologic cancers after external-beam radiation therapy. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, McKenna J. Neighbourhood typologies and associations with body mass index and obesity: A cross-sectional study. Prev Med 2018; 111:351-357. [PMID: 29195761 DOI: 10.1016/j.ypmed.2017.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/15/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
Little research has investigated associations between a combined measure of the food and physical activity (PA) environment, BMI (body-mass-index) and obesity. Cross-sectional data (n=22,889, age 18-86years) from the Yorkshire Health Study were used [2010-2013]. BMI was calculated using self-reported height and weight; obesity=BMI≥30. Neighbourhood was defined as a 2km radial buffer. Food outlets and PA facilities were sourced from Ordnance Survey Points of Interest (PoI) and categorised into 'fast-food', 'large supermarkets', 'convenience and other food retail outlets' and 'physical activity facilities'. Parks were sourced from Open Street Map. Latent class analysis was conducted on these five environmental variables and availability was defined by quartiles of exposure. Linear and logistic regressions were then conducted for BMI and obesity respectively for different neighbourhood types. Models adjusted for age, gender, ethnicity, area-level deprivation, and rural/urban classification. A five-class solution demonstrated best fit and was interpretable. Neighbourhood typologies were defined as; 'low availability', 'moderate availability', 'moderate PA, limited food', 'saturated' and 'moderate PA, ample food'. Compared to low availability, one typology demonstrated lower BMI (saturated, b=-0.50, [95% CI=-0.76, -0.23]), while three showed higher BMI (moderate availability, b=0.49 [0.27, 0.72]; moderate PA, limited food, b=0.30 [0.01, 0.59]; moderate PA, ample food, b=0.32 [0.08, 0.57]). Furthermore, compared to the low availability, saturated neighbourhoods showed lower odds of obesity (OR=0.86 [0.75, 0.99]) while moderate availability showed greater odds of obesity (OR=1.18 [1.05, 1.32]). This study supports population-level approaches to tackling obesity however neighbourhoods contained features that were health-promoting and -constraining.
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Affiliation(s)
- M Hobbs
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK.; School of Social and Health Sciences, Leeds Trinity University, Leeds, UK..
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
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Green MA, Radley D, Lomax N, Morris MA, Griffiths C. Is adolescent body mass index and waist circumference associated with the food environments surrounding schools and homes? A longitudinal analysis. BMC Public Health 2018; 18:482. [PMID: 29716577 PMCID: PMC5930416 DOI: 10.1186/s12889-018-5383-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/27/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There has been considerable interest in the role of access to unhealthy food options as a determinant of weight status. There is conflict across the literature as to the existence of such an association, partly due to the dominance of cross-sectional study designs and inconsistent definitions of the food environment. The aim of our study is to use longitudinal data to examine if features of the food environment are associated to measures of adolescent weight status. METHODS Data were collected from secondary schools in Leeds (UK) and included measurements at school years 7 (ages 11/12), 9 (13/14), and 11 (15/16). Outcome variables, for weight status, were standardised body mass index and standardised waist circumference. Explanatory variables included the number of fast food outlets, supermarkets and 'other retail outlets' located within a 1 km radius of an individual's home or school, and estimated travel route between these locations (with a 500 m buffer). Multi-level models were fit to analyse the association (adjusted for confounders) between the explanatory and outcome variables. We also examined changes in our outcome variables between each time period. RESULTS We found few associations between the food environment and measures of adolescent weight status. Where significant associations were detected, they mainly demonstrated a positive association between the number of amenities and weight status (although effect sizes were small). Examining changes in weight status between time periods produced mainly non-significant or inconsistent associations. CONCLUSIONS Our study found little consistent evidence of an association between features of the food environment and adolescent weight status. It suggests that policy efforts focusing on the food environment may have a limited effect at tackling the high prevalence of obesity if not supported by additional strategies.
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Affiliation(s)
- Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK.
| | - Duncan Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Nik Lomax
- School of Geography, University of Leeds, Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Michelle A Morris
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.,Leeds Institute for Biomedical and Clinical Services, University of Leeds, Leeds, UK
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Griffiths C, Howell R, Boinpally H, Jimenez E, Chalas E, Musa F, Gorenstein S. Using advanced wound care and hyperbaric oxygen to manage wound complications following treatment of vulvovaginal carcinoma. Gynecol Oncol Rep 2018; 24:90-93. [PMID: 29915804 PMCID: PMC6003433 DOI: 10.1016/j.gore.2018.04.002] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/21/2022] Open
Abstract
Postoperative management of patients with vulvar cancer is associated with a high incidence of poor wound healing and radiation -induced late tissue necrosis. This case series demonstrates the impact on wound healing with the use of hyperbaric oxygen therapy and advanced wound care following radical vulvectomy and/or radiation therapy. A retrospective case series was performed of all patients from 2016 to 2017 with lower genital cancer who underwent radical surgery with or without chemoradiation treatment, experienced wound dehiscence or late tissue radionecrosis, and were treated with advanced wound care, including hyperbaric oxygen therapy (HBO). Five patients were included with a mean age of 63; four had squamous cell carcinoma and one patient had vaginal adenocarcinoma secondary to prior diethylstilbestrol exposure. Three patients underwent radical vulvectomy. All received pelvic radiation therapy, subsequently experienced wound complications, and were managed with advanced wound care and HBO. The mean reduction in wound area at the final wound follow up visit after completion of HBO therapy was found to be 76%, ranging 42-95%, with an average follow up of five months. The mean number of HBO sessions per patient was 58. Complete tissue granulation or significant improvement in tissue radionecrosis was present in all patients. Advanced wound care and hyperbaric oxygen therapy are beneficial in the management of postoperative wound complications. Prospective studies are needed to identify the optimal use of perioperative hyperbaric oxygen and appropriate wound care for patients with gynecologic malignancies.
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Affiliation(s)
- C. Griffiths
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - R.S. Howell
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - H. Boinpally
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - E. Jimenez
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - E. Chalas
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - F. Musa
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
| | - S. Gorenstein
- Department of Gynecologic Oncology, NYU Winthrop Hospital, Mineola, NY, USA
- Department of Surgery, NYU Winthrop Hospital, Mineola, NY, USA
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Potter J, White V, Swinglehurst D, Griffiths C. 4.10-P7Did migrants with tuberculosis in the UK know their condition was exempt from charges? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Potter
- Queen Mary University London, United Kingdom
| | - V White
- Queen Mary University London, United Kingdom
| | | | - C Griffiths
- Queen Mary University London, United Kingdom
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Lichtenauer M, Wheatley SD, Martyn-St James M, Duncan MJ, Cobayashi F, Berg G, Musso C, Graffigna M, Soutelo J, Bovet P, Kollias A, Stergiou GS, Grammatikos E, Griffiths C, Ingle L, Jung C. Efficacy of anthropometric measures for identifying cardiovascular disease risk in adolescents: review and meta-analysis. Minerva Pediatr 2018; 70:371-382. [PMID: 29651834 DOI: 10.23736/s0026-4946.18.05175-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION To compare the ability of Body Mass Index (BMI), waist circumference (WC) and waist to height ratio (WHtR) to estimate cardiovascular disease (CVD) risk levels in adolescents. EVIDENCE ACQUISITION A systematic review and meta-analysis was performed after a database search for relevant literature (Cochrane, Centre for Review and Dissemination, PubMed, British Nursing Index, CINAHL, BIOSIS citation index, ChildData, metaRegister). EVIDENCE SYNTHESIS The study included 117 records representing 96 studies with 994,595 participants were included in the systematic review, 14 of which (13 studies, N.=14,610) were eligible for the meta-analysis. The results of the meta-analysis showed that BMI was a strong indicator of systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin; but not total cholesterol, low-density lipoprotein or glucose. Few studies were eligible for inclusion in the meta-analysis considering WC or WHtR (N.≤2). The narrative synthesis found measures of central adiposity to be consistently valid indicators of the same risk factors as BMI. CONCLUSIONS BMI was an indicator of CVD risk. WC and WHtR were efficacious for indicating the same risk factors BMI performed strongly for, though there was insufficient evidence to judge the relative strength of each measure possibly due to heterogeneity in the methods for measuring and classifying WC.
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Affiliation(s)
- Michael Lichtenauer
- Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Sean D Wheatley
- School of Sport, Carnegie Faculty, Leeds Beckett University, Leeds, UK -
| | | | - Michael J Duncan
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Fernanda Cobayashi
- Public Health Nutrition Program, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Gabriela Berg
- Lipids and Atherosclerosis Laboratory, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Carla Musso
- Division of Endocrinology, Milstein Hospital, Buenos Aires, Argentina
| | - Mabel Graffigna
- Division of Endocrinology, Carlos Durand Hospital, Buenos Aires, Argentina
| | - Jimena Soutelo
- Service Endocrinology, Churruca Visca Hospital, Buenos Aires, Argentina
| | - Pascal Bovet
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland and Ministry of Health, Victory, Republic of Seychelles
| | - Anastasios Kollias
- Hypertension Center STRIDE-7, Third Department of Medicine, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George S Stergiou
- Hypertension Center STRIDE-7, Third Department of Medicine, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Claire Griffiths
- School of Sport, Carnegie Faculty, Leeds Beckett University, Leeds, UK
| | - Lee Ingle
- Department of Sport, Health & Exercise Science, University of Hull, Hull, UK
| | - Christian Jung
- Division of Cardiology, Faculty of Medicine, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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