1
|
Leal J, Shen Y, Faris P, Dalton B, Sabuda D, Ocampo W, Bresee L, Chow B, Fletcher JR, Henderson E, Kaufman J, Kim J, Raman M, Kraft S, Lamont NC, Larios O, Missaghi B, Holroyd-Leduc J, Louie T, Conly J. Effectiveness of Bio-K+ for the prevention of Clostridioides difficile infection: Stepped-wedge cluster-randomized controlled trial. Infect Control Hosp Epidemiol 2024; 45:443-451. [PMID: 38073551 PMCID: PMC11007362 DOI: 10.1017/ice.2023.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/20/2023] [Accepted: 07/08/2023] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To evaluate the impact of administering probiotics to prevent Clostridioides difficile infection (CDI) among patients receiving therapeutic antibiotics. DESIGN Stepped-wedge cluster-randomized trial between September 1, 2016, and August 31, 2019. SETTING This study was conducted in 4 acute-care hospitals across an integrated health region. PATIENTS Hospitalized patients, aged ≥55 years. METHODS Patients were given 2 probiotic capsules daily (Bio-K+, Laval, Quebec, Canada), containing 50 billion colony-forming units of Lactobacillus acidophilus CL1285, L. casei LBC80R, and L. rhamnosus CLR2. We measured hospital-acquired CDI (HA-CDI) and the number of positive C. difficile tests per 10,000 patient days as well as adherence to administration of Bio-K+ within 48 and 72 hours of antibiotic administration. Mixed-effects generalized linear models, adjusted for influenza admissions and facility characteristics, were used to evaluate the impact of the intervention on outcomes. RESULTS Overall adherence of Bio-K+ administration ranged from 76.9% to 84.6% when stratified by facility and periods. Rates of adherence to administration within 48 and 72 hours of antibiotic treatment were 60.2% -71.4% and 66.7%-75.8%, respectively. In the adjusted analysis, there was no change in HA-CDI (incidence rate ratio [IRR], 0.92; 95% confidence interval [CI], 0.68-1.23) or C. difficile positivity rate (IRR, 1.05; 95% CI, 0.89-1.24). Discharged patients may not have received a complete course of Bio-K+. Our hospitals had a low baseline incidence of HA-CDI. Patients who did not receive Bio-K+ may have differential risks of acquiring CDI, introducing selection bias. CONCLUSIONS Hospitals considering probiotics as a primary prevention strategy should consider the baseline incidence of HA-CDI in their population and timing of probiotics relative to the start of antimicrobial administration.
Collapse
Affiliation(s)
- Jenine Leal
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Ye Shen
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
| | - Peter Faris
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Analytics, Alberta Health Services, Alberta, Canada
| | - Bruce Dalton
- Pharmacy Services, Alberta Health Services, Calgary, Alberta, Canada
| | - Deana Sabuda
- Pharmacy Services, Alberta Health Services, Calgary, Alberta, Canada
| | - Wrechelle Ocampo
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Lauren Bresee
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Blanda Chow
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
| | - Jared R. Fletcher
- Department of Health and Physical Education, Mount Royal University, Calgary, Alberta, Canada
| | - Elizabeth Henderson
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jaime Kaufman
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Joseph Kim
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
| | - Maitreyi Raman
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Scott Kraft
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Nicole C. Lamont
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Oscar Larios
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Bayan Missaghi
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Jayna Holroyd-Leduc
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
| | - Thomas Louie
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
| | - John Conly
- Infection Prevention and Control, Alberta Health Services, Alberta, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| |
Collapse
|
2
|
Bresee LC, Lamont N, Ocampo W, Holroyd-Leduc J, Sabuda D, Leal J, Dalton B, Kaufman J, Missaghi B, Kim J, Larios OE, Henderson E, Raman M, Fletcher JR, Faris P, Kraft S, Shen Y, Louie T, Conly JM. Implementation strategies for hospital-based probiotic administration in a stepped-wedge cluster randomized trial design for preventing hospital-acquired Clostridioides difficile infection. BMC Health Serv Res 2023; 23:1386. [PMID: 38082421 PMCID: PMC10714625 DOI: 10.1186/s12913-023-10350-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Clostridioides difficile infection (CDI) is associated with considerable morbidity and mortality in hospitalized patients, especially among older adults. Probiotics have been evaluated to prevent hospital-acquired (HA) CDI in patients who are receiving systemic antibiotics, but the implementation of timely probiotic administration remains a challenge. We evaluated methods for effective probiotic implementation across a large health region as part of a study to assess the real-world effectiveness of a probiotic to prevent HA-CDI (Prevent CDI-55 +). METHODS We used a stepped-wedge cluster-randomized controlled trial across four acute-care adult hospitals (n = 2,490 beds) to implement the use of the probiotic Bio-K + ® (Lactobacillus acidophilus CL1285®, L. casei LBC80R® and L. rhamnosus CLR2®; Laval, Quebec, Canada) in patients 55 years and older receiving systemic antimicrobials. The multifaceted probiotic implementation strategy included electronic clinical decision support, local site champions, and both health care provider and patient educational interventions. Focus groups were conducted during study implementation to identify ongoing barriers and facilitators to probiotic implementation, guiding needed adaptations of the implementation strategy. Focus groups were thematically analyzed using the Theoretical Domains Framework and the Consolidated Framework of Implementation Research. RESULTS A total of 340 education sessions with over 1,800 key partners and participants occurred before and during implementation in each of the four hospitals. Site champions were identified for each included hospital, and both electronic clinical decision support and printed educational resources were available to health care providers and patients. A total of 15 individuals participated in 2 focus group and 7 interviews. Key barriers identified from the focus groups resulted in adaptation of the electronic clinical decision support and the addition of nursing education related to probiotic administration. As a result of modifying implementation strategies for identified behaviour change barriers, probiotic adherence rates were from 66.7 to 75.8% at 72 h of starting antibiotic therapy across the four participating acute care hospitals. CONCLUSIONS Use of a barrier-targeted multifaceted approach, including electronic clinical decision support, education, focus groups to guide the adaptation of the implementation plan, and local site champions, resulted in a high probiotic adherence rate in the Prevent CDI-55 + study.
Collapse
Affiliation(s)
- Lauren C Bresee
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - Nicole Lamont
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Wrechelle Ocampo
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Jayna Holroyd-Leduc
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Deana Sabuda
- Pharmacy Services, Alberta Health Services, Calgary, AB, Canada
| | - Jenine Leal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bruce Dalton
- Pharmacy Services, Alberta Health Services, Calgary, AB, Canada
| | - Jaime Kaufman
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Bayan Missaghi
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Joseph Kim
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
| | - Oscar E Larios
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Elizabeth Henderson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maitreyi Raman
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Jared R Fletcher
- Department of Health and Physical Education, Mount Royal University, Calgary, AB, Canada
| | - Peter Faris
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Analytics, Alberta Health Services, Calgary, AB, Canada
| | - Scott Kraft
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Ye Shen
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
| | - Thomas Louie
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - John M Conly
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
- W21 Research and Innovation Centre, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada.
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- AGW5 - Special Services Bldg, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB, Canada, T2N 2T9.
| |
Collapse
|
3
|
Ho C, Ocampo W, Southern DA, Sola D, Baylis B, Conly JM, Hogan DB, Kaufman J, Stelfox HT, Ghali WA. Effect of a Continuous Bedside Pressure Mapping System for Reducing Interface Pressures: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2316480. [PMID: 37266939 DOI: 10.1001/jamanetworkopen.2023.16480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Importance Continuous bedside pressure mapping (CBPM) technology can assist in detecting skin areas with excessive interface pressure and inform efficient patient repositioning to prevent the development of pressure injuries (PI). Objective To evaluate the efficacy of CBPM technology in reducing interface pressure and the incidence of PIs. Design, Setting, and Participants This parallel, 2-group randomized clinical trial was performed at a tertiary acute care center. The study started to enroll participants in December 2014 and was completed in May 2018. Participants included adults partially or completely dependent for bed mobility. Statistical analysis was performed from September 2018 to December 2022. Intervention Nursing staff using visual feedback from CBPM technology for 72 hours. Main Outcomes and Measures Absolute number of sensing points with pressure readings greater than 40 mm Hg, mean interface pressure across all sensing points under a patient's body, proportion of participants who had pressure readings greater than 40 mm Hg, and pressure-related skin and soft tissue changes. Results There were 678 patients recruited. After attrition, 260 allocated to the control group (151 [58.1%] male; mean [SD] age, 61.9 [18.5] years) and 247 in the intervention group (147 [59.5%] male; mean [SD] age, 63.6 [18.1] years) were included in analyses. The absolute number of sensing points with pressures greater than 40 mm Hg were 11 033 in the control group vs 9314 in the intervention group (P = .16). The mean (SD) interface pressure was 6.80 (1.63) mm Hg in the control group vs 6.62 (1.51) mm Hg in the intervention group (P = .18). The proportion of participants who had pressure readings greater than 40 mm Hg was 99.6% in both the control and intervention groups. Conclusions and Relevance In this randomized clinical trial to evaluate the efficacy of CBPM technology in the reduction of interface pressure and the incidence of PIs in a tertiary acute care center, no statistically significant benefit was seen for any of the primary outcomes. These results suggest that longer duration of monitoring and adequately powered studies where CBPM feedback is integrated into a multifaceted intervention to prevent PI are needed. Trial Registration ClinicalTrials.gov Identifier: NCT02325388.
Collapse
Affiliation(s)
- Chester Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta and Alberta Health Services Neurosciences, Rehabilitation & Vision Strategic Clinical Network, Edmonton, Alberta, Canada
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Wrechelle Ocampo
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Danielle A Southern
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Darlene Sola
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Barry Baylis
- Department of Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - John M Conly
- Department of Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - David B Hogan
- Department of Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jaime Kaufman
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Henry Thomas Stelfox
- Department of Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Departments of Critical Care Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, Alberta, Canada
| | - William A Ghali
- Department of Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
4
|
Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [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] [Received: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
Collapse
Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
| |
Collapse
|
5
|
Peng M, Southern DA, Ocampo W, Kaufman J, Hogan DB, Conly J, Baylis BW, Stelfox HT, Ho C, Ghali WA. Exploring data reduction strategies in the analysis of continuous pressure imaging technology. BMC Med Res Methodol 2023; 23:56. [PMID: 36859239 PMCID: PMC9976437 DOI: 10.1186/s12874-023-01875-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Science is becoming increasingly data intensive as digital innovations bring new capacity for continuous data generation and storage. This progress also brings challenges, as many scientific initiatives are challenged by the shear volumes of data produced. Here we present a case study of a data intensive randomized clinical trial assessing the utility of continuous pressure imaging (CPI) for reducing pressure injuries. OBJECTIVE To explore an approach to reducing the amount of CPI data required for analyses to a manageable size without loss of critical information using a nested subset of pressure data. METHODS Data from four enrolled study participants excluded from the analytical phase of the study were used to develop an approach to data reduction. A two-step data strategy was used. First, raw data were sampled at different frequencies (5, 30, 60, 120, and 240 s) to identify optimal measurement frequency. Second, similarity between adjacent frames was evaluated using correlation coefficients to identify position changes of enrolled study participants. Data strategy performance was evaluated through visual inspection using heat maps and time series plots. RESULTS A sampling frequency of every 60 s provided reasonable representation of changes in interface pressure over time. This approach translated to using only 1.7% of the collected data in analyses. In the second step it was found that 160 frames within 24 h represented the pressure states of study participants. In total, only 480 frames from the 72 h of collected data would be needed for analyses without loss of information. Only ~ 0.2% of the raw data collected would be required for assessment of the primary trial outcome. CONCLUSIONS Data reduction is an important component of big data analytics. Our two-step strategy markedly reduced the amount of data required for analyses without loss of information. This data reduction strategy, if validated, could be used in other CPI and other settings where large amounts of both temporal and spatial data must be analysed.
Collapse
Affiliation(s)
- Mingkai Peng
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Danielle A Southern
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Wrechelle Ocampo
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada
| | - Jaime Kaufman
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada
| | - David B Hogan
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - John Conly
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Foothills Medical Centre, Special Services Building, Ground Floor, AGW5, Calgary, AB, T2N 2T9, Canada
| | - Barry W Baylis
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Foothills Medical Centre, Special Services Building, Ground Floor, AGW5, Calgary, AB, T2N 2T9, Canada
| | - Henry T Stelfox
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Alberta, Canada
| | - Chester Ho
- Department of Medicine, Division of Physical Medicine & Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - William A Ghali
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. .,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada. .,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Division of General Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
6
|
Li N, Al-Hakim R, Lewis S, Ferracane J, Campos L, Rugonyi S, Kaufman J. Abstract No. 96 Impact of Co-Axial Placement of Balloon-Expandable and Self-Expanding Stent on Crush Resistance in Vitro. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.144] [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: 02/26/2023] Open
|
7
|
Babione J, Panjwani D, Murphy S, Kelly J, Van Dyke J, Santana M, Kaufman J, Sargious P, Rabi D. Alignment of patient-centredness definitions with real-life patient and clinician experiences: A qualitative study. Health Expect 2022; 26:419-428. [PMID: 36462198 PMCID: PMC9854319 DOI: 10.1111/hex.13674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 12/07/2022] Open
Abstract
INTRODUCTION Patient-centred care (PCC) has come to the forefront for many institutions, funding agencies and clinicians, and is integrated into care. Does a disconnect in understanding still exist between patients, healthcare organizations and clinicians in what PCC means and how outstanding issues might be addressed? METHODS We conducted interviews and focus groups with self-reported chronic care patients and clinicians providing care to these patients exploring PCC experiences, expectations and practices. These data were initially analysed using inductive thematic analysis. This paper reports on the findings of a secondary analysis examining the alignment between patients and clinicians on five key predetermined dimensions of PCC. RESULTS Eighteen patients participated, representing a range of chronic conditions. Thirty-eight clinicians participated. One thousand and three hundred patient and 1800 clinician codes were identified and grouped into 5 main topics with 140 unique themes (patients) and 9 main topics with 54 unique themes (clinicians). A total of 166 quotes (patient = 93, clinician = 73) were identified for this PCC definition alignment analysis. Partial or complete alignment of patient and clinician perspectives was seen on most dimensions. Key disconnects were observed in patient involvement, patient empowerment and clinician-patient communication. Only 18% of patients reported experiencing patient-centred communication, whereas 57% of clinicians reported using patient-focused communication approaches. CONCLUSION Overall, study patients and clinicians endorse that many PCC elements occur. This study highlights key differences between patients and clinicians, suggesting persistent challenges. Clinician participants relayed their PCC approaches of informing and educating patients; however, patients often perceive these approaches as didactic, role-diminishing and noncollaborative. Collaborative approaches, such as shared decision-making, hold promise to bridge persistent PCC gaps and should be integrated into medical education programmes. PATIENT OR PUBLIC CONTRIBUTION This project was conceived and executed with a co-design approach wherein patients with chronic conditions who are trained in research (i.e., see descriptions of Patient and Community Engagement Research in the text) were involved in all stages of the research project alongside other researchers on the project team. Healthcare providers were involved as participants and as principal investigators in the project.
Collapse
Affiliation(s)
- Julie Babione
- Department of Medicine, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Dilshaan Panjwani
- Department of Medicine, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Sydney Murphy
- Department of Medicine, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Jenny Kelly
- Department of Medicine, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Jessica Van Dyke
- Department of Medicine, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Maria Santana
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Jaime Kaufman
- Department of Medicine, Cumming School of Medicine, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Peter Sargious
- Department of Medicine, Cumming School of Medicine, W21C Research and Innovation Centre, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Doreen Rabi
- Department of Medicine, Cumming School of Medicine, W21C Research and Innovation Centre, O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| |
Collapse
|
8
|
Sonalkar S, Kete C, Afreen R, McAllister A, Kaufman J, Keddem S. P090Perceptions of hiv risk screening strategies among patients seeking abortion, contraception, and pregnancy loss management. Contraception 2022. [DOI: 10.1016/j.contraception.2022.09.114] [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]
|
9
|
Li M, Zhao S, Guo J, Gauntner T, Schafer J, Chakravarthy K, Lopez G, Secor A, Das P, Surya N, Husain M, Patel S, Grogan M, Spakowicz D, Miah A, Wei L, He K, Bertino E, Alahmadi A, Memmott R, Kaufman J, Presley C, Shields P, Carbone D, Otterson G, Owen D. EP08.01-062 Body Mass Index, Immune Related Adverse Events, and Survival in Patients with Metastatic Non-small Cell Lung Cancer Treated with Immunotherapy. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.634] [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]
|
10
|
Li N, Ferracane J, Lewis S, Andeen N, Woltjer R, Farsad K, Kaufman J, Rugonyi S, Jahangiri Y, Uchida B, Gabr A, Li J, Yamada K, Al-Hakim R. Abstract No. 299 Impact of post-thrombotic vein wall biomechanics on luminal flow during venous angioplasty and stent placement: computational modeling results. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
11
|
Clopton RC, Ing RJ, Kaufman J. Do Children With Down Syndrome Require More Opioids During Cardiac Surgery? J Cardiothorac Vasc Anesth 2021; 36:200-201. [PMID: 34674930 DOI: 10.1053/j.jvca.2021.09.039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/11/2022]
Affiliation(s)
- R C Clopton
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
| | - R J Ing
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO.
| | - J Kaufman
- Department of Cardiology and Critical Care, Children's Hospital Colorado, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
| |
Collapse
|
12
|
Li N, Ferracane J, Lewis S, Andeen N, Woltjer R, Farsad K, Kaufman J, Rugonyi S, Jahangiri Y, Uchida B, Gabr A, Li J, Yamada K, Al-Hakim R. Abstract No. 225 Venous large animal model for stenosis, thrombosis, and chronic occlusion: short-term results, with biomechanical analysis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
13
|
Gabr A, Li N, Panick C, O’Sullivan J, Stoner R, Tillotson M, Kaufman J, Kolbeck K, Jahangiri Y, Farsad K. Abstract No. 561 Morphometric tumor analysis and response assessment after Y90 radioembolization for hepatocellular carcinoma. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
14
|
Gajra A, Klink A, Kaufman J, Laney J, Cseh A, Fernamberg K, Moehring B, Jonna S. P86.11 A Real-World Feasibility Study of Patients with Solid Tumors Harboring NRG1 Gene Fusions: NSCLC Subset Analysis. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
15
|
Babione JN, Ocampo W, Haubrich S, Yang C, Zuk T, Kaufman J, Carpendale S, Ghali W, Altabbaa G. Erratum to "Human-centred design processes for clinical decision support: A pulmonary embolism case study" [Int. J. Med. Inf. (2020) 104196]. Int J Med Inform 2021; 148:104417. [PMID: 33637405 DOI: 10.1016/j.ijmedinf.2021.104417] [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: 10/22/2022]
Affiliation(s)
- Julie N Babione
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Wrechelle Ocampo
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Sydney Haubrich
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Connie Yang
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Torre Zuk
- Department of Computer Science, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Jaime Kaufman
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Sheelagh Carpendale
- Computing Science, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - William Ghali
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Ghazwan Altabbaa
- W21C Research and Innovation Centre, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| |
Collapse
|
16
|
Gajra A, Klink A, Kaufman J, Laney J, Cseh A, Fernamberg K, Moehring B, Jonna S. MO01.34 Patients with Solid Tumors Harboring NRG1 Gene Fusions: A Real-World Feasibility Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.139] [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]
|
17
|
Babione JN, Ocampo W, Haubrich S, Yang C, Zuk T, Kaufman J, Carpendale S, Ghali W, Altabbaa G. Human-centred design processes for clinical decision support: A pulmonary embolism case study. Int J Med Inform 2020; 142:104196. [DOI: 10.1016/j.ijmedinf.2020.104196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 12/30/2022]
|
18
|
Gajra A, Klink A, Kaufman J, Laney J, Cseh A, Fernamberg K, Moehring B, Jonna S. 1956P A real-world feasibility study of patients with solid tumours harbouring NRG1 gene fusions. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
19
|
Hamilton E, Barve M, Tolcher A, Buscema J, Papadopoulos K, Zarwan C, Anderson C, Doroshow D, Wang D, Huebner D, Jansen V, Jarlenski D, Mosher R, Kaufman J, Moore K, Richardson D. 836P Safety and efficacy of XMT-1536 in ovarian cancer: A subgroup analysis from the phase I expansion study of XMT-1536, a NaPi2b antibody-drug conjugate. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
20
|
Grant B, O’Loughlin K, Holbrook H, Althoff R, Kearney C, Perepletchikova F, Grasso D, Hudziak J, Kaufman J. A multi-method and multi-informant approach to assessing post-traumatic stress disorder (PTSD) in children. Int Rev Psychiatry 2020; 32:212-220. [PMID: 31880487 PMCID: PMC7190440 DOI: 10.1080/09540261.2019.1697212] [Citation(s) in RCA: 8] [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] [Indexed: 10/25/2022]
Abstract
Trauma exposure is highly prevalent among children globally, and is associated with elevated rates of PTSD. The goal of this study was to systematically evaluate the effects of multiple informants and multiple screening measures on the identification of specific PTSD symptoms and rates of PTSD diagnoses. Participants in this study included 350 maltreated children from two cohorts, one recruited from Connecticut (n = 130), and the other from Vermont (n = 220). Both cohorts completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED) before a PTSD self-report measure. The KSADS psychiatric interview was also completed with the Connecticut cohort, with best-estimate ratings generated using parent and child interview, child self-report, and teacher questionnaire data. In addition to the SCARED and PTSD self-report scale, parents of the Vermont cohort completed the Child Behavioural Checklist. Significant differences emerged between parent and child report of sleep, nightmares, concentration, and irritability problems, suggesting the need for multiple informants in PTSD screening. Children also under-reported nightmares when asked in the context of a trauma-specific screening tool. As child trauma is associated with a broad range of psychiatric sequelae, comprehensive assessment using both general symptomatology and trauma-specific measures is recommended, since children often shut down when completing trauma measures.
Collapse
Affiliation(s)
- B.R. Grant
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - K. O’Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - H.M. Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - R.R. Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - C. Kearney
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD
| | - F. Perepletchikova
- Weill Cornell Medicine and NewYork-Presbyterian Hospital, White Plains, NY
| | - D.J. Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - J.J. Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - J. Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| |
Collapse
|
21
|
Jahangiri Y, Rahmani R, Nabavizadeh N, Degnin C, Chen Y, Tomozawa Y, Geeratikun Y, Hung A, Thomas C, Kolbeck K, Schenning R, Kaufman J, Farsad K. 03:00 PM Abstract No. 179 Combination therapy with TACE+ablation vs. TACE + SBRT for hepatocellular carcinoma (HCC): comparative analysis with propensity score–weighted cohorts. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.233] [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: 11/29/2022] Open
|
22
|
White P, Jahangiri Y, Farsad K, Kaufman J, Al-Hakim R. 03:45 PM Abstract No. 194 Does lateral tilt during inferior vena cava filter placement result in subsequent need for advanced retrieval technique? J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.249] [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] Open
|
23
|
Torkian P, Yaseri M, Kaufman J, Jahangiri Y. 03:45 PM Abstract No. 107 Symptomatic hepatic hemangiomas treated with transcatheter arterial chemoembolization (TACE): systematic review and meta-analysis. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
24
|
Li N, Farsad K, Kaufman J, Jahangiri Y, Uchida B, Al-Hakim R. 03:54 PM Abstract No. 389 Iron particle coating of venous endothelium for in vivo fluoroscopic visualization and real-time biomechanical analysis. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
25
|
Haubrich S, Ocampo W, Babione J, Kaufman J, Ghali W, Altabbaa G. Impact of a web-based clinical decision-support system on pulmonary embolism diagnoses. Int J Popul Data Sci 2018. [DOI: 10.23889/ijpds.v3i4.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
IntroductionPulmonary embolism (PE) is a disease that offers a diagnostic challenge for physicians. Literature suggests a gap remains between PE diagnostic guidelines and adherence to such guidelines in practice. While computerized decision support systems (CDSS) for PE exist, evidence is lacking on their impact in clinical settings.
Objectives and ApproachThe objective is to evaluate the impact of a web-based PE-CDSS on physician adherence to diagnostic guidelines by collecting and linking chart review data, hospital administrative data, and PE-CDSS usage data from six months before and after the CDSS is deployed. This CDSS was integrated into an electronic medical record system and deployed at two inpatient hospital sites in early 2018. Pre- and post-intervention workups are assigned a score based on their adherence to PE diagnostic guidelines, then compared. Data from a third hospital site with no access to the PE-CDSS will be used as a control.
ResultsPreliminary results will be available by mid-2018. Based on previous research, the investigators expect to see increased provider adherence to diagnostic guidelines for PE in settings where the PE-CDSS was deployed.
Conclusion/ImplicationsImplementing a PE-CDSS may increase provider adherence to evidence-based diagnostic guidelines by providing supportive information about PE diagnosis and addressing uncertainties about clinical decision making. This could result in greater diagnostic accuracy for PE and improved outcomes for patients with suspected PE.
Collapse
|
26
|
Peng M, Ocampo W, Southern D, Baylis B, Hogan D, Conly J, Stelfox T, Kaufman J, Ghali W, Ho C. Approaches to big data analysis of interface pressure measurements from continuous pressure imaging technology. Int J Popul Data Sci 2018. [DOI: 10.23889/ijpds.v3i4.752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
IntroductionOver 4.5 TB of data will be collected in a randomized clinical trial assessing continuous pressure imaging technology in reducing pressure injuries. To permit efficient analysis we examined different approaches to generating a reduced representation of the data that still produced similar analytical results to the full data set.
Objectives and ApproachOur primary objective was to develop an approach for reducing the pressure data to a manageable size, without loss of information. Frame by frame analysis of excluded participant imaging data allows us to identify changes in patient position. We explored different sampling frequencies (q5, 30, 60, 120, \& 240 seconds) for analysis, coalesced frames with periods of stillness, and used correlation coefficients as a measure of similarity between adjacent frames to identify patient position changes. Heat maps and plots were used to evaluate the performance characteristics and usefulness of different sampling frequencies and correlation coefficients to compress the data.
ResultsA sampling frequency q60 seconds provided reasonable representation of changes in interface pressure over time. This translates to using only 1.7\% of the collected data in our analyses. When the threshold of correlation coefficient was set at 0.99 for coalescing the information based on position changes, then there was a maximum of 80 position changes detected. Therefore, approximately 160 frames q24 hours is sufficient to represent pressure states of participants at high risk of developing pressure injuries. In total we would require 480 frames (160*3) from 72 hours of collected data for our analyses without loss of position changes and pressure information. This represents approximately 0.185\% of the data collected.
Conclusion/ImplicationsDecreasing the sampling frequency significantly reduced our data size without compromising resolution, while the use of correlation coefficients was effective at coalescing the continuous pressure imaging data. These methods of data reduction may be applicable to pre-processing large datasets obtained from other device monitoring technologies.
Collapse
|
27
|
Weng J, Bertisch S, Lutsey P, Kaufman J, McClelland R, Redline S. 0364 Insomnia with Objective Short Sleep Duration and Coronary Artery Calcification: Multi-Ethnic Study of Atherosclerosis. Sleep 2018. [DOI: 10.1093/sleep/zsy061.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Weng
- Brigham and Women’s Hospital, Boston, MA
| | | | - P Lutsey
- School of Public Health, University of Minnesota, Minneapolis, MN
| | - J Kaufman
- School of Public Health, University of Washington, Seattle, WA
| | - R McClelland
- School of Public Health, University of Washington, Seattle, WA
| | - S Redline
- Brigham and Women’s Hospital, Boston, MA
| |
Collapse
|
28
|
Tomozawa Y, Jahangiri Y, Farsad K, Kolbeck K, Kaufman J. 3:09 PM Abstract No. 262 Long-term toxicity after radioembolization with yttrium-90 for neuroendocrine tumor liver metastases. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Koenig M, Amann J, Oakes C, Kaufman J, Carbone D. P2.02-067 LKB1 Loss Is Associated with DNA Hypomethylation in Human Lung Adenocarcinoma. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1245] [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: 11/29/2022]
|
30
|
Gu Y, Xu K, Torre C, Samur M, Barwick BG, Rupji M, Arora J, Neri P, Kaufman J, Nooka A, Bernal-Mizrachi L, Vertino P, Sun SY, Chen J, Munshi N, Fu H, Kowalski J, Boise LH, Lonial S. 14-3-3ζ binds the proteasome, limits proteolytic function and enhances sensitivity to proteasome inhibitors. Leukemia 2017; 32:744-751. [DOI: 10.1038/leu.2017.288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/06/2017] [Accepted: 08/23/2017] [Indexed: 01/02/2023]
|
31
|
Quraishi S, Piepmeier L, Hinckley MD, Richter K, Yee B, Lin P, Neal-Perry G, Kaufman J, Hajat A. Exposure to ambient air pollution and live birth outcomes in women undergoing in vitro fertilization. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.277] [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: 12/01/2022]
|
32
|
Ocampo W, Cheung A, Baylis B, Clayden N, Conly JM, Ghali WA, Ho CH, Kaufman J, Stelfox HT, Hogan DB. Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries. Adv Skin Wound Care 2017; 30:319-333. [PMID: 28617751 PMCID: PMC5482558 DOI: 10.1097/01.asw.0000520289.89090.b0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
GENERAL PURPOSE To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. ABSTRACT BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. OBJECTIVE The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. DATA SOURCES Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. DATA EXTRACTION Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. DATA SYNTHESIS The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. CONCLUSIONS Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.
Collapse
Affiliation(s)
- Wrechelle Ocampo
- Wrechelle Ocampo, MBT • Research Associate • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada Amanda Cheung, MBT, BS • Research Assistant • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada Barry Baylis, MD • Executive Codirector • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada • Clinical Associate Professor • Department of Medicine • University of Calgary Nancy Clayden, EMT-P • Research Associate • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada John M. Conly, MD • Medical Director • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada • Professor • Departments of Medicine, Pathology and Laboratory Medicine, and Microbiology, Immunology and Infectious Diseases • University of Calgary William A. Ghali, MD • Scientific Director • O'Brien Institute for Public Health • University of Calgary • Calgary, Alberta • Canada • Professor • Division of General Internal Medicine, Departments of Medicine and Community Health Sciences • Cumming School of Medicine • University of Calgary Chester H. Ho, MD • Associate Professor and Head • Department of Clinical Neurosciences • University of Calgary • Calgary, Alberta • Canada Jaime Kaufman, PhD • Manager • W21C Strategic Programs • W21C Research and Innovation Centre • Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada Henry T. Stelfox, MD, PhD • Associate Professor • Departments of Community Health Sciences, Medicine, and Critical Care Medicine • University of Calgary • Calgary, Alberta • Canada David B. Hogan, MD • Brenda Stafford Foundation Chair • Geriatric Medicine • Calgary, Alberta • Canada • Professor • Departments of Medicine, Clinical Neurosciences, and Community Health Sciences • Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Hallihan G, Davies J, Baers J, Wiley K, Kaufman J, Conly J, Caird JK. Potential Health Care Worker Contamination from Ebola Virus Disease during Personal Protective Equipment Removal and Disposal. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1541931215591118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The transmission of Ebola Virus (EV) to health care workers (HCW) has been documented in highly-resourced care settings, even with HCW use of personal protective equipment (PPE). This research describes an observational study involving simulated Ebola Virus Disease (EVD) patient scenarios in four tertiary acute care centers. Researchers recorded and analyzed audiovisual data to identify instances of potential HCW EV contamination. Video-analysis was based on a coding taxonomy developed in collaboration with Infection Prevention and Control (IPC) professionals. The analysis focused on events and actions associated with potential HCW contamination during doffing and PPE disposal, and contributing system factors. The events and actions identified included out-of-sync doffing teams, HCW deviations from doffing protocols, and improper disposal of doffed PPE including the compression of PPE in biomedical waste containers containing potentially contaminated sharps. These observations are discussed along with recommendations for the re-design of doffing procedural aids and waste disposal.
Collapse
Affiliation(s)
- Greg Hallihan
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jan Davies
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Justin Baers
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Katelyn Wiley
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jaime Kaufman
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - John Conly
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeff K. Caird
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada
| |
Collapse
|
34
|
Ho CH, Cheung A, Southern D, Ocampo W, Kaufman J, Hogan DB, Baylis B, Conly JM, Stelfox HT, Ghali WA. A Mixed-methods Study to Assess Interrater Reliability and Nurse Perception of the Braden Scale in a Tertiary Acute Care Setting. Ostomy Wound Manage 2016; 62:30-38. [PMID: 28054924] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Research regarding the reliability of the Braden Scale and nurses' perspectives on the instrument for predicting pressure ulcer (PU) risk in acute care settings is limited. A mixed-methods study was conducted in a tertiary acute care facility to examine interrater reliability (IRR) of the Braden Scale and its subscales, and a qualitative survey using semi-structured interviews was conducted among nurses caring for patients in acute care units to gain nurse perspective regarding scale usability. Data were extracted from a previous retrospective, randomized, controlled trial involving adult patients with compromised mobility receiving care in a tertiary acute care hospital in Canada. One-way, intraclass correlation coefficients (ICCs) were calculated on item and total scores, and kappa statistics were used to determine reliability of categorizing patients on their risk. Interview results were categorized by common themes. Reliability was assessed on 64 patients, where nurses and research staff independently assessed enrolled participants at baseline and after 72 hours using the Braden Scale as it appeared on an electronic medical record. IRR for the total score was high (ICC = 0.807). The friction and shear item had the lowest reliability (ICC = 0.266). Reliability of categorizing patients' level of risk had moderate agreement (κ = 0.408). Three (3) major and 12 subthemes emerged from the 14 nurse interviews; nurses were aware of the scale's purpose but were uncertain of its effectiveness, some items were difficult to rate, and questions were raised as to whether using the scale enhanced patient care. Aspects identified by nurses to enhance usability included: 1) changes to the electronic version (incorporating the scale into daily assessment documents with readily available item descriptions), 2) additional training, and 3) easily available resource material to improve reliability and usability of scale. These findings need to be considered when using the Braden Scale in clinical practice. Further study of the value of the total Braden Scale and its subscales is warranted.
Collapse
Affiliation(s)
- Chester H Ho
- Cumming School of Medicine, University of Calgary; and Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, University of Calgary and Alberta Health Services at the Foothills Medical Centre, Calgary, AB, Canada
| | - Amanda Cheung
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary
| | - Danielle Southern
- O'Brien Institute of Public Health; and W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary
| | - Wrechelle Ocampo
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary
| | - Jaime Kaufman
- W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary
| | - David B Hogan
- the Brenda Strafford Foundation in Geriatric Medicine, University of Calgary
| | - Barry Baylis
- W21C Research and Innovation Centre; and Department of Medicine, Division of General Internal Medicine, Cumming School of Medicine, University of Calgary
| | - John M Conly
- W21C Research and Innovation Centre, Cumming School of Medicine; Departments of Medicine and Infection Prevention and Control, Alberta Health Services; and O'Brien Institute for Public Health, University of Calgary
| | - Henry T Stelfox
- Alberta Health Services' Critical Care Strategic Clinical Network; the Departments of Critical Care Medicine, Medicine and Community Health Sciences, University of Calgary; and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary
| | - William A Ghali
- O'Brien Institute for Public Health, Foothills Medical Centre, University of Calgary; W21C Research and Innovation Centre; and Departments of Community Health Sciences and General Internal Medicine, Cumming School of Medicine
| |
Collapse
|
35
|
Kaufman J, Kassube K, Rius AG. 0762 Feeding low crude protein diets in lactating dairy cows during summer months: 1. Improvements in milk production and nitrogen utilization. J Anim Sci 2016. [DOI: 10.2527/jam2016-0762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
36
|
Kassube K, Kaufman J, Pohler KG, Rius AG. 1589 The effect of heat stress and jugular infusions of methionine, lysine, and branched-chain amino acids in lactating dairy cattle. J Anim Sci 2016. [DOI: 10.2527/jam2016-1589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
37
|
Kaufman J, Kassube K, Pohler KG, Rius AG. 0749 Feeding low crude protein diets in lactating dairy cows during summer months: 2. Improvements in energy metabolism. J Anim Sci 2016. [DOI: 10.2527/jam2016-0749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
38
|
Robinson J, Maccari G, Bontrop RE, Ho S, Grimholt U, Kaufman J, Guethlein L, Ballingall K, Marsh SG, Hammond JA. S0117 Development of the ipd-MHC Database. J Anim Sci 2016. [DOI: 10.2527/jas2016.94supplement49x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
39
|
Olšovcová V, Versaci R, Ambrožová I, Zelenka Z, Kaufman J, Margarone D, Kim IJ, Jeong TM. RESPONSE OF DOSEMETERS IN FIELDS GENERATED BY LASER-ACCELERATED PROTONS. Radiat Prot Dosimetry 2016; 170:318-321. [PMID: 26979806 DOI: 10.1093/rpd/ncw037] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In laser-driven acceleration, ultra-short and intense laser pulses are focussed on targets to generate beams of ionising radiation. One of the most important issues to be addressed is personal monitoring. While traditional dosemeters were designed primarily for measurements in continuous fields, dosemeters for laser laboratories must be capable of working in pulsed fields of pulse length below 1 ps, in a single-shot regime up to the repetition rate of 1 kHz. Responses of conventional dosemeters (films, polyallyldiglycol carbonate, electronic personal dosemeter) to proton bunches of up to 30 MeV energy produced by South Korean PW laser system at the Advanced Photonics Research Institute, Gwangju Institute of Science and Technology were studied, both by means of Monte Carlo simulations and experimentally.
Collapse
Affiliation(s)
- V Olšovcová
- ELI Beamlines, Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, Prague 8, Czech Republic
| | - R Versaci
- ELI Beamlines, Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, Prague 8, Czech Republic
| | - I Ambrožová
- Nuclear Physics Institute, Academy of Sciences of the Czech Republic, Řež 130, Czech Republic
| | - Z Zelenka
- National Personal Dosimetry Service, Na Truhlářce 39/64, Prague 8, Czech Republic
| | - J Kaufman
- ELI Beamlines, Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, Prague 8, Czech Republic
| | - D Margarone
- ELI Beamlines, Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, Prague 8, Czech Republic
| | - I J Kim
- Advanced Photonics Research Institute, GIST, Gwangiu 500-712, Korea Present address: Optical Instrumentation Development Team, KBSI, Daejeon 34133, Korea
| | - T M Jeong
- Advanced Photonics Research Institute, GIST, Gwangiu 500-712, Korea ELI Beamlines, Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, Prague 8, Czech Republic
| |
Collapse
|
40
|
Kaufman J, Tosif S, Fitzpatrick P, Donath S, Hopper S, Bryant P, Babl F. Quick-Wee: A Novel Non-Invasive Urine Collection Method for Infants in the Emergency Department. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e95] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND: Urinary tract infection is one of the commonest paedi-atric infections, and important to diagnose or exclude in young children with fever. Limitations exist with all current urine collection methods, guidelines vary, and clinicians have different preferences. Clean catch urine (CCU) is a preferred non-invasive collection method and is convenient and painless compared to suprapubic aspirate and catheterisation. However, it can be unreliable and time-consuming, with high rates of sample contamination and collection failure. Only 12% void within 5 minutes based on recent data. An ideal method of urine collection would be fast, reliable and simple. Suprapubic stimulation may trigger involuntary parasympathetic detrusor contraction, inducing voiding via early childhood exteroceptive somato-bladder reflexes.
OBJECTIVES: We conducted a pilot study using a novel method (termed ‘Quick-Wee’) of gentle cutaneous suprapubic stimulation with saline-soaked gauze, to hasten voiding for non-invasive urine collection.
DESIGN/METHODS: Prospective pilot study of 40 pre-continent children age 1-24 months requiring CCU in a paediatric emergency department in Australia. Standard CCU was augmented by 5 minutes of suprapubic cutaneous stimulation (Quick-Wee method), with either cold (3 degrees Celsius) or room-temperature saline-soaked gauze. PRIMARY OUTCOME: Void <5 minutes. SECONDARY OUTCOMES: Successful catch of sample (if voids), contamination rate, parental/clinician satisfaction with technique.
RESULTS:
CONCLUSION: Gentle cutaneous suprapubic stimulation with saline-soaked gauze appears to be a promising technique with 30% voiding in <5 minutes, a rate higher than observed without such stimulation. A randomised controlled trial comparing Quick-Wee to standard CCU without suprapubic stimulation is now underway.
Collapse
|
41
|
Kaufman J, Tosif S, Fitzpatrick P, Donath S, Hopper S, Bryant P, Babl F. Urine Clean Catch Collection in the Paediatric Emergency Department: Success, Time to Void and Contamination Rates. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e94c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Young children frequently require investigation for urinary tract infection (UTI). Clean catch urine (CCU) is a common urine collection method in pre-continent children but can be time consuming or unsuccessful, and contaminated cultures may lead to an inability to diagnose or exclude UTI. There are few data available examining the success and time required for CCU and factors influencing contamination. We hypothesise that time taken to obtain CCU influences contamination, due to accidental contamination during collection.
OBJECTIVES: To determine the time taken to obtain CCU in pre-conti-nent children, and if time to collection is related to the contamination rate.
DESIGN/METHODS: Prospective observational study of CCU collection in pre-continent children aged 2-48 months at a paediatric emergency department in Australia. A standardised CCU collection protocol was used. Primary outcome was time to first void; secondary outcomes were success of obtaining (catching) CCU and contamination of urine cultures obtained. Contamination was defined as per hospital microbiology standards. Descriptive analysis of time to void included median and interquartile range (IQR). We performed a regression analysis of key factors possibly related to contamination, including age, sex and time to collection.
RESULTS: Of the 218 recruited patients, 61% were male, mean age 11.4 months (SD 8.5). The main indication for CCU was: 128 fever of unknown origin (59%), 31 vomiting (14%), 27 specifically suspected UTI (12%), 32 other reason (15%). From first CCU attempt, 174 voided (80%) of which 139 were successful catches (64%) and 34 were missed on voiding (16%). 44 first CCU attempts were stopped before voiding (20%), 26 patients had 2 attempts (12%), and 2 patients had 3 CCU attempts (1%). Median time to first void was 25 minutes (IQR 8 – 49). 27 children (12%) voided <5 minutes, 33 (19%) voided >1hr. Of the 130 patients who had urine culture results available, 50 were contaminated (38%). There was no significant difference in contamination rate by age, sex or time to sample collection. Of 218 patients where ED clinicians set out to collect CCU in the emergency department, only 80 (37%) resulted in a successful CCU attempt with an uncontaminated culture.
CONCLUSION: Contamination rates are high in clean catch urine, but not related to the time taken for sample collection. CCU attempts are often unsuccessful, and have a low diagnostic yield for investigation of UTI in young children in clinical practice.
Collapse
|
42
|
Horikawa M, Matsui Y, Uchida B, Kaufman J, Farsad K. How to start up IR research―an overview and literature review of VX2 liver tumor model in rabbits. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
43
|
Chansanti O, Matsui Y, Jahangiri Y, Geeratikun Y, Adachi A, Kaufman J, Kolbeck K, Stevens J, Farsad K. Tumor dose-response in Y-90 resin microsphere embolization for the neuroendocrine liver metastasis: a lesion-by-lesion analysis with dose estimation using SPECT-CT. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.295] [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: 11/28/2022] Open
|
44
|
Matsui Y, Horikawa M, Ohta K, Jahangiri Y, Uchida B, Timmermans H, Kaufman J, Farsad K. Mechanisms of Günther Tulip filter tilting: an experimental and clinical investigation. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.740] [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: 11/29/2022] Open
|
45
|
Matsui Y, Horikawa M, Jahangiri Y, Kaufman J, Kolbeck K, Barton R, Keller F, Farsad K. Degree of baseline Lipiodol accumulation after transarterial chemoembolization for hepatocellular carcinoma: identification of a threshold value predicting tumor response. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
46
|
Hallihan G, Baers J, Wiley K, Davies J, Kaufman J, Conly J, Caird J. Human Factors Evaluation to Identify Systems Factors to Improve Safety During Donning and Doffing Personal Protective Equipment (PPE) in Ebola Virus Disease Management Scenarios. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
47
|
Kaufman J, Linington M, Osborne VR, Wagner-Riddle C, Wright TC. Short communication: Field study of air ammonia concentrations in Ontario dairy calf housing microenvironments. Can J Anim Sci 2015. [DOI: 10.4141/cjas-2015-013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Kaufman, J., Linington, M., Osborne, V. R., Wagner-Riddle, C. and Wright, T. C. 2015. Short Communication: Field study of air ammonia concentrations in Ontario dairy calf housing microenvironments. Can. J. Anim. Sci. 95: 539–542. The objective of this study was to measure the ammonia concentrations in the microenvironment of the calf housing area on a sample of commercial dairies in Ontario under typical management conditions. Two approaches were used to measure ammonia concentrations: (1) weekly on four farms for a period of 8 wk and (2) one-time samples were taken from the calf areas on 15 other farms. The results indicated that ammonia levels are managed below the existing maximum threshold provided in the national dairy code of practice.
Collapse
Affiliation(s)
- J. Kaufman
- School of Environmental Sciences, University of Guelph, Guelph, Ontario, Canada N1G 2W1
- Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - M. Linington
- Department of Animal and Poultry Science, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - V. R. Osborne
- Department of Animal and Poultry Science, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - C. Wagner-Riddle
- School of Environmental Sciences, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - T. C. Wright
- Ontario Ministry of Agriculture Food and Rural Affairs, c/o Department of Animal and Poultry Science, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| |
Collapse
|
48
|
Brunetta DM, Kaufman J, De Santis GC, Mesquita DFG, Souza FNOA, Garcia JHP. Severe Acute Anemia After Liver Transplantation in an Elderly Jehovah's Witness Treated With High-dose Erythropoietin and Ferric Carboxymaltose: A Case Report. Transplant Proc 2015; 47:2548-51. [PMID: 26518969 DOI: 10.1016/j.transproceed.2015.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/12/2015] [Accepted: 09/02/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is no standard treatment for patients with severe anemia who refuse blood transfusion or cannot receive red blood cells. CASE REPORT After an orthotopic liver transplantation, an elderly Jehovah's Witness who refused blood transfusion presented with severe acute anemia with hemorrhagic shock. The calculated red blood cell loss was near 70%. Associated with surgical treatment and supportive measures, the patient was treated with high-dose erythropoietin and ferric carboxymaltose. RESULTS The patient presented a rapid increase in hemoglobin concentration and reticulocyte count with resolution of hemorrhagic shock after the proposed pharmacologic treatment combined with local hemostatic measures. She was transferred to a low-risk unit 4 days after transplantation and was discharged from the hospital on day 10. The hemoglobin concentration was normal 35 days after the bleeding event. CONCLUSION This case demonstrated that a protocol with high-dose erythropoietin and ferric carboxymaltose may be an option for patients with severe anemia who refuse blood transfusion or cannot receive red blood cells.
Collapse
Affiliation(s)
- D M Brunetta
- Walter Cantidio University Hospital, Federal University of Ceara, Hematology Division, Fortaleza, Ceará, Brazil.
| | - J Kaufman
- Walter Cantidio University Hospital, Federal University of Ceara, Hematology Division, Fortaleza, Ceará, Brazil
| | - G C De Santis
- Center for Cell Based Therapy, Medical School of Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - D F G Mesquita
- Walter Cantidio University Hospital, Federal University of Ceara, Liver Transplantation Division, Fortaleza, Ceará, Brazil
| | - F N O A Souza
- Walter Cantidio University Hospital, Federal University of Ceara, Liver Transplantation Division, Fortaleza, Ceará, Brazil
| | - J H P Garcia
- Walter Cantidio University Hospital, Federal University of Ceara, Liver Transplantation Division, Fortaleza, Ceará, Brazil
| |
Collapse
|
49
|
Wong H, Kaufman J, Baylis B, Conly JM, Hogan DB, Stelfox HT, Southern DA, Ghali WA, Ho CH. Efficacy of a pressure-sensing mattress cover system for reducing interface pressure: study protocol for a randomized controlled trial. Trials 2015; 16:434. [PMID: 26420303 PMCID: PMC4588270 DOI: 10.1186/s13063-015-0949-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 09/09/2015] [Indexed: 11/13/2022] Open
Abstract
Background Interface pressure is a key risk factor in the development of pressure ulcers. Visual feedback of continuous interface pressure between the body and support surface could inform clinicians on repositioning strategies and play a key role in an overall strategy for the prevention and management of pressure ulcers. Methods/Design A parallel two-group randomized controlled clinical trial will be conducted to study the effect of continuous pressure imaging on reducing interface pressure and on the incidence of pressure ulcers in vulnerable hospital patients. A total of 678 eligible consenting inpatients at risk of pressure ulcer development in a tertiary acute care institution will be randomly allocated to either having the ForeSite PT™ system with the liquid-crystal display monitor turned on to provide visual feedback to the clinicians while also collecting continuous interface pressure data (intervention group) or to having the ForeSite PT™ system with monitor turned off (that is, not providing visual feedback) but still collecting continuous interface pressure data (control group), in a ratio of 1:1. Continuous interface pressure data will be collected in both groups for 3 days (72 h). Data collection will continue until discharge for a subset of approximately 60 patients. The primary outcome will be the differences in the two groups’ interface pressure analysis. Interface pressure readings will be collected through hourly samplings of continuous interface pressure recordings. Secondary outcomes will be the differences between the two groups in pressure-related skin and soft tissue changes in areas at risk of pressure ulcer (obtained at baseline within 24 h of admission) and on the third day of the trial or at discharge and perceptions of the intervention by patients and clinicians (obtained on the third day or at discharge). Discussion This will be the first randomized controlled trial to investigate the effect of visual feedback with continuous interface pressure of vulnerable hospital patients across different care settings, and the association between interface pressure and development of pressure-related skin and soft tissue changes. The results could provide important information to guide clinical practice in the prevention and management of pressure ulcers. Trials registration ClinicalTrials.gov NCT02325388 (date of registration: 24 December 2014).
Collapse
Affiliation(s)
- Holly Wong
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, NW, Calgary, AB, T2N-4Z6, Canada.
| | - Jaime Kaufman
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, NW, Calgary, AB, T2N-4Z6, Canada.
| | - Barry Baylis
- Division of General Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - John M Conly
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, NW, Calgary, AB, T2N-4Z6, Canada. .,Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada. .,O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. .,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Foothills Medical Centre, Special Services Building, Ground Floor, AGW5, Calgary, AB T2N 2T9, Canada.
| | - David B Hogan
- Brenda Strafford Foundation (Geriatric Medicine), University of Calgary, HSC-3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
| | - Henry T Stelfox
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. .,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Alberta Health Services, Alberta, Canada.
| | - Danielle A Southern
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
| | - William A Ghali
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, NW, Calgary, AB, T2N-4Z6, Canada. .,Division of General Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. .,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Chester H Ho
- Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Foothills Hospital, University of Calgary, 1403 - 29th Street NW, Calgary, AB, T2N 2T9, Canada.
| |
Collapse
|
50
|
Horikawa M, Yamamoto M, Yamada K, Kaufman J. BRTO for gastric varices—advanced techniques and ideas how to overcome anatomical challenges and absence of required devices. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.568] [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: 11/28/2022] Open
|