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Barlow J, Sragi Z, Rodriguez N, Alsen M, Kappauf C, Ferrandino R, Chennareddy S, Kotz T, Kirke DN, Teng MS, Genden EM, Khan MN, Roof SA. Early feeding after free flap reconstruction of the oral cavity: A systematic review and meta-analysis. Head Neck 2024; 46:1224-1233. [PMID: 38414175 DOI: 10.1002/hed.27684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/28/2023] [Accepted: 02/03/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Traditionally, patients undergoing free flap reconstruction for oral cavity defects have been given nothing by mouth for 6-14 days post-operatively due to concern for orocutaneous fistula development. METHODS Multiple databases were screened for studies assessing the rate of orocutaneous fistula formation in early (≤5 days) versus late (>5 days) feeding groups following oral cavity free flap reconstruction. Fixed- and random-effects meta-analyses were used. RESULTS One randomized controlled trial, one prospective cohort, and three retrospective cohort studies were included. The early feeding group displayed no significant increase in orocutaneous fistula formation (RD = -0.02, p = 0.06) or free flap failure (RD = -0.01, p = 0.39), with a significantly shorter hospital length of stay (mean difference [days] = -2.43, p < 0.01). CONCLUSIONS While further prospective trials are necessary, initiation of oral intake before post-operative day 5 may be appropriate in properly selected patients following oral reconstruction.
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Affiliation(s)
- Joshua Barlow
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zara Sragi
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nina Rodriguez
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mathilda Alsen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Catharine Kappauf
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rocco Ferrandino
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susmita Chennareddy
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Tamar Kotz
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Diana N Kirke
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marita S Teng
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric M Genden
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mohemmed N Khan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Scott A Roof
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Barlow J, Gilja S, Ferrandino RM, Berger MH, Posner MR, Bakst RL, Khan MN, Teng MS, Genden EM, Chai RL, Roof SA. Evaluating human papillomavirus testing, prevalence, and association with prognosis in head and neck squamous cell carcinoma by subsite: A national cancer database study. Am J Otolaryngol 2024; 45:104243. [PMID: 38442460 DOI: 10.1016/j.amjoto.2024.104243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To compare human papillomavirus (HPV) testing, prevalence, and association with prognosis between head and neck squamous cell carcinoma (HNSCC) subsites. MATERIALS AND METHODS This study utilized the National Cancer Database (NCDB) to identify patients diagnosed with HNSCC between 2010 and 2017. Rates of HPV testing, HPV-positivity, and changes in these rates over time were measured by subsite. The impact of HPV-positivity on overall survival across six head and neck subsites was assessed using multivariable-adjusted Cox proportional hazards analysis. RESULTS A total of 121,550 patients were included. Of this cohort, 87,575 (72.1%) were tested for HPV, with the oropharynx (55,049/64,158; 85.8%) displaying the highest rates of testing and the sinonasal tract (1519/2853; 53.2%) displaying the lowest testing rates. Of the 86,136 with a definitive result, 46,878 (54.4%) were HPV-positive, with the oropharynx (40,313/54,205; 74.4%) displaying the highest rates of HPV-positivity and the oral cavity (1818/11,505; 15.8%) displaying the lowest. HPV-positive malignancy was associated with significantly improved adjusted overall survival in the oropharynx (HR = 0.42 [95% CI: 0.43-0.47]), oral cavity (HR = 0.86 [95% CI: 0.79-0.95]), sinonasal tract (HR = 0.63 [95% CI: 0.48-0.83]), larynx (HR = 0.78 [95% CI: 0.71-0.87]), and hypopharynx (HR = 0.56 [95% CI: 0.48-0.66]), but not the nasopharynx (HR = 0.93 [95% CI: 0.77-1.14]). CONCLUSION HPV testing rates were significantly lower in non-oropharyngeal subsites. This is relevant as HPV-associated disease displayed significantly improved overall survival in both the oropharynx and four of five non-oropharyngeal subsites. While validation with prospective studies is necessary, these findings may warrant HPV testing in all HNSCC subsites.
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Affiliation(s)
- Joshua Barlow
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America.
| | - Shivee Gilja
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Rocco M Ferrandino
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Michael H Berger
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Marshall R Posner
- Department of Hematology/Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Richard L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Mohemmed N Khan
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Marita S Teng
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Eric M Genden
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Raymond L Chai
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
| | - Scott A Roof
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America
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Barlow J, Sragi Z, Rivera-Rivera G, Al-Awady A, Daşdöğen Ü, Courey MS, Kirke DN. The Use of Deep Learning Software in the Detection of Voice Disorders: A Systematic Review. Otolaryngol Head Neck Surg 2024. [PMID: 38168017 DOI: 10.1002/ohn.636] [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: 07/07/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To summarize the use of deep learning in the detection of voice disorders using acoustic and laryngoscopic input, compare specific neural networks in terms of accuracy, and assess their effectiveness compared to expert clinical visual examination. DATA SOURCES Embase, MEDLINE, and Cochrane Central. REVIEW METHODS Databases were screened through November 11, 2023 for relevant studies. The inclusion criteria required studies to utilize a specified deep learning method, use laryngoscopy or acoustic input, and measure accuracy of binary classification between healthy patients and those with voice disorders. RESULTS Thirty-four studies met the inclusion criteria, with 18 focusing on voice analysis, 15 on imaging analysis, and 1 both. Across the 18 acoustic studies, 21 programs were used for identification of organic and functional voice disorders. These technologies included 10 convolutional neural networks (CNNs), 6 multilayer perceptrons (MLPs), and 5 other neural networks. The binary classification systems yielded a mean accuracy of 89.0% overall, including 93.7% for MLP programs and 84.5% for CNNs. Among the 15 imaging analysis studies, a total of 23 programs were utilized, resulting in a mean accuracy of 91.3%. Specifically, the twenty CNNs achieved a mean accuracy of 92.6% compared to 83.0% for the 3 MLPs. CONCLUSION Deep learning models were shown to be highly accurate in the detection of voice pathology, with CNNs most effective for assessing laryngoscopy images and MLPs most effective for assessing acoustic input. While deep learning methods outperformed expert clinical exam in limited comparisons, further studies integrating external validation are necessary.
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Affiliation(s)
- Joshua Barlow
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Zara Sragi
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Gabriel Rivera-Rivera
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Abdurrahman Al-Awady
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Ümit Daşdöğen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Mark S Courey
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Diana N Kirke
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Gilja S, Barlow J, Kumar A, Berger MH, Khan MN, Kirke DN, Roof SA. Evaluating depth of invasion across oral cavity subsites as part of the AJCC 8th edition T staging criteria for oral cavity squamous cell carcinoma. Head Neck 2023; 45:2780-2788. [PMID: 37698539 DOI: 10.1002/hed.27497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND The prognostic impact of depth of invasion (DOI) in American Joint Committee on Cancer 8th edition TNM staging for oral cavity squamous cell carcinoma (OCSCCa) across oral cavity subsites is unknown. METHODS Overall survival of patients with pT1-4a OCSCCa in the National Cancer Database (2010-2017), stratified by tumor size and DOI across eight oral cavity subsites, was evaluated using multivariable-adjusted Cox proportional hazards modeling. RESULTS When stratified by tumor size ≤2 cm and >2 cm, DOI >5 mm and DOI >10 mm were only associated with worse overall survival, respectively, for tumors of the oral tongue (Tumor size ≤2 cm, DOI >5 mm v DOI ≤5 mm: HR: 1.31, 95% CI: 1.12-1.53, p < 0.001; Tumor size >2 cm, DOI >10 mm v DOI ≤10 mm: HR: 1.15, 95% CI: 1.01-1.30, p = 0.03). DOI >5 mm and DOI >10 mm was not prognostic for any other tumor location. CONCLUSIONS These findings suggest that the current staging schema for DOI in OCSCCa may not be prognostic across all oral cavity subsites.
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Affiliation(s)
- Shivee Gilja
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joshua Barlow
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Arvind Kumar
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael H Berger
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mohemmed N Khan
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Diana N Kirke
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Scott A Roof
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Ferrandino RM, Chen S, Kappauf C, Barlow J, Gold BS, Berger MH, Westra WH, Teng MS, Khan MN, Posner MR, Misiukiewicz KJ, Bakst RL, Sindhu KK, Genden EM, Chai RL, Roof SA. Performance of Liquid Biopsy for Diagnosis and Surveillance of Human Papillomavirus-Associated Oropharyngeal Cancer. JAMA Otolaryngol Head Neck Surg 2023; 149:971-977. [PMID: 37422913 PMCID: PMC10331620 DOI: 10.1001/jamaoto.2023.1937] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 04/22/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
Importance There is growing interest in the use of circulating plasma tumor human papillomavirus (HPV) DNA for diagnosis and surveillance of patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Recent advances in the assays, combining the identification of circulating HPV tumor DNA and tumor DNA fragment analysis (tumor tissue-modified viral [TTMV]-HPV DNA), have been shown to be highly accurate. However, use of these newer techniques has been limited to small cohort studies and clinical trials. Objective To establish the clinical efficacy of plasma TTMV-HPV DNA testing in the diagnosis and surveillance of HPV-associated OPSCC in a contemporary clinical setting. Design, Setting, and Participants This retrospective observational cohort study included patients with OPSCC who underwent TTMV-HPV DNA testing between April 2020 and September 2022 during the course of routine clinical care. For the diagnosis cohort, patients with at least 1 TTMV-HPV DNA measurement prior to initiation of primary therapy were included. Patients were included in the surveillance cohort if they had at least 1 TTMV-HPV DNA test performed after completion of definitive or salvage therapy. Main Outcomes and Measures Per-test performance metrics, including sensitivity, specificity, positive predictive value, and negative predictive value, for TTMV-HPV DNA testing. Results Of 399 patients included in the analysis, 163 were in the diagnostic cohort (median [IQR] age, 63 [56-68.5] years; 142 [87.1%] male), and 290 were in the surveillance cohort (median [IQR] age, 63 [57-70] years; 237 [81.7%] male). Of the 163 patients in the diagnostic cohort, 152 (93.3%) had HPV-associated OPSCC while 11 (6.7%) had HPV-negative OPSCC. The TTMV-HPV DNA sensitivity in pretreatment diagnosis was 91.5% (95% CI, 85.8%-95.4% [139 of 152 tests]), and the specificity was 100% (95% CI, 71.5%-100% [11 of 11 tests]). In the surveillance cohort, 591 tests conducted in 290 patients were evaluated. A total of 23 patients had molecularly confirmed pathologic recurrences. The TTMV-HPV DNA test demonstrated sensitivity of 88.4% (95% CI, 74.9%-96.1% [38 of 43 tests]) and specificity of 100% (95% CI, 99.3%-100% [548 of 548 tests]) in detecting the recurrences. Positive predictive value was 100% (95% CI, 90.7%-100% [38 of 38 tests]), and negative predictive value was 99.1% (95% CI, 97.9%-99.7% [548 of 553 tests]). The median (range) lead time from positive TTMV-HPV DNA test to pathologic confirmation was 47 (0-507) days. Conclusions and Relevance This cohort study demonstrated that when evaluated in a clinical setting, the TTMV-HPV DNA assay demonstrated 100% specificity in both diagnosis and surveillance. However, the sensitivity was 91.5% for the diagnosis cohort and 88.4% for the surveillance cohort, signifying that nearly 1 in 10 negative tests among patients with HPV-associated OPSCC was a false negative. Additional research is required to validate the assay's performance and, if validated, then further research into the implementation of this assay into standard clinical practice guidelines will be required.
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Affiliation(s)
- Rocco M. Ferrandino
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sida Chen
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Catharine Kappauf
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua Barlow
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brandon S. Gold
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michael H. Berger
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - William H. Westra
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marita S. Teng
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mohemmed N. Khan
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marshall R. Posner
- Department of Hematology/Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Krzysztof J. Misiukiewicz
- Department of Hematology/Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Richard L. Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kunal K. Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eric M. Genden
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Raymond L. Chai
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Scott A. Roof
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
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Dickstein DR, Lehrer EJ, Bloom JR, Hsieh K, Jones B, Runnels J, Powers A, Barlow J, Chen S, Monrose E, Sindhu K, Factor O, Liu JT, Gupta V, Roof S, Kirke D, Misiukiewicz K, Posner M, Genden E, Bakst RL. Is 80 the New 70? Octogenarians with Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e577-e578. [PMID: 37785756 DOI: 10.1016/j.ijrobp.2023.06.1915] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As the human papilloma virus (HPV) pandemic evolves and life expectancy increases, the number of older adults with oropharyngeal squamous cell carcinoma (OPSCC) continues to increase. However, there is a paucity of data regarding the fastest growing subset of this population: octogenarians (OGs). We sought to understand differences in treatment tolerability and clinical outcomes between septuagenarians (SGs) and OGs with OPSCC. MATERIALS/METHODS We identified SGs (age 70-79) and OGs (age 80-89) with OPSCC from a cohort of older adults with nonrecurrent, nonmetastatic head and neck squamous cell carcinoma (HNSCC) treated curatively from 2007-2020. We compared demographics, treatment characteristics and toxicities using Fischer's exact test. Time-to-event outcomes, overall survival (OS), locoregional control (LRC), and disease-specific survival (DSS), were evaluated using the Kaplan-Meier method. RESULTS Of 293 patients (age 70-89) with HNSCC, 39% (n = 114) had OPSCC: 93 SGs (median age: 73; interquartile range [IQR]: 71-76), and 21 OGs (median age: 81, IQR: 80-84). The median follow-up for included patients was 2.4 years; 82% were male, 64% white, 48% > 20 pack year smoking history, 37% ECOG 1. Patients had AJCC 8th edition Stage: I (27%); II (33%); III (18%); IV (22%) OPSCC. Treatment consisted of adjuvant radiation (RT) (19%), adjuvant chemoradiation (CRT) (8%), surgery alone (6%), induction/concurrent CRT (27%), concurrent CRT (28%), or RT (12%), with no significant differences in stage or treatment modalities noted between SGs and OGs. Of note, 69% of SGs and 76% of OGs were HPV+. Among 107 patients who received any RT, 24% experienced a treatment interruption (19% of SGs vs. 48% of OGs, p = 0.001) and 2 patients (both HPV- SGs) died on treatment due to unrelated health conditions. Percutaneous endoscopic gastrostomy (PEG) tubes were placed prior to or during treatment in 43% of SGs and 62% of OGs, with OGs more likely to have a PEG placed during treatment (p = 0.025). There was no difference in the prevalence of late (> 6 months) CTCAE grade 2+ dysphagia (36%) or xerostomia (31%) between SGs and OGs. Estimated 3-year LRC, DSS, and OS were not significantly different between SGs (LRC:85%; DSS:87%; OS:76%) and OGs (LRC: 81%; DSS:94%; OS: 55%, p-values: 0.98, 0.42, 0.052, respectively). However, HPV+ disease significantly increased estimated 3-year OS for both SGs (HPV+: 84%; HPV-: 56%, p = 0.0006) and OGs (HPV+: 68%; HPV-: 20%, p = 0.008). CONCLUSION In our cohort, OGs had a higher proportion of HPV+ OPSCC, which was associated with improved OS. This finding may provide insight into the latency of the virus. While there were similar amounts of toxicities among SGs and OGs, OGs more frequently underwent PEG tube placement and experienced more treatment interruptions. Given high rates of HPV+ OPSCC in OGs, our findings suggest that de-escalation strategies should be further investigated to improve tolerability and maximize outcomes for this neglected population.
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Affiliation(s)
- D R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J R Bloom
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Hsieh
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - B Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Runnels
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Powers
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Barlow
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Chen
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E Monrose
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - O Factor
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J T Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - V Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Roof
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - D Kirke
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Misiukiewicz
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - M Posner
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E Genden
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - R L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
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Seretny M, Barlow J, Sidebotham D. The credibility plot for extreme explanations and all explanations in between. Anaesthesia 2023; 78:535. [PMID: 36480424 DOI: 10.1111/anae.15935] [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] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Affiliation(s)
- M Seretny
- Auckland City Hospital, Auckland, New Zealand
| | - J Barlow
- Auckland City Hospital, Auckland, New Zealand
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Seretny M, Barlow J, Sidebotham D. Multicentre randomised trials in anaesthesia: an analysis using Bayesian metrics. Anaesthesia 2023; 78:73-80. [PMID: 36128627 DOI: 10.1111/anae.15867] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 12/13/2022]
Abstract
Are the results of randomised trials reliable and are p values and confidence intervals the best way of quantifying efficacy? Low power is common in medical research, which reduces the probability of obtaining a 'significant result' and declaring the intervention had an effect. Metrics derived from Bayesian methods may provide an insight into trial data unavailable from p values and confidence intervals. We did a structured review of multicentre trials in anaesthesia that were published in the New England Journal of Medicine, The Lancet, Journal of the American Medical Association, British Journal of Anaesthesia and Anesthesiology between February 2011 and November 2021. We documented whether trials declared a non-zero effect by an intervention on the primary outcome. We documented the expected and observed effect sizes. We calculated a Bayes factor from the published trial data indicating the probability of the data under the null hypothesis of zero effect relative to the alternative hypothesis of a non-zero effect. We used the Bayes factor to calculate the post-test probability of zero effect for the intervention (having assumed 50% belief in zero effect before the trial). We contacted all authors to estimate the costs of running the trials. The median (IQR [range]) hypothesised and observed absolute effect sizes were 7% (3-13% [0-25%]) vs. 2% (1-7% [0-24%]), respectively. Non-zero effects were declared for 12/56 outcomes (21%). The Bayes factor favouring a zero effect relative to a non-zero effect for these 12 trials was 0.000001-1.9, with post-test zero effect probabilities for the intervention of 0.0001-65%. The other 44 trials did not declare non-zero effects, with Bayes factors favouring zero effect of 1-688, and post-test probabilities of zero effect of 53-99%. The median (IQR [range]) study costs reported by 20 corresponding authors in US$ were $1,425,669 ($514,766-$2,526,807 [$120,758-$24,763,921]). We think that inadequate power and mortality as an outcome are why few trials declared non-zero effects. Bayes factors and post-test probabilities provide a useful insight into trial results, particularly when p values approximate the significance threshold.
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Affiliation(s)
- M Seretny
- Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand.,Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
| | - J Barlow
- University of Auckland, Auckland, New Zealand
| | - D Sidebotham
- Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand.,Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
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9
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Mindell JS, Parag Y, Bartington SE, Stoll L, Barlow J, Janda KB. The Middle-Out Perspective: an approach to formalise 'normal practice' in public health advocacy. Perspect Public Health 2022:17579139221138451. [PMID: 36583536 DOI: 10.1177/17579139221138451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS The middle-out perspective (MOP) provides a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote broader societal changes from the middle-out (rather than the top-down or bottom-up). The MOP has been used in recent years in the fields of energy, climate change, and development studies. We argue that public health practitioners involved with advocacy activities and creating alliances to amplify health promotion actions will be familiar with the general MOP concept if not the formal name. The article aims to demonstrate this argument. METHODS This article introduces the MOP conceptual framework and customises it for a public health audience by positioning it among existing concepts and theories for actions within public health. Using two UK case studies (increasing signalised crossing times for pedestrians and the campaign for smoke-free legislation), we illustrate who middle actors are and what they can do to result in better public health outcomes. RESULTS These case studies show that involving a wider range of middle actors, including those not traditionally involved in improving the public's health, can broaden the range and reach of organisations and individuals involving in advocating for public health measures. They also demonstrate that middle actors are not neutral. They can be recruited to improve public health outcomes, but they may also be exploited by commercial interests to block healthy policies or even promote a health-diminishing agenda. CONCLUSION Using the MOP as a formal approach can help public health organisations and practitioners consider potential 'allies' from outside traditional health-related bodies or professions. Formal mapping can expand the range of who are considered potential middle actors for a particular public health issue. By applying the MOP, public health organisations and staff can enlist the additional leverage that is brought to bear by involving additional middle actors in improving the public's health.
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Affiliation(s)
- J S Mindell
- Professor of Public Health, Institute of Epidemiology & Health Care, UCL, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Y Parag
- Professor of Energy Policy, Vice Dean, School of Sustainability, Reichman University, Herzliya, Israel
| | - S E Bartington
- Clinical Research Fellow, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - L Stoll
- Public Health Specialty Registrar, Institute of Epidemiology & Health Care, UCL, London, UK
| | - J Barlow
- Professor of Technology & Innovation Management (Healthcare), Imperial College Business School, London, UK
| | - K B Janda
- Principal Research Fellow, Energy Institute, UCL, London, UK
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10
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Little CC, Barlow J, Alsen M, van Gerwen M. Association between polychlorinated biphenyl exposure and thyroid hormones: a systematic review and meta-analysis. J Environ Sci Health C Toxicol Carcinog 2022; 40:248-267. [PMID: 36515092 DOI: 10.1080/26896583.2022.2149213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Purpose: To conduct a comprehensive meta-analysis investigating the association between polychlorinated biphenyl (PCB) exposure and serum thyroid hormone levels among adults. Methods: Eleven studies met inclusion criteria for analysis following systematic search of PubMed, Embase, and Scopus databases. Of these, 7 studies measured exposure by the total sum of PCB congeners (∑PCB), 1 study measured individual PCB congener levels, and 3 studies measured both ∑PCB levels and PCB congener levels. Correlation coefficients (r) were extracted from each study. Summary estimates were calculated for ∑PCB levels and PCB congeners reported by 2 or more studies: PCB 28, 52, 101, 105, 118, 138, 153, and 180, using random effects model. Results: Significant negative correlation was found between ∑PCBs and T3 (r: -0.09; 95% CI: -0.17, -0.02) and FT3 (r: -0.24; 95% CI: -0.36, -0.12). Congener-specific analysis found T3 to be negatively correlated with PCB-153 (r: -0.19; 95% CI: -0.34, -0.03) and PCB-180 (r: -0.14; 95% CI: -0.26, -0.01), whereas TSH was positively correlated with PCB-105 (r: 0.15; 95% CI: 0.02, 0.28). Conclusions: The present study is the first meta-analysis to investigate the association between PCB exposure and thyroid hormone dysfunction among adults. Results suggest a significant association between PCB exposure and thyroid hormone dysregulation.
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Affiliation(s)
- Christine C Little
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua Barlow
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mathilda Alsen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maaike van Gerwen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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11
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Rojas-Bracho L, Taylor B, Booth C, Thomas L, Jaramillo-Legorreta A, Nieto-García E, Cárdenas Hinojosa G, Barlow J, Mesnick SL, Gerrodette T, Olson P, Henry A, Rizo H, Hidalgo-Pla E, Bonilla-Garzón A. More vaquita porpoises survive than expected. ENDANGER SPECIES RES 2022. [DOI: 10.3354/esr01197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In 2018, it was estimated that fewer than 20 of Mexico’s endemic vaquita porpoise Phocoena sinus remained, and the species was declining by 47% yr-1. Entanglement in gillnets is the sole threat to the species, and since the last population size estimate, gillnetting has increased in the small area where most vaquitas remain—a 12 × 24 km area in the Gulf of California near San Felipe, Mexico. We conducted research efforts in 2019 and 2021 in that area to estimate the minimum numbers of adults and calves and look for any signs that vaquitas are unhealthy. Through expert elicitation, we estimated between 7 and 15 unique individuals were seen in 2019 and 5-13 were seen in 2021. Calves were seen in both years, and all vaquitas appeared healthy. Population projections from the last full survey indicated that more vaquitas have survived than expected. We suggest that these surviving adult vaquitas may have learned to avoid entanglement in gillnets. These vaquitas and their calves provide hope that the species can survive. However, given the high levels of illegal gillnetting and the theft of equipment which hindered our monitoring efforts, and with only around 10 individuals remaining, survival can only be assured if vaquita habitat is made gillnet-free.
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Affiliation(s)
- L Rojas-Bracho
- PNUD/Sinergiaen en la Comisión Nacional de Áreas Naturales Protegidas, Ensenada, BC, México
| | - B Taylor
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - C Booth
- SMRU Consulting, St Andrews, Fife KY16 8LB, UK
| | - L Thomas
- Centre for Research into Ecological and Environmental Modelling, University of St Andrews, St Andrews, Fife KY16 9LZ, UK
| | | | - E Nieto-García
- Comisión Natural de Áreas Naturales Protegidas, Ensenada, BC, México
| | | | - J Barlow
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - SL Mesnick
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - T Gerrodette
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - P Olson
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - A Henry
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - H Rizo
- Museo de la Ballena y Ciencias del Mar, La Paz, BC 23000, México
| | - E Hidalgo-Pla
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA 92037, USA
| | - A Bonilla-Garzón
- K. Lisa Yang Center for Conservation Bioacoustics, Ithaca, NY 14850, USA
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12
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Grillo MN, Barlow J, Carreno J. 151. Association Between Outpatient Antibiotic Prescribing, Antimicrobial Resistance, and Initial Presentation to Inpatient Setting for Urinary Tract Infections Among Older Adults in New York State. Open Forum Infect Dis 2021. [PMCID: PMC8645020 DOI: 10.1093/ofid/ofab466.353] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Antibiotic prescribing (AP) and resistance (AR) may influence severity of illness in urinary tract infection (UTI). Limited data exist assessing the relationship between county-level AP and AR on initial presentation to hospital for UTI. This study evaluated the association between county-level AP and AR on UTI severity of illness among hospitalized patients in New York State. Methods Retrospective, cross-sectional analysis, combining data from New York State Statewide Planning and Research Cooperative System (SPARCS) and previously published data on countywide antimicrobial resistance and antimicrobial prescribing. Inclusion criteria: female patients admitted to a New York inpatient setting in 2017, UTI (CCS 159), Medicare insurance. Exclusion criteria: missing countywide prescribing or resistance. All-patient refined (APR) clinical severity ≥ 3 was the primary outcome. Counties were classified as prescribing above or below the median prescribing proportion, and above or below the median prevalence of E. coli resistance for TMP-SMX and NTF. Countywide prescribing practices, antimicrobial resistance, patient factors, and location factors were evaluated for association with APR clinical severity ≥ 3 using chi-squared and logistic regression. Results 8,024 patients met study criteria. Baseline characteristics are presented in Table 1. 3,597 (44.8%) had an APR severity of ≥ 3. Factors associated with APR severity ≥ 3 include age group (P < 0.001), ethnicity (P = 0.013), hospital county (P < 0.001), first line prescribing ≥ 45.4% (P = 0.049), E. coli TMP-SMX resistance ≥ 29.0% (P < 0.001) via chi-squared test. In the logistic regression analysis counties with higher first line prescribing was associated with decreased odds for severe infection (aOR: 0.83 [0.72 – 0.97]). Additional factors associated with severe infection are presented in Table 2. ![]()
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Conclusion Prescribing patterns may have a significant influence on initial presentation to the hospital for urinary tract infections. Outpatient antimicrobial stewardship should endeavor to promote guideline driven prescribing. Further research is needed to corroborate the findings from this cross-sectional study. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Marissa N Grillo
- Albany College of Pharmacy and Health Sciences, Secaucus, New Jersey
| | - Joshua Barlow
- Albany College of Pharmacy and Health Sciences, Secaucus, New Jersey
| | - Joseph Carreno
- Albany College of Pharmacy and Health Sciences, Secaucus, New Jersey
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13
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Thompson B, Philcox S, Devereaux B, Metz A, Croagh D, Windsor J, Davaris A, Gupta S, Barlow J, Rhee J, Tagkalidis P, Zimet A, Sharma A, Manocha R, Neale RE. A decision support tool for the detection of pancreatic cancer in general practice: A modified Delphi consensus. Pancreatology 2021; 21:1476-1481. [PMID: 34483054 DOI: 10.1016/j.pan.2021.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Diagnosis of pancreatic cancer is often delayed, contributing to patient and family distress and leading to worse survival. We aimed to develop a decision support tool to support primary care providers to identify patients that should undergo investigations for pancreatic cancer, and to recommend initial diagnostic pathways. METHODS A modified Delphi process, including a series of three surveys, was undertaken to ascertain clinical expert opinion on which combinations of signs, symptoms and risk factors should be included in a tool for the early identification of pancreatic cancer. A group of clinical specialists finalised the development of the tool during a focus group meeting. RESULTS The tool presents individual or combinations of signs, symptoms, and risk factors in three tiers which direct the urgency of investigation. Tier 1 includes 5 clinical presentation and risk factors clusters that indicate the need for urgent investigation of the pancreas. A further five clusters are included as Tier 2 aiming to elimate other causes and reduce the time to investigating the pancreas. Tier 3 includes a list of non-specific signs, symptoms and risk factors that indicate the need to consider pancreatic cancer as a potential diagnosis, but without specific recommendations for investigation. CONCLUSIONS Prospective validation studies are now required prior to implementation in the primary care setting. Implementation into primary care practice and as an educational resource may facilitate rapid diagnosis and improve outcomes such as distress and survival.
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Affiliation(s)
- B Thompson
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia.
| | - S Philcox
- Gastroenterology Department, John Hunter Hosptial, New South Wales, Australia
| | - B Devereaux
- The Gastroenterology and Hepatology Department, Royal Brisbane and Women's Hospital, Queensland, Australia; School of Clinical Medicine, University of Queensland, Queensland, Australia
| | - A Metz
- Gastroenterology and Hepatology, Royal Melbourne Hospital, Victoria, Australia
| | - D Croagh
- Department of Surgery (School of Clinical Sciences at Monash Health), Monash University, Victoria, Australia
| | - J Windsor
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - A Davaris
- Royal Australian College of General Practitioners, Australia
| | - S Gupta
- Sydney Adventist Hospital, Sydney, New South Wales, Australia
| | - J Barlow
- Bankstown Family Medical Practice, Sydney, Australia
| | - J Rhee
- Royal Australian College of General Practitioners, Australia; General Practice Academic Unit, Graduate Medicine, University of Wollongong, New South Wales, Australia
| | - P Tagkalidis
- Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Zimet
- Epworth Hospital, Victoria, Australia
| | - A Sharma
- School of Clinical Medicine, University of Queensland, Queensland, Australia
| | - R Manocha
- HealthEd, Melbourne, Victoria, Australia
| | - R E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia; School of Public Health, University of Queensland, Queensland, Australia
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Mindell JS, Bartington S, Janda KB, Stoll L, Barlow J, Parag Y. Using the Middle-Out Perspective to augment advocacy for smokefree legislation. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
Complementing ‘Bottom-up' and ‘Top-down' approaches, the Middle-Out Perspective (MOP) conceptual framework focuses on how middle actors can influence action by enhancing other actors' interest and ability to act. Middle actors exert influence sideways on other middle actors, upwards on policymakers and downwards on individuals. Middle actors can be immediate targets as potential allies or communication channels.
Description of the problem
Successive governments' longstanding voluntary agreements with industry have not protected children and non-smokers from secondhand smoke. Can the MOP enhance effectiveness of small organisations whose voices are ignored?
Results
The NGO Action on Smoking and Health (ASH) built a coalition of NGOs, practitioners' organisations, and others to advocate for smokefree legislation. Aggregating these voices made them more visible and their demand more influential. Involvement of trade unions and lawyers threatened legal action by exposed employees. Local government support and threats of local legislation changed the hospitality trade's opposition to support. Middle actors' supporters and members lobbied their MPs. ASH's professional expertise and reputation made them a trustworthy actor with legitimacy. The consortium led to the national government in England passing smokefree legislation in 2006.
Lessons
Middle actors can be agents of change, promoting desirable public health goals in a middle-out manner. Formal MOP mapping at the start of work can help public health staff identify potential non-traditional ‘allies' to expand the range of who are considered potential middle actors for a particular issue, enlisting powerful additional leverage in improving the public's health. However, middle actors are not neutral. They can contribute to better public health, but they may also be exploited by commercial interests to block healthy policies or promote a health-diminishing agenda.
Key messages
The Middle-Out Perspective (MOP) provide a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote changes in a middle-out manner. Using MOP as a formal approach can help public health organisations and practitioners consider potential ‘allies’ from outside traditional health-related bodies or professions.
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Affiliation(s)
- JS Mindell
- Epidemiology & Public Health, University College London, London, UK
| | - S Bartington
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - KB Janda
- Energy Institute, University College London, London, UK
| | - L Stoll
- Epidemiology & Public Health, University College London, London, UK
| | - J Barlow
- Imperial College Business School, Imperial College, London, UK
| | - Y Parag
- School of Sustainability, Interdisciplinary Center, Herzliya, Israel
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15
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Barlow J. What is the role of video feedback in supporting parents experiencing mental health problems? Eur Psychiatry 2021. [PMCID: PMC9471298 DOI: 10.1192/j.eurpsy.2021.78] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract Body Parental mental health problems have been found to have a significant impact on a range of aspects of parental caregiving during the postnatal period, with significant implications in terms of key aspects of the child’s development. Video feedback is a generic term that refers to the use of videotaped interactions of the parent and child to promote parental sensitivity, and a recent meta‐analysis of 20 studies (1757 parent‐child dyads) found that video feedback can improve parental sensitivity compared with a control or no intervention up to six months’ follow‐up. This paper will examine the ways in which video feedback might contribute to the ability of parents with mental health problems to provide the type of caregiving that will promote the development of a secure attachment in the infant. Disclosure No significant relationships.
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Little C, Alsen M, Barlow J, Naymagon L, Tremblay D, Genden E, Trosman S, Iavicoli L, van Gerwen M. The Impact of Socioeconomic Status on the Clinical Outcomes of COVID-19; a Retrospective Cohort Study. J Community Health 2021; 46:794-802. [PMID: 33387149 PMCID: PMC7775835 DOI: 10.1007/s10900-020-00944-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 01/22/2023]
Abstract
There have been limited data assessing the influence of disadvantaged socioeconomic status (SES) on the incidence and clinical outcomes of COVID-19 patients within the diverse communities of the United States. Here, we aim to investigate the association between poverty level, as an indicator of SES, and COVID-19 related clinical outcomes including hospitalization and all-cause mortality. This retrospective cohort study included 3528 patients with laboratory confirmed COVID-19 seen at a large New York City health system between March 1, 2020 and April 1, 2020. Data for neighborhood level poverty was acquired from the American Community Survey 2014–2018 and defined as the percent of residents in each ZIP code whose household income was below the federal poverty threshold (FPT): 0% to < 20% below FPT (low poverty) and > 20% below FPT (high poverty). COVID-19 positive patients who resided in high poverty areas were significantly younger, had a higher prevalence of comorbidities and were more likely to be of female gender or a racial minority when compared to individuals living in low poverty areas. Residence in a high poverty area was not associated with an increased risk of COVID-19 related hospitalization and was found to be associated with a decreased risk of in-hospital mortality. This study suggests the existence of an unequal socioeconomic gradient in the demographic and clinical presentation of COVID-19 patients including differences in age, gender and race between poverty groups. Further studies are needed to fully assess the intersectionality of SES with the COVID-19 pandemic.
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Affiliation(s)
- Christine Little
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Mathilda Alsen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Joshua Barlow
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Leonard Naymagon
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Douglas Tremblay
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Eric Genden
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Samuel Trosman
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Laura Iavicoli
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Maaike van Gerwen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA. .,Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA.
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van Gerwen M, Alsen M, Little C, Barlow J, Genden E, Naymagon L, Tremblay D. Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study. J Med Virol 2020; 93:907-915. [PMID: 32706392 PMCID: PMC7404409 DOI: 10.1002/jmv.26337] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 01/10/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a global pandemic and information on risk factors for worse prognosis is needed to accurately identify patients at risk and potentially provide insight into therapeutic options. In this retrospective cohort study, including 3703 patients with laboratory confirmed COVID-19, we identified risk factors associated with all-cause mortality, need for hospitalization and mechanical ventilation. Male gender was independently associated with increased risk of hospitalization (adjusted odds ratio [ORadj ]: 1.62; 95% confidence interval [95% CI]: 1.38-1.91)), mechanical ventilation (ORadj : 1.35; 95% CI: 1.08-1.69) and death (ORadj : 1.46; 95% CI: 1.17-1.82). Patients > 60 years had higher risk of hospitalization (ORadj : 5.47; 95% CI: 4.29-6.96), mechanical ventilation (ORadj : 3.26; 95% CI: 2.08-5.11) and death (ORadj : 13.04; 95% CI: 6.25-27.24). Congestive heart failure (ORadj: 1.47; 95% CI: 1.06-2.02) and dementia (ORadj : 2.03; 95% CI: 1.46-2.83) were associated with increased odds of death, as well as the presence of more than two comorbidities (ORadj : 1.90; 95% CI: 1.35-2.68). Patients with COVID-19 of older age, male gender, or having more than two comorbidities are at higher risk of hospitalization, mechanical ventilation and death, and should therefore be closely monitored.
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Affiliation(s)
- Maaike van Gerwen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.,Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mathilda Alsen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christine Little
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua Barlow
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eric Genden
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Leonard Naymagon
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Douglas Tremblay
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
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van Gerwen M, Alsen M, Little C, Barlow J, Naymagon L, Tremblay D, Sinclair CF, Genden E. Outcomes of Patients With Hypothyroidism and COVID-19: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2020; 11:565. [PMID: 33013686 PMCID: PMC7461836 DOI: 10.3389/fendo.2020.00565] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/10/2020] [Indexed: 12/26/2022] Open
Abstract
Coronavirus diseases (COVID-19) is associated with high rates of morbidity and mortality and worse outcomes have been reported for various morbidities. The impact of pre-existing hypothyroidism on COVID-19 outcomes remains unknown. The aim of the present study was to identify a possible association between hypothyroidism and outcomes related to COVID-19 including hospitalization, need for mechanical ventilation, and all-cause mortality. All patients with a laboratory confirmed COVID-19 diagnosis in March 2020 in a large New York City health system were reviewed. Of the 3703 COVID-19 positive patients included in present study, 251 patients (6.8%) had pre-existing hypothyroidism and received thyroid hormone therapy. Hypothyroidism was not associated with increased risk of hospitalization [Adjusted Odds Ratio (ORadj): 1.23 (95% Confidence Interval (CI): 0.88- 1.70)], mechanical ventilation [ORadj: 1.17 (95% CI: 0.81-1.69)] nor death [ORadj: 1.07 (95% CI: 0.75-1.54)]. This study provides insight into the role of hypothyroidism on the outcomes of COVID-19 positive patients, indicating that no additional precautions or consultations are needed. However, future research into the potential complications of COVID-19 on the thyroid gland and function is warranted.
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Affiliation(s)
- Maaike van Gerwen
- Department of Otolaryngology- Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- *Correspondence: Maaike van Gerwen
| | - Mathilda Alsen
- Department of Otolaryngology- Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Christine Little
- Department of Otolaryngology- Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Joshua Barlow
- Department of Otolaryngology- Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Leonard Naymagon
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Douglas Tremblay
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine F. Sinclair
- Department of Otolaryngology- Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Catherine F. Sinclair
| | - Eric Genden
- Department of Otolaryngology- Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Ali A, Amaryan M, Anassontzis EG, Austregesilo A, Baalouch M, Barbosa F, Barlow J, Barnes A, Barriga E, Beattie TD, Berdnikov VV, Black T, Boeglin W, Boer M, Briscoe WJ, Britton T, Brooks WK, Cannon BE, Cao N, Chudakov E, Cole S, Cortes O, Crede V, Dalton MM, Daniels T, Deur A, Dobbs S, Dolgolenko A, Dotel R, Dugger M, Dzhygadlo R, Egiyan H, Ernst A, Eugenio P, Fanelli C, Fegan S, Foda AM, Foote J, Frye J, Furletov S, Gan L, Gasparian A, Gauzshtein V, Gevorgyan N, Gleason C, Goetzen K, Goncalves A, Goryachev VS, Guo L, Hakobyan H, Hamdi A, Han S, Hardin J, Huber GM, Hurley A, Ireland DG, Ito MM, Jarvis NS, Jones RT, Kakoyan V, Kalicy G, Kamel M, Kourkoumelis C, Kuleshov S, Kuznetsov I, Larin I, Lawrence D, Lersch DI, Li H, Li W, Liu B, Livingston K, Lolos GJ, Lyubovitskij V, Mack D, Marukyan H, Matveev V, McCaughan M, McCracken M, McGinley W, McIntyre J, Meyer CA, Miskimen R, Mitchell RE, Mokaya F, Nerling F, Ng L, Ostrovidov AI, Papandreou Z, Patsyuk M, Pauli P, Pedroni R, Pentchev L, Peters KJ, Phelps W, Pooser E, Qin N, Reinhold J, Ritchie BG, Robison L, Romanov D, Romero C, Salgado C, Schertz AM, Schumacher RA, Schwiening J, Seth KK, Shen X, Shepherd MR, Smith ES, Sober DI, Somov A, Somov S, Soto O, Stevens JR, Strakovsky II, Suresh K, Tarasov V, Taylor S, Teymurazyan A, Thiel A, Vasileiadis G, Werthmüller D, Whitlatch T, Wickramaarachchi N, Williams M, Xiao T, Yang Y, Zarling J, Zhang Z, Zhao G, Zhou Q, Zhou X, Zihlmann B. First Measurement of Near-Threshold J/ψ Exclusive Photoproduction off the Proton. Phys Rev Lett 2019; 123:072001. [PMID: 31491124 DOI: 10.1103/physrevlett.123.072001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/05/2019] [Indexed: 05/24/2023]
Abstract
We report on the measurement of the γp→J/ψp cross section from E_{γ}=11.8 GeV down to the threshold at 8.2 GeV using a tagged photon beam with the GlueX experiment. We find that the total cross section falls toward the threshold less steeply than expected from two-gluon exchange models. The differential cross section dσ/dt has an exponential slope of 1.67±0.39 GeV^{-2} at 10.7 GeV average energy. The LHCb pentaquark candidates P_{c}^{+} can be produced in the s channel of this reaction. We see no evidence for them and set model-dependent upper limits on their branching fractions B(P_{c}^{+}→J/ψp) and cross sections σ(γp→P_{c}^{+})×B(P_{c}^{+}→J/ψp).
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Affiliation(s)
- A Ali
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - M Amaryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - E G Anassontzis
- National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - A Austregesilo
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - M Baalouch
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - F Barbosa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Barlow
- Florida State University, Tallahassee, Florida 32306, USA
| | - A Barnes
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - E Barriga
- Florida State University, Tallahassee, Florida 32306, USA
| | - T D Beattie
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - V V Berdnikov
- National Research Nuclear University Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - T Black
- University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - W Boeglin
- Florida International University, Miami, Florida 33199, USA
| | - M Boer
- The Catholic University of America, Washington, D.C. 20064, USA
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - T Britton
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W K Brooks
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - B E Cannon
- Florida State University, Tallahassee, Florida 32306, USA
| | - N Cao
- Institute of High Energy Physics, Beijing 100049, People's Republic of China
| | - E Chudakov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Cole
- Arizona State University, Tempe, Arizona 85287, USA
| | - O Cortes
- The George Washington University, Washington, D.C. 20052, USA
| | - V Crede
- Florida State University, Tallahassee, Florida 32306, USA
| | - M M Dalton
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Daniels
- University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Dobbs
- Florida State University, Tallahassee, Florida 32306, USA
| | - A Dolgolenko
- National Research Centre Kurchatov Institute, Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - R Dotel
- Florida International University, Miami, Florida 33199, USA
| | - M Dugger
- Arizona State University, Tempe, Arizona 85287, USA
| | - R Dzhygadlo
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - H Egiyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Ernst
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Eugenio
- Florida State University, Tallahassee, Florida 32306, USA
| | - C Fanelli
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Fegan
- The George Washington University, Washington, D.C. 20052, USA
| | - A M Foda
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - J Foote
- Indiana University, Bloomington, Indiana 47405, USA
| | - J Frye
- Indiana University, Bloomington, Indiana 47405, USA
| | - S Furletov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Gan
- University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - A Gasparian
- North Carolina A&T State University, Greensboro, North Carolina 27411, USA
| | - V Gauzshtein
- Tomsk State University, 634050 Tomsk, Russia
- Tomsk Polytechnic University, 634050 Tomsk, Russia
| | - N Gevorgyan
- A.I. Alikhanian National Science Laboratory (Yerevan Physics Institute), 0036 Yerevan, Armenia
| | - C Gleason
- Indiana University, Bloomington, Indiana 47405, USA
| | - K Goetzen
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - A Goncalves
- Florida State University, Tallahassee, Florida 32306, USA
| | - V S Goryachev
- National Research Centre Kurchatov Institute, Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - L Guo
- Florida International University, Miami, Florida 33199, USA
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - A Hamdi
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - S Han
- Wuhan University, Wuhan, Hubei 430072, People's Republic of China
| | - J Hardin
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - A Hurley
- College of William and Mary, Williamsburg, Virginia 23185, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M M Ito
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N S Jarvis
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - R T Jones
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - V Kakoyan
- A.I. Alikhanian National Science Laboratory (Yerevan Physics Institute), 0036 Yerevan, Armenia
| | - G Kalicy
- The Catholic University of America, Washington, D.C. 20064, USA
| | - M Kamel
- Florida International University, Miami, Florida 33199, USA
| | - C Kourkoumelis
- National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - S Kuleshov
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - I Kuznetsov
- Tomsk State University, 634050 Tomsk, Russia
- Tomsk Polytechnic University, 634050 Tomsk, Russia
| | - I Larin
- University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - D Lawrence
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Lersch
- Florida State University, Tallahassee, Florida 32306, USA
| | - H Li
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - W Li
- College of William and Mary, Williamsburg, Virginia 23185, USA
| | - B Liu
- Institute of High Energy Physics, Beijing 100049, People's Republic of China
| | - K Livingston
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - G J Lolos
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - V Lyubovitskij
- Tomsk State University, 634050 Tomsk, Russia
- Tomsk Polytechnic University, 634050 Tomsk, Russia
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Marukyan
- A.I. Alikhanian National Science Laboratory (Yerevan Physics Institute), 0036 Yerevan, Armenia
| | - V Matveev
- National Research Centre Kurchatov Institute, Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - M McCaughan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M McCracken
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - W McGinley
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J McIntyre
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - C A Meyer
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - R Miskimen
- University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - R E Mitchell
- Indiana University, Bloomington, Indiana 47405, USA
| | - F Mokaya
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - F Nerling
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - L Ng
- Florida State University, Tallahassee, Florida 32306, USA
| | - A I Ostrovidov
- Florida State University, Tallahassee, Florida 32306, USA
| | - Z Papandreou
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - M Patsyuk
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - P Pauli
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - R Pedroni
- North Carolina A&T State University, Greensboro, North Carolina 27411, USA
| | - L Pentchev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K J Peters
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - W Phelps
- The George Washington University, Washington, D.C. 20052, USA
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N Qin
- Northwestern University, Evanston, Illinois 60208, USA
| | - J Reinhold
- Florida International University, Miami, Florida 33199, USA
| | - B G Ritchie
- Arizona State University, Tempe, Arizona 85287, USA
| | - L Robison
- Northwestern University, Evanston, Illinois 60208, USA
| | - D Romanov
- National Research Nuclear University Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - C Romero
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - C Salgado
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - A M Schertz
- College of William and Mary, Williamsburg, Virginia 23185, USA
| | - R A Schumacher
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J Schwiening
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - K K Seth
- Northwestern University, Evanston, Illinois 60208, USA
| | - X Shen
- Institute of High Energy Physics, Beijing 100049, People's Republic of China
| | - M R Shepherd
- Indiana University, Bloomington, Indiana 47405, USA
| | - E S Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Sober
- The Catholic University of America, Washington, D.C. 20064, USA
| | - A Somov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Somov
- National Research Nuclear University Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - O Soto
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - J R Stevens
- College of William and Mary, Williamsburg, Virginia 23185, USA
| | - I I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - K Suresh
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - V Tarasov
- National Research Centre Kurchatov Institute, Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - S Taylor
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Teymurazyan
- University of Regina, Regina, Saskatchewan, Canada S4S 0A2
| | - A Thiel
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - G Vasileiadis
- National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - D Werthmüller
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - T Whitlatch
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - M Williams
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - T Xiao
- Northwestern University, Evanston, Illinois 60208, USA
| | - Y Yang
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Zarling
- Indiana University, Bloomington, Indiana 47405, USA
| | - Z Zhang
- Wuhan University, Wuhan, Hubei 430072, People's Republic of China
| | - G Zhao
- Institute of High Energy Physics, Beijing 100049, People's Republic of China
| | - Q Zhou
- Institute of High Energy Physics, Beijing 100049, People's Republic of China
| | - X Zhou
- Wuhan University, Wuhan, Hubei 430072, People's Republic of China
| | - B Zihlmann
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
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Antonacci G, Reed JE, Sriram V, Barlow J. ISQUA18-1682Quality Improvement through Interactive Simulation. Int J Qual Health Care 2018. [DOI: 10.1093/intqhc/mzy167.41] [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: 11/13/2022] Open
Affiliation(s)
- G Antonacci
- NIHR CLAHRC NWL, Imperial College
- Imperial College Business School, London, United Kingdom
| | - J E Reed
- NIHR CLAHRC NWL, Imperial College
| | - V Sriram
- NIHR CLAHRC NWL, Imperial College
| | - J Barlow
- Imperial College Business School, London, United Kingdom
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Halland M, Ravi K, Barlow J, Arora A. Correlation between the radiological observation of isolated tertiary waves on an esophagram and findings on high-resolution esophageal manometry. Dis Esophagus 2016; 29:22-6. [PMID: 25327483 DOI: 10.1111/dote.12292] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Barium esophagrams are a frequently performed test, and radiological observations about potential abnormal esophageal motility, such as tertiary contractions, are commonly reported. We sought to assess the correlation between tertiary waves, and in particular isolated tertiary waves, on esophagrams and findings on non-synchronous high-resolution esophageal manometry. We retrospectively reviewed reports of esophagrams performed at a tertiary referral center and identified patients in whom tertiary waves were observed and a high-resolution esophageal manometry had been performed. We defined two groups; group 1 was defined as patients with isolated tertiary waves, whereas group 2 had tertiary waves and evidence of achalasia or an obstructing structural abnormality on the esophagram. We collected data on demographics, dysphagia score, associated findings on esophagram, and need for intervention. We reviewed the reports of 2100 esophagrams of which tertiary waves were noted as an isolated abnormality in 92, and in association with achalasia or a structural obstruction in 61. High-resolution manometry was performed in 17 patients in group 1, and five had evidence of a significant esophageal motility disorder and 4 required any intervention. Twenty-one patients in group 2 underwent manometry, and 18 had a significant esophageal motility disorder. An isolated finding of tertiary waves on an esophagram is rarely associated with a significant esophageal motility disorder that requires intervention. All patients with isolated tertiary waves who required intervention had a dysphagia to liquids. Tertiary contractions, in the absence of dysphagia to liquids, indicate no significant esophageal motility disorder.
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Affiliation(s)
- M Halland
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - K Ravi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - J Barlow
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - A Arora
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Forney KA, Becker EA, Foley DG, Barlow J, Oleson EM. Habitat-based models of cetacean density and distribution in the central North Pacific. ENDANGER SPECIES RES 2015. [DOI: 10.3354/esr00632] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Miller BS, Barlow J, Calderan S, Collins K, Leaper R, Olson P, Ensor P, Peel D, Donnelly D, Andrews-Goff V, Olavarria C, Owen K, Rekdahl M, Schmitt N, Wadley V, Gedamke J, Gales N, Double MC. Validating the reliability of passive acoustic localisation: a novel method for encountering rare and remote Antarctic blue whales. ENDANGER SPECIES RES 2015. [DOI: 10.3354/esr00642] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ferreira J, Aragão LEOC, Barlow J, Barreto P, Berenguer E, Bustamante M, Gardner TA, Lees AC, Lima A, Louzada J, Pardini R, Parry L, Peres CA, Pompeu PS, Tabarelli M, Zuanon J. Environment and Development. Brazil's environmental leadership at risk. Science 2014; 346:706-7. [PMID: 25378611 DOI: 10.1126/science.1260194] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- J Ferreira
- See the supplementary materials for author af liations.
| | | | - J Barlow
- See the supplementary materials for author af liations
| | - P Barreto
- See the supplementary materials for author af liations
| | - E Berenguer
- See the supplementary materials for author af liations
| | - M Bustamante
- See the supplementary materials for author af liations
| | - T A Gardner
- See the supplementary materials for author af liations
| | - A C Lees
- See the supplementary materials for author af liations
| | - A Lima
- See the supplementary materials for author af liations
| | - J Louzada
- See the supplementary materials for author af liations
| | - R Pardini
- See the supplementary materials for author af liations
| | - L Parry
- See the supplementary materials for author af liations
| | - C A Peres
- See the supplementary materials for author af liations
| | - P S Pompeu
- See the supplementary materials for author af liations
| | - M Tabarelli
- See the supplementary materials for author af liations
| | - J Zuanon
- See the supplementary materials for author af liations
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25
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O'Leary A, Usher C, Barlow J, Gallagher P. The Use of Real World Data in the Decision-Making Process: An Example Using Blood Glucose Test Strip Use In Patients With Type 2 Diabetes In Ireland. Value Health 2014; 17:A360. [PMID: 27200731 DOI: 10.1016/j.jval.2014.08.784] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A O'Leary
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - C Usher
- National Centre for Pharmacoeconomics, Dublin, Ireland
| | - J Barlow
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - P Gallagher
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Becker EA, Forney KA, Foley DG, Smith RC, Moore TJ, Barlow J. Predicting seasonal density patterns of California cetaceans based on habitat models. ENDANGER SPECIES RES 2014. [DOI: 10.3354/esr00548] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
BACKGROUND Many patients attribute their symptoms of facial pain or headache to sinus problems. Facial pain is one of the symptoms of rhinosinusitis according to European and American consensus documents. This symptom, however, has been insufficiently studied in the group of patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The aim of this work is to study the symptom of facial pain in patients with CRSwNP. METHODS Patients with CRSwNP were prospectively asked to score their facial pain according to the scoring system used in the Sino Nasal Outcome Test 22 (SNOT 22). RESULTS Fifty patients fulfilled the inclusion criteria. Thirty-one patients had grade II polyps and 19 patients had grade III polyps. Of these patients, 76% had absent or very mild facial pain. Only 16% of patients had moderate or severe facial pain. All patients with severe facial pain had viscid secretions within their sinuses. CONCLUSION Significant facial pain is uncommon in patients with CRSwNP. It is important to consider this when counselling patients before surgery.
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Affiliation(s)
- A Z Eweiss
- Royal National Throat, Nose and Ear Hospital, London, UK.
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28
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Barlow J. Personal accounts: an unsuspected recovery. Psychiatr Serv 2013; 64:727-8. [PMID: 23903604 DOI: 10.1176/appi.ps.640801] [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] [Indexed: 11/30/2022]
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Conaghan P, Porcheret M, Gammon A, Soni A, Hurley M, Rayman M, Barlow J, Hull R, Cumming J, Llewelyn K, Moscogiuri F, Lyons J, Birrell F. SAT0332 The personal impact of osteoarthritis on individuals and how they use therapies: The arthritis care OA nation 2012 survey. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Redfern JV, McKenna MF, Moore TJ, Calambokidis J, Deangelis ML, Becker EA, Barlow J, Forney KA, Fiedler PC, Chivers SJ. Assessing the risk of ships striking large whales in marine spatial planning. Conserv Biol 2013; 27:292-302. [PMID: 23521668 DOI: 10.1111/cobi.12029] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 10/30/2012] [Indexed: 05/26/2023]
Abstract
Marine spatial planning provides a comprehensive framework for managing multiple uses of the marine environment and has the potential to minimize environmental impacts and reduce conflicts among users. Spatially explicit assessments of the risks to key marine species from human activities are a requirement of marine spatial planning. We assessed the risk of ships striking humpback (Megaptera novaeangliae), blue (Balaenoptera musculus), and fin (Balaenoptera physalus) whales in alternative shipping routes derived from patterns of shipping traffic off Southern California (U.S.A.). Specifically, we developed whale-habitat models and assumed ship-strike risk for the alternative shipping routes was proportional to the number of whales predicted by the models to occur within each route. This definition of risk assumes all ships travel within a single route. We also calculated risk assuming ships travel via multiple routes. We estimated the potential for conflict between shipping and other uses (military training and fishing) due to overlap with the routes. We also estimated the overlap between shipping routes and protected areas. The route with the lowest risk for humpback whales had the highest risk for fin whales and vice versa. Risk to both species may be ameliorated by creating a new route south of the northern Channel Islands and spreading traffic between this new route and the existing route in the Santa Barbara Channel. Creating a longer route may reduce the overlap between shipping and other uses by concentrating shipping traffic. Blue whales are distributed more evenly across our study area than humpback and fin whales; thus, risk could not be ameliorated by concentrating shipping traffic in any of the routes we considered. Reducing ship-strike risk for blue whales may be necessary because our estimate of the potential number of strikes suggests that they are likely to exceed allowable levels of anthropogenic impacts established under U.S. laws.
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Affiliation(s)
- J V Redfern
- Protected Resources Division, Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, 8901 La Jolla Shores Drive, La Jolla, CA 92037, U.S.A.
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Svanberg P, Barlow J, Tigbe W. The Parent–Infant Interaction Observation Scale: reliability and validity of a screening tool. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2012.751586] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
BACKGROUND A range of voluntary sector organizations are involved in the delivery of services to children, particularly within the Early Year's sector and children's centres. Peers Early Education Partnership (PEEP) Early Explorers project is one example of the way in which explicit partnerships are being forged across statutory and voluntary sectors with the aim of improving outcomes for children and families. This paper reports an exploration of stakeholder views and experiences of two Early Explorer clinics located in areas of high deprivation. METHODS Semi-structured interviews were conducted with a purposive sample of stakeholders (n= 25) from children's centres, PEEP, the health visiting service and service users. Data were fully transcribed and analysed using a thematic approach. RESULTS The data suggest that the two key groups of stakeholders providing Early Explorer clinics (i.e. health visitors and PEEP practitioners) had quite different objectives in terms of their early goals for the clinic, but that despite these differences good progress was achieved in terms of working together effectively. All stakeholders including service users referred to the presence of PEEP as having improved the quality of the clinic environment, and participating mothers identified a wide range of benefits from the enhanced service. However, somewhat restricted views about the role of practitioners within the clinics were identified by users, and the findings suggest that although the early goals for the clinic had been exceeded, these may have been limited in terms of true 'partnership' working. CONCLUSIONS Early Explorer clinics appeared to have enhanced the service provided within traditional child health clinics and to have provided practitioners with access to hard-to-reach families and parents with access to services that are consistent with the broader policy aims of improving parent-infant interaction. However, questions remain as to whether the benefit of 'partnership' working was fully realized.
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Affiliation(s)
- J Barlow
- Warwick Infant and Family Well-being Unit, Warwick Medical School, University of Warwick, Coventry, UK
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Abstract
Work disability is a major problem for people with arthritis. The INTO WORK Personal Development (IWPD) programme aims to prevent work disability by addressing the internal and external barriers faced by people with arthritis seeking to fulfil their employment potential. The effectiveness of the programme was examined in a pretest-post-test study with an intervention group (n = 37) and a comparison control group (n = 42). Data were collected through self-administered questionnaires and focus groups. Significant decreases on anxiety (p = .0002), depression (p = .009) and negative mood (p = .029), and significant improvements on positive mood (p = .011), self-esteem (p = .002) and satisfaction with life (p = .010) were found for the intervention group only. The IWPD programme appears to promote self-determination, psychological well-being and strategies for overcoming perceived barriers to employment among people with arthritis.
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Affiliation(s)
- J Barlow
- Psychosocial Rheumatology Research Centre, School of Health and Social Sciences, Coventry University, UK
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Loh KP, Ghorab H, Clarke E, Conroy R, Barlow J. Complementary and alternative medicine: knowledge, interest and attitudes of medical students. BMC Proc 2012. [PMCID: PMC3426044 DOI: 10.1186/1753-6561-6-s4-p29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Forney KA, Ferguson MC, Becker EA, Fiedler PC, Redfern JV, Barlow J, Vilchis IL, Ballance LT. Habitat-based spatial models of cetacean density in the eastern Pacific Ocean. ENDANGER SPECIES RES 2012. [DOI: 10.3354/esr00393] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Becker EA, Foley DG, Forney KA, Barlow J, Redfern JV, Gentemann CL. Forecasting cetacean abundance patterns to enhance management decisions. ENDANGER SPECIES RES 2012. [DOI: 10.3354/esr00390] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Affiliation(s)
- J. Hidasi-Neto
- Departamento de Ecologia; Universidade Federal de Goiás; Goiânia; GO; Brazil
| | - J. Barlow
- Lancaster Environment Centre; Lancaster University; Lancaster; UK
| | - M. V. Cianciaruso
- Departamento de Ecologia; Universidade Federal de Goiás; Goiânia; GO; Brazil
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Witteveen BH, Straley JM, Chenoweth E, Baker CS, Barlow J, Matkin C, Gabriele CM, Neilson J, Steel D, von Ziegesar O, Andrews AG, Hirons A. Using movements, genetics and trophic ecology to differentiate inshore from offshore aggregations of humpback whales in the Gulf of Alaska. ENDANGER SPECIES RES 2011. [DOI: 10.3354/esr00351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Danansuriya M, Barlow J, Underdown A*. Systematic review of parenting programs for preterm and low birthweight infants on enhancing parent-infant interaction by improving parental sensitivity. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hibbitts A, Kelly C, Barlow J, Jefferies C, O’Brien F, Cryan S. Development of a high throughput method for screening of novel nanotechnologies for siRNA transfection of airway cells using high content screening (HCS). Drug Discov Today 2010. [DOI: 10.1016/j.drudis.2010.09.423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Infant growth and lifestyle are now recognized as being critical determinants of later obesity. EMPOWER (Empowering Parents to Prevent Obesity at Weaning: Exploratory Research) was developed as an intervention for parents whose babies are at high risk. Delivered by specially trained health visitors, it is underpinned by the Family Partnership Model and uses a strengths-based, solution-focused way of working with families. METHODS Mothers of babies participating in the pilot of EMPOWER in Leeds were recruited to take part in a study to examine perceptions about the programme's acceptability and usefulness. Interviews were taped and transcribed, and thematic analysis undertaken. RESULTS Families talked positively about the approach of the EMPOWER health visitor with her emphasis on listening, partnership working and shared problem-solving. Parents particularly valued the use of a non-judgemental approach, which they felt had helped them to discuss openly, sensitive issues such as weight and diet. They identified a number of important benefits ranging from increased knowledge about the most appropriate types and amount of food to feed their toddler, to more far-reaching changes within the family as a whole, including modifications to their own diet and lifestyle. Programmes of this nature were perceived as more valuable than the standard help that is currently available. CONCLUSION The EMPOWER programme appears to be both acceptable and valued by targeted parents and a potentially effective means of supporting high-risk families to prevent their children from developing obesity. An exploratory randomized controlled trial is now underway to ascertain the feasibility of conducting a definitive phase 3 trial.
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Affiliation(s)
- J Barlow
- Public Health in the Early Years, Warwick Medical School, University of Warwick, Gibbet Hill, University of Warwick, Coventry, UK.
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Barlow J, Edwards R, Turner A. The experience of attending a lay-led, chronic disease self-management programme from the perspective of participants with multiple sclerosis. Psychol Health 2010; 24:1167-80. [PMID: 20204986 DOI: 10.1080/08870440802040277] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined. The present qualitative study addressed this omission. Ten participants with MS (7 female; age range 35 to 60 years; disease duration 4 to 19 years) were interviewed before attending the CDSMC and at 4-month follow-up. Data were analysed using Framework Analysis. Some participants learned new self-management techniques and reported enhanced confidence (self-efficacy), whereas other participants were already confident in their self-management ability and found the CDSMC acted as a reminder of techniques previously used. Relaxation, pacing, and goal setting were particularly valuable for managing fatigue. Goal setting helped some participants to build confidence. Participants valued meeting similar others including those with different conditions. The CDSMC was an opportunity for social comparison and inspirational role modelling. Improvements to the CDSMC were suggested, including the addition of specific MS information. Overall, the CDSMC was viewed as a valuable source of new skills and a reminder of previously learned self-management skills, particularly in the context of managing fatigue. Gender differences emerged.
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Affiliation(s)
- J Barlow
- Coventry University, Coventry, CV1 5FB, United Kingdom.
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Jadon DR, Cavill C, Waldron N, Barton A, Korendowych E, McHugh NJ, Coates LC, Helliwell PS, van der Heijde D, Emery P, Patra K, Lavie F, Skerrett J, van der Weide I, Barlow J, Keat A, Gladman D, Kavanaugh A, Chattopadhyay C, Mease P, Krueger GG, Zrubek J, Beutler A, Hsu B, Mudivarthy S, Mack M, McInnes IB, Kirkham B, Fitzgerald O, Robertson D, Estojak J, Foehl J, Molta C, Freundlich B, Navarro F, Sueiro JLF, Torre Alonso JC, Queiro R, Gonzalez C, Gratacos J, Loza E, Linares L, Zarco P, Juanola X, Andres Roman Ivorra J, Martin Mola E, Sanmarti R, Mulero J, Diaz G, Alfonso E, Collantes E, Healey EL, Haywood KL, Jordan KP, Garratt AM, Packham JC. Concurrent Oral 6 - Spondylarthropathies [OP40-OP47]: OP40. Association of IL23R and IL12B Polymorphisms with Psoriatic Arthritis. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq706] [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
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Travers B, Henderson S, Vasireddy S, SeQueira EJ, Cornell PJ, Richards S, Khan A, Hasan S, Withrington R, Leak A, Sandhu J, Joseph A, Packham JC, Lyle S, Martin JC, Goodfellow RM, Rhys-Dillon C, Morgan JT, Mogford S, Rowan-Phillips J, Moss D, Wilson H, McEntegart A, Morgan JT, Martin JC, Rhys Dillon C, Goodfellow R, Gould L, Bukhari M, Hassan S, Butt S, Deighton C, Gadsby K, Love V, Kara N, Gohery M, Keat A, Lewis A, Robinson R, Bastawrous S, Roychowdhury B, Roskell S, Douglas B, Keating H, Giles S, McPeake J, Molloy C, Chalam V, Mulherin D, Price T, Sheeran T, Benjamin SR, Thompson PW, Cornell P, Siddle HJ, Backhouse MR, Monkhouse RA, Harris NJ, Helliwell PS, Azzopardi L, Hudson S, Mallia C, Cassar K, Coleiro B, Cassar PJ, Aquilina D, Camilleri F, Serracino Inglott A, Azzopardi LM, Robinson S, Peta H, Margot L, David W, Mann C, Gooberman-Hill R, Jagannath D, Healey E, Goddard C, Pugh MT, Gilham L, Bawa S, Barlow JH, MacFarland L, Tindall L, Leddington Wright S, Tooby J, Ravindran J, Perkins P, McGregor L, Mabon E, Bawa S, Bond U, Swan J, O'Connor MB, Rathi J, Regan MJ, Phelan MJ, Doherty T, Martin K, Ruth C, Panthakalam S, Bondin D, Castelino M, Evin S, Gooden A, Peacock C, Teh LS, Ryan SJ, Bryant E, Carter A, Cox S, Moore AP, Jackson A, Kuisma R, Pattman J, Juarez M, Quilter A, Williamson L, Collins D, Price E, Chao Y, Mooney J, Watts R, Graham K, Birrell F, Reed M, Croyle S, Stell J, Vasireddy S, Storrs P, McLoughlin YM, Scott G, McKenna F, Papou A, Rahmeh FH, Richards SC, Westlake SL, Birrell F, Morgan L, Baqir W, Walsh NE, Ward L, Caine R, Williams M, Breslin A, Owen C, Ahmad Y, Morgan L, Blair A, Birrell F, Ramachandran Nair J, Zia A, Mewar D, Peffers GM, Larder R, Dockrell D, Wilson S, Cummings J, Bansal J, Barlow J. BHPR: Audit/Service Delivery [239-277]: 239. Arma-Based Audit of Rheumatology Service Delivered Predominantly Outside the Traditional Hospital Setting. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wig S, Bischoff P, Holt M, Collins S, Goodfellow R, Martin J, Rhys-Dillon C, Lyle S, Rowan Phillips J, Mease PJ, Perdok R, Kary S, Kupper H, Humphreys E, Amos N, Nash J, Jones S, McHugh K, Giles J, Kollnberger S, Kuroi K, Maenaka K, Bowness P, El Miedany Y, El Gaafary M, Youssef S, Palmer D, Marshall CL, Harrison PV, Bukhari M, Greenwood MC, Omar F, Hakim AJ, Donnelly SP, Rooney MM, Lanham JG, Tahir H, Mease PJ, Kavanaugh A, Perdok R, Kupper H, Lavie F, Barlow JH, McFarland L, Tindall L, Ravindran J, Perkins P, Ciurtin C, Doufexi D, Bartko J, Roussou E, Phillips JR, Collins S, Lyle S, Goodfellow R, Martin J, Rhys-Dillon C, Thompson B, Rapley T, Broderick W, May C, Kay L, Sandhu J, Packham JC, Healey EL, Jordan K, Garratt AM, Haywood KL, Utriainen L, Cerovic V, McInnes I, Milling S, Ritchlin CT, Mease PJ, Perdok R, Kupper H, Lavie F, Freeston JE, Coates LC, Helliwell PS, Hensor EM, Wakefield RJ, Emery P, Conaghan PG, Skerrett J, van der Weide I, Barlow J, Keat A, van der Heijde D, Braun J, Sieper J, Wishneski C, Vlahos B, Szumski A, Foehl J, Freundlich B, Koenig A, Gatia A, Bartko J, Doufexi D, Roussou E, Kavanaugh A, Gladman D, Chattopadhyay C, Mease P, McInnes IB, Beutler A, Zrubek J, Buchanan J, Parasuraman S, Mack M, Krueger GG, Wazir TU, Cairns AP, Bell A, Giles JL, Shaw J, McHugh K, Ridley A, Bowness P, Kollnberger S, Pritchard GS, Bukhari M, Wilcox L, Freeston JE, Coates LC, Helliwell PS, Hensor EM, Wakefield RJ, Emery P, Conaghan PG, Packham J, Jordan KP, Lebmeier M, Garratt AM, Healey EL, Haywood KL, Ciurtin C, Roussou E, Clarke L, Kay L, Gingold MJ, Bansback N, Guh DP, Cavill C, Porteous R, Kyle SD, Waldron N, Korendowych E, McHugh N, Braun J, van der Heijde AD, Deodhar L, Diekman J, Sieper SI, Kim A, Beutler M, Mack S, Xu J, Zrubek B, Hsu R, Inman O. Spondyloarthropathies (Including Psoriatic Arthritis) [40-69]: 40. Eagle's Syndrome: An Unusual Association with Sero-Negative Arthropathy. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Joubert J, Reid C, Barton D, Cumming T, McLean A, Joubert L, Barlow J, Ames D, Davis S. Integrated care improves risk-factor modification after stroke: initial results of the Integrated Care for the Reduction of Secondary Stroke model. J Neurol Neurosurg Psychiatry 2009; 80:279-84. [PMID: 19010943 DOI: 10.1136/jnnp.2008.148122] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Despite evidence demonstrating that risk-factor management is effective in reducing recurrent cerebrovascular disease, there are very few structured care programmes for stroke survivors. The aim was to implement and evaluate an integrated care programme in stroke. METHODS 186 patients with stroke were randomised to either the treatment (integrated care) or control (usual care) group and were followed up over 12 months. The Integrated Care for the Reduction of Secondary Stroke (ICARUSS) model of integrated care involved collaboration between a specialist stroke service, a hospital coordinator and a patient's general practitioner. The primary aim was to promote the management of vascular risk factors through ongoing patient contact and education. RESULTS In the 12 months poststroke, systolic blood pressure (sBP) decreased in the treatment group but increased in controls. The group difference was significant, and remained so when age, sex, disability and sBP at discharge were accounted for (p = 0.04). Treatment patients also exhibited better modification of body mass index (p = 0.007) and number of walks taken (p<0.001) than controls. Rankin scores indicated significantly reduced disability in treatment patients relative to controls in the year poststroke (p = 0.003). CONCLUSIONS Through an integrated system of education, advice and support to both patient and GP, the ICARUSS model was effective in modifying a variety of vascular risk factors and therefore should decrease the likelihood or recurrent stroke or vascular event.
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Affiliation(s)
- J Joubert
- Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.
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Picard J, Ward SC, Zumpe R, Meek T, Barlow J, Harrop-Griffiths W. Guidelines and the adoption of 'lipid rescue' therapy for local anaesthetic toxicity. Anaesthesia 2009; 64:122-5. [PMID: 19143686 DOI: 10.1111/j.1365-2044.2008.05816.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Gathering evidence from animal experiments, an editorial in this journal and published human case reports culminated in the Association of Anaesthetists of Great Britain and Ireland recommending in August 2007 that lipid emulsion be immediately available to all patients given potentially cardiotoxic doses of local anaesthetic drugs. This development offered an opportunity to track the adoption of an innovation by anaesthetists in the UK and to gauge the effects of guidelines. Two surveys, each of 66 NHS hospitals delivering acute care within London and its penumbra, examined the adoption of lipid emulsion therapy. After the publication of the editorial in autumn 2006, the spread of 'lipid rescue' was rapid. The timing of the adoption and the impetus for innovation varied substantially between the sampled hospitals. When the formal guidelines were published, approximately half of the hospitals surveyed did not have lipid rescue. Of those that subsequently adopted it, half attributed their decision to the guidelines. At the end of 2007, there remained a small number of hospitals that had yet to adopt lipid rescue. Lipid rescue's adoption by anaesthetists in the UK offers a rare example of swift uptake of an innovation. National guidelines accelerated the adoption of innovation by some hospitals.
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Affiliation(s)
- J Picard
- Imperial College Healthcare NHS Trust, London, UK.
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Barlow J, Turner A, Swaby L, Gilchrist M, Wright C, Doherty M. An 8-yr follow-up of arthritis self-management programme participants. Rheumatology (Oxford) 2008; 48:128-33. [PMID: 19036778 DOI: 10.1093/rheumatology/ken429] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [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
OBJECTIVES To examine the pattern of scores on self-efficacy, health status and use of self-management techniques among a group of Arthritis Self-Management Programme (ASMP) participants over an 8-yr period, and to describe participants' perspectives of the ASMP and current use of self-management. METHODS Data from 125 participants who attended the ASMP as part of a randomized controlled trial and completed assessments at baseline, 4-month and 8-yr follow-ups were entered into the analysis. A sub-sample of 10 participants (five high- and five low self-efficacy) was interviewed. RESULTS The sample was 87% female; mean age 65 (s.d. 12) yrs; mean disease duration 19 (s.d. 11) yrs; 48% RA; 48% OA. The overall pattern of scores showed improvements between baseline and 4 months, which appeared to be maintained at 8-yr follow-up on self-efficacy, positive and negative affect, anxious and depressed moods, pain and fatigue, cognitive symptom management and communication with physician. The exception was HAQ, which was stable from baseline to 4 months (as expected), but had increased at 8 yrs indicating a decline in physical functioning. Sub-group analyses by RA and OA showed similar patterns of results. Interviews revealed that some participants continued to have problems with disease acceptance and highlighted the importance of pre-course expectations. CONCLUSIONS Long-term maintenance of self-efficacy, psychological well-being and self-management techniques may be possible following attendance on the ASMP. The need for additional psychological support for those who are having difficulty adjusting to their condition and its consequences is highlighted.
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Affiliation(s)
- J Barlow
- Self-Management Programme, Applied Research Centre in Health and Lifestyle Interventions, Faculty of Health and Life Sciences, Coventry University, Whitefriars Building, Priory Street, Coventry CV15FB, UK.
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