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Faux-Nightingale A, Kelemen M, Lilley S, Robinson K, Stewart C. Hospital corridors as lived spaces: The reconfiguration of social boundaries during the early stages of the Covid pandemic. Sociol Health Illn 2024. [PMID: 38619094 DOI: 10.1111/1467-9566.13777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/28/2024] [Indexed: 04/16/2024]
Abstract
This article explores the meanings and uses of a hospital corridor through 98 diary entries produced by the staff of an English specialist hospital during the early stages of the COVID-19 pandemic. Drawing on Lefebvre's (1991, The production of space. Blackwell) threefold theorisation of space, corridors are seen as conceived, perceived and lived spaces, produced through and enabling the reconfiguration and reinterpretation of social interactions. The diaries depict two distinct versions of the central hospital corridor: its 'normal' operation prior to the pandemic when it was perceived as a social and symbolic space for collective sensemaking and the 'COVID-19 empty corridor' described as a haunting place that divided hospital staff along ostensibly new social and moral boundaries that impacted negatively on lived work experiences and staff relationships. The mobilisation of the central hospital corridor in the daily social construction of meaning and experience during a period of organisational and societal crisis suggests that corridors should not be only seen as a material backdrop for work relationships but as social entities that come into being and are maintained and reproduced through the (lack of) performance of social relations.
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Affiliation(s)
- Alice Faux-Nightingale
- School of Medicine, Keele University, Keele, UK
- School of Pharmacy and Bioengineering, Keele University, Keele, UK
| | - Mihaela Kelemen
- Nottingham University Business School, University of Nottingham, Nottingham, UK
| | - Simon Lilley
- Lincoln International Business School, University of Lincoln, Lincoln, UK
| | - Kerry Robinson
- Liverpool John Moores University, Liverpool, UK
- The Performance Practice Ltd., Liverpool, UK
| | - Caroline Stewart
- School of Pharmacy and Bioengineering, Keele University, Keele, UK
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation, Oswestry, Shropshire, UK
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Sheldon E, Ezaydi N, Ditmore M, Fuseini O, Ainley R, Robinson K, Hind D, Lobo AJ. Patient and public involvement in the development of health services: Engagement of underserved populations in a quality improvement programme for inflammatory bowel disease using a community-based participatory approach. Health Expect 2024; 27:e14004. [PMID: 38433003 PMCID: PMC10909615 DOI: 10.1111/hex.14004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Involving people with lived experience is fundamental to healthcare development and delivery. This is especially true for inflammatory bowel disease (IBD) services, where holistic and personalised models of care are becoming increasingly important. There is, however, a significant lack of representation of underserved and diverse groups in IBD research, and there are significant barriers to healthcare access and utilisation among minority groups in IBD. IBD centres need to be aware of these experiences to address barriers via service changes, improve interactions with local communities and promote meaningful engagement for improved health outcomes. METHODS A pragmatic community-based approach was taken to engage with leaders and members of underserved groups across 11 workshops representing Roma, Afro-Caribbean, people of African descent and the wider black, Asian and minority ethnic (BAME) communities, Muslim women, refugee community members, deprived areas of South Yorkshire, LGBTQ+ and deaf populations. Thematic analysis of field notes identified patterns of attention across the community groups and where improvements to services were most frequently suggested. RESULTS Findings demonstrated several barriers experienced to healthcare access and utilisation, including language accessibility, staff attitudes and awareness, mental health and stigma, continuity of support, and practical factors such as ease of service use and safe spaces. These barriers acted as a lever to co-producing service changes that are responsive to the health and social care needs of these groups. CONCLUSIONS Engaging with people from a range of communities is imperative for ensuring that service improvements in IBD are accessible and representative of individual needs and values. PATIENT OR PUBLIC CONTRIBUTION Local community leaders and members of community groups actively participated in the co-design and development of improvements to the IBD service for a local hospital. Their contributions further informed a pilot process for quality improvement programmes in IBD centres.
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Affiliation(s)
- Elena Sheldon
- Sheffield Centre for Health and Related Research (ScHARR)The University of SheffieldSheffieldUK
| | - Naseeb Ezaydi
- Sheffield Centre for Health and Related Research (ScHARR)The University of SheffieldSheffieldUK
| | | | - Olga Fuseini
- Freelance Interpreter and Roma ConsultantSheffieldUK
| | | | - Kerry Robinson
- Sheffield Inflammatory Bowel Disease Centre, Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - Daniel Hind
- Sheffield Centre for Health and Related Research (ScHARR)The University of SheffieldSheffieldUK
| | - Alan J. Lobo
- Sheffield Inflammatory Bowel Disease Centre, Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
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Stefanidis KB, Truelove V, Robinson K, Mills L, Nicolls M, Delhomme P, Freeman J. Do comparative judgements affect the perceived relevance of mobile phone road safety campaigns? Traffic Inj Prev 2024; 25:364-371. [PMID: 38426905 DOI: 10.1080/15389588.2023.2301415] [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] [Received: 03/04/2023] [Accepted: 12/28/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Given the prevalence of illegal mobile phone use while driving and reliance upon messaging campaigns in deterring the behavior, there is a need to explore to what extent comparative judgements may influence desired outcomes of such campaigns. This exploratory study investigated (a) the perceived relevance and influence of different mobile phone road safety campaigns within a sample of Queensland motorists who reported using their mobile phone while driving and (b) if these varied depending on whether participants believed that their crash risk whilst using a phone was higher (comparative pessimism), lower (comparative optimism) or similar to the same-age and sex driver. METHODS A total of 350 licensed drivers residing within Queensland (Australia) were included in this study, of which 200 reported using their hand-held phone on some occasion. Participation involved completing a 20-25 min online anonymous survey, which included viewing three mobile phone road safety campaigns (injury-based, sanction-based and humor) and responding to questions about the perceived relevance and impact of each campaign. RESULTS A total of 64 (32%) participants displayed comparative optimism, 50 displayed similar judgements (25%) and 86 (43%) exhibited comparative pessimism. First, it was found that the injury-based campaign was perceived to be significantly more relevant than the humor campaign. Second, whilst the relevance of each campaign did not vary as a function of group membership, the campaigns were significantly less relevant to those displaying comparative optimism relative to those with similar judgements and comparative pessimism. Finally, the injury-based campaign was perceived to be significantly more influential than the other campaigns. However, overall, participants displaying comparative optimism believed that they would be less influenced by the campaigns compared to those with comparative pessimism. CONCLUSIONS Although preliminary, these findings suggest that low perceptions of risk may dilute or extinguish the desired behavioral outcomes of mobile phone road safety campaigns. Nonetheless, experimental research is needed to examine these effects directly.
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Affiliation(s)
- K B Stefanidis
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Australia
| | - V Truelove
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Australia
| | - K Robinson
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Australia
| | - L Mills
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Australia
| | - M Nicolls
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Australia
| | - P Delhomme
- Univ Gustave Eiffel, Université de Paris Cité, LaPEA, Versailles, France
| | - J Freeman
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Australia
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Lee MJ, Folan AM, Baker DM, Blackwell S, Wootton R, Robinson K, Sebastian S, Brown SR, Jones GL, Lobo AJ. A survey of patient informational preferences when choosing between medical and surgical therapy for ulcerative colitis: a sub-study from the DISCUSS project. Colorectal Dis 2023. [PMID: 37237447 DOI: 10.1111/codi.16625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/31/2022] [Accepted: 04/01/2023] [Indexed: 05/28/2023]
Abstract
AIM People living with ulcerative colitis (UC) have two broad treatment avenues, namely medical or surgical therapy. The choice between these can depend on patient preference as well as the receipt of relevant information. The aim of this study was to define the informational needs of patients with UC. METHOD A postal survey was designed to capture respondent demographics, treatment experienced within the previous 12 months and informational preferences by rating a long list of items. It was delivered through two hospitals that provide tertiary inflammatory bowel disease services. Descriptive analyses were performed to describe demographics and experiences. Principal component analysis was carried out using a varimax rotation to investigate informational needs. RESULTS A total of 101 responses were returned (20.1% response rate). The median age of respondents was 45 years and the median time since diagnosis was 10 years. Control preferences skewed towards shared (42.6%) or patient-led but clinician-informed (35.6%). Decision regret was low for the population (median 12.5/100, range 0-100). Key informational needs related to medical therapy were benefits and risks of long-term therapy, burden of hospital attendance, reproductive health, need for steroid treatment and impact on personal life. For surgery, these were stoma information, effect on daily life, effect on sexual and reproductive health, risks and benefits and disruption of life due to surgery. CONCLUSION This study has identified key areas for discussion when counselling patients about treatment decisions around medical therapy and surgery for UC.
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Affiliation(s)
- M J Lee
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - A M Folan
- Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - D M Baker
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - R Wootton
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - K Robinson
- Department of Gastroenterology, Hull and East Yorkshire Hospitals, Hull, UK
| | - S Sebastian
- Sheffield Inflammatory Bowel Disease Centre, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S R Brown
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - G L Jones
- Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - A J Lobo
- Department of Gastroenterology, Hull and East Yorkshire Hospitals, Hull, UK
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Conneely M, Leahy S, Trépel D, Robinson K, Boland F, Moriarty F, Galvin R. 1298 THE IMPACT OF ACUTE HEALTHCARE UTILISATION ON FUNCTIONAL DECLINE IN OLDER ADULTS OVER TIME: A POPULATION-BASED COHORT STUDY. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.046] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
Acute healthcare use varies by age, with older adults the highest users of most acute healthcare services. International reports have highlighted increased use of Emergency Department (ED) services by older adults. Older adults who visit the ED may be admitted to hospital or discharged home and are vulnerable to adverse outcomes including cognitive decline, falls, readmission, mortality and hospital acquired limitations in activities of daily living. Using data from The Irish Longitudinal Study on Ageing (TILDA), the aim of this study was to investigate the impact of acute healthcare utilisation at baseline on subjective and objective measures of function at four-year follow-up in older adults.
Methods
This study represents a secondary analysis of a prospective cohort study where data from Wave 1 (baseline) and Wave 3 (four-year follow up) of TILDA were analysed in conjunction with a public and patient involvement group of older adults. Acute healthcare utilisation was defined as an ED visit with or without hospitalisation in the previous 12 months. Function was assessed objectively using Timed-Up-and Go (TUG) and grip strength and subjectively using self-report limitations in activities of daily living and instrumental activities of daily living.
Results
A total of 1516 participants met the study inclusion criteria. Mean age was 70.9 years (SD=4.6) and 48% were male. At baseline, 1280 participants reported no acute healthcare use. 118 indicated an ED visit but no hospitalisation in the previous twelve months and 118 reported both an ED visit and hospitalisation. Adjusting for all covariates, compared to those with no acute healthcare utilisation, those with an ED visit with no hospital admission had poorer TUG performance at follow up (β= 0.67, 95% CI: 0.34, 1.29, p=0.039).
Conclusion
The results of this study support a relationship between acute healthcare utilisation and functional decline assessed by TUG at follow-up.
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Affiliation(s)
- M Conneely
- University of Limerick School of Allied Health, Ageing Research Centre, Health Research Institute, , Ireland
| | - S Leahy
- Atlantic Technological University Department of Sport, Exercise and Nutrition, School of Science and Computing, , ATU Galway City, Ireland
| | - D Trépel
- Trinity College Dublin Trinity Institute of Neurosciences, , Ireland
| | - K Robinson
- University of Limerick School of Allied Health, Ageing Research Centre, Health Research Institute, , Ireland
| | - F Boland
- Royal College of Surgeons Data Science Centre and Department of General Practice, Ireland , Dublin 2
| | - F Moriarty
- Royal College of Surgeons School of Pharmacy and Biomolecular Sciences, Ireland , Dublin 2
| | - R Galvin
- University of Limerick School of Allied Health, Ageing Research Centre, Health Research Institute, , Ireland
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Leahy A, O’Shaughnessy I, Barry L, Gabr A, Shanahan E, O'Connor M, Galvin R, Robinson K. 299 OLDER PERSONS’ EXPERIENCES AND PERSPECTIVES OF COMPREHENSIVE GERIATRIC ASSESSMENT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is an abundance of evidence to demonstrate the positive impacts of Comprehensive Geriatric Assessment (CGA) on clinical and process outcomes for older adults across settings of care. However, it is unclear how older adults themselves view CGA and their experiences of the care process. The aim of this qualitative evidence synthesis is to explore the experiences and perspectives of older adults of CGA.
Methods
A comprehensive literature search was completed across MEDLINE, CINAHL, PsycINFO, PsycARTICLES and Social Sciences Full Text. Qualitative or mixed methods studies that included qualitative data on the perspectives and experiences of older adults of CGA were included. The methodological quality of the included studies was appraised using the Critical Appraisal Skills Programme checklist for qualitative research. Findings were synthesised using thematic analysis
Results
Nine studies were included in the synthesis, including studies where CGA was completed in hospital, outpatient assessment unit and home settings. Divergent experiences of CGA were reported. Older adults reported experiences of being respected and listened to during CGA and attention paid to all their issues and priorities. Good communication by healthcare providers was central to these positive experiences (theme 1). In contrast, experiences of being unclear about the aim of CGA or perceived benefits of CGA, feeling that the outcome of CGA did not align with their priorities (theme 2) and not feeling involved in decision making during CGA (theme 3) were also commonly reported.
Conclusion
Findings indicate that CGA is a process by which older adults can felt respected and paid attention to. However, scope exists to further improve older adults’ experiences of CGA. Enhanced healthcare provider communication and facilitation of older adult involvement in decision-making are priority areas for improvement. Further research should focus on exploring other stakeholder groups experiences of CGA including caregivers and healthcare professionals.
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Affiliation(s)
- A Leahy
- Health Research Institute School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, , Limerick, Ireland
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - I O’Shaughnessy
- Health Research Institute School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, , Limerick, Ireland
| | - L Barry
- University of Limerick School of Nursing and Midwifery, Faculty of Education and Health Sciences, , Limerick, Ireland
| | - A Gabr
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - E Shanahan
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - M O'Connor
- University Hospital Limerick Department of Ageing and Therapeutics, , Limerick, Ireland
| | - R Galvin
- Health Research Institute School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, , Limerick, Ireland
| | - K Robinson
- Health Research Institute School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, , Limerick, Ireland
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Conneely M, Leahy S, Trépel D, Robinson K, Boland F, Moriarty F, Galvin R. 267 WHAT IS THE IMPACT OF ACUTE HEALTHCARE UTILISATION ON FUNCTIONAL DECLINE IN OLDER ADULTS OVER TIME? A POPULATION-BASED COHORT STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Acute healthcare use varies by age, with older adults the highest users of most acute healthcare services. Using data from The Irish Longitudinal Study on Ageing (TILDA), the aim of this study was to investigate the impact of acute healthcare utilisation at baseline on subjective and objective measures of function at four-year follow-up in older adults.
Methods
This study represents a secondary analysis of a prospective cohort study where data from Wave 1 (baseline) and Wave 3 (four-year follow up) of TILDA were analysed in conjunction with a public and patient involvement group of older adults. Acute healthcare utilisation was defined as an Emergency Department (ED) visit with or without hospitalisation in the previous 12 months. Function was assessed objectively using Timed-Up-and Go (TUG) and grip strength and subjectively using self-report limitations in activities of daily living and instrumental activities of daily living. Linear regression was used to investigate the relationship between ED use at baseline and grip strength and TUG performance at Wave 3. Logistic regression was used to investigate the relationship between ED use at baseline and whether a participant had a disability in ADL and IADL, or not, at Wave 3.
Results
A total of 1516 participants met the study inclusion criteria. Mean age was 70.9 years (SD=4.6) and 48% were male. At baseline, 1280 participants reported no acute healthcare use. 118 indicated an ED visit but no hospitalisation in the previous twelve months and 118 reported both an ED visit and hospitalisation. Adjusting for all covariates, compared to those with no acute healthcare utilisation, those with an ED visit with no hospital admission had poorer TUG performance at follow up (β= 0.67, 95% CI: 0.34, 1.29, p=0.039).
Conclusion
The results of this study support a relationship between acute healthcare utilisation and functional decline assessed by TUG at follow-up.
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Affiliation(s)
- M Conneely
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - S Leahy
- School of Science & Computing, Atlantic Technological University, ATU Galway City Department of Sport, Exercise & Nutrition, , Old Dublin Road, Galway, Ireland
| | - D Trépel
- Trinity College Dublin Trinity Institute of Neurosciences, School of Medicine, , Dublin, Ireland
| | - K Robinson
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - F Boland
- Royal College of Surgeons in Ireland Data Science Centre and the Department of General Practice, , Dublin, Ireland
| | - F Moriarty
- Royal College of Surgeons in Ireland School of Pharmacy and Biomolecular Sciences, , Dublin, Ireland
| | - R Galvin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
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Conneely M, Holmes A, O'Connor M, Leahy A, Gabr A, Saleh A, Okpaje B, Corey G, Barry L, Griffin A, O'Shaughnessy Í, Ryan L, Synott A, McCarthy A, Carroll I, Leahy S, Trepél D, Ryan D, Robinson K, Galvin R. 265 A PHYSIOTHERAPY-LED TRANSITION TO HOME INTERVENTION FOR OLDER ADULTS FOLLOWING EMERGENCY DEPARTMENT DISCHARGE: A PILOT FEASIBILITY RANDOMISED-CONTROLLED TRIAL. Age Ageing 2022. [PMCID: PMC9620307 DOI: 10.1093/ageing/afac218.233] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Older adults frequently attend the Emergency Department (ED) and experience high rates of adverse outcomes following ED presentation including functional decline, ED re-presentation and unplanned hospital admission. The development of effective interventions to prevent such outcomes is a key priority for research and service provision. A presentation to an ED can be viewed as an opportunity to assess those at risk of adverse outcomes and initiate a care plan in those deemed as ‘high risk'. Our aim was to evaluate the feasibility of a physiotherapy led integrated care intervention for older adults discharged from the ED (ED-PLUS). Methods Older adults presenting to the ED with undifferentiated medical complaints and discharged within 72 hours were computer randomised in a ratio of 1:1:1 to deliver usual care, Comprehensive Geriatric Assessment (CGA) in the ED, or ED-PLUS (Trial registration: NCT04983602). ED-PLUS is an evidence-based and stakeholder-informed intervention to bridge the care transition between the ED and community by initiating a CGA in the ED and implementing a six-week, multi-component, self-management programme in the patient’s own home. Feasibility (recruitment and retention rates) and acceptability of the programme were assessed quantitatively and qualitatively. Functional decline was examined post-intervention using the Barthel Index. All outcomes were assessed by a research nurse blinded to group allocation. Results 29 participants were recruited, indicating 97% of our recruitment target. 90% of participants completed the ED-PLUS intervention. All participants expressed positive feedback about the intervention. The incidence of functional decline at 6 weeks was 10% in the ED-PLUS group versus 70-89% in the usual care and CGA-only groups. Conclusion High adherence and retention rates were observed among participants and preliminary findings indicate a lower incidence of functional decline in the ED-PLUS group. Recruitment challenges existed in the context of COVID-19. Data collection is ongoing for six-month outcomes.
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Affiliation(s)
- M Conneely
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - A Holmes
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - M O'Connor
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Leahy
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Gabr
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Saleh
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - B Okpaje
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - G Corey
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - L Barry
- University of Limerick School of Nursing and Midwifery, Faculty of Education and Health Sciences, , Limerick, Ireland
| | - A Griffin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - Í O'Shaughnessy
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - L Ryan
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Synott
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A McCarthy
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - I Carroll
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - S Leahy
- School of Science & Computing, Atlantic Technological University, ATU Galway City Department of Sport, Exercise & Nutrition, , Old Dublin Road, Galway, Ireland
| | - D Trepél
- Trinity College Dublin Trinity Institute of Neurosciences, School of Medicine, , Ireland
| | - D Ryan
- University Hospital Limerick Limerick EM Education Research Training, Emergency Department, , Dooradoyle, Limerick, Ireland
| | - K Robinson
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - R Galvin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
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Leighton P, Sprange K, Robinson K, Rick C. Establishing Covid-19 Research in UK Care Homes – Infrastructure Challenges for Trial Design. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.751] [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
Background
The Covid-19 pandemic brought into sharp relief the role that long-term care facilities play in health and social care of an aging population. It also cast a spotlight upon the need for high-quality research to assess the effectiveness of any care home interventions. The Prophylactic Therapies in Care Homes (PROTECT-CH) trial was one such study (funded by the UK National Institute for Health and Care Research). PROTECT-CH was designed to collect data in 200 care homes (approximately 6,400 residents), and whilst the changing epidemiology of Covid-19 in the UK (due to vaccination take-up) made this unfeasible other insights were gained about establishing large-scale research in care homes.
Methods
An iterative process evaluation of the set-up phase of a large, platform trial testing prophylactic measures in long-term care facilities. Including a documentary review of the PROTECT-CH working groups and an online survey of working group members.
Results
Documents were reviewed from 24 working groups, which in a hub and spoke model represented the PROTECT-CH trial infrastructure; representative of 20 of these groups completed an online survey about their organisation and working. Data demonstrated the number and organisation of individuals required to set up a large-scale care-home trial - 91 individuals representing a mix of academic, clinical, and methodological contributions from 25 organisations. Data demonstrated working groups specific to care home research, and activities designed to address the specific challenges of researching in care homes. PROTECT-CH produced dedicated training materials and reporting templates for care home research. PROTECT-CH established novel mechanisms for prescribing and clinical oversight in care home research.
Conclusions
PROTECT-CH has highlighted the complexity of establishing large, scale RCT research in long-term care facilities. It has produced resources which might be of use in subsequent care home research.
Key messages
• Infrastructure is required to support high quality research in long-term care facilities.
• RCTs in long-term care facilities pose specific challenged to researchers.
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Affiliation(s)
- P Leighton
- University of Nottingham, School of Medicine , Nottingham, UK
| | - K Sprange
- University of Nottingham, School of Medicine , Nottingham, UK
| | - K Robinson
- University of Nottingham, School of Medicine , Nottingham, UK
| | - C Rick
- University of Nottingham, School of Medicine , Nottingham, UK
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10
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Beck Jepsen D, Robinson K, Ogliari G, Montero-Odasso M, Kamkar N, Ryg J, Freiberger E, Masud T. Correction: Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. BMC Geriatr 2022; 22:780. [PMID: 36199031 PMCID: PMC9533482 DOI: 10.1186/s12877-022-03352-5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- D Beck Jepsen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - K Robinson
- Department of Health Care for Older People (HCOP), Research and Innovation, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. .,School of Medicine, University of Nottingham, Nottingham, UK.
| | - G Ogliari
- Department of Health Care for Older People (HCOP), Research and Innovation, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - M Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada.,Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario , London, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - N Kamkar
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada
| | - J Ryg
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - E Freiberger
- Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Nuremberg, Germany
| | - T Masud
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Health Care for Older People (HCOP), Research and Innovation, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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11
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Beck Jepsen D, Robinson K, Ogliari G, Montero-Odasso M, Kamkar N, Ryg J, Freiberger E, Tahir M. Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. BMC Geriatr 2022; 22:615. [PMID: 35879666 PMCID: PMC9310405 DOI: 10.1186/s12877-022-03271-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 07/05/2022] [Indexed: 12/23/2022] Open
Abstract
Background To review the validated instruments that assess gait, balance, and functional mobility to predict falls in older adults across different settings. Methods Umbrella review of narrative- and systematic reviews with or without meta-analyses of all study types. Reviews that focused on older adults in any settings and included validated instruments assessing gait, balance, and functional mobility were included. Medical and allied health professional databases (MEDLINE, PsychINFO, Embase, and Cochrane) were searched from inception to April 2022. Two reviewers undertook title, abstract, and full text screening independently. Review quality was assessed through the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS). Data extraction was completed in duplicate using a standardised spreadsheet and a narrative synthesis presented for each assessment tool. Results Among 2736 articles initially identified, 31 reviews were included; 11 were meta-analyses. Reviews were primarily of low quality, thus at high risk of potential bias. The most frequently reported assessments were: Timed Up and Go, Berg Balance Scale, gait speed, dual task assessments, single leg stance, functional Reach Test, tandem gait and stance and the chair stand test. Findings on the predictive ability of these tests were inconsistent across the reviews. Conclusions In conclusion, we found that no single gait, balance or functional mobility assessment in isolation can be used to predict fall risk in older adults with high certainty. Moderate evidence suggests gait speed can be useful in predicting falls and might be included as part of a comprehensive evaluation for older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03271-5.
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Affiliation(s)
- D Beck Jepsen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - K Robinson
- Department of Health Care for Older People (HCOP), Research and Innovation, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. .,School of Medicine, University of Nottingham, Nottingham, UK.
| | - G Ogliari
- Department of Health Care for Older People (HCOP), Research and Innovation, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - M Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, SLawson Health Research Institute, London, ON, Canada.,Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario London, London, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - N Kamkar
- Gait and Brain Lab, Parkwood Institute, SLawson Health Research Institute, London, ON, Canada
| | - J Ryg
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - E Freiberger
- Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Nuremberg, Germany
| | - Masud Tahir
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Health Care for Older People (HCOP), Research and Innovation, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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12
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O'Shaughnessy Í, Robinson K, O'Connor M, Conneely M, Ryan D, Steed F, Carey L, Leahy A, Shanahan E, Quinn C, Galvin R. 941 EFFECTIVENESS OF ACUTE GERIATRIC UNIT CARE AMONG HOSPITALISED OLDER ADULTS WITH ACUTE MEDICAL COMPLAINTS: A META-ANALYSIS. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.009] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Older adults are clinically heterogeneous and are at increased risk of adverse outcomes during hospitalisation due to the presence of multiple comorbid and complex conditions. This systematic review and meta-analysis aims to update and synthesise the totality of research evidence on the effectiveness of acute geriatric unit (AGU) care for older adults admitted to hospital with acute medical complaints.
Method
MEDLINE, CINAHL, CENTRAL, and Embase databases were systematically searched from 2008 to February 2021. Screening, data extraction, and quality grading were undertaken by two reviewers. Only trials with a randomised design comparing AGU care and conventional care units were included. Meta-analyses were performed in Review Manager 5.4 and the Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence for outcomes reported. The primary outcome measure was incidence of functional decline between baseline two-week prehospital admission status and discharge and at follow-up.
Results
11 trials recruiting 7,496 participants across three countries were included. AGU care was associated with a 23% reduction in functional decline at six-month follow-up (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.64–0.92; moderate certainty evidence), and significant cost savings (mean difference (MD) -538.01USD, 95% CI -571.05USD—-504.96USD; low certainty evidence). No differences were found in functional decline at hospital discharge or at three-month follow-up, length of hospital stay, the likelihood of living at home, mortality, hospital readmission, cognitive function, or patient satisfaction with the index admission.
Conclusion
AGU care improves clinical and process outcomes for older adults admitted to hospital with acute medical complaints. Future research should focus on greater inclusion of clinical and patient reported outcome measures including quality of life. Use of such measures may lead to a greater focus on patient-centered care and service provision priorities.
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Affiliation(s)
- Í O'Shaughnessy
- Faculty of Education and Health Sciences , Ageing Research Centre, Health Research Institute, , Ireland
- University of Limerick , Ageing Research Centre, Health Research Institute, , Ireland
| | - K Robinson
- Faculty of Education and Health Sciences , Ageing Research Centre, Health Research Institute, , Ireland
- University of Limerick , Ageing Research Centre, Health Research Institute, , Ireland
| | - M O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
- School of Medicine , Faculty of Education and Health Sciences, , Ireland
- University of Limerick , Faculty of Education and Health Sciences, , Ireland
| | - M Conneely
- Faculty of Education and Health Sciences , Ageing Research Centre, Health Research Institute, , Ireland
- University of Limerick , Ageing Research Centre, Health Research Institute, , Ireland
| | - D Ryan
- School of Medicine , Faculty of Education and Health Sciences, , Ireland
- University of Limerick , Faculty of Education and Health Sciences, , Ireland
- Emergency Department, University Hospital Limerick , Ireland
| | - F Steed
- Medicine Directorate, University Hospital Limerick , Ireland
| | - L Carey
- Department of Occupational Therapy, University Hospital Limerick, Irl
| | - A Leahy
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
| | - E Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
| | - C Quinn
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
| | - R Galvin
- Department of Ageing and Therapeutics, University Hospital Limerick , Ireland
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13
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Conneely M, Leahy S, Dore L, Trépel D, Robinson K, Jordan F, Galvin R. 1075 THE EFFECTIVENESS OF INTERVENTIONS TO REDUCE ADVERSE OUTCOMES AMONG OLDER ADULTS FOLLOWING EMERGENCY DEPARTMENT DISCHARGE. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Population ageing is increasing rapidly worldwide. Older adults are frequent users of health care services including the Emergency Department (ED) and experience a number of adverse outcomes following an ED visit. Adverse outcomes include functional decline, unplanned hospital admission and an ED revisit. Given these adverse outcomes a number of interventions have been examined to improve the outcomes of older adults. The aim of this umbrella review was to evaluate the effectiveness of ED interventions in reducing adverse outcomes in older adults discharged from the ED.
Method
Systematic reviews of randomised controlled trials investigating ED interventions for older adults presenting to the ED exploring clinical, patient experience and healthcare utilisation outcomes were included. A comprehensive search strategy was employed in eleven databases and grey literature was searched. Quality was assessed using the A MeaSurement Tool to Assess Systematic Reviews 2 tool. Overlap between systematic reviews was assessed and an algorithm to assign the Grading of Recommendations Assessment, Development and Evaluation to assess the strength of evidence was applied to outcomes.
Results
Nine systematic reviews including 29 randomised controlled trials were included. Interventions comprised of solely ED-based or transitional interventions. The specific interventions delivered were highly variable. There was high overlap and low methodological quality of the trials informing the systematic reviews. There is low quality evidence to support ED interventions in reducing functional decline, improving patient experience and improving quality of life. The quality of evidence of the effectiveness of ED interventions to reduce mortality and ED revisits varied from very low to moderate.
Conclusion
Older adults are the most important emerging group in healthcare for several economic, social and political reasons. The evidence for the effectiveness of ED interventions for older adults is limited. Higher quality intervention studies in line with current geriatric medicine research guidelines are recommended.
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Affiliation(s)
- M Conneely
- School of Allied Health , Faculty of Education and Health Sciences, Health Research Institute,
- University of Limerick , Faculty of Education and Health Sciences, Health Research Institute,
| | - S Leahy
- School of Allied Health , Faculty of Education and Health Sciences, Health Research Institute,
- University of Limerick , Faculty of Education and Health Sciences, Health Research Institute,
| | - L Dore
- Glucksman Library, University of Limerick
| | - D Trépel
- Trinity Institute of Neurosciences, Trinity College Dublin
| | - K Robinson
- School of Allied Health , Faculty of Education and Health Sciences, Health Research Institute,
- University of Limerick , Faculty of Education and Health Sciences, Health Research Institute,
| | - F Jordan
- School of Nursing and Midwifery, National University of Ireland Galway
| | - R Galvin
- School of Allied Health , Faculty of Education and Health Sciences, Health Research Institute,
- University of Limerick , Faculty of Education and Health Sciences, Health Research Institute,
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14
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Connor EO, Dolan E, Horgan F, Robinson K, Galvin R. 1030 EXPERIENCES OF EARLY SUPPORTED DISCHARGE SERVICES FOLLOWING A STROKE: A QUALITATIVE EVIDENCE SYNTHESIS. Age Ageing 2022. [DOI: 10.1093/ageing/afac124.012] [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
Background
Early supported discharge (ESD) facilitates people with a stroke to be discharged from the hospital environment earlier than conventional care to continue their rehabilitation within the home with a multi-disciplinary team. Known benefits of ESD from Randomised Controlled Trials conducted include reducing the length of a hospital stay, long term dependency, and cost savings. There is limited qualitative evidence available on ESD. This systematic review and qualitative synthesis explored the experiences of those involved in ESD including people with stroke, family members, caregivers as well as healthcare professionals.
Method
A literature search was completed in 11 databases which generated 3,425 articles. Qualitative or mixed
Method
studies that included qualitative data on the experiences of people with stroke, family members, caregivers and healthcare professionals of an ESD service were included. The Critical Appraisal Skills Programme checklist was used to appraise the methodological quality of the papers. The findings were synthesised using the three step process for thematic synthesis.
Results
A total of fourteen studies were included with the methodological quality of the studies deemed good overall. Four key themes emerged: 1) ESD is experienced by people with stroke as a goal-focused and supportive process leading to positive outcomes, 2) ESD eases the transition from the hospital to the home environment but the transition from ESD to social and community services is often problematic, 3) Organisational, logistical and inter-professional factors are critical to the success of ESD and 4) The home environment enhances rehabilitation.
Conclusion
The findings of this qualitative evidence synthesis highlight the importance of the home environment in the rehabilitation process post stroke. Key practice implications point to the need for increased attention to periods where care transitions occur from ESD to community services.
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Affiliation(s)
- E O Connor
- School of Allied Health, University of Limerick, Castletroy , Limerick, Ireland
- Connolly Hospital, Blanchardstown , Dublin 15, Ireland
| | - E Dolan
- Connolly Hospital, Blanchardstown , Dublin 15, Ireland
| | - F Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin 2, Ireland
| | - K Robinson
- School of Allied Health, University of Limerick, Castletroy , Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Castletroy , Limerick, Ireland
| | - R Galvin
- School of Allied Health, University of Limerick, Castletroy , Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Castletroy , Limerick, Ireland
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15
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Robinson K, Katzenellenbogen JM, Kleinig T, Kim J, Budgeon C, Thrift A, Nedkoff L. Burden of stroke incidence among atrial fibrillation, valvular heart disease and coronary heart disease patients. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council of Australia
Background
The public health burden of stroke has continued to increase in recent decades. In patients with cardiac disease, the risk of stroke is 2-4 times higher than in the general population, and therefore investigating stroke incidence in these patients is important for identifying opportunities for stroke prevention.
Purpose
We aimed to measure the incidence of stroke in people with atrial fibrillation (AF), valvular heart disease (VHD) or coronary heart disease (CHD) to assess the risk of stroke by age, sex, pre-existing vs new cardiac disease, and nonfatal/fatal status.
Methods
We used a person-linked hospitalisation/mortality dataset to identify all people hospitalized with AF, VHD or CHD from 1985 to 2017 in a whole-population setting. These cardiac cases were stratified as pre-existing (hospitalised between 1985 and 2012, who were alive at 31st October 2012 with no history of stroke) or new (first-ever cardiac hospitalisation from November 1st, 2012 to October 31st, 2017, with no prior hospitalisation for AF, VHD or CHD, and no history of stroke). Patients aged 20-94 years were included in the study. Pre-existing and new cardiac cases were followed over the 5-year study period (1st November 2012 to 31st December 2017) to identify first-ever stroke events. Age-specific and age-standardised rates (ASR) for stroke incidence were calculated for all cardiac cases combined, and separately for pre-existing and new cases.
Results
The cohort comprised 175,560 patients. The majority of the cohort had a single cardiac condition (55.7% CHD; 23.0% AF; 5.0% VHD), while 16.3% of patients had multiple cardiac conditions. There were 5,871 (3.3%) first-ever strokes (5.2% in AF patients, 4.0% in VHD, 2.8% in CHD). Stroke incidence ASRs were greater in women than men across each cardiac group and irrespective of the presence of single or multiple cardiac conditions (Figure). This was largely driven by women aged ≥75 years, with stroke incidence being greater in women than men in each cardiac group. In women aged 20-54 years, there was a 4.9-fold higher incidence of stroke in those with multiple versus single cardiac conditions, and this differential appeared to decline with increasing age (Figure). Incidence of non-fatal strokes was greater than fatal stroke in all age groups except among 85-94 year olds. Incidence rates in each cardiac group were between 1.2 and 2.4 times higher in those with new versus pre-existing cardiac disease.
Conclusions
Stroke incidence is substantial in patients with cardiac disease. Older women with AF and VHD had the highest stroke rates overall, although younger patients with multiple cardiac conditions were also at high risk. These cardiac patients should be targeted for evidence-based management to minimise their stroke risk, especially in the period immediately following diagnosis when risk is highest.
Figure Legend. Age-specific and age-standardised stroke incidence rates in all cardiac cases.
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Affiliation(s)
- K Robinson
- University of Western Australia, Perth, Australia
| | | | - T Kleinig
- Royal Adelaide Hospital, Adelaide, Australia
| | - J Kim
- Monash University, Melbourne, Australia
| | - C Budgeon
- University of Western Australia, Perth, Australia
| | - A Thrift
- Monash University, Melbourne, Australia
| | - L Nedkoff
- University of Western Australia, Perth, Australia
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16
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Gough J, Mowat S, Robinson K, Sellman L, Youings M, Mandeville H. PD-0169 Active breathing control for children and teenage patients receiving thoracic radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02774-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Tun GSZ, Robinson K, Marshall L, Wright A, Thompson L, Wild G, Sargur R, Brooks AJ, Hale MF, Chew TS, Lobo AJ. The effect of infliximab dose escalation in inflammatory bowel disease patients with antibodies to infliximab. Eur J Gastroenterol Hepatol 2022; 34:295-301. [PMID: 35100176 DOI: 10.1097/meg.0000000000002289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Infliximab dose escalation (DE) can be used in inflammatory bowel disease patient; however, the long-term benefit remains unclear, especially in those with antibodies to infliximab (ATI). The aim was to assess the effect of DE in patients with ATI on drug level, clinical response and ATI status. METHODS All patients undergoing infliximab DE (a reduction in dose interval between infusions <8 weeks ± an increase in dose up to 10 mg/kg) at a referral centre between April 2016 and August 2019 were included. RESULTS Ninety-two patients were DE: 51 were men, 50 had CD and 63 were receiving immunosuppression. A total of 87 people received DE for a median of 44 weeks (range 4-176). Five stopped infliximab after 1 dose of DE: 2 for loss of response and 3 for infusion reaction. In patients with ATI ≤10 vs. >10 AU/mL, DE significantly increased drug levels: median infliximab levels of 1.4 and 0.9 at baseline, respectively, to 3.2 and 3.5 at week 24. After DE, 21/35 ATI-positive patients had a fall in ATI ≤10 AU/mL. At week 24 following DE 62/92 patients were in clinical remission. Duration of clinical remission was shorter in those with ATI >10 AU/mL (median 24 weeks, range 0-88) than in those with transient/ATI ≤10 AU/mL (median 36 weeks, range 0-126, P = 0.06). CONCLUSIONS A strategy of DE for selected patients receiving infliximab is associated with an increase in drug levels and reduced ATI positivity. This is associated with clinical remission in approximately 70% of patients at 6 months.
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Affiliation(s)
| | | | | | | | | | - Graeme Wild
- Department of Immunology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Ravishankar Sargur
- Department of Immunology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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18
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Andrew L, Dare J, Robinson K, Costello L. Nursing practicum equity for a changing nurse student demographic: a qualitative study. BMC Nurs 2022; 21:37. [PMID: 35093048 PMCID: PMC8800819 DOI: 10.1186/s12912-022-00816-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The nursing practicum (clinical practice) is an essential but often highly stressful aspect of the nursing degree. A review of the published literature reveals a strong focus on the stressors that originate within the practicum environment, rather than the student’s life outside the university and practice setting. This article reports on an Australian study, completed before the COVID-19 pandemic, of the university experiences of undergraduate women nurse students with family responsibilities. The findings reveal the importance of factors outside the university on the women students’ practicum experience and their ability to engage and achieve.
Methods
The study was qualitative, guided by Gadamer’s hermeneutic philosophy. Twenty-nine women students with family responsibilities (partners and children) were interviewed at two stages of their degree journey. Over 50 h of data were thematically analysed.
Findings
The themes ‘family pressure’ and ‘practicum poverty’ describe the impact of domestic work, family finances and practicum organisation on student stress, wellbeing, achievement, thoughts of attrition, and family tension. These findings are particularly pertinent to Australia and other developed nations where the nurse student demographic continues to age. An interpretation of these findings against the recent impact of COVID-19 on nurse education and women’s life choices reveals the likelihood that these difficulties have intensified for women students with family responsibilities since the pandemic began.
Conclusions and Recommendations
Many developed nations, including Australia, are increasingly reliant on older women nurse students to maintain the future graduate nursing workforce. This change in nurse student demographic to the mature-age student requires a revision of the organisation of the nursing practicum. Recommendations to nurse education to improve practicum accessibility for women students who have family responsibilities include the application of a flexible and collaborative approach to practicum organisation and communication. Wider recommendations to Government include a revision of the way the nursing student is financially supported during the practicum. Further research that explores the practicum experience for women nurse students during and following the COVID-19 pandemic is also recommended.
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19
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Salter M, Robinson K, Ullman J, Denson N, Ovenden G, Noonan K, Bansel P, Huppatz K. Gay, Bisexual, and Queer Men's Attitudes and Understandings of Intimate Partner Violence and Sexual Assault. J Interpers Violence 2021; 36:11630-11657. [PMID: 31948330 DOI: 10.1177/0886260519898433] [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: 06/10/2023]
Abstract
Gay, bisexual, and queer (GBQ) men experience significant rates of intimate partner violence (IPV) and sexual assault (SA); however, there is limited research into their attitudes and understandings of IPV and SA. This article presents the findings of a 2018 survey of 895 GBQ men currently residing in Australia, focused on their views and experiences of healthy and unhealthy relationships. The survey included quantitative and open-ended qualitative questions. The findings presented in this article are primarily descriptive, with cross-tabulations and t tests to demonstrate significant differences between groups and correlational statistics to outline associations between variables. Qualitative data were coded under broad themes. The study found a considerable proportion of men (three in five) identified that they had experienced an unhealthy or abusive relationship in the past, with minimal disclosure to police or health services. Men with a history of partner abuse or violence were more likely to report binge drinking or drug use and more likely to know a friend who had abused his partner. 40% of the sample had witnessed an incident of relationship violence between GBQ men, and two-thirds intervened in the violence in some way. The findings of this study underscore the need to engage GBQ men in discussions about respectful relationships, address the role of alcohol and drugs in GBQ socialization and relationships, and provide bystander skills for men to intervene in situations of aggression or violence between men in relationships.
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Affiliation(s)
| | - Kerry Robinson
- Western Sydney University, Penrith, New South Wales, Australia
| | | | - Nida Denson
- Western Sydney University, Penrith, New South Wales, Australia
| | | | - Kai Noonan
- ACON, Surry Hills, New South Wales, Australia
| | - Peter Bansel
- Western Sydney University, Penrith, New South Wales, Australia
| | - Kate Huppatz
- Western Sydney University, Penrith, New South Wales, Australia
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20
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Connor EO, Dolan E, Horgan F, Robinson K, Galvin R. 24 EXPERIENCES OF EARLY SUPPORTED DISCHARGE SERVICES FOLLOWING A STROKE: A QUALITATIVE EVIDENCE SYNTHESIS. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.24] [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: 02/25/2023] Open
Abstract
Abstract
Background
Early supported discharge (ESD) facilitates people with a stroke to be discharged from the hospital environment earlier than conventional care to continue their rehabilitation within the home with a multi-disciplinary team. From Randomised Controlled Trials, benefits of ESD include reducing long term dependency, the length of hospital stay and cost savings. This systematic review and qualitative synthesis explores the experiences of those involved in ESD including people with stroke, family members, caregivers as well as the healthcare professionals.
Methods
A literature search was completed in 11 databases which generated 3,425 articles. Qualitative or mixed methods studies that included qualitative data on the experiences of people with stroke, family members, caregivers and healthcare professionals of an ESD service were included. Methodological quality was appraised using the Critical Appraisal Skills Programme checklist. Findings were synthesised using thematic synthesis.
Results
A total of fourteen studies were identified. The methodological quality of the studies was good overall. Four key themes emerged: 1) ESD is experienced by people with stroke as a goal-focused and supportive process leading to positive outcomes, 2) ESD eases the transition from the hospital to the home environment but the transition from ESD to social and community services is often problematic, 3) Organisational, logistical and inter-professional factors are critical to the success of ESD and 4) The home environment enhances rehabilitation.
Conclusion
Our findings highlight the importance of home in the rehabilitation process post stroke. Key practice implications point to the need for increased attention to periods where care transitions occur.
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Affiliation(s)
- E O Connor
- School of Allied Health, University of Limerick , Castletroy, Limerick, Ireland
- Connolly Hospital, Blanchardstown , Dublin 15, Ireland
| | - E Dolan
- Connolly Hospital, Blanchardstown , Dublin 15, Ireland
| | - F Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin 2, Ireland
| | - K Robinson
- School of Allied Health, University of Limerick , Castletroy, Limerick, Ireland
- Ageing Research Centre , Health Research Institute, , Castletroy, Limerick, Ireland
- University of Limerick , Health Research Institute, , Castletroy, Limerick, Ireland
| | - R Galvin
- School of Allied Health, University of Limerick , Castletroy, Limerick, Ireland
- Ageing Research Centre , Health Research Institute, , Castletroy, Limerick, Ireland
- University of Limerick , Health Research Institute, , Castletroy, Limerick, Ireland
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21
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A Gibbons L, Rafferty C, Robinson K, Abad M, Maslanka F, Le N, Mo J, Clark K, Madden F, Hayes R, McCarthy B, Rode C, O'Mahony J, Rea R, O'Mahony Hartnett C. Raman based chemometric model development for glycation and glycosylation real time monitoring in a manufacturing scale CHO cell bioreactor process. Biotechnol Prog 2021; 38:e3223. [PMID: 34738336 DOI: 10.1002/btpr.3223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022]
Abstract
The Quality by Design (QbD) approach to the production of therapeutic monoclonal antibodies (mAbs) emphasizes an understanding of the production process ensuring product quality is maintained throughout. Current methods for measuring critical quality attributes (CQAs) such as glycation and glycosylation are time and resource intensive, often, only tested offline once per batch process. Process analytical technology (PAT) tools such as Raman spectroscopy combined with chemometric modeling can provide real time measurements process variables and are aligned with the QbD approach. This study utilizes these tools to build partial least squares (PLS) regression models to provide real time monitoring of glycation and glycosylation profiles. In total, seven cell line specific chemometric PLS models; % mono-glycated, % non-glycated, % G0F-GlcNac, % G0, % G0F, % G1F, and % G2F were considered. PLS models were initially developed using small scale data to verify the capability of Raman to measure these CQAs effectively. Accurate PLS model predictions were observed at small scale (5 L). At manufacturing scale (2000 L) some glycosylation models showed higher error, indicating that scale may be a key consideration in glycosylation profile PLS model development. Model robustness was then considered by supplementing models with a single batch of manufacturing scale data. This data addition had a significant impact on the predictive capability of each model, with an improvement of 77.5% in the case of the G2F. The finalized models show the capability of Raman as a PAT tool to deliver real time monitoring of glycation and glycosylation profiles at manufacturing scale.
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Affiliation(s)
- Luke A Gibbons
- BioTherapeutics Development, Janssen Sciences Ireland UC, Cork, Ireland.,Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Carl Rafferty
- BioTherapeutics Development, Janssen Sciences Ireland UC, Cork, Ireland
| | - Kerry Robinson
- Analytical Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Marta Abad
- BioTherapeutics Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Francis Maslanka
- BioTherapeutics Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Nikky Le
- BioTherapeutics Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Jingjie Mo
- Analytical Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Kevin Clark
- BioTherapeutics Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Fiona Madden
- BioTherapeutics Development, Janssen Sciences Ireland UC, Cork, Ireland
| | - Ronan Hayes
- BioTherapeutics Development, Janssen Sciences Ireland UC, Cork, Ireland
| | - Barry McCarthy
- BioTherapeutics Development, Janssen Sciences Ireland UC, Cork, Ireland
| | - Christopher Rode
- BioTherapeutics Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Malvern, Pennsylvania, USA
| | - Jim O'Mahony
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Rosemary Rea
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
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Bailey J, Brown G, Corbera-Hincapie M, Clemm C, Dasenbrook E, Durham D, Oates G, Reno K, Sapp S, Schechter M, Robinson K. 337: Food insecurity in the cystic fibrosis care center network during COVID-19: Prevalence, screening, and interventions. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01761-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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DeVoe S, Kennedy A, Repp A, Prior C, Consigli A, Robinson K, Teneback C. 95: Improving the integration of young adults patients: Implementation of a “welcome visit” into an adult cystic fibrosis clinic. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01520-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Bradley Dexter S, Payne L, Kavanagh Salmond K, Mahato S, Chia MC, Robinson K. Readiness for scale-up: lessons learned from the Public Health Agency of Canada's Innovation Strategy. Can J Public Health 2021; 112:204-219. [PMID: 34383265 PMCID: PMC8360256 DOI: 10.17269/s41997-021-00517-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/26/2021] [Indexed: 01/04/2023]
Abstract
SETTING The Public Health Agency of Canada Innovation Strategy (PHAC-IS) funded the development and delivery of interventions that addressed priority population health issues over a 10-year period between 2009 and 2020. The design of the PHAC-IS funding program integrated the intentional effort of scale-up to increase the reach and impact of proven population health promotion interventions towards long-term, sustained impact benefit at individual, community, and systems levels. INTERVENTION Recognizing that social innovation and adaptive cycles are necessary for effective scale-up, the PHAC-IS developed and applied a Scale-up Readiness Assessment Tool (SRAT) to assess the level of scale-up readiness of a funded project. OUTCOMES Development of the SRAT included identifying predictors of success for the scale-up of effective population health interventions, organized into eight common characteristics among projects that indicated scale-up readiness: (1) intervention evidence and evaluation, (2) reach and scale, (3) organizational capacity, (4) partnership development, (5) system readiness, (6) community context, (7) cost factors, and (8) knowledge development and exchange. IMPLICATIONS Although the SRAT was not a standalone decision-making rubric, it was a key part of a framework for review, consideration, and assessment for scale-up along a phased approach to funding. The development and application of the SRAT to measure readiness for scale-up provides insights into domains that can be used by funding organizations to inform scale-up decisions or for community organizations to assess their own readiness for scale-up.
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Affiliation(s)
- Shannon Bradley Dexter
- Health Promotion and Chronic Disease Prevention Branch/Direction générale de la promotion de la santé et de la prévention des maladies chroniques, Public Health Agency of Canada/Agence de la santé publique du Canada, Ottawa, Ontario, Canada.
- Public Health Agency of Canada, 301-351 Abbott Street, Vancouver, BC, V6B 0G6, Canada.
| | - Leslie Payne
- Health Promotion and Chronic Disease Prevention Branch/Direction générale de la promotion de la santé et de la prévention des maladies chroniques, Public Health Agency of Canada/Agence de la santé publique du Canada, Ottawa, Ontario, Canada
- Public Health Agency of Canada, 301-351 Abbott Street, Vancouver, BC, V6B 0G6, Canada
| | - Kelly Kavanagh Salmond
- Health Promotion and Chronic Disease Prevention Branch/Direction générale de la promotion de la santé et de la prévention des maladies chroniques, Public Health Agency of Canada/Agence de la santé publique du Canada, Ottawa, Ontario, Canada
| | - Sarah Mahato
- Health Promotion and Chronic Disease Prevention Branch/Direction générale de la promotion de la santé et de la prévention des maladies chroniques, Public Health Agency of Canada/Agence de la santé publique du Canada, Ottawa, Ontario, Canada
| | - Marie C Chia
- Office of the Chief Public Health Officer/Bureau de l'administrateur en chef de la santé publique, Public Health Agency of Canada/Agence de la santé publique du Canada, Ottawa, ON, Canada
| | - Kerry Robinson
- Office of Strategic Policy and Planning/Bureau des politiques et de la planification stratégique, Public Health Agency of Canada/Agence de la santé publique du Canada, Ottawa, Ontario, Canada
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25
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Aloraibi S, Gladman J, Godfrey D, Booth V, Robinson K, Lunt E, Caswell A, Kerr M, Ollivere B, Gordon AL. Optimal care for the management of older people non-weight bearing after lower limb fracture: a consensus study. BMC Geriatr 2021; 21:332. [PMID: 34030635 PMCID: PMC8146625 DOI: 10.1186/s12877-021-02265-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/05/2021] [Indexed: 01/03/2023] Open
Abstract
Background Older people who are non-weight-bearing after a lower limb fracture are at risk of poor outcomes but there are no clinical guidelines for this group of patients. Given the paucity of the research evidence base, we conducted a consensus exercise to ascertain expert opinion about the management of this group. Methods A three-round e-Delphi technique was planned to use the online JISC survey tool with a multidisciplinary panel of health professionals. Panellists were invited by email via professional organisations and UK NHS Trusts. The initial statements for this study were prepared by the authors based upon the findings of their scoping review. Consensus required >/= 70% agreement with statements. Results Only 2 survey rounds were required. Ninety panellists, representing seven clinical disciplines, reached consensus for 24 statements about general issues (osteoporosis detection and management, falls risk reduction and nutrition) and specific non-weight bearing issues (such as the need for activity to be promoted during this period). Conclusions These findings can be used in the generation of a clinical guideline for this group of patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02265-z.
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Affiliation(s)
- S Aloraibi
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK. .,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.
| | - J Gladman
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK.,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.,Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Room WC1388 Level C, West Block, Nottingham, NG7 2UH, UK.,NHR Applied Research Collaboration (ARC) East Midlands, Nottingham, UK
| | - D Godfrey
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Beckside, Gamston, Nottingham, NG2 6PR, UK
| | - V Booth
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK.,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.,Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Room WC1388 Level C, West Block, Nottingham, NG7 2UH, UK
| | - K Robinson
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK.,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.,Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Room WC1388 Level C, West Block, Nottingham, NG7 2UH, UK
| | - E Lunt
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK.,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.,Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Room WC1388 Level C, West Block, Nottingham, NG7 2UH, UK
| | - A Caswell
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK
| | - M Kerr
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK
| | - B Ollivere
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK.,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.,Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Room WC1388 Level C, West Block, Nottingham, NG7 2UH, UK
| | - A L Gordon
- Division of Rehabilitation, Ageing and Wellbeing, The Medical School, Queens Medical Centre, University of Nottingham, B109, Floor B, Derby Road, Nottingham, NG7 2UH, UK.,Division of Rehabilitation, Ageing and Wellbeing, NIHR Nottingham Biomedical Research Centre, Medical School, QMC, B111, Nottingham, NG7 2UH, UK.,Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby Medical School, Room DSN407, Derby, DE22 3NE, UK
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26
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Lai TC, Davies C, Robinson K, Feldman D, Elder CV, Cooper C, Pang KC, McDougall R. Effective fertility counselling for transgender adolescents: a qualitative study of clinician attitudes and practices. BMJ Open 2021; 11:e043237. [PMID: 34011585 PMCID: PMC8137211 DOI: 10.1136/bmjopen-2020-043237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Fertility counselling for trans and gender diverse (TGD) adolescents has many complexities, but there is currently little guidance for clinicians working in this area. This study aimed to identify effective strategies for-and qualities of-fertility counselling for TGD adolescents based on clinicians' experiences. DESIGN We conducted qualitative semi-structured individual interviews in 2019 which explored clinician experiences and fertility counselling practices, perspectives of the young person's experience and barriers and facilitators to fertility preservation access. Data were analysed using thematic analysis. SETTING This qualitative study examined experiences of clinicians at the Royal Children's Hospital-a tertiary, hospital-based, referral centre and the main provider of paediatric TGD healthcare in Victoria, Australia. PARTICIPANTS We interviewed 12 clinicians from a range of disciplines (paediatrics, psychology, psychiatry and gynaecology), all of whom were involved with fertility counselling for TGD adolescents. RESULTS Based on clinician experiences, we identified five elements that can contribute to an effective approach for fertility counselling for TGD adolescents: a multidisciplinary team approach; shared decision-making between adolescents, their parents and clinicians; specific efforts to facilitate patient engagement; flexible personalised care; and reflective practice. CONCLUSIONS Identification of these different elements can inform and hopefully improve future fertility counselling practices for TGD adolescents, but further studies examining TGD adolescents' experiences of fertility counselling are also required.
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Affiliation(s)
- Timothy Chwan Lai
- Austin Health, Heidelberg, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kerry Robinson
- School of Social Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - Debi Feldman
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Charlotte Victoria Elder
- Austin Health, Heidelberg, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Charlie Cooper
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ken C Pang
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rosalind McDougall
- The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
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27
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Papasavas P, Olugbile S, Wu U, Robinson K, Roberts AL, O'Sullivan DM, McLaughlin T, Mather JF, Steinberg AC, Orlando R, Kumar A. Seroprevalence of SARS-CoV-2 antibodies, associated epidemiological factors and antibody kinetics among healthcare workers in Connecticut. J Hosp Infect 2021; 114:117-125. [PMID: 33930487 PMCID: PMC8076763 DOI: 10.1016/j.jhin.2021.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at the front line of the ongoing coronavirus 2019 (COVID-19) pandemic. Comprehensive evaluation of the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) among HCWs in a large healthcare system could help to identify the impact of epidemiological factors and the presence of symptoms on the immune response to the infection over time. AIM To determine the seroprevalence of SARS-CoV-2-specific antibodies among HCWs, identify associated epidemiological factors and study antibody kinetics. METHODS A longitudinal evaluation of the seroprevalence and epidemiology of SARS-CoV-2-specific antibodies was undertaken in approximately 30,000 HCWs in the largest healthcare system in Connecticut, USA. FINDINGS At baseline, the prevalence of SARS-CoV-2 antibody among 6863 HCWs was 6.3% [95% confidence interval (CI) 5.7-6.9%], and was highest among patient care support (16.7%), medical assistants (9.1%) and nurses (8.2%), and lower for physicians (3.8%) and advanced practice providers (4.5%). Seroprevalence was significantly higher among African Americans [odds ratio (OR) 3.26 compared with Caucasians, 95% CI 1.77-5.99], in participants with at least one symptom of COVID-19 (OR 3.00, 95% CI 1.92-4.68), and in those reporting prior quarantine (OR 3.83, 95% CI 2.57-5.70). No symptoms were reported in 24% of seropositive participants. Among the 47% of participants who returned for a follow-up serological test, the seroreversion rate was 39.5% and the seroconversion rate was 2.2%. The incidence of re-infection in the seropositive group was zero. CONCLUSION Although there is a decline in the immunoglobulin G antibody signal over time, 60.5% of seropositive HCWs had maintained their seroconversion status after a median of 5.5 months.
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Affiliation(s)
- P Papasavas
- Department of Surgery, Hartford Hospital, Hartford, CT, USA.
| | - S Olugbile
- Cancer Institute, Hartford HealthCare, Hartford, CT, USA
| | - U Wu
- Administration, Hartford HealthCare, Hartford, CT, USA
| | - K Robinson
- Department of Emergency Medicine, Hartford Hospital, Hartford, CT, USA
| | - A L Roberts
- Department of Clinical Laboratory Services: Microbiology, Hartford HealthCare, Hartford, CT, USA
| | | | - T McLaughlin
- Department of Surgery, Hartford Hospital, Hartford, CT, USA
| | - J F Mather
- Hartford Healthcare Research Program, Hartford, CT, USA
| | - A C Steinberg
- Department of Medical Affairs, Hartford HealthCare, Hartford, CT, USA
| | - R Orlando
- Department of Academic Affairs, Hartford HealthCare, Hartford, CT, USA
| | - A Kumar
- Clinical Affairs, Hartford HealthCare, Hartford, CT, USA
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28
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Abstract
BACKGROUND Many transgender (trans) parents experience challenges related to their mental health, which can affect and impact on their experiences of parenting, however there is scant research on how Australian trans parents contextualize and experience their mental health, the support they receive for it, and impacts within the family context. AIMS The present study aims to address these gaps in the literature, through examining how Australian trans parents contextualize and experience issues around their mental health, and their experience of formal and informal support for their mental health? METHODS This study aimed to explore these experiences, through a qualitative research design using online open-ended survey data and one-on-one interviews, with 66 trans parents, aged 24-67 years old. Data was analyzed using thematic analysis. RESULTS Many participants reported significant challenges in relation to their mental health: such as depression, anxiety, and suicidal ideation, which reportedly made parenting challenging. However, participants reported that gender affirmation as well as family and social support had a positive impact on their mental health. The majority of participants reported feeling they had to educate their therapist, that they were pigeon-holed by their gender identity or, had concerns about confidentiality. However, some participants expressed positive interactions with therapists, particularly therapists specializing in, or knowledgeable of, trans health. CONCLUSION The results reinforced the need for mental health professionals and associated services to be competent in treating trans parents and reiterated the positive impact of family and social support, as well as support for gender affirmation, on the mental health of trans parents and their ability to parent.
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Affiliation(s)
- Rosie Charter
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Kerry Robinson
- School of Social Sciences, Western Sydney University, Penrith, Australia
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29
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Thomas L, Cousen P, Svec A, Robinson K, Carmichael AJ. Treatment-resistant presumed allergic contact dermatitis of the face. Clin Exp Dermatol 2020; 46:391-393. [PMID: 33091185 DOI: 10.1111/ced.14472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/17/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
- L Thomas
- Departments of, Department of Dermatology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - P Cousen
- Departments of, Department of Dermatology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - A Svec
- Department of Histopathology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - K Robinson
- Department of Haematology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - A J Carmichael
- Departments of, Department of Dermatology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
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30
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, 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P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Kiel S, Marrari M, Robinson K, Zeevi A, Sanchez P, Morrell M, Pilewski J, Nolley E. Association between MRSA Colonization and Chronic Lung Allograft Dysfunction in Lung Transplantation for Cystic Fibrosis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Robinson K, Allen F, Darby J, Fox C, Gordon AL, Horne JC, Leighton P, Sims E, Logan PA. Contamination in complex healthcare trials: the falls in care homes (FinCH) study experience. BMC Med Res Methodol 2020; 20:46. [PMID: 32106827 PMCID: PMC7047395 DOI: 10.1186/s12874-020-00925-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background Trials are at risk of contamination bias which can occur when participants in the control group are inadvertently exposed to the intervention. This is a particular risk in rehabilitation studies where it is easy for trial interventions to be either intentionally or inadvertently adopted in control settings. The Falls in Care Homes (FinCH) trial is used in this paper as an example of a large randomised controlled trial of a complex intervention to explore the potential risks of contamination bias. We outline the FinCH trial design, present the potential risks from contamination bias, and the strategies used in the design of the trial to minimise or mitigate against this. The FinCH trial was a multi-centre randomised controlled trial, with embedded process evaluation, which evaluated whether systematic training in the use of the Guide to Action Tool for Care Homes reduced falls in care home residents. Data were collected from a number of sources to explore contamination in the FinCH trial. Where specific procedures were adopted to reduce risk of, or mitigate against, contamination, this was recorded. Data were collected from study e-mails, meetings with clinicians, research assistant and clinician network communications, and an embedded process evaluation in six intervention care homes. During the FinCH trial, there were six new falls prevention initiatives implemented outside the study which could have contaminated our intervention and findings. Methods used to minimise contamination were: cluster randomisation at the level of care home; engagement with the clinical community to highlight the risks of early adoption; establishing local collaborators in each site familiar with the local context; signing agreements with NHS falls specialists that they would maintain confidentiality regarding details of the intervention; opening additional research sites; and by raising awareness about the importance of contamination in research among participants. Conclusion Complex rehabilitation trials are at risk of contamination bias. The potential for contamination bias in studies can be minimized by strengthening collaboration and dialogue with the clinical community. Researchers should recognise that clinicians may contaminate a study through lack of research expertise.
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Affiliation(s)
- K Robinson
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK. .,Division of Rehabilitation, Ageing and Wellbeing, Nottingham, UK.
| | - F Allen
- Division of Rehabilitation, Ageing and Wellbeing, Nottingham, UK
| | - J Darby
- Division of Rehabilitation, Ageing and Wellbeing, Nottingham, UK
| | - C Fox
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - A L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK.,East Midlands Collaboration for Leadership in Applied Health Research and Care (EM-CLAHRC), Nottingham, UK.,University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - J C Horne
- Division of Rehabilitation, Ageing and Wellbeing, Nottingham, UK
| | - P Leighton
- School of Medicine, University of Nottingham, Nottingham, UK
| | - E Sims
- Norwich Clinical Trials Unit, University of East Anglia, Nottingham, UK
| | - P A Logan
- Division of Rehabilitation, Ageing and Wellbeing, Nottingham, UK.,Nottingham CityCare Partnership NHS organisation, Nottingham, UK
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Baker DM, Lee MJ, Folan AM, Blackwell S, Robinson K, Wootton R, Sebastian S, Brown SR, Jones GL, Lobo AJ. Development and evaluation of a patient decision aid for patients considering ongoing medical or surgical treatment options for ulcerative colitis using a mixed-methods approach: protocol for DISCUSS study. BMJ Open 2020; 10:e031845. [PMID: 31941765 PMCID: PMC7045112 DOI: 10.1136/bmjopen-2019-031845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Approximately 20%-30% of patients with ulcerative colitis (UC) require surgery, the majority of these being elective due to chronic symptoms refractory to medical treatment. The decision for surgery is difficult and dependent on patient preferences. Current resources for patients considering surgery have been found not to meet minimum international standards. The overall aim of the 'DISCUSS' study is to develop and evaluate a new patient decision aid (PtDA) for patients considering surgery for UC created in line with international minimum standards. METHODS AND ANALYSIS This is a prospective mixed-methods study of adults (18+ years) who are considering surgical intervention for UC across two regional centres in Yorkshire, UK. This study is in three stages. In stage 1 we will develop the PtDA and its content via systematic reviews and a patient questionnaire. In stage 2 we will assess the face validity of the PtDA using mixed-methods on key stakeholders using both semistructured interviews and questionnaires, following which the PtDA will be refined. In stage 3 we will assess the acceptability of using the PtDA in clinical practice. This will use a mixed-methods approach on clinicians and patients who are considering undergoing elective surgery. Questionnaires including the Preparation for Decision-Making Scale, a measure of anxiety and decisional conflict will be analysed at two timepoints using paired sample t-tests and CIs. Interviews with patients and clinicians will be analysed using thematic analysis. ETHICS AND DISSEMINATION Research ethics approval from North East-Tyne & Wear South Research Ethics Committee (Ref: 19/NE/0073) and Health Research Authority approval (Ref: 257044) have been granted. Results will be published in open access peer-reviewed journals, presented in conferences and distributed through the Crohn's and Colitis UK charity. External endorsement will be sought from the International Patient Decision Aid Standards Collaboration inventory of PtDAs. PROSPERO REGISTRATION NUMBER CRD42018115513, CRD42019126186, CRD42019125193.
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Affiliation(s)
| | - Matthew James Lee
- Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Anne-Mairead Folan
- Department of Psychology, Leeds Beckett University, Leeds, West Yorkshire, UK
| | | | - Kerry Robinson
- Inflammatory Bowel Disease Nurse Specialist, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Rebecca Wootton
- Stoma Care Specialist Nurse, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Shaji Sebastian
- Department of Gastroenterology, Hull and East Yorkshire Hospitals NHS Trust, Hull, Kingston upon Hull, UK
| | - Steven R Brown
- Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Georgina Louise Jones
- Deparment of Psychology, Leeds Beckett University Faculty of Health and Social Sciences, Leeds, UK
| | - Alan J Lobo
- Gastroenterology Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Bean A, Paster J, Pruner K, O J, Sommer W, Robinson K, Hanekamp I, Benichou G, Madsen J. Standard Drug Immunosuppression Eliminates Peripheral Transitional B Cells but Does Not Create a Distinct Genetic Signature in Non-Human Primates. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Yuan Y, Yost S, Blanchard S, Yin H, Li M, Robinson K, Tang A, Martinez N, Leong L, Somlo G, Tank Patel N, Waisman J, Portnow J, Hurria A, Luu TH, Mortimer J. Abstract P6-18-18: Phase I trial of eribulin and everolimus in patients with metastatic triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-18] [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: 11/16/2022]
Abstract
Abstract
Background: Alteration of PI3K/Akt/mTOR pathway is the most common genomic abnormality detected in triple negative breast cancer (TNBC). Everolimus acts synergistically with eribulin in inducing apoptosis in TNBC cell lines and xenografts in our preclinical study. This phase I trial was designed to test the safety and tolerability of combining eribulin and everolimus in patients (pts) with metastatic TNBC.
Methods: The overall objective of this study was to describe the safety and toxicities of the combination. The secondary objective was to assess activity based on response rate (RR) and progression free survival (PFS). Eligibility criteria included pts with metastatic TNBC, ECOG 0-2, 0-3 lines of prior chemotherapy in metastatic setting, and prior treatment with anthracycline and/or taxane therapy. The study utilized the toxicity equivalence range (TEQR) design with a target equivalence range for dose-limiting toxicities (DLTs) of 0.20-0.35. The recommended phase 2 dose (RP2D) will be the dose closest to the target of 0.25 below 0.51 based on isotonic regression.Three dosing levels of the combinations were tested: level A1 (everolimus 5mg daily; eribulin 1.4 mg/m2 days 1, 8 every 3 weeks), level A2 (everolimus 7.5mg daily; eribulin 1.4 mg/m2, days 1, 8 every 3 weeks), level B1(everolimus 5mg daily; eribulin 1.1 mg/m2 days 1, 8 every 3 weeks). Nanostring RNA analysis and genomic mutation analysis were conducted in 16 pts with available tumor tissue.
Results: A total of 27 pts were enrolled. Median age was 55 years (range 36-76). Two pts were ineligible due to HER2+ on repeat biopsy and were only included in the toxicity analysis. Dose level B1 (everolimus 5mg daily and eribulin 1.1 mg/m2 days 1, 8 every 3 weeks) was determined to be the RP2D doses. The DLTs were neutropenia, stomatitis and hyperglycemia. Across all cycles, 59% (16/27) had a ≥ Gr3 toxicity attributed to treatment at the possible or above level. 44% (12/27) had Gr3 heme-toxicities. The most common toxicities were ≥ Gr3 neutropenia (10 pts), Gr3 lymphopenia (6 pts) and ≥ Gr3 leukopenia (7 pts). 33% (9/27) had Gr3 non-heme toxicities. The most common were Gr3 stomatitis (3 pts), Gr3 hyperglycemia (3 pts) and Gr3 fatigue (5 pts). The median number of cycles completed was 4 (0-8). 68% (17/25) had a dose modification or hold, 14 of 25 (56%) were for eribulin and 15 of 25 (60%) were for everolimus. Of 25 eligible pts, 8 (32%) achieved a best response as partial response, 11 (44%) had stable disease and 6 (24%) had progression. 80% (20/25) experienced progression by RECIST or showed clinical progression, and the median time to progression was 2.7 mo (95% CI (2.2, 4.6)). At the time of this analysis, 16 participants had died, median OS was 6.3 mo (95% CI (5.3, undefined)). Two pts are still being followed on treatment. PI3K-Akt-mTOR pathway genes and mutations profiles were studied.
Conclusion: Eribulin 1.1 mg/m2 days 1, 8 and everolimus 5mg daily was defined as the RP2D. Genomic analysis is currently underway to understand the molecular mechanisms of resistance.
Citation Format: Yuan Y, Yost S, Blanchard S, Yin H, Li M, Robinson K, Tang A, Martinez N, Leong L, Somlo G, Tank Patel N, Waisman J, Portnow J, Hurria A, Luu T-H, Mortimer J. Phase I trial of eribulin and everolimus in patients with metastatic triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-18.
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Affiliation(s)
- Y Yuan
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - S Yost
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - S Blanchard
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - H Yin
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - M Li
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - K Robinson
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - A Tang
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - N Martinez
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - L Leong
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - G Somlo
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - N Tank Patel
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - J Waisman
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - J Portnow
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - A Hurria
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - T-H Luu
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
| | - J Mortimer
- City of Hope National Medical Center, Duarte, CA; OncoGambit, Irvine, CA
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David O, Sinha R, Robinson K, Cardone D. The Prevalence of Anaemia, Hypochromia and Microcytosis in Preoperative Cardiac Surgical Patients. Anaesth Intensive Care 2019; 41:316-21. [DOI: 10.1177/0310057x1304100307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- O. David
- Royal Adelaide Hospital, Department of Anaesthesia, Adelaide, South Australia, Australia
| | - R. Sinha
- Royal Adelaide Hospital, Department of Anaesthesia, Adelaide, South Australia, Australia
- Faculty of Health Sciences, Flinders University
| | - K. Robinson
- Royal Adelaide Hospital, Department of Anaesthesia, Adelaide, South Australia, Australia
- Australian Red Cross Blood Service and Clinical Lead, BloodSafe Program, SA Health
| | - D. Cardone
- Royal Adelaide Hospital, Department of Anaesthesia, Adelaide, South Australia, Australia
- Department of Anaesthesia, Royal Adelaide Hospital and Senior Clinical Lecturer, Faculty of Acute Care Medicine, University of Adelaide
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Douglas B, Robinson K, Gordon C, Eaton M, Tibbitt C, Khaghani Far I, Li X. SELF-MANAGEMENT OF HYPERTENSION LIFESTYLE BEHAVIORS USING A SMARTPHONE EMA/I APP WITH OLDER ADULT BLACK WOMEN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1325] [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)
- B Douglas
- Northeastern University, Boston, Massachusetts, United States
| | - K Robinson
- Northeastern University School of Nursing, Boston, MA, USA
| | - C Gordon
- Northeastern University College of Computer and Informaton Science, Boston, MA, USA
| | - M Eaton
- Northeastern University School of Nursing, Boston, MA, USA
| | - C Tibbitt
- Northeastern University School of Nursing, Boston, MA, USA
| | - I Khaghani Far
- Northeastern University College of Computer and Informaton Science, Boston, MA, USA
| | - X Li
- Northeastern University College of Computer and Informaton Science and Bouve College of Health Science, Boston, MA, USA
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Poghosyan H, Robinson K, Gordon C, Eaton M, Tibbitt C, Khaghani Far I, Li X, Jimison H. CIGARETTE USE AMONG INDIVIDUALS AT HIGH RISK FOR LUNG CANCER. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Poghosyan
- Northeastern University, Boston, Massachusetts, United States
| | - K Robinson
- Northeastern University School of Nursing, Boston, MA, USA
| | - C Gordon
- Northeastern University College of Computer and Informaton Science, Boston, MA, USA
| | - M Eaton
- Northeastern University School of Nursing, Boston, MA, USA
| | - C Tibbitt
- Northeastern University School of Nursing, Boston, MA, USA
| | - I Khaghani Far
- Northeastern University College of Computer and Information Science, Boston, MA, USA
| | - X Li
- Northeastern University College of Computer and Informaton Science and Bouve College of Health Science, Boston, MA, USA
| | - H Jimison
- Northeastern University College of Computer and Informaton Science and Bouve College of Health Science, Boston, MA, USA
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Robinson K, Menne H. FUNCTIONAL AND COGNITIVE IMPAIRMENTS AMONG OLDER ADULTS RECEIVING HOME-DELIVERED MEALS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - H Menne
- Administration for Community Living/HHS
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Boyko JA, Riley BL, Willis CD, Stockton L, Zummach D, Kerner J, Robinson K, Chia M. Knowledge translation for realist reviews: a participatory approach for a review on scaling up complex interventions. Health Res Policy Syst 2018; 16:101. [PMID: 30348180 PMCID: PMC6198505 DOI: 10.1186/s12961-018-0374-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/24/2018] [Indexed: 11/11/2022] Open
Abstract
Background Knowledge syntheses that use a realist methodology are gaining popularity. Yet, there are few reports in the literature that describe how results are summarised, shared and used. This paper aims to inform knowledge translation (KT) for realist reviews by describing the process of developing a KT strategy for a review on pathways for scaling up complex public health interventions. Methods The participatory approach used for the realist review was also used to develop the KT strategy. The approach included three main steps, namely (1) an international meeting focused on interpreting preliminary findings from the realist review and seeking input on KT activities; (2) a targeted literature review on KT for realist reviews; and (3) consultations with primary knowledge users of the review. Results The international meeting identified a general preference among knowledge users for findings from the review that are action oriented. A need was also identified for understanding how to tailor findings for specific knowledge user groups in relation to their needs. The literature review identified four papers that included brief descriptions of planned or actual KT activities for specific research studies; however, information was minimal on what KT activities or products work for whom, under what conditions and why. The consultations revealed that KT for realist reviews should consider the following: (1) activities closely aligned with the preferences of specific knowledge user groups; (2) key findings that are sensitive to factors within the knowledge user’s context; and (3) actionable statements that can advance KT goals, activities or products. The KT strategy derived from the three activities includes a planning framework and tailored KT activities that address preferences of knowledge users for findings that are action oriented and context relevant. Conclusions This paper provides an example of a KT strategy for realist reviews that blends theoretical and practical insights. Evaluation of the strategy’s implementation will provide useful insights on its effectiveness and potential for broader application. Electronic supplementary material The online version of this article (10.1186/s12961-018-0374-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer A Boyko
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada.
| | - Barbara L Riley
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Cameron D Willis
- Movember Foundation, P.O. Box 60, East Melbourne, VIC, 8002, Australia.,Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
| | - Lisa Stockton
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Dana Zummach
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Jon Kerner
- Canadian Partnership Against Cancer, 145 King Street West Suite 900, Toronto, ON, M5H 1J8, Canada
| | - Kerry Robinson
- Public Health Agency of Canada, 130 Colonnade Road A.L. 6501H, Ottawa, ON, K1A 0K9, Canada
| | - Marie Chia
- Public Health Agency of Canada, 130 Colonnade Road A.L. 6501H, Ottawa, ON, K1A 0K9, Canada
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McCartney K, Robinson K, Horne JC, Logan PA. 33CHALLENGES AND FACILITATORS TO COLLECTING RESEARCH DATA IN CARE HOMES. Age Ageing 2018. [DOI: 10.1093/ageing/afy124.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Horne JC, Robinson K, Sims E, Stirling S, Sach T, Armstrong S, Logan PA. 24IMPROVING TRIAL RECRUITMENT IN CARE HOMES: THE FALLS IN CARE HOME (FINCH) EXPERIENCE. Age Ageing 2018. [DOI: 10.1093/ageing/afy124.04] [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: 11/15/2022] Open
Affiliation(s)
| | - K Robinson
- Research and Innovation, Nottinghamshire Healthcare NHS Trust
| | - E Sims
- Norwich Clinical Trials Units, University of East Anglia, UK
| | - S Stirling
- Norwich Clinical Trials Units, University of East Anglia, UK
| | - T Sach
- Norwich Clinical Trials Units, University of East Anglia, UK
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Robinson K, Horne J, Sims E, Logan P. 25SUPPORTING EFFECTIVE RECRUITMENT IN A LARGE REHABILITATION TRIAL THROUGH A RESEARCH ASSISTANT NETWORK. Age Ageing 2018. [DOI: 10.1093/ageing/afy124.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Robinson
- Research and Innovation, Nottinghamshire Healthcare NHS Trust
| | - J Horne
- Division of Rehabilitation and Ageing, University of Nottingham
| | - E Sims
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, UK
| | - P Logan
- Division of Rehabilitation and Ageing, University of Nottingham
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McCartney K, Robinson K, Horne JC, Logan PA. 31DEMQOL: FIT FOR PURPOSE IN CARE HOMES? Age Ageing 2018. [DOI: 10.1093/ageing/afy124.11] [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: 11/12/2022] Open
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Robinson K, Horne J, McCartney K, Sims E, Logan P. 23ADDRESSING CONTAMINATION IN REHABILITATION RESEARCH TRIALS. Age Ageing 2018. [DOI: 10.1093/ageing/afy124.03] [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)
- K Robinson
- Research and Innovation, Nottinghamshire Healthcare NHS Trust
| | - J Horne
- Division of Rehabilitation and Ageing, University of Nottingham
| | - K McCartney
- Division of Rehabilitation and Ageing, University of Nottingham
| | - E Sims
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, UK
| | - P Logan
- Division of Rehabilitation and Ageing, University of Nottingham
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Booth V, Hood-Moore V, Hancox J, Logan P, Robinson K. 62HOW ARE REHABILITATION INTERVENTIONS FOR OLDER ADULTS DEVELOPED? A SYSTEMATIC REVIEW OF FRAMEWORKS THAT HAVE BEEN USED TO DEVELOP REHABILITATION INTERVENTIONS FOR OLDER ADULTS. Age Ageing 2018. [DOI: 10.1093/ageing/afy127.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V Booth
- University of Nottingham
- Nottingham University Hospitals NHS Trust
| | | | | | - P Logan
- University of Nottingham
- Nottingham CityCare Partnership
| | - K Robinson
- University of Nottingham
- Nottinghamshire Healthcare NHS Trust
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Neitzel D, Alouf C, Zhu M, Robinson K, Faulkner N. A novel next-generation sequencing-based aneuploidy screening technology: capturing single-nucleotide polymorphism data to reduce the transfer of polyploid and haploid embryos. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Affiliation(s)
| | | | - R Laws
- Memphis VAMC, Memphis, TN
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Nguyen V, Treat L, Griffith C, Robinson K. Creation of Secondary AV Fistulas from Failed Hemodialysis Grafts: The Role of Routine Vein Mapping. J Vasc Access 2018. [DOI: 10.1177/112972980700800205] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pre-existing forearm grafts lead to dilatation of upper arm veins of the ipsilateral arm that greatly facilitates the creation of secondary arteriovenous fistulas (AVF). In this retrospective review of 18 patients, the routine and periodical revision of failed grafts were discontinued. Vein mapping by physical examination or Duplex studies was performed prior to graft failure and a secondary AVF was created when the graft failed. Using this management strategy, an AVF creation success rate of 95% was achieved despite high incidence of co-morbidity factors within the patient population. This success rate demonstrates the value of vein selection by vascular mapping prior to graft failure and early vascular access planning in the successful creation of secondary AVF.
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Affiliation(s)
- V.D. Nguyen
- Memorial Nephrology Associates, Olympia, Washington - USA and Fistula First Initiative, Leadership Group member
| | - L. Treat
- Renal Care Group of the Northwest, Washington - USA
| | - C. Griffith
- Surgical Associates, Olympia, Washington - USA
| | - K. Robinson
- Surgical Associates, Olympia, Washington - USA
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